Heart failure & cardiomyopathies
Telehealth-Aided Outpatient Management of Acute Heart Failure in a Specialist Virtual Ward Compared with Standard Care
Authors' conclusion
Telehealth-guided specialist HFVW management for ADHF may offer a safe and efficacious alternative to hospitalization in suitable patients.
Study context
- Population
- Patients with acute decompensated heart failure (HF) (ADHF), May 2022–October 2023 vs 2021 cohort
- Participants
- 554 vs 404
- Exposure
- Telehealth-guided HF virtual ward vs standard care
- HFVWn = 554
- SCn = 404reference
- Outcome
- Re-hospitalizations and mortality
- Follow-up
- 1, 3, 6 and 12 months
Main finding
As reported in the abstract
HFVW
- Re-hospitalization 1 month
- 8.6%
- Re-hospitalization 3 months
- 21%
- Re-hospitalization 6 months
- 28%
- Re-hospitalization 12 months
- 47%
- Mortality 1 month
- 5%
- Mortality 3 months
- 9.5%
- Mortality 6 months
- 15%
- Mortality 12 months
- 20%
SC
- Re-hospitalization 1 month
- 21.5%
- Re-hospitalization 3 months
- 30%
- Re-hospitalization 6 months
- 41%
- Re-hospitalization 12 months
- 57%
- Mortality 1 month
- 13.7%
- Mortality 3 months
- 15%
- Mortality 6 months
- 21%
- Mortality 12 months
- 26%
Re-hospitalization 1 month
HFVW8.6%
SC21.5%
Re-hospitalization 3 months
HFVW21%
SC30%
Re-hospitalization 6 months
HFVW28%
SC41%
Re-hospitalization 12 months
HFVW47%
SC57%
Mortality 1 month
HFVW5%
SC13.7%
Mortality 3 months
HFVW9.5%
SC15%
Mortality 6 months
HFVW15%
SC21%
Mortality 12 months
HFVW20%
SC26%
HFVW vs SCOdds ratio (95% CI)P value
Readmission, 1 month
0.3(0.2–0.5)
P < 0.0001Readmission, 3 months
0.15(0.1–0.3)
P < 0.0001Readmission, 6 months
0.35(0.2–0.6)
P = 0.0002Readmission, 12 months
0.25(0.15–0.4)
P ≤ 0.001Mortality, 1 month
0.26(0.14–0.48)
P < 0.0001Mortality, 3 months
0.11(0.04–0.27)
P < 0.0001Mortality, 6 months
0.35(0.2–0.61)
P = 0.0002Mortality, 12 months
0.6(0.48–0.73)
P = 0.03Observational data: associations, not effects.
Further findings
Predictor: higher GWTG-HF score · 1, 3, 6 and 12 months
- Re-hospitalization OR 1/3/6/12 months
- 1.2 [1.1-1.3]; 1.5 [1.37; 1.64]; 1.3 [1.2-1.4]; 1.1 [1.05-1.2]
- Mortality OR 1/3/6/12 months
- 1.21 [1.1-1.3]; 1.3 [1.2-1.4]; 1.2 [1.1-1.3]; 1.3 [1.1-1.7]
Predictor: higher clinical frailty score · 1, 3, 6 and 12 months
- Re-hospitalization OR 1/3/6/12 months
- 1.9 [1.5-2.4]; 1.8 [1.3-2.4]; 1.4 [1.1-1.8]; 1.9 [1.2-3]
- Mortality OR 1/3/6/12 months
- 2.1 [1.6-2.8]; 1.8 [1.2-2.6]; 2.34 [1.51-5.6]; 2.6 [1.6-7]
Predictor: increased daily step count on HFVW
- Re-hospitalization OR 1 month
- 0.85[0.7-0.9]
- Re-hospitalization OR 3 months
- 0.95 [0.93-0.98]
- Mortality OR 1 month
- 0.85 [0.7-0.95]
Predictor: Charlson co-morbidity index, adverse outcomes · 12 months
- OR
- 1.2 [1.1-1.4]
- P = 0.03
Original publication
Telehealth-Aided Outpatient Management of Acute Heart Failure in a Specialist Virtual Ward Compared with Standard Care. ESC Heart Fail. Published 13 August 2024. doi:10.
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