RT Journal Article
T1 Departments involved during the first episode of acute heart failure and subsequent emergency department revisits and rehospitalisations: an outlook through the NOVICA cohort.
A1 Miró, Òscar
A1 García Sarasola, Ana
A1 Fuenzalida, Carolina
A1 Calderón, Sofía
A1 Jacob, Javier
A1 Aguirre, Alfons
A1 Wu, Da M
A1 Rizzi, Miguel A
A1 Malchair, Pierre
A1 Haro, Antonio
A1 Herrera, Sergio
A1 Gil, Víctor
A1 Martín-Sánchez, Francisco J
A1 Llorens, Pere
A1 Herrero Puente, Pablo
A1 Bueno, Héctor
A1 Domínguez Rodríguez, Alberto
A1 Müller, Christian E
A1 Mebazaa, Alexandre
A1 Chioncel, Ovidiu
A1 Alquézar-Arbé, Aitor
A1 ICA-SEMES Research Group, 
K1 De novo acute heart failure
K1 Emergency department
K1 Heart failure
K1 Hospitalisation
K1 Mortality
K1 Rehospitalisation
AB We investigated the natural history of patients after a first episode of acute heart failure (FEAHF) requiring emergency department (ED) consultation, focusing on: the frequency of ED visits and hospitalisations, departments admitting patients during the first and subsequent hospitalisations, and factors associated with difficult disease control. We included consecutive patients diagnosed with FEAHF (either with or without previous heart failure diagnosis) in four EDs during 5 months in three different time periods (2009, 2011, 2014). Diagnosis was adjudicated by local principal investigators. The clinical characteristics of the index event were prospectively recorded, and all post-discharge ED visits and hospitalisations [related/unrelated to acute heart failure (AHF)], as well as departments involved in subsequent hospitalisations were retrospectively ascertained. 'Uncontrolled disease' during the first year after FEAHF was considered if patients were attended at ED (≥ 3 times) or hospitalised (≥ 2 times) for AHF or died. Overall, 505 patients with FEAHF were included and followed for a mean of 2.4 years. In-hospital mortality was 7.5%. Among 467 patients discharged alive, 288 died [median survival 3.9 years, 95% confidence interval (CI) 3.5-4.4], 421 (90%) revisited the ED (2342 ED visits; 42.4% requiring hospitalisation, 34.0% AHF-related) and 357 (77%) were hospitalised (1054 hospitalisations; 94.1% through ED, 51.4% AHF-related). AHF-related hospitalisations were mainly in internal medicine (28.0%), short-stay unit (26.3%), cardiology (20.8%), and geriatrics (14.1%). Only 47.4% of AHF-related hospitalisations were in the same department as the FEAHF, and internal medicine involvement significantly increased with subsequent hospitalisations (P = 0.01). Uncontrolled disease was observed in 31% of patients, which was independently related to age > 80 years [odds ratio (OR) 1.80, 95% CI 1.17-2.77], systolic blood pressure  80 years [odds ratio (OR) 1.80, 95% CI 1.17-2.77], systolic blood pressure  In the present aged cohort of AHF patients from Barcelona, Spain, the natural history after FEAHF showed different patterns of hospital department involvement. Advanced age, low systolic blood pressure and anaemia were factors related to uncontrolled disease during the year after debut.
YR 2019
FD 2019-08-07
LK https://hdl.handle.net/10668/25919
UL https://hdl.handle.net/10668/25919
LA en
DS RISalud
RD Apr 9, 2025