Characterization of acute heart failure hospitalizations in a Portuguese cardiology department

Abstract

Aims: We describe the clinical characteristics, management and outcomes of patients hospitalised with acute heart failure (AHF) in a south western European Cardiology Department. We sought to identify the determinants of length of stay (LOS) and heart failure (HF) rehospitalisation or death during a 12-months follow-up period. Methods and Results:This was a retrospective cohort study including all patients admitted during 2010 with either a primary or secondary diagnosis of AHF. Death and readmission were followed through 2011.Amongst the 924 patients admitted, 201 (21%) had AHF, 107 (53%) of which with new-onset AHF. The main precipitating factors were acute coronary syndrome (ACS) (63%) and arrhythmia (14%). The most frequent clinical presentations were heart failure (HF) after ACS (63%), chronic decompensate HF (47%) and acute pulmonary oedema (21%). On admission 73% had left ventricular ejection fraction (LVEF) < 0.50. Median LOS was 11 days and inhospital mortality was 5.5%. Rehospitalisation rate was 21% and 24% at six and 12 months respectively. All-cause mortality was 16% at 12 months. The independent predictors of rehospitalisation or death were HF hospitalisation during previous year (Hazard Ratio -HR -3.177), serum sodium < 135 mmol/L on admission (HR 1.995), atrial fibrillation (HR 1.791) and reduced LVEF (HR 0.518). Conclusions:Our patients more often presented new-onset AHF, due to an ACS, causing reduced LVEF. Several predictive factors of death or rehospitalisation were identified that may help to select high risk patients to be followed in a HF management programme after discharge.3

Characteristics and outcomes of heart failure hospitalization before implementation of a heart failure clinic: The PRECIC study

“…In that study 73.2% of patients had HFrEF, which reflects considerable differences between the two study populations and is evidence of how observational studies provide valuable information about acute HF managed in different clinical scenarios. 20,21 Our data on gender are in agreement with other reports showing that elderly patients hospitalized with HF are mainly women 22 and that patients with HFpEF are older and more often female than those with HFrEF. 1,5,6,8,13 HF patients managed by internists are more likely to have the characteristics of those managed by general practitioners.…”