BACKGROUND: Several predictors of survival have been described in stable heart failure (HF) patients. Few reports have focused on decompensated patients. METHODS: We studied 170 patients who presented to the emergency department (ED) with decompensated HF. Mean age was 72.5 +/- 13 years (range 17 to 99) and 107 (63%) were male. We evaluated clinical features, in-hospital evolution, and prognostic factors related to all-cause mortality in a mean follow-up of 14 +/- 8.6 months (range 1 to 36). RESULTS: Eighteen (10.6%) patients died during the index admission. During outpatient follow-up, 45 deaths occurred. One-year survival rate for the population as a whole was 63%. Advanced age (hazard ratio [HR] = 1.27 per 10-year increment; 95% confidence interval [CI], 1.04 to 1.55; p = 0.017), mean arterial pressure (inverse relationship with total mortality, HR = 0.83 per 10 mmHg increment; 95% CI, 0.72 to 0.95; p = 0.008) and hyponatremia (HR = 2.0; 95% CI, 1.19 to 3.36; p = 0.009) were found to be independent predictors of survival. CONCLUSION: Patients who present to the ED with decompensated HF have high mortality rates. Those at increased risk can be identified early in the ED.
BACKGROUND: Several predictors of survival have been described in stable heart failure (HF) patients. Few reports have focused on decompensated patients. METHODS: We studied 170 patients who presented to the emergency department (ED) with decompensated HF. Mean age was 72.5 +/- 13 years (range 17 to 99) and 107 (63%) were male. We evaluated clinical features, in-hospital evolution, and prognostic factors related to all-cause mortality in a mean follow-up of 14 +/- 8.6 months (range 1 to 36). RESULTS: Eighteen (10.6%) patients died during the index admission. During outpatient follow-up, 45 deaths occurred. One-year survival rate for the population as a whole was 63%. Advanced age (hazard ratio [HR] = 1.27 per 10-year increment; 95% confidence interval [CI], 1.04 to 1.55; p = 0.017), mean arterial pressure (inverse relationship with total mortality, HR = 0.83 per 10 mmHg increment; 95% CI, 0.72 to 0.95; p = 0.008) and hyponatremia (HR = 2.0; 95% CI, 1.19 to 3.36; p = 0.009) were found to be independent predictors of survival. CONCLUSION:Patients who present to the ED with decompensated HF have high mortality rates. Those at increased risk can be identified early in the ED.
Authors: Carlos Henrique Del Carlo; Juliano Novaes Cardoso; Marcelo Eidi Ochia; Mucio Tavares de Oliveira; José Antonio Franchini Ramires; Antonio Carlos Pereira-Barretto Journal: Arq Bras Cardiol Date: 2014-04-17 Impact factor: 2.000
Authors: Fernanda de Souza Nogueira Sardinha Mendes; Jacob Atié; Marcelo Iorio Garcia; Eliza de Almeida Gripp; Andréa Silvestre de Sousa; Luiz Augusto Feijó; Sergio Salles Xavier Journal: Arq Bras Cardiol Date: 2014-08-29 Impact factor: 2.000
Authors: Giovanni Corona; Corinna Giuliani; Gabriele Parenti; Dario Norello; Joseph G Verbalis; Gianni Forti; Mario Maggi; Alessandro Peri Journal: PLoS One Date: 2013-12-18 Impact factor: 3.240