Prognostic factors on mortality in patients admitted to hospital with heart failure

Authors

  • M. Valdivia-Marchal Servicio de Medicina Interna. Hospital de Montilla, Montilla (Córdoba). Agencia Sanitaria Alto Guadalquivir.
  • J.L. Zambrana-Luque Servicio de Medicina Interna. Hospital de Montilla, Montilla (Córdoba). Agencia Sanitaria Alto Guadalquivir.
  • E. Girela-López Sección de Medicina Legal. Departamento de Medicina. Facultad de Medicina y Enfermería. Universidad de Córdoba.
  • P. Font-Ugalde Sección de Bioestadística. Departamento de Medicina. Facultad de Medicina y Enfermería. Universidad de Córdoba.
  • M.C. Salcedo-Sánchez Biblioteca. Hospital de Montilla, Montilla (Córdoba). Agencia Sanitaria Alto Guadalquivir.
  • J.L. Zambrana-García Servicio de Medicina Interna. Hospital de Montilla, Montilla (Córdoba). Agencia Sanitaria Alto Guadalquivir.

DOI:

https://doi.org/10.23938/ASSN.0753

Keywords:

Heart failure. In-hospital mortality. Long-term mortality. Predictors.

Abstract

Background. Heart failure (HF) is the leading cause of hospitalization for aging populations in Western countries, and is showing an increasing mortality. The aim of this study was to assess the probable long-term mortality risk factors for patients admitted because of HF.

Methods. Retrospective study of a cohort of 202 patients consecutively hospitalized because of HF and followed up for a maximum period of 5 years. Clinical and epidemiological factors and their relationship to in-hospital and long-term mortality were analyzed.

Results. In-hospital mortality was 16%.The independent predictors were: age >75 years (HR = 2.68, 95% IC: 1.65-4.36, p = 0.001); cognitive impairment (HR = 2.77, 95% IC: 1.40-5.48, p = 0.004); Barthel index ≥60 (HR = 0.54, 95% IC: 0.37-0.78, p = 0,009); creatinine levels >1.16 mg/dl at admission (HR = 1.57, 95% IC: 1.12-2.20, p = 0.009); and number of diagnostics >10 on discharge (HR = 1. 64, 95% IC: 1.14-2.36, p = 0.007). Accumulated mortality at 12, 24, 36 and 48 months after hospital discharge were 43%, 51%, 67% and 70%, respectively; the independent predictors for this were: age >75 years (HR = 2.55, 95% IC: 1.56-4.15, p <0.001); cognitive impairment (HR = 2.45, 95% IC: 1.22-4.90, p = 0.011); creatinine levels >1.16 mg/dl on admission (HR = 1.59, 95% IC: 1.12-2.24, p = 0.009); systolic blood pressure >140 mm Hg on admission (HR = 0.56, 95% IC: 0.40-0.80, p <0.001); and number of diagnostics >10 on discharge (HR = 1. 49, 95% IC: 1.03-2.16, p = 0.033).

Conclusions. Clinical and epidemiological factors related to in-hospital and long-term mortality could help to improve the management of patients with HF.

Downloads

Download data is not yet available.

References

MONTES-SANTIAGO J, AREVALO LORIDO JC, CERQUEIRO GONZALEZ JM. Epidemiologia de la insuficiencia cardiaca aguda. Med Clin (Barc) 2014; 142(Suppl 1): 3-8. https://doi.org/10.1016/S0025-7753(14)70075-2

RUIZ-ROMERO V, LORUSSO N, EXPÓSITO GARCÍA S, PÁEZ-PINTO JM, PALMERO-PALMERO C, CABALLERO-DELGADO G et al. Hospitalizaciones evitables por insuficiencia cardíaca. Variables relacionadas. Rev Esp Salud Publica 2016; 90: e1-e11.

OTERO-RAVIÑA F, GRIGORIAN-SHAMAGIAN L, FRANSI-GALIANA L, NÁZARA-OTERO C, FERNÁNDEZ-VILLAVERDE JM, DEL ALAMO-ALONSO A et al. Morbidity and mortality among heart failure patients in Galicia, N.W. Spain: the GALICAP study. Int J Cardiol 2009; 136: 56-63. https://doi: 10.1016/j.ijcard.2008.04.025.

LÓPEZ-CASTRO J, ALMAZÁN ORTEGA R, PÉREZ DE JUAN ROMERO M, GONZALEZ JUANATEY JR. Factores pronósticos de mortalidad de la insuficiencia cardiaca en una cohorte del noroeste de España. Estudio EPICOUR. Rev Clin Esp 2010; 210: 438-447. https://doi.org/10.1016/j.rce.2010.02.009

QUIRÓS LÓPEZ R, GARCÍA ALEGRÍA J, MARTÍN ESCALANTE MD, TRUJILLO SANTOS J, VILLENA RUIZ MA, PEREA MILLA E. Factores pronósticos y supervivencia a largo plazo tras el diagnóstico inicial de insuficiencia cardiaca. Med Clin (Barc) 2012; 138: 602-608. https://doi.org/10.1016/j.medcli.2011.03.031

CHENG RK, COX M, NEELY ML, HEIDENREICH PA, BHATT DL, EAPEN ZJ et al. Outcomes in patients with heart failure with preserved, borderline, and reduced ejection fraction in the Medicare population. Am Heart J 2014; 168: 721-730.e3. https://doi.org/10.1016/j.ahj.2014.07.008

GOLDBERG RJ, CIAMPA J, LESSARD D, MEYER TE, SPENCER FA. Long-term survival alter heart failure. A contemporary population-based perspective. Arch Intern Med 2007; 167: 490-496. https://doi.org/10.1001/archinte.167.5.490

GHEORGHIADE M, BRAUNWALD E. Hospitalizations for heart failure in the United States. A sign of hope. JAMA 2011; 306: 1705-1706. https://doi.org/10.1001/jama.2011.1510

CONTHE P, Grupo de Trabajo de Insuficiencia Cardíaca de la Sociedad Española de Medicina Interna (SEMI). La insuficiencia cardíaca en los servicios de medicina interna (estudio SEMI-IC). Med Clin (Barc) 2002; 118: 605-610. https://doi.org/10.1016/S0025-7753(02)72468-8

GARCÍA CASTELO A, MUÑIZ GARCÍA J, SESMA SÁNCHEZ P, CASTRO BEIRAS A. Utilización de recursos diagnósticos y terapéuticos en pacientes ingresados por insuficiencia cardíaca: influencia del servicio de ingreso (estudio INCARGAL). Rev Esp Cardiol 2003; 56: 49-56. https://doi.org/10.1157/13042342

SAYAGO-SILVA I, GARCÍA-LÓPEZ F, SEGOVIA-CUBERO J. Epidemiología de la insuficiencia cardíaca en España en los últimos 10 años. Rev Esp Cardiol 2013; 66: 649-656. https://doi.org/10.1016/j.recesp.2013.03.014

FORMIGA F, CHIVITE D, MANITO N, CASAS S, RIERA A, PUJOL R. Predictors of in-hospital mortality present at admission among patients hospitalised because of decompensated heart failure. Cardiology 2007; 108: 73-78. https://doi.org/10.1159/000095885

MIYAGISHIMA K, HIRAMITSU S, KIMURA H, MORI K, UEDA T, KATO S et al. Long term prognosis of chronic heart failure: reduced vs preserved left ventricular ejection fraction. Circ J 2009; 73: 92-99. https://doi.org/ 10.1253/circj.CJ-07-1016

VARELA-ROMAN A, GRIGORIAN L, BARGE E, BASSANTE P, DE LA PEÑA MG, GONZALEZ-JUANATEY JR. Heart failure in patients with preserved and deteriorated left ventricular ejection fraction. Heart 2005; 91: 489-494. https://doi.org/10.1136/hrt.2003.031922

GODA A, YAMASHITA T, SUZUKI S, OHTSUKA T, UEJIMA T, OIKAWA Y et al. Heart failure with preserved versus reduced left ventricular systolic function: a prospective cohort of Shinken Database 2004-2005. J Cardiol 2010; 55: 108-116. https://doi.org/10.1016/j.jjcc.2009.10.009

BHATIA RS, TU JV, LEE DS, AUSTIN PC, FANG J, HAOUZI A et al. Outcome of heart failure with preserved ejection fraction in a population-based study. N Engl J Med 2006; 355: 260-269. https://doi.org/10.1056/NEJMoa051530

TRIBOUILLOY C, RUSINARU D, MAHJOUB H, SOULIÈ V, LÉVY F, PELTIER M et al. Prognosis of heart failure with preserved ejection fraction: a 5 year prospective population-based study. Eur Heart J 2008; 29: 339-347. https://doi.org/10.1093/eurheartj/ehm554

JONG P, VOWINCKEL E, LIU PP, GONG Y, TU JV. Prognosis and determinants of survival in patients newly hospitalized for heart failure: a population-based study. Arch Intern Med 2002; 162: 1689-1694. https://doi.org/10.1001/archinte.162.15.1689

SHAH KS, XU H, MATSOUAKA RA, BHATT DL, HEIDENREICH PA, HERNANDEZ AF et al. Heart failure with preserved, borderline, and reduced ejection fraction: 5-Year Outcomes. J Am Coll Cardiol 2017; 70: 2476-2486. doi: 10.1016/j.jacc.2017.08.074

BONIG I, MARTINEZ F, DIAGO JL, REDON J. Valor pronóstico de la función renal en la mortalidad de pacientes con insuficiencia cardiaca. Med Clin (Barc) 2009; 133: 644-645. https://doi.org/10.1016/j.medcli.2008.09.021

MÉNDEZ-BAILÓN M, MUÑOZ-RIVAS N, ORTIZ-ALONSO J, AUDIBERT-MENA L. Implicaciones pronósticas del NTproBNP en insuficiencia cardíaca con fracción de eyección preservada. Med Clin (Barc) 2011; 136:600. https://doi.org/10.1016/j.medcli.2010.03.040

CORTÉS R, RIVERA M, MARTÍNEZ-DOLZ L, JORDÁN A, ROSELLÓ-LLETÍ E, MIRÓ V et al. Valor pronóstico a largo plazo de los valores séricos y urinarios del fragmento N terminal del péptido natriurético tico tipo B y del filtrado glomerular en pacientes con insuficiencia cardíaca. Med Clin (Barc) 2010; 134: 296-302. https://doi.org/10.1016/j.medcli.2009.07.052

Published

2020-04-20

How to Cite

Valdivia-Marchal, M., Zambrana-Luque, J., Girela-López, E., Font-Ugalde, P., Salcedo-Sánchez, M., & Zambrana-García, J. (2020). Prognostic factors on mortality in patients admitted to hospital with heart failure. Anales Del Sistema Sanitario De Navarra, 43(1), 57–67. https://doi.org/10.23938/ASSN.0753

Issue

Section

Research articles

Most read articles by the same author(s)