Emergency department predictors of survival in decompensated heart failure patients.
BACKGROUND
Several predictors of survival have been described in stable heart failure (HF) patients. Few reports have focused on decompensated patients.


METHODS
We studied 170 patients who presented to the emergency department (ED) with decompensated HF. Mean age was 72.5 +/- 13 years (range 17 to 99) and 107 (63%) were male. We evaluated clinical features, in-hospital evolution, and prognostic factors related to all-cause mortality in a mean follow-up of 14 +/- 8.6 months (range 1 to 36).


RESULTS
Eighteen (10.6%) patients died during the index admission. During outpatient follow-up, 45 deaths occurred. One-year survival rate for the population as a whole was 63%. Advanced age (hazard ratio [HR] = 1.27 per 10-year increment; 95% confidence interval [CI], 1.04 to 1.55; p = 0.017), mean arterial pressure (inverse relationship with total mortality, HR = 0.83 per 10 mmHg increment; 95% CI, 0.72 to 0.95; p = 0.008) and hyponatremia (HR = 2.0; 95% CI, 1.19 to 3.36; p = 0.009) were found to be independent predictors of survival.


CONCLUSIONS
Patients who present to the ED with decompensated HF have high mortality rates. Those at increased risk can be identified early in the ED.
VillaCorta
Humberto
H
Hospital Pró-Cardíaco-Emergency Department-Rio de Janeiro, Brasil.
Mesquita
Evandro Tinoco
ET
Cardoso
Rosana
R
Bonates
Therezil
T
Maia
Eduardo Reis
ER
Silva
Antônio Cláudio M
AC
Guimarães
Marici A P
MA
Dohmann
Hans J F
HJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015996:Survival Rate