A Comparison of Precipitants and Mortality When Acute Decompensated Heart Failure Occurs in the Community and Hospital Settings

Taylor, David; Fui, Mark Ng Tang; Chung, An-Doc; Gani, Linsey; Zajac, Jeffrey D; Burrell, Louise M.

doi:10.1016/j.hlc.2012.04.008

Cited by 10 publications

(18 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The frequency of post-admission ADHF onset in our study (7%) is somewhat consistent with a previous study by Taylor, et al (13%) of 359 consecutively admitted ADHF patients from a single hospital (3). Moreover, both studies observed a large proportion of these patients also presented with MI and arrhythmias.…”

Section: Discussionsupporting

confidence: 93%

“…Moreover, both studies observed a large proportion of these patients also presented with MI and arrhythmias. However, our study found a higher prevalence of renal failure (27%) than Taylor, et al found (6%) in a small sample (N=47) from a single hospital in Australia (3). Notably, they collected data specifically on precipitants of ADHF, such as respiratory infection and intravenous fluid complications (3).…”

Section: Discussioncontrasting

confidence: 87%

“…However, our study found a higher prevalence of renal failure (27%) than Taylor, et al found (6%) in a small sample (N=47) from a single hospital in Australia (3). Notably, they collected data specifically on precipitants of ADHF, such as respiratory infection and intravenous fluid complications (3). In our study, data were not collected or available on precise causes of ADHF onset during the hospital stay.…”

Section: Discussioncontrasting

confidence: 87%

“…Studies of hospitalized HF focus mainly on patients that present to the hospital with symptoms of acute decompensated HF (ADHF); however, ADHF may develop after admission to the hospital (2, 3). Post-admission onset of ADHF may be iatrogenic such as precipitated by procedures or surgery, intravenous fluid administration, changes in medications, or it may be precipitated by a comorbid medical problem such as myocardial infarction (MI), pulmonary embolus, or atrial fibrillation (4).…”

Section: Introductionmentioning

confidence: 99%

“…Post-admission onset of ADHF may be iatrogenic such as precipitated by procedures or surgery, intravenous fluid administration, changes in medications, or it may be precipitated by a comorbid medical problem such as myocardial infarction (MI), pulmonary embolus, or atrial fibrillation (4). Although empirical evidence is limited, it is likely that such in-hospital occurrences of ADHF are associated with increased length of hospital stay, morbidity, and mortality (2, 3). Precipitating factors and clinical outcomes are important in informing HF management (5, 6), and additional investigation into the patients characteristics and outcomes associated with post-admission onset of ADHF may improve our understanding of its causes and opportunities for prevention.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Characteristics and Outcomes of Patients With Acute Decompensated Heart Failure Developing After Hospital Admission

Patel

Kalbaugh

Chang

et al. 2014

The American Journal of Cardiology

View full text Add to dashboard Cite

There are limited data on ADHF that develops after hospital admission. This study sought to compare patient characteristics, comorbidities, mortality, and length of stay by timing of acute decompensated heart failure (ADHF) onset. The surveillance component of the Atherosclerosis Risk in Communities Study (2005–2011) sampled, abstracted, and adjudicated hospitalizations with select ICD-9-CM discharge codes from 4 U.S. communities among those aged 55 years and older. We included 5,602 validated ADHF hospitalizations further classified as pre- or post-admission onset. Vital status was assessed up to 1 year since admission. We estimated multivariable-adjusted associations of in-hospital mortality, 28-day case fatality, and 365-day case fatality with timing of ADHF onset (post-versus pre-admission). All analyses were weighted to account for the stratified sampling design. Of 25,862 weighted ADHF hospitalizations, 7% had post-admission onset of ADHF. Patients with post-admission ADHF were more likely to be older, white, and female. The most common primary discharge diagnosis codes for those with post-admission ADHF included diseases of the circulatory or digestive systems or infectious diseases. Short-term mortality among post-admission ADHF was almost 3 times that of pre-admission ADHF (in-hospital mortality: odds ratio: 2.7, 95% confidence interval: 1.9–3.9; 28-day case fatality: odds ratio: 2.6, 95% confidence interval: 1.8–3.7). The average hospital stay was almost twice as long among post-admission as pre-admission ADHF (9.6 vs. 5.0 days). In conclusion, post-admission onset of ADHF is characterized by differences in comorbidities and worse short-term prognosis, and opportunities for reducing post-admission ADHF occurrence and associated risks need to be studied.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Discussioncontrasting

confidence: 87%