Timing of previous heart failure hospitalization as a prognostic factor for emergency department heart failure patients

To investigate whether the timing of a previous hospital admission for acute heart failure (AHF) is a prognostic factor for AHF patients revisiting the emergency department (ED) in the subsequent 12-month follow-up. All ED AHF patients enrolled in the previously described EAHFE registry were stratif...

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Bibliographic Details
Authors: Romero, Carlos|||0009-0002-1803-6303, Alquézar-Arbé, A.|||0000-0003-4164-274X, Herrera, Sergio|||0000-0001-6134-0402, Llorens, Pere, Gil, Víctor, Curtelin, David, Jacob, Javier|||0000-0003-1101-1066, Herrero-Puente, Pablo|||0000-0002-5529-5008, María Pilar Lopez Díez, Llauger, Lluis, Luisa López Grima, M., Gil, Cristina, Tost, Josep|||0000-0003-3846-9616, Agüera Urbano, Carmen, Espinosa, Begoña, Campos-Meneses, Maria, Fernandez, G, Torres, A., Escoda, Rosa, Martín, Enrique, Garrido, Jose Manuel, Lucas-Imbernon, Francisco Javier, Rodríguez-Adrada, Esther, Torres Gárate, Raquel|||0000-0002-8731-9350, Andueza, Juan Antonio, Peacock, W. Frank, Miró, Oscar|||0000-0002-7924-9751
Format: article
Publication Date:2024
Country:España
Institution:Universitat Autònoma de Barcelona
Repository:Dipòsit Digital de Documents de la UAB
Language:English
OAI Identifier:oai:dnet:uabarcelona_::f1748fb560a0d76ff9dffbe2d6a8cfe5
Online Access:https://ddd.uab.cat/record/327374
https://dx.doi.org/urn:doi:10.1007/s11739-023-03505-3
Access Level:Open access
Keyword:Acute heart failure
Previous hospitalization
Emergency departments
Description
Summary:To investigate whether the timing of a previous hospital admission for acute heart failure (AHF) is a prognostic factor for AHF patients revisiting the emergency department (ED) in the subsequent 12-month follow-up. All ED AHF patients enrolled in the previously described EAHFE registry were stratified by the presence or absence of an AHF hospitalization admission in the prior 12 months. The primary outcome was 12-month all-cause mortality post ED visit. Secondary end points were hospital admission, prolonged hospitalization (> 7 days), mortality during hospitalization and a 90-day post-discharge adverse composite event (ACE) rate, defined as ED revisits due to AHF, hospitalizations due to AHF, or all-cause mortality. Outcomes were adjusted for baseline and AHF episode characteristics.Of 5,757 patients included, the median age was 84 years (IQR 77-88); 57% were women, and 3,759 (65.3%) had an AHF hospitalization in the previous 12 months. The 12-month mortality was 37% (41.7% vs. 28.3% p < 0.001), hospital admission was 76.1% (78.8% vs. 71.1% p < 0.001) ACE was 60.2% (65.1% vs. 50.5% p < 0.001). In the adjusted analysis, patients with AHF hospitalization in the prior 12 months had a higher mortality (HR = 1.41; 95% CI 1.27-1.56), 90-day ACE rate (HR = 1.45: 95% CI 1.32-1.59), and more hospital admissions (OR = 1.32; 95% CI 1.16-1.51), with shorter times since the previous hospitalization being related to the outcomes analyzed. One-year mortality, adverse events at 90 days, and readmission rates are increased in ED AHF patients previously admitted within the last 12 months.

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