First hospital admission due to heart failure: In-hospital mortality and patient profile

J Masip; F Formiga; M Fernández-Castañer; P Fernández; J Comín-Colet; X Corbella

doi:10.1016/j.rce.2018.09.014

First hospital admission due to heart failure: In-hospital mortality and patient profile

Rev Clin Esp (Barc). 2019 Apr;219(3):130-140. doi: 10.1016/j.rce.2018.09.014. Epub 2018 Dec 23.

[Article in English, Spanish]

Authors

J Masip¹, F Formiga², M Fernández-Castañer³, P Fernández³, J Comín-Colet⁴, X Corbella⁵

Affiliations

¹ Unidad de Codificación Médica, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España. Electronic address: joan2masip@gmail.com.
² Unidad de Geriatría, Departamento de Medicina, Hospital Universitari de Bellvitge-Instituto de Investigación Biomédica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España.
³ Departamento de Sistemas de Información, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.
⁴ Programa de Insuficiencia Cardiaca, Departamento de Cardiología, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España; Grupo de Investigación de Enfermedades Cardiovasculares, Programa de Investigación en Enfermedades Inflamatorias, Crónicas y Degenerativas, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España; Grupo de Investigación Biomédica de Enfermedades del Corazón, Programa de Investigación de Trastornos Inflamatorios y Cardiovasculares, Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Parque de Investigación Biomédica de Barcelona, Barcelona, España.
⁵ Unidad de Geriatría, Departamento de Medicina, Hospital Universitari de Bellvitge-Instituto de Investigación Biomédica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España; Cátedra Hestia de Salud Integrada y Cuidado Social, Facultad de Medicina y Ciencias de la Salud, Universitat Internacional de Catalunya, Barcelona, España.

PMID: 30587328
DOI: 10.1016/j.rce.2018.09.014

Abstract

Objectives: We evaluated the patient profile and outcomes of first heart failure (HF) related hospital admission patients in the 2010-2014 period.

Design: Retrospective, single-centre, cohort study.

Setting: We used administrative data from a tertiary care hospital (Hospital Universitari de Bellvitge, Barcelona, Spain).

Participants: All patients with primary diagnosis of HF registered at the hospital discharge database from 2010 to 2014 were included, ruling out that HF was present 10 years prior to the current episode.

Intervention: Primary care HF diagnosis status was assessed in order to distinguish new onset from no-new onset patients.

Main measures: Descriptive, bivariate and multivariate analysis were performed using age, previous primary care HF diagnosis and in-hospital death as grouping variables. Significant variables were fitted into a Linear logistic regression model for each outcome.

Results: We selected 3,868 first HF-related admissions (56.8% of all HF episodes). In 1,220 patients (31.7%) HF was diagnosed by their primary care physician. Main pattern was a woman (OR=2.4), with higher prevalence of hypertension (OR=1.7), atrial fibrillation (OR=1.3), chronic kidney disease (OR=1.6) and mortality rate (9.8%). In-hospital death rate was 5.8%, age over 85 (OR=5.57), chronic kidney disease (OR=1.44) and length of stay over 7 days (OR=1.90) being the main contributors.

Conclusions: First HF related admissions account for 56.7% of all HF episodes. Roughly one third of patients were already diagnosed by the time of their first hospital admission. Elderly women were the most frequent, but not the only, group of patients. Age, hospital stay and chronic kidney disease were the main contributors for in-hospital death.

Keywords: Epidemiology; Epidemiología; First hospital admission; Heart failure; In-hospital mortality; Inicio; Insuficiencia cardiaca; Mortalidad intrahospitalaria; Onset; Primer ingreso hospitalario.