Clinical, biological, echocardiographic and therapeutic determinants of the length of hospital stay of patients with acute heart failure.

HYPOTHESIS

The length of hospital stay (LOS) is a unanimously accepted measure of risk and treatment efficacy for in-patients.

PURPOSE

Our aim was to identify the parameters with predictive value for the LOS of patients with acute heart failure (AHF).

METHODS

We analyzed 125 patients consecutively admitted to our clinic with a slight male predominance (54.4%) and a mean age of 71.54 years. Patients were divided into groups according to the clinical form at presentation and left ventricular function. Mean LOS was of 8.74 days.

RESULTS

Patients with LVEF<30% had a significantly higher LOS compared to those with LVEF>30% (F(2)=6.54, p<0.05). The same difference was discovered for those who received inotropic support (p<0.001), i.v. loop diuretic>140mg (p<0.001) as well as for those with QRS>160ms (p<0.05) or LBBB. The linear regression equation exposed a single significant statistical model indicating that the need for vasopressor amines, mean diuretic dose and PAAT<90msec explain 56% of the variance of LOS F(3.46)=20.55, p<0.001. The highest contribution to the model was achieved by the need for vasopressor amines (β=0.66), with a unique contribution of 42% to the variance of the number of days of stay. The mean dose of diuretic had β=0.27 and a unique contribution to the model of 7.2%, followed by PAAT<90 msec with β=0.26 and a unique contribution to the model of 7%.

CONCLUSIONS

LOS is influenced by numerous parameters, some specific to certain clinical forms of AHF while others are independent, which is why evaluations on larger groups of patients are further needed.