Timing of previous heart failure hospitalization as a prognostic factor for emergency department heart failure patients
Romero, Carlos (Institut de Recerca Sant Pau)
Alquézar-Arbé, A. (Institut de Recerca Sant Pau)
Herrera, Sergio (Institut de Recerca Sant Pau)
Llorens, Pere (Hospital Doctor Balmis de Alicante)
Gil, Víctor (Universitat de Barcelona)
Curtelin, David (Universitat de Barcelona)
Jacob, Javier (Hospital Universitari de Bellvitge)
Herrero-Puente, Pablo (Hospital Universitario Central de Asturias)
María Pilar Lopez Díez (Hospital Universitario de Burgos)
Llauger, Lluis (Hospital Universitari de Vic)
Luisa López Grima, M. (Hospital Universitari Doctor Peset (València))
Gil, Cristina (Hospital Universitario de Salamanca)
Tost, Josep (Hospital Universitari MútuaTerrassa)
Agüera Urbano, Carmen (Hospital Costa del Sol (Marbella))
Espinosa, Begoña (Hospital Doctor Balmis de Alicante)
Campos-Meneses, Maria (Institut de Recerca Sant Pau)
Fernandez, G (Institut de Recerca Sant Pau)
Torres, A. (Institut de Recerca Sant Pau)
Escoda, Rosa (Universitat de Barcelona)
Martín, Enrique (Hospital Sant Pau i Santa Tecla (Tarragona))
Garrido, Jose Manuel (Hospital Universitario Virgen Macarena (Sevilla, Andalusia))
Lucas-Imbernon, Francisco Javier (Complejo Hospitalario Universitario de Albacete)
Rodríguez-Adrada, Esther (Hospital Universitario Rey Juan Carlos (Madrid))
Torres Gárate, Raquel (Hospital Universitario Severo Ochoa)
Andueza, Juan Antonio (Hospital General Universitario Gregorio Marañón)
Peacock, W. Frank (Baylor College of Medicine (Houston, Estats Units d'Amèrica))
Miró, Oscar (Universitat de Barcelona)

Date:	2024
Abstract:	To investigate whether the timing of a previous hospital admission for acute heart failure (AHF) is a prognostic factor for AHF patients revisiting the emergency department (ED) in the subsequent 12-month follow-up. All ED AHF patients enrolled in the previously described EAHFE registry were stratified by the presence or absence of an AHF hospitalization admission in the prior 12 months. The primary outcome was 12-month all-cause mortality post ED visit. Secondary end points were hospital admission, prolonged hospitalization (> 7 days), mortality during hospitalization and a 90-day post-discharge adverse composite event (ACE) rate, defined as ED revisits due to AHF, hospitalizations due to AHF, or all-cause mortality. Outcomes were adjusted for baseline and AHF episode characteristics. Of 5,757 patients included, the median age was 84 years (IQR 77-88); 57% were women, and 3,759 (65. 3%) had an AHF hospitalization in the previous 12 months. The 12-month mortality was 37% (41. 7% vs. 28. 3% p < 0. 001), hospital admission was 76. 1% (78. 8% vs. 71. 1% p < 0. 001) ACE was 60. 2% (65. 1% vs. 50. 5% p < 0. 001). In the adjusted analysis, patients with AHF hospitalization in the prior 12 months had a higher mortality (HR = 1. 41; 95% CI 1. 27-1. 56), 90-day ACE rate (HR = 1. 45: 95% CI 1. 32-1. 59), and more hospital admissions (OR = 1. 32; 95% CI 1. 16-1. 51), with shorter times since the previous hospitalization being related to the outcomes analyzed. One-year mortality, adverse events at 90 days, and readmission rates are increased in ED AHF patients previously admitted within the last 12 months.
Grants:	Ministerio de Economía y Competitividad PI15/01019 Ministerio de Economía y Competitividad PI15/00773 Instituto de Salud Carlos III PI18/00393 Instituto de Salud Carlos III PI18/00456
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Language:	Anglès
Document:	Article ; recerca ; Versió acceptada per publicar
Subject:	Acute heart failure ; Previous hospitalization ; Emergency departments
Published in:	Internal and Emergency Medicine, Vol. 19, Num. 4 (June 2024) , p. 1089-1098, ISSN 1970-9366

DOI: 10.1007/s11739-023-03505-3
PMID: 38466555

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