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Gingele AJ, Brandts L, Brunner-La Rocca HP, et al. Introduction of a new scoring tool to identify clinically stable heart failure patients. Neth Heart J. 2022;doi: 10.1007/s12471-021-01654-8.
Gingele, A. J., Brandts, L., Brunner-La Rocca, H. P., Cleuren, G., Knackstedt, C., & Boyne, J. J. J. (2022). Introduction of a new scoring tool to identify clinically stable heart failure patients. Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation, . https://doi.org/10.1007/s12471-021-01654-8
Gingele, A J, et al. "Introduction of a new scoring tool to identify clinically stable heart failure patients." Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation vol. (2022). doi: https://doi.org/10.1007/s12471-021-01654-8
Gingele AJ, Brandts L, Brunner-La Rocca HP, Cleuren G, Knackstedt C, Boyne JJJ. Introduction of a new scoring tool to identify clinically stable heart failure patients. Neth Heart J. 2022 Jan 05; doi: 10.1007/s12471-021-01654-8. Epub 2022 Jan 05. PMID: 34988879.
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Neth Heart J. 2022 Jan 05; doi: 10.1007/s12471-021-01654-8. Epub 2022 Jan 05.

Introduction of a new scoring tool to identify clinically stable heart failure patients.

Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation

A J Gingele, L Brandts, H P Brunner-La Rocca, G Cleuren, C Knackstedt, J J J Boyne

Affiliations

  1. Department of Cardiology, Maastricht University Medical Centre+, Maastricht, The Netherlands. [email protected].
  2. Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre+, Maastricht, The Netherlands.
  3. Department of Cardiology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
  4. Department of Patient and Care, Maastricht University Medical Centre+, Maastricht, The Netherlands.
  5. Department of Health Services Research, CAPHRI, Maastricht University, Maastricht, The Netherlands.

PMID: 34988879 DOI: 10.1007/s12471-021-01654-8

Abstract

INTRODUCTION: Heart failure (HF) poses a burden on specialist care, making referral of clinically stable HF patients to primary care a desirable goal. However, a structured approach to guide patient referral is lacking.

METHODS: The Maastricht Instability Score-Heart Failure (MIS-HF) questionnaire was developed to objectively stratify the clinical status of HF patients: patients with a low MIS-HF (0-2 points, indicating a stable clinical condition) were considered for treatment in primary care, whereas high scores (> 2 points) indicated the need for specialised care. The MIS-HF was evaluated in 637 consecutive HF patients presenting between 2015 and 2018 at Maastricht University Medical Centre.

RESULTS: Of the 637 patients, 329 (52%) had a low score and 205 of these 329 (62%) patients were referred to primary care. The remaining 124 (38%) patients remained in secondary care. Of the 308 (48%) patients with a high score (> 2 points), 265 (86%) remained in secondary care and 41 (14%) were referred to primary care. The primary composite endpoint (mortality, cardiac hospital admissions) occurred more frequently in patients with a high compared to those with a low MIS-HF after 1 year of follow-up (29.2% vs 10.9%; odds ratio (OR) 3.36, 95% confidence interval (CI) 2.20-5.14). No significant difference in the composite endpoint (9.8% vs 12.9%; OR 0.73, 95% CI 0.36-1.47) was found between patients with a low MIS-HF treated in primary versus secondary care.

CONCLUSION: The MIS-HF questionnaire may improve referral policies, as it helps to identify HF patients that can safely be referred to primary care.

© 2022. The Author(s).

Keywords: Consultation; Heart failure; Mortality; Primary health care; Referral

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