CHARACTERISTICS AND OUTCOMES OF PATIENTS ADMITTED FOR ACUTE HEART FAILURE IN A SINGLE CENTRE STUDY

Aims: Acute heart failure represents a medical condition with very high mortality. The aim of our study was to characterise real-life patients admitted for acute heart failure in a region with one tertiary medical centre and to describe risk factors of mortality.

Methods and results: We performed a retrospective analysis of patients admitted from January 2017 to December 2017 to Department of cardiology of the University Hospital in Hradec Kralove. We identified 385 patients. The median of age was 74 years (IQR 67.5 - 80) and 34% of patients were females. The most common comorbidities were arterial hypertension (77.7%), dyslipidaemia (67.3%) and coronary artery disease (63.1%). Coronary artery disease (52.7% of cases) and valve disease (28.1% of cases) were the most common etiologies of heart failure. The all-cause in-hospital mortality was 12.7%, 30-day mortality was 14.6% and 1-year mortality was 34%. Among risk factors of in-hospital mortality, the most significant factors were haemodialysis during the hospitalization (OR 15.82, 95% CI 2.96 – 84.57, p = 0.0008), chronic heart failure (OR 4.27, 95% CI 1.66 – 11.03, p = 0.001) and STEMI as a precipitating factor of heart failure (OR 4.19, 95% CI 1.23 – 14.25, p = 0.023). Haemodialysis during the hospitalization (OR 4.28, 95% CI 1.17 – 15.61, p = 0.025) and the comorbidity depression and anxiety (OR 3.49, 95% CI 1.45 – 8.39, p = 0.005) were the most significant risk factors of long-term mortality.

Conclusion: Our study confirms very high mortality rates among patients with acute heart failure underlying poor prognosis of these patients. Comorbidities, precipitating factors of heart failure, complications occurring during the hospitalization and the age of patients should be included in the risk stratification of in-hospital, 30-day and 1-year mortality.