Factors associated with in-hospital mortality and adverse outcomes during the vulnerable post-discharge phase after the first episode of acute heart failure: results of the NOVICA-2 study

Autor: Miguel Alberto, Rizzi, Ana García, Sarasola, Aitor Alquezar, Arbé, Sergio Herrera, Mateo, Víctor, Gil, Pere, Llorens, Javier, Jacob, Francisco Javier, Martín-Sánchez, Pablo Herrero, Puente, Rosa, Escoda, Begoña, Espinosa, Àlex, Roset, Raquel, Torres-Gárate, José, Torres-Murillo, Ana B, Mecina, María Pilar, López-Díez, José María Álvarez, Pérez, Josep, Tost, Eva, Salvo, María Luisa, López-Grima, Cristina, Gil, María, Mir, Frank, Rutzinska, Ovidiu, Chioncel, Òscar, Miró, Belén Rodríguez, Miranda
Rok vydání: 2021
Předmět:
Male
medicine.medical_specialty
Time Factors
De novo acute heart failure
Emergency department
Mortality
Rehospitalisation
Risk factors
Vulnerable phase
Aftercare
Disease
030204 cardiovascular system & hematology
Patient Readmission
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
Epidemiology
medicine
Humans
Dementia
Decompensation
Hospital Mortality
Registries
030212 general & internal medicine
Mortality
Retrospective Studies
Aged
80 and over
Heart Failure
First episode
business.industry
Emergency department
Medical record
General Medicine
medicine.disease
humanities
Patient Discharge
Survival Rate
Risk factors
Spain
Rehospitalisation
Heart failure
Acute Disease
Vulnerable phase
Cardiology
Female
De novo acute heart failure
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Zdroj: CLINICAL RESEARCH IN CARDIOLOGY
r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
instname
r-FISABIO: Repositorio Institucional de Producción Científica
Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
r-FISABIO. Repositorio Institucional de Producción Científica
Clinical Research in Cardiology
r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe
ISSN: 1861-0684
Popis: Objective To identify patients at risk of in-hospital mortality and adverse outcomes during the vulnerable post-discharge period after the first acute heart failure episode (de novo AHF) attended at the emergency department. Methods This is a secondary review of de novo AHF patients included in the prospective, multicentre EAHFE (Epidemiology of Acute Heart Failure in Emergency Department) Registry. We included consecutive patients with de novo AHF, for whom 29 independent variables were recorded. The outcomes were in-hospital all-cause mortality and all-cause mortality and readmission due to AHF within 90 days post-discharge. A follow-up check was made by reviewing the hospital medical records and/or by phone. Results We included 3422 patients. The mean age was 80 years, 52.1% were women. The in-hospital mortality was 6.9% and was independently associated with dementia (OR = 2.25, 95% CI = 1.62-3.14), active neoplasia (1.97, 1.41-2.76), functional dependence (1.58, 1.02-2.43), chronic treatment with beta-blockers (0.62, 0.44-0.86) and severity of decompensation (6.38, 2.86-14.26 for high-/very high-risk patients). The 90-day post-discharge combined endpoint was observed in 19.3% of patients and was independently associated with hypertension (HR = 1.40, 1.11-1.76), chronic renal insufficiency (1.23, 1.01-1.49), heart valve disease (1.24, 1.01-1.51), chronic obstructive pulmonary disease (1.22, 1.01-1.48), NYHA 3-4 at baseline (1.40, 1.12-1.74) and severity of decompensation (1.23, 1.01-1.50; and 1.64, 1.20-2.25; for intermediate and high-/very high-risk patients, respectively), with different risk factors for 90-day post-discharge mortality or rehospitalisation. Conclusions The severity of decompensation and some baseline characteristics identified de novo AHF patients at increased risk of developing adverse outcomes during hospitalisation and the vulnerable post-discharge phase, without significant differences in these risk factors according to patient age at de novo AHF presentation. [GRAPHICS] .
Databáze: OpenAIRE
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