Acute heart failure (AHF) is a major public health issue due to high incidence and poor prognosis. Only a few studies are available on the long-term prognosis and on outcome predictors in the unselected population attending the emergency department (ED) for AHF. We carried out a 1-year follow-up analysis of 1234 consecutive patients from selected Italian EDs from January 2011 to June 2012 for an episode of AHF. Their prognosis and outcome-associated factors were tested by Cox proportional hazard model. Patients’ mean age was 84, with 66.0 % over 80 years and 56.2 % females. Comorbidities were present in over 50 % of cases, principally a history of acute coronary syndrome, chronic obstructive pulmonary disease, diabetes, chronic kidney disease, valvular heart disease. Death occurred within 6 h in 24 cases (1.9 %). At 30-day follow-up, death was registered in 123 cases (10.0 %): 110 cases (89.4 %) died of cardiovascular events and 13 (10.6 %) of non-cardiovascular causes (cancer, gastrointestinal hemorrhages, sepsis, trauma). At 1-year follow-up, all-cause death was recorded in 50.1 % (over 3 out of 4 cases for cardiovascular origin). Six variables (older age, diabetes, systolic arterial pressure <110 mm/Hg, high NT pro-BNP, high troponin levels and impaired cognitive status) were selected as outcome predictors, but with limited discriminant capacity (AUC = 0.649; SE 0.015). Recurrence of AHF was registered in 31.0 %. The study identifies a cluster of variables associated with 1-year mortality in AHF, but their predictive capacity is low. Old age and the presence of comorbidities, in particular diabetes are likely to play a major role in dictating the prognosis.
Fabbri, A., Marchesini, G., Carbone, G., Cosentini, R., Ferrari, A., Chiesa, M., et al. (2016). Acute heart failure in the emergency department: a follow-up study. INTERNAL AND EMERGENCY MEDICINE, 11(1), 115-122.
|Citazione:||Fabbri, A., Marchesini, G., Carbone, G., Cosentini, R., Ferrari, A., Chiesa, M., et al. (2016). Acute heart failure in the emergency department: a follow-up study. INTERNAL AND EMERGENCY MEDICINE, 11(1), 115-122.|
|Tipo:||Articolo in rivista - Articolo scientifico|
|Carattere della pubblicazione:||Scientifica|
|Presenza di un coautore afferente ad Istituzioni straniere:||No|
|Titolo:||Acute heart failure in the emergency department: a follow-up study|
|Autori:||Fabbri, A; Marchesini, G; Carbone, G; Cosentini, R; Ferrari, A; Chiesa, M; Bertini, A; Rea, F|
REA, FEDERICO (Ultimo)
|Data di pubblicazione:||2016|
|Rivista:||INTERNAL AND EMERGENCY MEDICINE|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1007/s11739-015-1336-z|
|Appare nelle tipologie:||01 - Articolo su rivista|