The Egyptian Heart Journal (Sep 2017)

Clinical and laboratory characteristics of short-term mortality in Egyptian patients with acute heart failure

  • Ahmad Tageldien Abdellah,
  • Alaa Desouky Mohamed,
  • Hamdy Ali Hendawi,
  • Magdi Ali Omera

DOI
https://doi.org/10.1016/j.ehj.2017.02.003
Journal volume & issue
Vol. 69, no. 3
pp. 201 – 208

Abstract

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Objective: To identify the clinical and laboratory predictors of short-term mortality in patients with acute heart failure (AHF). Subjects and methods: We conducted a prospective, single center study on 120 consecutive patients presented with acute heart failure to the emergency department. All patients had clinical, laboratory, electrocardiographic and echocardiographic evaluation. Short-term mortality was reported within 30 days of presentation. Results: Mean age was 59.29 ± 10.1 years, 55.8% were males and 50.8% were smokers. The common AHF presentations were dyspnea (91.7%), chest tightness (62.5%) and lower limb edema (54.2%). Ischemic heart disease, diabetes and hypertension were present in 72.5%, 43.3% and 35% of patients, respectively. Short-term mortality was reported in 29 patients (24.16%); most of them died in-hospital (19 patients, 65.52%). The following parameters were significantly associated with short-term mortality: hypoxia (P < 0.001), tachycardia (P < 0.01), raised jugular venous pressure (JVP) (P < 0.001), low systolic blood pressure (P < 0.01), prolonged PR interval (P < 0.007), atrial fibrillation (AF) (P < 0.038), left bundle branch block (LBBB) (P < 0.04), impaired kidney function (P < 0.007), anemia (P < 0.029), hyponatremia (P < 0.006), hypoalbuminemia (P < 0.005), dilated left ventricle (LV) (P < 0.001), low LV ejection fraction (LVEF) (P < 0.001), and dilated left atrium (LA) (P < 0.002). ROC curve analysis showed that low LVEF (≤24%), dilated LV end diastolic diameter (LVESD) ≥ 66.5 mm, dilated LV end systolic diameter (LVESD) ≥ 53.5 mm, dilated LA diameter ≥ 48 mm, increased serum creatinine ≥ 1.6 mg/dl, and decreased serum albumin ≤ 3 g/dl can significantly predict short-term mortality in patients with acute heart failure. Conclusion: Variable clinical, laboratory, electrocardiographic and echocardiographic parameters were associated with short-term mortality. Our study showed that low LVEF, dilated LV diameter, dilated LA diameter, impaired kidney function and low serum albumin can predict short-term mortality in patients with acute heart failure.

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