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Luigi Tavazzi, Aldo P. Maggioni, Donata Lucci, Giuseppe Cacciatore, Gerardo Ansalone, Fabrizio Oliva, Maurizio Porcu, on behalf of the Italian survey on Acute Heart Failure Investigators, Nationwide survey on acute heart failure in cardiology ward services in Italy, European Heart Journal, Volume 27, Issue 10, May 2006, Pages 1207–1215, https://doi.org/10.1093/eurheartj/ehi845
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Abstract
Aims Chronic heart failure (HF) is recognized as an important public health problem but little attention has been focused on acute-stage HF.
Methods and results Nationwide, prospective, observational study setting 206 cardiology centres with intensive cardiac care units. During 3 months, 2807 patients diagnosed as having de novo acute HF (44%) or worsening chronic HF (56%) were enrolled. Acute pulmonary oedema was the presenting clinical feature in 49.6% of patients, cardiogenic shock in 7.7%, and worsened NYHA functional class in 42.7% of cases. Anaemia (Hb<12 g/dL) was present in 46% of patients, renal dysfunction (creatinine ≥1.5 mg%) in 47%, and hyponatraemia (≤136 mEq/L) in 45%. An ejection fraction (EF)>40% was found in 34% of cases. Intravenous diuretics, nitrates, and inotropes were given to 95, 51, and 25% of patients, respectively. The median duration of hospital stay was 9 days. In-hospital mortality rate was 7.3%. Older age, use of inotropic drugs, elevated troponin, hyponatraemia, anaemia, and elevated blood urea nitrogen were independent predictors of all-cause death; prior revascularization procedures and elevated blood pressure were indicators of a better outcome. The rehospitalization rate within 6 months was 38.1%, all-cause mortality from discharge to 6 months was 12.8%.
Conclusion Acute HF is an ominous condition, needing more research activity and resources.
- heart failure, acute
- anemia
- nitrate
- troponin
- diuretics
- chronic heart failure
- hypertension
- cardiology
- hyponatremia
- pulmonary edema, acute
- cardiogenic shock
- heart failure
- blood urea nitrogen
- creatinine
- kidney failure
- cardiac care facilities
- hospital mortality
- italy
- patient readmission
- patients' rooms
- mortality
- public health medicine
- inotropic agents
- ejection fraction
- revascularization
- new york heart association classification