title: Current aspects of the spectrum of acute heart failure syndromes in a real-life setting: the OFICA study.
abstract: OBJECTIVE
  To improve knowledge of epidemiological data, management, and clinical outcome of acute heart failure (AHF) in a real-life setting in France.
  
  
  RESULTS
  We conducted an observational survey constituting a single-day snapshot of all unplanned hospitalizations because of AHF in 170 hospitals throughout France (the OFICA survey). A total of 1658 patients (median age 79 years, 55% male) were included. Family doctors were the first medical contact in 43% of cases, and patients were admitted through emergency departments in 64% of cases. Clinical scenarios were mainly acutely decompensated HF (48%) and acute pulmonary oedema (38%) with similar clinical and biological characteristics as well as outcome. Characteristics were different and severity higher in both shock and right HF. Infection and arrhythmia were the most frequent precipitating factors (27% and 24% of cases); diabetes and chronic pulmonary disease were the most frequent co-morbidities (31% and 21%). Over 80% of patients underwent both natriuretic peptide testing and echocardiography. LVEF was preserved (>50%) in 36% of patients and associated with specific characteristics and lower severity. Median hospital stay was 13 days; in-hospital mortality was 8.2%, and independent predictors were age, blood pressure, and creatinine. Treatment at discharge in patients with reduced LVEF included ACE inhibitors/ARBs, beta-blockers, and aldosterone inhibitors in 78, 67, and 27% cases. Non-surgical devices were reported in <20% of potential candidates.
  
  
  CONCLUSIONS
  This comprehensive survey analysing AHF in real life emphasizes the heterogeneous nature and overall high severity of AHF. It could be a useful tool to identify unsolved medical issues and improve outcome.
  
  
  BACKGROUND
  NCT01080937.
authors.affiliation: AP-HP, Groupe Hospitalier Lariboisiere Saint Louis, INSERM U942, Paris 7 University, Paris, France. damien.logeart@lrb.aphp.fr
authors.forename: Damien
authors.initials: D
authors.lastname: Logeart
authors.forename: Richard
authors.initials: R
authors.lastname: Isnard
authors.forename: Matthieu
authors.initials: M
authors.lastname: Resche-Rigon
authors.forename: Marie-France
authors.initials: MF
authors.lastname: Seronde
authors.forename: Pascal
authors.initials: P
authors.lastname: de Groote
authors.forename: Guillaume
authors.initials: G
authors.lastname: Jondeau
authors.forename: Michel
authors.initials: M
authors.lastname: Galinier
authors.forename: Geneviève
authors.initials: G
authors.lastname: Mulak
authors.forename: Erwan
authors.initials: E
authors.lastname: Donal
authors.forename: François
authors.initials: F
authors.lastname: Delahaye
authors.forename: Yves
authors.initials: Y
authors.lastname: Juilliere
authors.forename: Thibaud
authors.initials: T
authors.lastname: Damy
authors.forename: Patrick
authors.initials: P
authors.lastname: Jourdain
authors.forename: Fabrice
authors.initials: F
authors.lastname: Bauer
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Eicher
authors.forename: Yannick
authors.initials: Y
authors.lastname: Neuder
authors.forename: Jean-Noël
authors.initials: JN
authors.lastname: Trochu
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006333:Heart Failure / Q000150:complications / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy*; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D012042:Registries; D012720:Severity of Illness Index; D016896:Treatment Outcome