Document Detail


Predictors of short term mortality in heart failure - insights from the Euro Heart Failure survey.
MedLine Citation:
PMID:  18789548     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To identify factors associated with short term mortality in hospitalised patients with heart failure. BACKGROUND: Hospitalisation is frequent in patients with heart failure and is associated with a high mortality. METHODS: The Euro Heart Failure survey collected data from patients with suspected heart failure. We searched this data for predictors of short term mortality. RESULTS: Of 10,701 patients, 1404 (13%) died within 12 weeks of admission. On univariate analysis, increasing age, hyponatraemia, renal impairment, hyperkalaemia, anaemia, severe mitral regurgitation, severe LV systolic dysfunction(LVSD), increasing QRS and female sex carried adverse prognosis. ACEI, beta-blockers, nitrates, anti-thrombotic and lipid lowering drugs were associated with a better prognosis. On multivariable analysis the following provided independent prognostic information: increasing age (OR per SD=1.5, 95% CI 1.4-1.6), severe LVSD (1.8, 1.5-2.1), serum creatinine (1.2, 1.2-1.3), sodium (0.9, 0.8-0.9), Hb (0.9, 0.8-0.9) and treatment with ACEI (0.5, 0.5-0.6), beta-blockers (0.7, 0.6-0.8), statins (0.6, 0.5-0.7), calcium channel blockers (0.7, 0.6-0.8), warfarin (0.5, 0.4-0.6), heparin (1.7, 1.4-1.9), anti-platelet drugs (0.6, 0.5-0.6) and need for inotropes (5.5, 4.6-6.6). A simple risk score (range 0-11) identified cohorts with a 12 week mortality ranging from 2% to 44%. CONCLUSIONS: Simple and readily available clinical variables and a risk score based on medical history and routine tests that all patients admitted with heart failure have, can identify patients with good, intermediate and high short term mortality.
Authors:
Periaswamy Velavan; Nasrin K Khan; Kevin Goode; Alan S Rigby; Poay H Loh; Michel Komajda; Ferenc Follath; Karl Swedberg; Hugo Madeira; John G F Cleland
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Publication Detail:
Type:  Journal Article     Date:  2008-09-11
Journal Detail:
Title:  International journal of cardiology     Volume:  138     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-07     Completed Date:  2010-02-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  63-9     Citation Subset:  IM    
Affiliation:
Department of Academic Cardiology, University of Hull, UK. drvelavan@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use
Age Distribution
Aged
Aged, 80 and over
Calcium Channel Blockers / therapeutic use
Cardiotonic Agents / therapeutic use
Cholesterol / blood
Comorbidity
Europe / epidemiology
Female
Fibrinolytic Agents / therapeutic use
Health Surveys*
Heart Failure / drug therapy,  mortality*
Hospitalization / statistics & numerical data*
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
Logistic Models
Male
Middle Aged
Multivariate Analysis
Predictive Value of Tests
Risk Factors
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Calcium Channel Blockers; 0/Cardiotonic Agents; 0/Fibrinolytic Agents; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 57-88-5/Cholesterol

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


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