title: Nationwide survey on acute heart failure in cardiology ward services in Italy.
abstract: OBJECTIVE
  Chronic heart failure (HF) is recognized as an important public health problem but little attention has been focused on acute-stage HF.
  
  
  RESULTS
  Nationwide, prospective, observational study setting 206 cardiology centres with intensive cardiac care units. During 3 months, 2807 patients diagnosed as having de novo acute HF (44%) or worsening chronic HF (56%) were enrolled. Acute pulmonary oedema was the presenting clinical feature in 49.6% of patients, cardiogenic shock in 7.7%, and worsened NYHA functional class in 42.7% of cases. Anaemia (Hb<12 g/dL) was present in 46% of patients, renal dysfunction (creatinine > or =1.5 mg%) in 47%, and hyponatraemia (< or =136 mEq/L) in 45%. An ejection fraction (EF)>40% was found in 34% of cases. Intravenous diuretics, nitrates, and inotropes were given to 95, 51, and 25% of patients, respectively. The median duration of hospital stay was 9 days. In-hospital mortality rate was 7.3%. Older age, use of inotropic drugs, elevated troponin, hyponatraemia, anaemia, and elevated blood urea nitrogen were independent predictors of all-cause death; prior revascularization procedures and elevated blood pressure were indicators of a better outcome. The rehospitalization rate within 6 months was 38.1%, all-cause mortality from discharge to 6 months was 12.8%.
  
  
  CONCLUSIONS
  Acute HF is an ominous condition, needing more research activity and resources.
authors.affiliation: Department of Cardiology, IRCCS Policlinico S. Matteo, Piazzale Golgi, 2-27100 Pavia, Italy. centro_studi@anmco.it
authors.forename: Luigi
authors.initials: L
authors.lastname: Tavazzi
authors.forename: Aldo P
authors.initials: AP
authors.lastname: Maggioni
authors.forename: Donata
authors.initials: D
authors.lastname: Lucci
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cacciatore
authors.forename: Gerardo
authors.initials: G
authors.lastname: Ansalone
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Oliva
authors.forename: Maurizio
authors.initials: M
authors.lastname: Porcu
mesh_terms: D000328:Adult; D000368:Aged; D003422:Critical Care; D005260:Female; D006333:Heart Failure / Q000453:epidemiology*; D017052:Hospital Mortality; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology