Mortality after an episode of acute heart failure in a cohort of patients with intermediate ventricular function: Global analysis and relationship with admission department
Por:
Miro O, Javaloyes P, Gil V, Jacob J, Herrero-Puente P, Martin-Sanchez FJ, Salvo E, Alonso H, Juan Gomez MA, Parissis J, Llorens P and en nombre del grupo de investigacion ICA-SEMES
Publicada:
21 sep 2018
Ahead of Print:
23 dic 2017
Categoría:
Medicine (miscellaneous)
Resumen:
Background and objective: To compare the outcome of patients with acute heart failure (AHF) with a mid-range left ventricular ejection fraction (HFmrEF) with patients with a reduced (HFrEF) or preserved (HFpEF) left ventricular ejection fraction.
Patients and method: A prospective observational study included patients diagnosed with AHF in 41 emergency departments. Patients were divided into 3 groups: HFrEF < 40%, HFmrEF 40-49% and HFpEF >= 50%. We collected 38 independent variables and the adjusted and crude all-cause mortality at one-year in the HFmrEF group was compared with that of the HFrEF and HFpEF groups. The analysis was stratified according to patient destination following ED care.
Results: Three thousand nine hundred and fifty-eight patients were included: 580 HFmrEF (14.6%), 929 HFrEF (23.5%) and 2,449 HFpEF (61.9%). Global mortality at one year was 28.5%. The crude mortality of the HFmrEF group was similar to that of the HFpEF group (HR 1.009; 95% CI 0.819-1.243; P=.933) and lower than the HFrEF group (HR 0.800; 95% CI 0.635-1.008; P = .058), but after adjustment for discordant basal characteristics among groups, the mortality of the HFmrEF group did not differ from that of the HFpEF (HRa 1.025; 95% CI 0.825-1.275; P = .821) or HFrEF group (HRa 0.924; 95% CI 0.720-1.186; P = .535). Neither were significant differences found between the HFmrEF group and the other 2 groups in the analysis stratified according to admission or discharge direct from the emergency department.
Conclusion: Mortality at one-year after an AHF episode in patients with HFmrEF does not differ from that of patients with HFpEF or HfrEF, either globally or based on the main destinations after emergency department care. (C) 2017 Elsevier Espana, S.L.U. All rights reserved.
Filiaciones:
Miro O:
Grupo de investigacion <>, Area de Urgencias, Hospital Clinic, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Espana
Departamento de Medicina, Facultad de Medicina, Universitat de Barcelona, Barcelona, Espana
Javaloyes P:
Unidad de Corta Estancia y Hospitalizacion a Domicilio, Servicio de Urgencias, Hospital General Universitario de Alicante, Instituto de Investigacion Sanitaria y Biomedica de Alicante (ISABIAL)-Fundacion FISABIO, Alicante, Espana
Gil V:
Grupo de investigacion <>, Area de Urgencias, Hospital Clinic, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Espana
Jacob J:
Servicio de Urgencias, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Espana
Herrero-Puente P:
Servicio de Urgencias, Hospital Universitario Central de Asturias, Instituto de Investigacion Sanitaria del Principado de Asturias (IISPA), Oviedo, Asturias, Espana
Martin-Sanchez FJ:
Servicio de Urgencias, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid, Espana
Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Espana
Salvo E:
Servicio de Urgencias, Hospital La Fe, Valencia, Espana
Alonso H:
Servicio de Urgencias, Hospital Marques de Valdecilla, Santander, Espana
:
Servicio de Urgencias, Hospital Doctor Peset, Valencia, Espana
Parissis J:
Heart Failure Unit, Department of Cardiology, Attikon University Hospital, Athens, Grecia
Llorens P:
Unidad de Corta Estancia y Hospitalizacion a Domicilio, Servicio de Urgencias, Hospital General Universitario de Alicante, Instituto de Investigacion Sanitaria y Biomedica de Alicante (ISABIAL)-Fundacion FISABIO, Alicante, Espana
Departamento de Medicina Clinica, Universidad Miguel Hernandez, Elche, Alicante, Espana
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