[Prolonged hospitalization in patients admitted for acute heart failure in the short stay unit (EPICA-UCE study): study of associated factors].
OBJECTIVE
To study the factors associated with prolonged hospitalization in patients admitted for acute heart failure (AHF) in Spanish short-stay units (SSUs).


METHODS
This was a multicentre, multipurpose cohort study with prospective follow-up including all patients admitted for AHF in the 11 SSUs of the EAHFE registry. Demographic data, previous illness, baseline cardiorespiratory and functional status, acute episode and admission and follow up variables at 60 days were recorded. The primary outcome was prolonged hospitalization in the SSU (>72h). A logistic regression model was used to control the effects of confounding factors.


RESULTS
Eight-hundred and nineteen patients were included with a mean age of 80.9 (SD 8.4) years, 483 (59.0%) being women. The median length stay was 3.0 (IQR 2.0-5.0) days with an in-hospital mortality of 2.7%. The independent factors associated with prolonged hospitalization were the coexistence of chronic obstructive pulmonary disease (odds ratio [OR] 1.56; 95% IC 1.02-2.38; P=.040) and anaemia (OR 1.72; 95% CI 1.21-2.44; P=.002), basal oxygen saturation<90% on arrival to the Emergency Department (OR 2.21, 95% CI 1.51-3.23; P<.001), hypertensive episode as the precipitating factor of the AHF (protective factor OR 0.49; 95% CI 0.26-0.93; P=.028) and admission on Thursday (OR 1.90; 95% CI 1.19-3.05; P=.008). There were no significant differences between both groups regarding to in-hospital mortality (2.4 vs. 3.0%), mortality (4.1 vs. 4.2%) or revisit at 60 days (18.4 vs. 21.6%).


CONCLUSIONS
Several factors including hypertensive episode, insufficiency respiratory, anaemia, chronic obstructive pulmonary disease, and admission on Thursday should be taken into account in patients with AHF admitted in SSU stay to avoid prolonged hospitalization.
Servicio de Urgencias, Hospital Clínico San Carlos Madrid, España; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, España. Electronic address: fjjms@hotmail.com.
Francisco Javier
FJ
Martín-Sánchez
Servicio de Urgencias, Hospital Universitario Río Hortega, Valladolid, España.
Virginia
V
Carbajosa
Servicio de Urgencias-UCE y UHD, Hospital General Universitario de Alicante, Alicante, España.
Pere
P
Llorens
Servicio de Urgencias, Hospital Universitario Central de Asturias, Oviedo, Asturias, España.
Pablo
P
Herrero
Servicio de Urgencias, Hospital Universitari de Bellvitge, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España.
Javier
J
Jacob
Servicio de Urgencias, Hospital La Fe, Valencia, España.
María José
MJ
Pérez-Dura
Servicio de Urgencias, Hospital Marqués de Valdecilla, Santander, España.
Héctor
H
Alonso
Servicio de Urgencias, Hospital Reina Sofía, Córdoba, España.
José Manuel
JM
Torres Murillo
Servicio de Urgencias, Hospital Virgen Macarena, Sevilla, España.
Manuel
M
Garrido
Servicio de Urgencias, Hospital Doctor Peset, Valencia, España.
María Luisa
ML
López-Grima
Servicio de Urgencias, Hospital Reina Sofía, Murcia, España.
Pascual
P
Piñera
Servicio de Urgencias, Hospital Univeristari Parc Taulí, Sabadell, Barcelona, España.
Francisco
F
Epelde
Servicio de Urgencias, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
Aitor
A
Alquezar
Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, España; Servicio de Medicina Preventiva, Hospital Clínico San Carlos, Madrid, España.
Cristina
C
Fernández
Área de Urgencias, Hospital Clínic, Barcelona, España; Grupo de investigación Urgencias: procesos y patologías, Institut d'Investigacions Biomèdiques Ausgust Pi i Sunyer (IDIBAPS), Barcelona, España.
Oscar
O
Miró
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000453:epidemiology*; D017052:Hospital Mortality; D006757:Hospital Units / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology; D012042:Registries; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology
Acute heart failure; Estancia prolongada; Insuficiencia cardiaca aguda; Prolongad hospitalization; Short-Stay Unit; Unidad de Corta Estancia