Causes and Predictors of In-Hospital Mortality in Patients Admitted with or for Heart Failure at a Tertiary Hospital in Brazil

Abstract

BackgroundAlthough heart failure (HF) has high morbidity and mortality, studies in Latin America on causes and predictors of in-hospital mortality are scarce. We also do not know the evolution of patients with compensated HF hospitalized for other reasons.ObjectiveTo identify causes and predictors of in-hospital mortality in patients hospitalized for acute decompensated HF (ADHF), compared to those with HF and admitted to the hospital for non-HF related causes (NDHF).MethodsHistorical cohort of patients hospitalized in a public tertiary hospital in Brazil with a diagnosis of HF identified by the Charlson Comorbidity Index (CCI).ResultsA total of 2056 patients hospitalized between January 2009 and December 2010 (51% men, median age of 71 years, length of stay of 15 days) were evaluated. There were 17.6% of deaths during hospitalization, of which 58.4% were non-cardiovascular (63.6% NDHF vs 47.4% ADHF, p = 0.004). Infectious causes were responsible for most of the deaths and only 21.6% of the deaths were attributed to HF. The independent predictors of in-hospital mortality were similar between the groups and included: age, length of stay, elevated potassium, clinical comorbidities, and CCI. Renal insufficiency was the most relevant predictor in both groups.ConclusionPatients hospitalized with HF have high in-hospital mortality, regardless of the primary reason for hospitalization. Few deaths are directly attributed to HF; Age, renal function and levels of serum potassium, length of stay, comorbid burden and CCI were independent predictors of in-hospital death in a Brazilian tertiary hospital.

Patterns of Mortality Occurrence in a Cardiology Unit of a Low-Income Country: A Critical Analysis at the Yaoundé Central Hospital

“…The socio-economic gap between the two countries, Cameroon and the USA notably in terms of human and material resources could also explain the difference in death rate. Wajner et al found in a selective population of patients with heart failure in Brazilan in-hospital mortality rate of 17.6% [7]. Heart failure is known as a serious public health problem and the leading cause of death in cardiology units [4].…”

Influência De Fatores Clínicos Na Lesão Renal Aguda

“…A identificação da maior gravidade clínica caracterizou-se pela elevação do Índice de Comorbidade de Charlson (ICC). Este perfil clínico favoreceu a maior incidência de LRA e pior desfecho, achado também observado em diferentes evidências científicas (22)(23)(24) . dos indivíduos com comprometimento renal é fundamental independentemente do grau aparente de recuperação (10) .…”

Determinants of Pulse Rate change and Time-To Default from Treatment among Congestive Heart Failure Patients in Felege- Hiwot Referral Hospital, Bahir Dar, Ethiopia; comparison of separate and joint models

“…Although the advancement in therapy and treatment of heart failure is high, nowadays it is a chronic illness with an unpromising diagnosis, and has a high socioeconomic problem [12]. HF is one of the major causes of hospitalization and high rates of mortality in several countries [13]. Even though the number of HF patients admitted to CHF clinics is increasing from year to year, there are a number of HF related deaths and loss to follow-ups every year.…”