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.

Tytuł:: 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.
Autorzy:: Rizzi MA; Emergency Department, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain. .
Sarasola AG; Emergency Department, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain.
Arbé AA; Emergency Department, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain.
Mateo SH; Emergency Department, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain.
Gil V; Emergency Department, Hospital Clínic, University of Barcelona, Barcelona, Spain.
Llorens P; Emergency Department, Short Stay Unit and Hospitalization at Home, Hospital General de Alicante, Miguel Hernandez University, Alicante, Spain.
Jacob J; Emergency Department, Hospital Universitari de Bellvitge, Barcelona, Spain.
Martín-Sánchez FJ; Emergency Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, Spain.
Puente PH; Emergency Department, Hospital Universitario Central de Asturias, Oviedo, Spain.
Escoda R; Emergency Department, Hospital Clínic, University of Barcelona, Barcelona, Spain.
Espinosa B; Emergency Department, Short Stay Unit and Hospitalization at Home, Hospital General de Alicante, Miguel Hernandez University, Alicante, Spain.
Roset À; Emergency Department, Hospital Universitari de Bellvitge, Barcelona, Spain.
Torres-Gárate R; Emergency Department, Hospital Universitario Severo Ochoa de Leganés, Madrid, Spain.
Torres-Murillo J; Emergency Department, Hospital Universitario Nuestra Señora de Valme, Sevilla, Spain.
Mecina AB; Emergency Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
López-Díez MP; Emergency Department, Hospital Universitario de Burgos, Burgos, Spain.
Pérez JMÁ; Emergency Department, Hospital Universitario de Burgos, Burgos, Spain.
Tost J; Emergency Department, Hospital de Terrassa, Barcelona, Spain.
Salvo E; Emergency Department, Hospital Universitario La Fe, Valencia, Spain.
López-Grima ML; Emergency Department, Hospital Doctor Peset, Valencia, Spain.
Gil C; Emergency Department, Hospital Universitario de Salamanca, Salamanca, Spain.
Mir M; Emergency Department, Hospital Infanta Leonor, Madrid, Spain.
Rutzinska F; Emergency Department, Hospital Universitario de Salamanca, Salamanca, Spain.
Chioncel O; Emergency Department, Hospital Infanta Leonor, Madrid, Spain.
Miró Ò; Emergency Department, Hospital Clínic, University of Barcelona, Barcelona, Spain.
Corporate Authors:: ICA-SEMES Research Group
Źródło:: Clinical research in cardiology : official journal of the German Cardiac Society [Clin Res Cardiol] 2021 Jul; Vol. 110 (7), pp. 993-1005. Date of Electronic Publication: 2020 Sep 21.
Typ publikacji:: Journal Article; Multicenter Study
Język:: English
Imprint Name(s):: Publication: Aug. 2007- : Heidelberg, Germany : Springer Medizin
Original Publication: Darmstadt, Germany : Springer Medizin, [2006]-
MeSH Terms:: Registries*
Aftercare/*methods
Heart Failure/*mortality
Patient Discharge/*statistics & numerical data
Acute Disease ; Aged, 80 and over ; Female ; Follow-Up Studies ; Heart Failure/therapy ; Hospital Mortality/trends ; Humans ; Male ; Patient Readmission/trends ; Retrospective Studies ; Risk Factors ; Spain/epidemiology ; Survival Rate/trends ; Time Factors
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Contributed Indexing:: Investigator: M Fuentes; C Gil; H Alonso; E Pérez-Llantada; FJ Martín-Sánchez; GL García; MS Cadenas; Ò Miró; V Gil; R Escoda; C Xipell; C Sánchez; MJ Pérez-Durá; E Salvo; J Pavón; A Noval; JM Torres; ML López-Grima; A Valero; MÁ Juan; A Aguirre; MA Pedragosa; SM Masó; MI Alonso; F Ruiz; JM Franco; AB Mecina; J Tost; M Berenguer; R Donea; SS Ramón; VC Rodríguez; P Piñera; JAS Nicolás; RT Garate; A Alquézar-Arbé; MA Rizzi; S Herrera; J Jacob; A Roset; I Cabello; A Haro; F Richard; JMÁ Pérez; MPL Diez; PH Puente; JV Álvarez; BP García; MG García; MS González; P Llorens; P Javaloyes; V Marquina; I Jiménez; N Hernández; B Brouzet; B Espinosa; JA Andueza; R Romero; M Ruíz; R Calvache; MTL Serralta; LEC Jave; BA Arriaga; BS Bergua; EM Mojarro; BSA Jiménez; LT Bécquer; G Burillo; LL García; GC LaSalle; CA Urbano; ABG Soto; ED Padial; ES Ferrer; JM Garrido; FJ Lucas-Imbernón; R Gaya; C Bibiano; M Mir; B Rodríguez; JL Carballo; E Rodríguez-Adrada; BR Miranda
Keywords: De novo acute heart failure; Emergency department; Mortality; Rehospitalisation; Risk factors; Vulnerable phase
Entry Date(s):: Date Created: 20200922 Date Completed: 20211129 Latest Revision: 20211129
Update Code:: 20240105
DOI:: 10.1007/s00392-020-01710-0
PMID:: 32959081
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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.

Erratum in: Clin Res Cardiol. 2020 Dec 23;:. (PMID: 33355684)

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