Predictors of short term mortality in heart failure - insights from the Euro Heart Failure survey

Velavan, Periaswamy; Khan, Nasrin K.; Goode, Kevin; Rigby, Alan S.; Loh, Poay H.; Komajda, Michel; Follath, Ferenc; Swedberg, Karl; Madeira, Hugo; Cleland, John G.F.

Abstract

Objective: To identify factors associated with short term mortality in hospitalised patients with heart failure. Background: Hospitalisation is frequent in patients with heart failure and is associated with a high mortality. Methods: The Euro Heart Failure survey collected data from patients with suspected heart failure. We searched this data for predictors of short term mortality. Results: Of 10,701 patients, 1404 (13%) died within 12 weeks of admission. On univariate analysis, increasing age, hyponatraemia, renal impairment, hyperkalaemia, anaemia, severe mitral regurgitation, severe LV systolic dysfunction(LVSD), increasing QRS and female sex carried adverse prognosis. ACEI, beta-blockers, nitrates, anti-thrombotic and lipid lowering drugs were associated with a better prognosis. On multivariable analysis the following provided independent prognostic information: increasing age (OR per SD=1.5, 95% CI 1.4-1.6), severe LVSD (1.8, 1.5-2.1), serum creatinine (1.2, 1.2-1.3), sodium (0.9, 0.8-0.9), Hb (0.9, 0.8-0.9) and treatment with ACEI (0.5, 0.5-0.6), beta-blockers (0.7, 0.6-0.8), statins (0.6, 0.5-0.7), calcium channel blockers (0.7, 0.6-0.8), warfarin (0.5, 0.4-0.6), heparin (1.7, 1.4-1.9), antiplatelet drugs (0.6, 0.5-0.6) and need for inotropes (5.5, 4.6-6.6). A simple risk score (range 0-11) identified cohorts with a 12 week mortality ranging from 2% to 44%. Conclusions: Simple and readily available clinical variables and a risk score based on medical history and routine tests that all patients admitted with heart failure have, can identify patients with good, intermediate and high short term mortality. (C) 2008 Elsevier Ireland Ltd. All rights reserved.

Citation

Velavan, P., Khan, N. K., Goode, K., Rigby, A. S., Loh, P. H., Komajda, M., Follath, F., Swedberg, K., Madeira, H., & Cleland, J. G. (2010). Predictors of short term mortality in heart failure - insights from the Euro Heart Failure survey. International journal of cardiology, 138(1), 63-69. https://doi.org/10.1016/j.ijcard.2008.08.004

• Journal Article Type: Article
• Acceptance Date: Aug 8, 2008
• Online Publication Date: Sep 11, 2008
• Publication Date: Jan 7, 2010
• Journal: INTERNATIONAL JOURNAL OF CARDIOLOGY
• Print ISSN: 0167-5273
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 138
• Issue: 1
• Pages: 63-69
• DOI: https://doi.org/10.1016/j.ijcard.2008.08.004
• Keywords: Heart failure; Mortality; Cholesterol; Risk score; Euro Heart Failure survey
• Public URL: https://hull-repository.worktribe.com/output/396208
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S0167527308009509?via%3Dihub#!