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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

Abstract: 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.

Otras publicaciones de la misma revista o congreso con autores/as de la Universidad de Cantabria

 Fuente: Clin Res Cardiol . 2021 Jul;110(7):993-1005

Editorial: Springer

 Año de publicación: 2021

Nº de páginas: 13

Tipo de publicación: Artículo de Revista

 DOI: 10.1007/s00392-020-01710-0

ISSN: 1861-0684,1861-0692

Url de la publicación: https://doi.org/10.1007/s00392-020-01710-0

Autores/as

RIZZI, MIGUEL ALBERTO

SARASOLA, ANA GARCÍA

ARBÉ, AITOR ALQUEZAR

MATEO, SERGIO HERRERA

GIL, VÍCTOR

LLORENS, PERE

JACOB, JAVIER

MARTÍN-SÁNCHEZ, FRANCISCO JAVIER

PUENTE, PABLO HERRERO

ESCODA, ROSA

ESPINOSA, BEGOÑA

ROSET, ÀLEX

TORRES-GÁRATE, RAQUEL

TORRES-MURILLO, JOSÉ

MECINA, ANA B

LÓPEZ-DÍEZ, MARÍA PILAR

PÉREZ, JOSÉ MARÍA ÁLVAREZ

TOST, JOSEP

SALVO, EVA