Document Detail


Clinical profile, contemporary management and one-year mortality in patients with severe acute heart failure syndromes: The EFICA study.
MedLine Citation:
PMID:  16516552     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Little is known about the epidemiology of acute decompensated heart failure (ADHF) in patients admitted to intensive and coronary care units (ICU/CCU). Observational data may improve disease management and guide the design of clinical trials.
AIMS: EFICA is an observational study of the clinical profile, management and survival of ADHF patients admitted to ICU/CCU.
METHODS: The study included 599 patients admitted to 60 ICU/CCUs across France. Relevant data was recorded during hospitalisation. Survival was assessed at 4 weeks and 1 year.
RESULTS: The main cause of ADHF was ischaemic heart disease (61%); 29% of patients had cardiogenic shock. Mortality was 27.4% at 4 weeks and 46.5% at 1 year, increasing to 43.2% and 62.5%, respectively, when including pre-admission deaths. Shock patients had the highest [57.8% vs. 15.2% without shock (p < 0.001)] and patients with hypertension and pulmonary oedema had the lowest 4-week mortality: (7%). Pre-admission NYHA class III-IV heart failure, not initial clinical presentation, influenced 1-year mortality.
CONCLUSION: ADHF is a heterogeneous syndrome. Based on initial clinical presentation, three entities with distinct features and outcome may be described: cardiogenic shock, pulmonary oedema with hypertension, and 'decompensated' chronic heart failure. This should be taken into account in future observational studies, guidelines and clinical trials.
Authors:
Faiez Zannad; Alexandre Mebazaa; Yves Juillière; Alain Cohen-Solal; Louis Guize; François Alla; Pierre Rougé; Patrick Blin; Marie-Hélène Barlet; Laurence Paolozzi; Catherine Vincent; Michel Desnos; Kamran Samii;
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2006-03-03
Journal Detail:
Title:  European journal of heart failure     Volume:  8     ISSN:  1388-9842     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-10-30     Completed Date:  2007-01-30     Revised Date:  2011-06-08    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  697-705     Citation Subset:  IM    
Affiliation:
Department of Cardiology, University Hospital of Nancy, France. f.zannad@chu-nancy.fr
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MeSH Terms
Descriptor/Qualifier:
Aged
Female
France / epidemiology
Heart Failure / mortality*,  pathology,  therapy
Hospital Mortality
Humans
Intensive Care Units / statistics & numerical data
Length of Stay / statistics & numerical data
Male
Outcome Assessment (Health Care)*
Physician's Practice Patterns / statistics & numerical data*
Severity of Illness Index
Survival Analysis
Syndrome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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