| Predictors of short term mortality in heart failure - insights from the Euro Heart Failure survey. | |
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MedLine Citation:
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PMID: 18789548 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article Date: 2008-09-11 |
Journal Detail:
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Title: International journal of cardiology Volume: 138 ISSN: 1874-1754 ISO Abbreviation: Int. J. Cardiol. Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2009-12-07 Completed Date: 2010-02-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8200291 Medline TA: Int J Cardiol Country: Netherlands |
Other Details:
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Languages: eng Pagination: 63-9 Citation Subset: IM |
Affiliation:
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Department of Academic Cardiology, University of Hull, UK. drvelavan@hotmail.com |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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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:
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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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