ESC Heart Failure (Apr 2020)

Real‐world analysis of acute decompensated heart failure outcomes in Portugal

  • Patrícia Marques‐Alves,
  • Ana Vera Marinho,
  • José Paulo Almeida,
  • Tatiana Gonçalves,
  • Marta Costa,
  • Mafalda Ferreira,
  • Rui Baptista,
  • Susana Costa,
  • Fátima Franco,
  • Isabel Fonseca,
  • Lino Gonçalves

DOI
https://doi.org/10.1002/ehf2.12599
Journal volume & issue
Vol. 7, no. 2
pp. 551 – 558

Abstract

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Abstract Aims In Portugal, in the last 5 years, no study has published recent data regarding outcomes of patients with acute decompensated heart failure (ADHF). We aimed to determine the characteristics and outcomes of a large contemporaneous Portuguese cohort of ADHF patients admitted to our emergency department (ED). Methods and results We conducted a retrospective, study of all 1024 patients admitted to our ED with a discharge diagnosis of ADHF from November 2016 to December 2017. Baseline clinical data and outcomes {in‐hospital, 30 day, and follow‐up all‐cause mortality, and readmissions; median follow‐up, 5 months; interquartile range [(IQR), 3–11 months]} were determined. Mean age was 78 ± 10 years, and 53% were male; of the 1024 patients, 554 (54%) were hospitalized. The median hospitalization length was 9 (IQR, 5–15) days, and in‐hospital mortality was 12.7%. Hospitalized patients were predominantly men (56% vs. 47%; P < 0.001), younger (77 ± 9 vs. 79 ± 11 years; P = 0.002) and had higher creatinine values and B‐type natriuretic peptide values (P < 0.001) than discharged patients. Patients with prior hospitalization had lower 30 day readmission rate (8% vs. 14%; P = 0.01), same overall readmission rate (30% vs. 32%), and higher 30 day (13% vs. 5%; P < 0.001) and overall mortality rates (28% vs. 15%; P < 0.001). Conclusions Approximately half of the patients admitted to the ED were hospitalized. Of these, only 8% were readmitted in the ED within 30 days. The clinical and analytical status in the ED are important predictors of hospitalization.

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