RT Journal Article
T1 Factors associated with in-hospital mortality and adverse outcomes during the vulnerable post-discharge phase after the first episode of acute heart failure: results of the NOVICA-2 study.
A1 Rizzi, Miguel Alberto
A1 Garcia-Sarasola, Ana
A1 Alquezar-Arbe, Aitor
A1 Herrera-Mateo, Sergio
A1 Gil, Victor
A1 Llorens, Pere
A1 Jacob, Javier
A1 Martin-Sanchez, Francisco Javier
A1 Herrero-Puente, Pablo
A1 Escoda, Rosa
A1 Espinosa, Begoña
A1 Roset, Alex
A1 Torres-Garate, Raquel
A1 Torres-Murillo, Jose
A1 Mecina, Ana B
A1 Lopez-Diez, Maria Pilar
A1 Perez, Jose Maria Alvarez
A1 Tost, Josep
A1 Salvo, Eva
A1 Lopez-Grima, Maria Luisa
A1 Gil, Cristina
A1 Mir, Maria
A1 Ruschitzka, Frank
A1 Chioncel, Ovidiu
A1 Miro, Oscar
K1 Emergency department
K1 De novo acute heart failure
K1 Vulnerable phase
K1 Mortality
K1 Rehospitalisation
K1 Risk factors
AB Objective To identify patients at risk of in-hospital mortality and adverse outcomes during the vulnerable post-discharge period after the first acute heart failure episode (de novo AHF) attended at the emergency department. Methods This is a secondary review of de novo AHF patients included in the prospective, multicentre EAHFE (Epidemiology of Acute Heart Failure in Emergency Department) Registry. We included consecutive patients with de novo AHF, for whom 29 independent variables were recorded. The outcomes were in-hospital all-cause mortality and all-cause mortality and readmission due to AHF within 90 days post-discharge. A follow-up check was made by reviewing the hospital medical records and/or by phone. Results We included 3422 patients. The mean age was 80 years, 52.1% were women. The in-hospital mortality was 6.9% and was independently associated with dementia (OR=2.25, 95% CI=1.62–3.14), active neoplasia (1.97, 1.41–2.76), functional dependence (1.58, 1.02–2.43), chronic treatment with beta-blockers (0.62, 0.44–0.86) and severity of decompensation (6.38, 2.86–14.26 for high-/very high-risk patients). The 90-day post-discharge combined endpoint was observed in 19.3% of patients and was independently associated with hypertension (HR=1.40, 1.11–1.76), chronic renal insufficiency (1.23, 1.01–1.49), heart valve disease (1.24, 1.01–1.51), chronic obstructive pulmonary disease (1.22, 1.01–1.48), NYHA 3–4 at baseline (1.40, 1.12–1.74) and severity of decompensation (1.23, 1.01–1.50; and 1.64, 1.20–2.25; for intermediate and high-/very high-risk patients, respectively), with different risk factors for 90-day post-discharge mortality or rehospitalisation. Conclusions The severity of decompensation and some baseline characteristics identified de novo AHF patients at increased risk of developing adverse outcomes during hospitalisation and the vulnerable post-discharge phase, without significant differences in these risk factors according to patient age at de novo AHF presentation.
PB Springer
YR 2020
FD 2020-09-21
LK http://hdl.handle.net/10668/16839
UL http://hdl.handle.net/10668/16839
LA en
NO Rizzi MA, Sarasola AG, Arbé AA, Mateo SH, Gil V, Llorens P, et al. Factors associated with in-hospital mortality and adverse outcomes during the vulnerable post-discharge phase after the first episode of acute heart failure: results of the NOVICA-2 study. Clin Res Cardiol. 2021 Jul;110(7):993-1005
DS RISalud
RD Aug 6, 2025