简介:Itisestimatedthatmorethanonemillionheartfailurehospitalizationsoccureachyear.Systolicheartfailureandheartfailurewithpreservedejectionfractioncontributeequallytoheartfailurehospitalizations.Heartfailurereadmissionratescontinuetobeabout25%.Strategiestoreduceheartfailurereadmissionarekeytoreducinghospitalizationrates.Thestrategiestoreduceheartfailurehospitalizationareasfollows:(1)Duringhospitalization,diuresistotheeuvolemicstateisessential.Fiftypercentofdischargedheartfailurepatientshaveminimalweightlossduringthehospitalization,representingminimaldiuresis,butstillfluidoverload.(2)Duringhospitalization,interrogatethedefibrillatororbiventricularpacemaker(ifapplicable)toensurethatthereisnorightventricularpacingandthereisappropriatebiventricularpacing.Interrogationofdevicescanidentifyarrhythmiaorsuboptimalbiventricularpacing,whichcancontributetodecompensation.(3)Beforedischarge,identifythereasonfordecompensation,suchasatrialfibrillation,infection,pulmonaryembolism,ornoncompliance.(4)Beforedischargeamultidisciplinaryteamisneededtoeducatethepatientondiet,medications,fluidweightsurveillance,andexercise.(5)Apostdischargevisitshouldoccurwithin10daysandwithemphasisonuptitrationofneurohormonalblockersandcontinuedcongestionmanagement.Suchinterventionsconductedbyamultidisciplinaryteamhavethepotentialtoreduceheartfailurehospitalizationrates.