Diagnosis and Management of Heart Failure in Elderly Patients from Hospital Admission to Discharge: Position Paper
Multidisciplinary management of worsening heart failure (HF) in the elderly improves survival. To ensure patients have access to adequate care, the current HF and French health authority guidelines advise establishing a clearly defined HF patient pathway. This pathway involves coordinating multiple...
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doaj-00b72e43a62b4af383eea2de5d58d7d22021-08-26T13:55:10ZengMDPI AGJournal of Clinical Medicine2077-03832021-08-01103519351910.3390/jcm10163519Diagnosis and Management of Heart Failure in Elderly Patients from Hospital Admission to Discharge: Position PaperThibaud Damy0Tahar Chouihed1Nicholas Delarche2Gilles Berrut3Patrice Cacoub4Patrick Henry5Nicholas Lamblin6Emmanuel Andrès7Olivier Hanon8Service de Cardiologie, CHU H. Mondor, 94000 Créteil, FranceService des SAMU-SMUR-Urgences, Centre d’Investigations Cliniques-1433, INSERM UMR_S 1116, Université de Lorraine, CHRU Nancy, F-CRIN INI-CRCT, 541000 Nancy, FranceService de Cardiologie, CH Pau, 64000 Pau, FranceCHU Nantes, Pôle Hospitalo-Universitiare de Gérontologie Clinique, 44000 Nantes, FranceGroupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology, AP-HP, 75000 Paris, FranceService de Cardiologie, APHP, Hôpital Lariboisière, 75000 Paris, FranceService de Cardiologie, Institut Pasteur de Lille, CHU de Lille, Université de Lille, U1167, 59000 Lille, FranceService Méd. Interne, Diabète, Maladies Métaboliques, Clinique Médicale B, CHU Strasbourg, 67000 Strasbourg, FranceService de Gériatrie, APHP, Hôpital Broca, Université de Paris, 54 Rue Pascal, 75013 Paris, FranceMultidisciplinary management of worsening heart failure (HF) in the elderly improves survival. To ensure patients have access to adequate care, the current HF and French health authority guidelines advise establishing a clearly defined HF patient pathway. This pathway involves coordinating multiple disciplines to manage decompensating HF. Yet, recent registry data indicate that insufficient numbers of patients receive specialised cardiology care, which increases the risk of rehospitalisation and mortality. The patient pathway in France involves three key stages: presentation with decompensated HF, stabilisation within a hospital setting and transitional care back out into the community. In each of these three phases, HF diagnosis, severity and precipitating factors need to be promptly identified and managed. This is particularly pertinent in older, frail patients who may present with atypical symptoms or coexisting comorbidities and for whom geriatric evaluation may be needed or specific geriatric syndrome management implemented. In the transition phase, multi-professional post-discharge management must be coordinated with community health care professionals. When the patient is discharged, HF medication must be optimised, and patients educated about self-care and monitoring symptoms. This review provides practical guidance to clinicians managing worsening HF in the elderly.https://www.mdpi.com/2077-0383/10/16/3519practical guidanceheart failure managementelderly |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Thibaud Damy Tahar Chouihed Nicholas Delarche Gilles Berrut Patrice Cacoub Patrick Henry Nicholas Lamblin Emmanuel Andrès Olivier Hanon |
spellingShingle |
Thibaud Damy Tahar Chouihed Nicholas Delarche Gilles Berrut Patrice Cacoub Patrick Henry Nicholas Lamblin Emmanuel Andrès Olivier Hanon Diagnosis and Management of Heart Failure in Elderly Patients from Hospital Admission to Discharge: Position Paper Journal of Clinical Medicine practical guidance heart failure management elderly |
author_facet |
Thibaud Damy Tahar Chouihed Nicholas Delarche Gilles Berrut Patrice Cacoub Patrick Henry Nicholas Lamblin Emmanuel Andrès Olivier Hanon |
author_sort |
Thibaud Damy |
title |
Diagnosis and Management of Heart Failure in Elderly Patients from Hospital Admission to Discharge: Position Paper |
title_short |
Diagnosis and Management of Heart Failure in Elderly Patients from Hospital Admission to Discharge: Position Paper |
title_full |
Diagnosis and Management of Heart Failure in Elderly Patients from Hospital Admission to Discharge: Position Paper |
title_fullStr |
Diagnosis and Management of Heart Failure in Elderly Patients from Hospital Admission to Discharge: Position Paper |
title_full_unstemmed |
Diagnosis and Management of Heart Failure in Elderly Patients from Hospital Admission to Discharge: Position Paper |
title_sort |
diagnosis and management of heart failure in elderly patients from hospital admission to discharge: position paper |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2021-08-01 |
description |
Multidisciplinary management of worsening heart failure (HF) in the elderly improves survival. To ensure patients have access to adequate care, the current HF and French health authority guidelines advise establishing a clearly defined HF patient pathway. This pathway involves coordinating multiple disciplines to manage decompensating HF. Yet, recent registry data indicate that insufficient numbers of patients receive specialised cardiology care, which increases the risk of rehospitalisation and mortality. The patient pathway in France involves three key stages: presentation with decompensated HF, stabilisation within a hospital setting and transitional care back out into the community. In each of these three phases, HF diagnosis, severity and precipitating factors need to be promptly identified and managed. This is particularly pertinent in older, frail patients who may present with atypical symptoms or coexisting comorbidities and for whom geriatric evaluation may be needed or specific geriatric syndrome management implemented. In the transition phase, multi-professional post-discharge management must be coordinated with community health care professionals. When the patient is discharged, HF medication must be optimised, and patients educated about self-care and monitoring symptoms. This review provides practical guidance to clinicians managing worsening HF in the elderly. |
topic |
practical guidance heart failure management elderly |
url |
https://www.mdpi.com/2077-0383/10/16/3519 |
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