Tribouilloy C, Rusinaru D, Leborgne L, Mahjoub H, Szymanski C, Houpe D, Béguin M, Peltier M
Inserm, ERI 12, Département des maladies cardiovasculaires, Centre hospitalier universitaire, Amiens.
Arch Cardiovasc Dis. 2008 Apr;101(4):226-34. doi: 10.1016/s1875-2136(08)73697-0.
Heart failure (HF) is associated with high morbidity and mortality. A significant component of HF-related adverse outcome occurs during hospitalization. Objective. - To assess features and in-hospital outcomes of patients hospitalized for a first episode of HF.
We prospectively recruited 799 consecutive patients hospitalized for a first episode of HF during 2000 in the Somme department (France). We evaluated in-hospital mortality in this cohort, identified factors predictive for hospital death, and compared the mortality in patients with preserved or reduced ejection fraction (EF).
The mean age of the study population was 75+/-12 years. EF, assessed in 662 patients (83%), was preserved (> or = 50%) in 56% of cases. During hospitalization, 64 deaths (8%) were recorded. The major causes of in-hospital death were acute pulmonary oedema (50%) and cardiogenic shock (22%). Coronary artery disease, low systolic blood pressure on admission, increased heart rate on admission, renal failure, reduced EF (<50%) and older age were identified as independent predictors of in-hospital mortality. Patients with preserved EF were older and comprised a greater proportion of women. In-hospital mortality of the reduced EF group was higher than that of the preserved EF group (8.2% versus 2.7%, p=0.002). On multivariable analysis, reduced EF was independently associated with in-hospital death (odds ratio 2.32; 95% confidence interval 1.06-5.11; p=0.03). In propensity-matched patients, in-hospital mortality was higher in the reduced EF group (7.6% versus 2.2% p=0.02).
The in-hospital outcome of patients admitted for new-onset HF is poor. Patients with preserved EF are older but have lower in-hospital mortality.
心力衰竭（HF）与高发病率和高死亡率相关。与HF相关的不良结局的一个重要部分发生在住院期间。目的：评估因首次发生HF而住院的患者的特征和住院结局。
我们前瞻性地招募了2000年在法国索姆省因首次发生HF而住院的799例连续患者。我们评估了该队列中的住院死亡率，确定了预测医院死亡的因素，并比较了射血分数（EF）保留或降低的患者的死亡率。
研究人群的平均年龄为75±12岁。在662例患者（83%）中评估了EF，其中56%的病例EF保留（≥50%）。住院期间，记录到64例死亡（8%）。住院死亡的主要原因是急性肺水肿（50%）和心源性休克（22%）。冠状动脉疾病、入院时收缩压低、入院时心率增加、肾衰竭、EF降低（<50%）和年龄较大被确定为住院死亡率的独立预测因素。EF保留的患者年龄较大，女性比例更高。EF降低组的住院死亡率高于EF保留组（8.2%对2.7%，p = 0.002）。在多变量分析中，EF降低与住院死亡独立相关（比值比2.32；95%置信区间1.06 - 5.11；p = 0.03）。在倾向匹配的患者中，EF降低组的住院死亡率更高（7.6%对2.2%，p = 0.02）。
因新发HF入院的患者的住院结局较差。EF保留的患者年龄较大，但住院死亡率较低。
