150 Predictors of Increased Length of Stay in Heart Failure: An Australian Tertiary Hospital Experience

Abstract

and non-invasive ventilation. TTE revealed biventricular dilatation with severe global systolic dysfunction, and raised pulmonary pressures. A small residual pericardial effusion remained. CT coronary angiogram revealed calcium score of zero. He was discharged on bisoprolol, ramipril, and ivabradine. Progress TTE 6 weeks post-pericardiocentesis revealed resolution of systolic function. Discussion: Three possible mechanisms include pre/ afterload mismatch [1], unmasking of pre-existing LV dysfunction [3], and myocardial stunning from compression of epicardial vessels [4]. Literature reviews [2, 5] note that PDS occurred after drainage of 450-2100ml, onset within seconds to weeks, a third of cases were fatal, and two thirds of systolic dysfunction normalised. Intercostal catheters are routinely clamped to prevent re-expansion pulmonary oedema, however no such guidelines exist for pericardiocentesis. Here we suggest limiting immediate drainage to 200ml in order to reduce the likelihood of PDS. Conclusion: Further research on limiting the rate and volume of drainage may clarify how to prevent PDS.

Heart Failure with Reduced Ejection Fraction—Does Sex Matter?

“…Only one recent paper showed women had more hospitalisations than men, albeit reporting on a mostly male population (70.1%) [5]. Additionally, papers reviewed in the last 5 years also indicated women were less likely to be readmitted for HF and had a shorter length of stay [4,50,51].…”