OPEN IN READ APP
JOURNAL ARTICLE

[The determination of the factors impacting on in-hospital mortality in patients with acute heart failure in a tertiary referral center]

Mehdi Zoghi, Hamza Duygu, Hasan Güngör, Sanem Nalbantgil, Gülsüm Meral Yilmaz, Kamil Tülüce, Filiz Ozerkan, Azem Akilli, Mustafa Akin
Anatolian Journal of Cardiology: AKD 2008, 8 (4): 255-9
18676300

OBJECTIVE: Despite impressive advances in therapeutics in the last years, acute heart failure (AHF) remains a major cause of cardiovascular morbidity and mortality. Patients hospitalized because of heart failure (HF), irrespective of left ventricular systolic function, represent a high-risk population with limited short-term prognosis. A substantial component of HF-related mortality occurs during a hospital stay. In this study, we aimed to determine the factors impacting on in-hospital mortality in patients with AHF.

METHODS: During a 15-month period (December 2005-March 2007), 85 consecutive patients with (mean age: 64+/-8 years, male: 54%) an episode of AHF were included in this study. The effect of demographic, clinical, electrocardiographic, and echocardiographic characteristics, laboratory findings on in-hospital mortality were evaluated retrospectively.

RESULTS: Of 85 patients 24.7% of patients had new-onset HF. Coronary artery disease (61%) was the most common underlying disease. The 44.7% of patients had hypertension, 37.6% had diabetes mellitus, 21% had chronic renal failure and 16.4% had chronic obstructive pulmonary disease. Left ventricular ejection fraction was 35+/-7%. In-hospital mortality rate was found as 11.7% (10 patients). The major cause of mortality was the progression of HF to cardiogenic shock in 60% of deaths. In comparison with surviving patients in terms of the clinical, demographic, electrocardiographic, and laboratory characteristics and left and right ventricular functions, patients died during hospitalization had higher blood urea nitrogen (45+/-20 mg/dl vs. 36+/-12 mg/dl, p=0.04), higher creatinine level (2.2+/-0.8 mg/dl vs. 1.1+/-0.5 mg/dl, p=0.001), and wider QRS duration (130+/-13 ms vs. 116+/-18 ms, p=0.04) whereas they had lower plasma sodium level (128+/-5 mmol/l vs. 135+/-9 mmol/l, p=0.02) and systolic blood pressure (p=0.01). Logistic regression analysis revealed that plasma creatinine level (OR 1.5, 95% CI 1.2 to 2.1, p=0.01), blood urea nitrogen (OR 2.1, 95% CI 1.8 to 3.1, p=0.001), plasma sodium level (OR 1.3, 95% CI 1.1 to 1.7, p=0.02), and systolic blood pressure (OR 2.2, 95% CI 1.9 to 2.8, p=0.01) were the independent predictors of in-hospital mortality.

CONCLUSION: In-hospital mortality increases in patients who had lower systolic blood pressure, lower plasma sodium level, and renal dysfunction on admission.

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Available on the App Store

Available on the Play Store
Remove bar
Read by QxMD icon Read
18676300
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"