Mortalidad hospitalaria y reingresos por insuficiencia cardiaca en España. Un estudio de los episodios índice y los reingresos por causas cardiacas a los 30 días y al año

Santos, Paula Martínez; Freire, Ramón Bover; Esteban‐Fernández, Alberto; Bernal, José Luis; Pérez, Cristina Fernández; Somoza, Francisco Javier Elola; Miguel, Carlos Macaya; Vilacosta, Isidre

doi:10.1016/j.recesp.2019.01.020

Cited by 26 publications

(4 citation statements)

References 28 publications

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“…These results are not consistent with what has been described in previous HF registries, 32 in which 1 year all-cause mortality ranged from 15% to 35% in patients with acute HF. This could be explained because of our short follow-up time (90 days) and a small sample size; nevertheless, the median age of our population and the number of comorbidities are similar to the rates described in prior studies, 32 and several trials have described that the highest readmission rates occur during the first 30 days after discharge and that nearly half of HF readmissions occurred before the first ambulatory visit. 33 Our findings are possibly explained by a lower fluid depletion in patients guided by BIA, which means that these patients were less dehydrated at discharge.…”

Section: Discussioncontrasting

confidence: 99%

The role of bioimpedance analysis in overweight and obese patients with acute heart failure: a pilot study

Venegas‐Rodríguez,

Pello,

López‐Castillo

et al. 2023

ESC Heart Failure

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Aims Residual congestion at the time of hospital discharge is an important readmission risk factor, and its detection with physical examination and usual diagnostic techniques have strong limitations in overweight and obese patients. New tools like bioelectrical impedance analysis (BIA) could help to determine when euvolaemia is reached. The aim of this study was to investigate the usefulness of BIA in management of heart failure (HF) in overweight and obese patients. Methods and results Our study is a single‐centre, single‐blind, randomized controlled trial that included 48 overweight and obese patients admitted for acute HF. The study population was randomized into two arms: BIA‐guided group and standard care. Serum electrolytes, kidney function, and natriuretic peptides were followed up during their hospital stay and at 90 days after discharge. The primary endpoint was development of severe acute kidney injury (AKI) defined as an increase in serum creatinine by >0.5 mg/dL during hospitalization, and the main secondary endpoint was the reduction of N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) levels during hospitalization and within 90 days after discharge. The BIA‐guided group showed a remarkable lower incidence of severe AKI, although no significant differences were found (41.4% vs. 16.7%; P = 0.057). The proportion of patients who achieved levels of NT‐proBNP < 1000 pg/mL at 90 days was significantly higher in the BIA‐guided group than in the standard group (58.8% vs. 25%; P = 0.049). No differences were observed in the incidence of adverse outcomes at 90 days. Conclusions Among overweight and obese patients with HF, BIA reduces NT‐proBNP levels at 90 days compared with standard care. In addition, there is a trend towards lower incidence of AKI in the BIA‐guided group. Although more studies are required, BIA could be a useful tool in decompensated HF management in overweight and obese patients.

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Section: Discussioncontrasting

confidence: 99%

The role of bioimpedance analysis in overweight and obese patients with acute heart failure: a pilot study

Venegas‐Rodríguez,

Pello,

López‐Castillo

et al. 2023

ESC Heart Failure

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“…The results of our study are consistent with other previous studies, most notably the study by Martinez-Santos 23 , which analysed all admissions of patients with a diagnosis of HF at discharge registered in Spain between January 1, 2012 and December 31, 2012. The differences found could be attributed to an older population.…”

Section: Discussionsupporting

confidence: 92%

Analysis and prediction of readmissions for heart failure in the first year after discharge with INCA score

Rubini,

Vilaplana-Prieto,

Vázquez-Jarén

et al. 2023

Sci Rep

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To determine the readmissions trends and the comorbidities of patients with heart failure that most influence hospital readmission rates. Heart failure (HF) is one of the most prevalent health problems as it causes loss of quality of life and increased health-care costs. Its prevalence increases with age and is a major cause of re-hospitalisation within 30 days after discharge. INCA study had observational and ambispective design, including 4,959 patients from 2000 to 2019, with main diagnosis of HF in Extremadura (Spain). The variables examined were collected from discharge reports. To develop the readmission index, capable of discriminating the population with higher probability of re-hospitalisation, a Competing-risk model was generated. Readmission rate have increased over the period under investigation. The main predictors of readmission were: age, diabetes mellitus, presence of neoplasia, HF without previous hospitalisation, atrial fibrillation, anaemia, previous myocardial infarction, obstructive pulmonary disease (COPD) and chronic kidney disease (CKD). These variables were assigned values with balanced weights, our INCA index showed that the population with values greater than 2 for men and women were more likely to be re-admitted. Previous HF without hospital admission, CKD, and COPD appear to have the greatest effect on readmission. Our index allowed us to identify patients with different risks of readmission.

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“…It is estimated that one in five people will develop heart failure at some point in their life [3]. There is a great variability in epidemiological studies, but its prevalence increases with age being higher than 10% in patients over 70 years old and >14% in those over 75 years old [4][5][6]with an average incidence of 2-6 cases per 1000 inhabitants. In Spain, the estimated hospitalization rate is 2.37, with an average stay of 8.5 days and accounts for between 3% and 5% of hospital admissions [7].…”

Section: Introductionmentioning

confidence: 99%

Prognostic significance of Lung ultrasound for Heart Failure Patient Management in Primary Care. A Systematic Review

Panisello-Tafalla,

Montoya,

Caballol-Angelats

et al. 2024

Preprint

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Heart failure (HF) affects about 60 million people worldwide, making it one of the chronic conditions with the greatest health and economic impact. The primary objective was to assess the efficacy of lung ultrasound (LUS) in the management of HF in order to intervene early and reduce the rate of hospital readmissions. A systematic search was conducted on PubMed, Embase, Google Scholar, Web of Science, and Scopus, including clinical trials, meta-analysis, systematic reviews, and original articles from 2019/1/1-2023/12/31, about LUS for the assessment of HF, on an outpatient basis, for HF diagnosis or/and decompensation. There may be risk of bias because the effects are dependent on the persons delivering the intervention. The results were synthetized by PRISMA method. A total of 873 articles were identified of which 33 articles were selected: [n=19] focused on prognostic assessment of HF, [n=11] centred on multimodal diagnostic assessments, and [n=2] addressing therapeutic guidance for HF diagnosis. LUS exhibits advantages in the detection of sub-clinical congestion linked to prognostic significance in re-admission and mortality during out-patient follow-up, after hospital discharge, and in complex scenarios as the patients' homes or institutional long-term care facilities. However, there are considerable uncertainties in their interpretation and monitoring changes due to its lack of standardization. The need for an updated international consensus on the use of LUS seems obvious.

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Mortalidad hospitalaria y reingresos por insuficiencia cardiaca en España. Un estudio de los episodios índice y los reingresos por causas cardiacas a los 30 días y al año

Cited by 26 publications

References 28 publications

The role of bioimpedance analysis in overweight and obese patients with acute heart failure: a pilot study

The role of bioimpedance analysis in overweight and obese patients with acute heart failure: a pilot study

Analysis and prediction of readmissions for heart failure in the first year after discharge with INCA score

Prognostic significance of Lung ultrasound for Heart Failure Patient Management in Primary Care. A Systematic Review

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