First hospital admission due to heart failure: In-hospital mortality and patient profile

Masip, Joan Corominas; Formiga, Francesç; Fernández-Castañer, M.; Fernández, P.; Comín‐Colet, Josep; Corbella, Xavier

doi:10.1016/j.rceng.2018.09.007

Cited by 3 publications

(4 citation statements)

References 21 publications

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“…When comparing the baseline characteristics, our cohort showed a remarkably high prevalence of comorbidities such as diabetes mellitus and chronic kidney disease, which explains the relatively high event rate 38,40 . In line with our findings, higher age and NYHA class were found as predictors of fatal outcome 24,39 . Akintoye and colleagues also reported a significant association of CCI with in‐hospital mortality, but there has been no distinction between elective and non‐elective hospital admission in their study 41 .…”

Section: Discussionsupporting

confidence: 81%

“…38,40 In line with our findings, higher age and NYHA class were found as predictors of fatal outcome. 24, 39 Akintoye and colleagues also reported a significant association of CCI with in-hospital mortality, but there has been no distinction between elective and non-elective hospital admission in their study. 41 Obesity was associated with a reduced in-hospital death rate, which has been previously described as the 'obesity mortality paradox' in patients with HF.…”

Section: Discussionmentioning

confidence: 88%

“…9 In-hospital mortality rates in previously published studies investigating non-electively hospitalized HF populations range from 4.0-8.0% with a decrease during the last years. 24,[36][37][38][39][40] When comparing the baseline characteristics, our cohort showed a remarkably high prevalence of comorbidities such as diabetes mellitus and chronic kidney disease, which explains the relatively high event rate. 38,40 In line with our findings, higher age and NYHA class were found as predictors of fatal outcome.…”

Section: Discussionmentioning

confidence: 89%

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In‐hospital care in acute heart failure during the COVID‐19 pandemic: insights from the German‐wide Helios hospital network

König

Hohenstein

Meier‐Hellmann

et al. 2020

European J of Heart Fail

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Aims The coronavirus disease 2019 (COVID‐19) pandemic has led to changes in health care utilization for different acute cardiovascular diseases. Whether hospitalization rates and in‐hospital mortality were affected by the pandemic in patients with acute symptomatic heart failure (HF) was investigated in this study. Methods and results Administrative data provided by 67 German Helios hospitals were examined for patients with a main discharge diagnosis of HF using ICD codes. Urgent hospital admissions per day were compared for a study period (13 March–21 May 2020) with control intervals in 2020 (1 January–12 March) and 2019 (13 March–21 May), resulting in a total of 13 484 patients excluding all patients with laboratory‐proven COVID‐19 infection. Incidence rate ratios (IRR) were calculated using Poisson regression. Generalized linear mixed models were used for univariable and multivariable analysis to identify predictors of in‐hospital mortality. The number of admissions per day was lower in the study period compared to the same year [IRR 0.69, 95% confidence interval (CI) 0.67–0.73, P < 0.01] and the previous year control group (IRR 0.73, 95% CI 0.70–0.76, P < 0.01). Age was similar throughout the intervals, but case severity increased in terms of distribution within New York Heart Association (NYHA) classes and comorbidities. Within the study period, 30‐day rates for urgent hospital readmissions were higher compared to the same year but not the previous year control group. In‐hospital mortality was 7.3% in the study period, 6.1% in the same year (P = 0.03) and 6.0% in the previous year control group (P = 0.02). In multivariable analysis, age, NYHA class and other predictors of fatal outcome were identified but hospitalization during the study period was not independently associated with mortality. Conclusion Our data showed a significant reduction of urgent hospital admissions for HF with increased case severity and concomitant in‐hospital mortality during the COVID‐19 pandemic in Germany. Identifying causes of reduced inpatient treatment rates is essential for the understanding and valuation with regard to future optimal management of patients with HF.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 89%

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In‐hospital care in acute heart failure during the COVID‐19 pandemic: insights from the German‐wide Helios hospital network

König

Hohenstein

Meier‐Hellmann

et al. 2020

European J of Heart Fail

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“…Remarkably, this mixture of AHF patients has been proposed to be a relevant confounding factor in clinical trials . Second, although specific comparisons have been performed between DNAHF and acutely decompensated HF, and there are even registries exclusively including DNAHF patients, they only include hospitalised patients, sometimes from a single hospital department. This imposes the bias of hospitalisation and disregards the subset of AHF patients that are seen at the emergency department (ED, where most of these patients are first seen) and are directly discharged home without hospitalisation (between one sixth and one third, depending on the country) .…”

Section: Introductionmentioning

confidence: 99%

Departments involved during the first episode of acute heart failure and subsequent emergency department revisits and rehospitalisations: an outlook through the NOVICA cohort

Sarasola

Fuenzalida

Calderón

et al. 2019

European J of Heart Fail

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ObjectivesWe investigated the natural history of patients after a first episode of acute heart failure (FEAHF) requiring emergency department (ED) consultation, focusing on: the frequency of ED visits and hospitalisations, departments admitting patients during the first and subsequent hospitalisations, and factors associated with difficult disease control.We included consecutive patients diagnosed with FEAHF (either with or without previous heart failure diagnosis) in four EDs during 5 months in three different time periods (2009, 2011, 2014). Diagnosis was adjudicated by local principal investigators. The clinical characteristics of the index event were prospectively recorded, and all post-discharge ED visits and hospitalisations [related/unrelated to acute heart failure (AHF)], as well as departments involved in subsequent hospitalisations were retrospectively ascertained. 'Uncontrolled disease' during the first year after FEAHF was considered if patients were attended at ED (≥ 3 times) or hospitalised (≥ 2 times) for AHF or died. Overall, 505 patients with FEAHF were included and followed for a mean of 2.4 years. In-hospital mortality was 7.5%. Among 467 patients discharged alive, 288 died [median survival 3.9 years, 95% confidence interval (CI) 3.5-4.4], 421 (90%) revisited the ED (2342 ED visits; 42.4% requiring hospitalisation, 34.0% AHF-related) and 357 Ò. Miró et al.(77%) were hospitalised (1054 hospitalisations; 94.1% through ED, 51.4% AHF-related). AHF-related hospitalisations were mainly in internal medicine (28.0%), short-stay unit (26.3%), cardiology (20.8%), and geriatrics (14.1%). Only 47.4% of AHF-related hospitalisations were in the same department as the FEAHF, and internal medicine involvement significantly increased with subsequent hospitalisations (P = 0.01). Uncontrolled disease was observed in 31% of patients, which was independently related to age > 80 years [odds ratio (OR) 1.80, 95% CI 1.17-2.77], systolic blood pressure < 110 mmHg at ED arrival (OR 2.61, 95% CI 1. 26-5.38) and anaemia (OR 2.39, 95% CI

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Pneumocystis jirovecii in Spanish Patients With Heart Failure

Merino-Casallo

Friaza

Menao

et al. 2019

Front. Public Health

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Objective: Pneumocystis colonization is frequent in patients with chronic obstructive pulmonary disease (COPD) producing local and systemic inflammation. Heart failure is also a common comorbidity among patients with COPD. Heart failure is a chronic, frequent, and disabling condition with high morbidity and mortality, but with a modifiable course where endothelial dysfunction and pulmonary arterial hypertension have great importance. Animal models have shown that Pneumocystis infection can cause relevant functionally changes in vascular responses in the lung, promoting the development of pulmonary hypertension. Pneumocystis colonization could be a hidden cause of worsening heart failure through it capacity to induce inflammatory response with subsequent endothelial dysfunction and pulmonary hypertension. The aim of the present study was to investigate the prevalence of Pneumocystis jirovecii colonization in heart failure patients and its possible association with reduced or preserved ejection fraction.Methods: A cross-sectional study was carried out including 36 heart failure patients and 36 control cases. Identification of P. jirovecii colonization was performed by means of molecular techniques in oropharyngeal washing.Results: Pneumocystis-DNA was identified in oropharyngeal washing in 1 (2.7%) of 36 heart failure patients and in 3 (8.3%) of 36 controls.Conclusions: Pneumocystis colonization does not seem to have a role in the pathophysiology of heart failure.

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First hospital admission due to heart failure: In-hospital mortality and patient profile

Cited by 3 publications

References 21 publications

In‐hospital care in acute heart failure during the COVID‐19 pandemic: insights from the German‐wide Helios hospital network

In‐hospital care in acute heart failure during the COVID‐19 pandemic: insights from the German‐wide Helios hospital network

Departments involved during the first episode of acute heart failure and subsequent emergency department revisits and rehospitalisations: an outlook through the NOVICA cohort

Pneumocystis jirovecii in Spanish Patients With Heart Failure

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