Baseline characteristics and hospital mortality in the Acute Heart Failure Database (AHEAD) Main registry

Abstract

IntroductionThe prognosis of patients hospitalized with acute heart failure (AHF) is poor and risk stratification may help clinicians guide care. The objectives of the Acute Heart Failure Database (AHEAD) registry are to assess patient characteristics, etiology, treatment and outcome of AHF.MethodsThe AHEAD main registry includes patients hospitalized for AHF in seven centers with a Catheterization Laboratory Service in the Czech Republic. The data were collected from September 2006 to October 2009. The inclusion criteria for the database adhere to the European guidelines for AHF (2005) and patients were systematically classified according to the basic syndromes, type and etiology of AHF.ResultsOf 4,153 patients, 12.7% died during hospitalization. The median length of hospitalization was 7.1 days. Mean age of patients was 71.5 ± 12.4 years; men were younger (68.6 ± 12.4 years) compared to women (75.5 ± 11.5 years) (P < 0.001). De-novo heart failure was seen in 58.3% of the patients. According to the classification of heart failure syndromes, acute decompensated heart failure (ADHF) was reported in 55.3%, hypertensive AHF in 4.4%, pulmonary edema in 18.4%, cardiogenic shock in 14.7%, high output failure in 3.3%, and right heart failure in 3.8%. The mortality of cardiogenic shock was 62.7%, of right AHF 16.7%, of pulmonary edema 7.1%, of high output HF 6.1%, whereas the mortality of hypertensive AHF or ADHF was < 2.5%. According to multivariate analyses, low systolic blood pressure, low cholesterol level, hyponatremia, hyperkalemia, the use of inotropic agents and norepinephrine were predictive parameters for in-hospital mortality in patients without cardiogenic shock. Severe left ventricular dysfunction and renal insufficiency were predictive parameters for mortality in patients with cardiogenic shock. Invasive ventilation and age over 70 years were the most important predictive factors for mortality in both genders with or without cardiogenic shock.ConclusionsThe AHEAD Main registry provides up-to-date information on the etiology, treatment and hospital outcomes of patients hospitalized with AHF. The results highlight the highest risk patients.

Clinical characteristics and 1-year outcome of hyponatremic patients hospitalized for heart failure

“…2-5, 7,10,11,13 In the current analysis, hyponatremic patients were hospitalized longer and were at a higher risk of death during the index hospitalization compared with normonatremic patients. In our previous study conducted in Polish ESC-HF Pilot participants, a lower sodium concentration on admission proved to be an independent predictive factor of death during hospitalization.…”

Long-term survival following acute heart failure: The Acute Heart Failure Database Main registry (AHEAD Main)

“…The Acute Heart Failure Database registry (AHEAD) has already been described [8,15]. Briefly, the AHEAD Main registry includes consecutive patients from 7 centers which have 24-hour cathlab service and centralized care for patients with acute coronary syndromes.…”

“…The hospital mortality of patients with AHF is reported to range from approximately 4% to 11% [4][5][6][7]; the in-hospital mortality rate listed in the AHEAD Main registry was 12.7% [8]. Less information is known about the long-term prognosis of patients discharged following hospitalization due to AHF.…”

Correlation between clinical and socioeconomic characteristics and perceived health status of patients with heart failure

“…Studies show that low income is related to the difficult access to health services by associated comorbidities, as well as difficulty to acquisition of medicines, adaptation and change of lifestyle has directly impact on patient PHS (ALMEIDA et al, 2013;SOUZA, et al, 2014) Likewise, minor amounts of blood ejected by the heart to body systems obtained by LVEF increase symptoms caused by the disease and reduce good health perception by the individual (LINDVALL; HULTMAN; JACKSON, 2013;SPINAR et al, 2011;GAUI;OLIVEIRA;KLEIN, 2014).…”