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Anales del Sistema Sanitario de Navarra
versión impresa ISSN 1137-6627
Resumen
VALDIVIA-MARCHAL, M. et al. Prognostic factors on mortality in patients admitted to hospital with heart failure. Anales Sis San Navarra [online]. 2020, vol.43, n.1, pp.57-67. Epub 17-Ago-2020. ISSN 1137-6627. https://dx.doi.org/10.23938/assn.0753.
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.
Palabras clave : Heart failure; In-hospital mortality; Long-term mortality; Predictors.