title: Emergency department predictors of survival in decompensated heart failure patients.
abstract: 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.
authors.affiliation: Hospital Pró-Cardíaco-Emergency Department-Rio de Janeiro, Brasil.
authors.forename: Humberto
authors.initials: H
authors.lastname: VillaCorta
authors.forename: Evandro Tinoco
authors.initials: ET
authors.lastname: Mesquita
authors.forename: Rosana
authors.initials: R
authors.lastname: Cardoso
authors.forename: Therezil
authors.initials: T
authors.lastname: Bonates
authors.forename: Eduardo Reis
authors.initials: ER
authors.lastname: Maia
authors.forename: Antônio Cláudio M
authors.initials: AC
authors.lastname: Silva
authors.forename: Marici A P
authors.initials: MA
authors.lastname: Guimarães
authors.forename: Hans J F
authors.initials: HJ
authors.lastname: Dohmann
mesh_terms: 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