Dietary sodium indiscretion frequently contributes to hospitalizations in elderly heart failure patients. Animal models suggest an important role for dietary sodium intake in the pathophysiology of heart failure with preserved systolic function. The documentation and effects of hospital discharge recommendations, particularly for sodium-restricted diet, have not been extensively investigated in heart failure with preserved systolic function. We analyzed heart failure admissions to Michigan community hospitals. We compared documentation of guideline-based discharge recommendations between preserved systolic function and systolic heart failure patients with chi-squared testing, and used logistic regression to identify predictors of day death and hospital readmission in a prespecified follow-up cohort of patients with preserved systolic function. We hypothesized that patients who received a documented discharge recommendation for sodium-restricted diet would have lower day adverse event rates. Upon propensity score-adjusted multivariable analysis, patients with preserved systolic function who received a documented sodium-restricted diet recommendation had decreased odds of day combined death and readmission odds ratio 0. No other discharge recommendations predicted day outcomes. Clinicians document appropriate discharge instructions less frequently in heart failure with preserved systolic function than systolic heart failure. Selected heart failure patients with preserved systolic function who receive advice for sodium-restricted diet may have improved short-term outcomes after hospital discharge. Many early rehospitalizations in elderly heart failure patients follow dietary sodium indiscretion.
Clin Exp Hypertens. We compared documentation of guideline-based discharge recommendations between preserved systolic function and systolic heart failure patients with chi-squared testing, and used logistic regression to identify predictors of day death and hospital readmission in a prespecified follow-up cohort of patients with preserved systolic function. Circ Heart Fail ; 7 — The pathophysiology of acute heart failure—is it all about fluid accumulation? Which lifestyle changes or medications are likely to help me? Hospitalization is necessary if severely decompensated HF hypotension, worsening renal function, or altered mentation, dyspnea at rest, hemodynamically significant arrhythmia including new-onset rapid atrial fibrillation, or acute coronary syndromes. Pathophysiology of Heart Failure. Related information. It is only necessary if patients are potentially eligible for revascularization. History and Physical A thorough history and physical exam should be obtained and performed in all patients with suspected HF, as the entire basis of the diagnosis is on clinical symptoms and signs. Outcomes in heart failure patients with preserved ejection fraction: mortality, readmission, and functional decline. J Am Coll Cardiol ; 52 —
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Good news! By managing your heart failure carefully and following your treatment plan, you may be able to help yourself experience fewer symptoms and achieve a greater sense of well-being. People with improved or recovered ejection fractions, as a whole, tend to have fewer hospitalizations and better overall outcomes. Download a printable version of this information PDF. Your healthcare provider can help you draft a realistic plan. What works for another person, may not be right for you. Ask your doctor or other healthcare provider for his or her recommendations, and accept the encouragement and support of family members or friends who can help you reach your goals. Before you decide on your next steps, first discuss the following questions with your healthcare provider. Find out if your HF is clearly linked to an underlying cause. By managing those conditions, you may be able to help your heart failure and your ejection fraction improve.