Wajner André, Zuchinali Priccila, Olsen Vírgilio, Polanczyk Carisi A, Rohde Luis Eduardo
Hospital Nossa Senhora da Conceição, Brazil.
Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
Arq Bras Cardiol. 2017 Oct;109(4):321-330. doi: 10.5935/abc.20170136. Epub 2017 Sep 28.
Although heart failure (HF) has high morbidity and mortality, studies in Latin America on causes and predictors of in-hospital mortality are scarce. We also do not know the evolution of patients with compensated HF hospitalized for other reasons.
To identify causes and predictors of in-hospital mortality in patients hospitalized for acute decompensated HF (ADHF), compared to those with HF and admitted to the hospital for non-HF related causes (NDHF).
Historical cohort of patients hospitalized in a public tertiary hospital in Brazil with a diagnosis of HF identified by the Charlson Comorbidity Index (CCI).
A total of 2056 patients hospitalized between January 2009 and December 2010 (51% men, median age of 71 years, length of stay of 15 days) were evaluated. There were 17.6% of deaths during hospitalization, of which 58.4% were non-cardiovascular (63.6% NDHF vs 47.4% ADHF, p = 0.004). Infectious causes were responsible for most of the deaths and only 21.6% of the deaths were attributed to HF. The independent predictors of in-hospital mortality were similar between the groups and included: age, length of stay, elevated potassium, clinical comorbidities, and CCI. Renal insufficiency was the most relevant predictor in both groups.
Patients hospitalized with HF have high in-hospital mortality, regardless of the primary reason for hospitalization. Few deaths are directly attributed to HF; Age, renal function and levels of serum potassium, length of stay, comorbid burden and CCI were independent predictors of in-hospital death in a Brazilian tertiary hospital.
尽管心力衰竭（HF）的发病率和死亡率很高，但拉丁美洲关于住院死亡率的原因和预测因素的研究却很少。我们也不清楚因其他原因住院的代偿性HF患者的病情发展情况。
确定因急性失代偿性HF（ADHF）住院的患者与因非HF相关原因（NDHF）住院的HF患者相比，住院死亡率的原因和预测因素。
通过查尔森合并症指数（CCI）确定在巴西一家公立三级医院住院且诊断为HF的患者的历史队列。
对2009年1月至2010年12月期间住院的2056例患者（51%为男性，中位年龄71岁，住院时间15天）进行了评估。住院期间死亡率为17.6%，其中58.4%为非心血管原因（NDHF组为63.6%，ADHF组为47.4%，p = 0.004）。感染性原因是导致大多数死亡的原因，只有21.6%的死亡归因于HF。两组住院死亡率的独立预测因素相似，包括：年龄、住院时间、血钾升高、临床合并症和CCI。肾功能不全是两组中最相关的预测因素。
无论住院的主要原因是什么，因HF住院的患者住院死亡率都很高。很少有死亡直接归因于HF；在巴西一家三级医院，年龄、肾功能、血钾水平、住院时间、合并症负担和CCI是住院死亡的独立预测因素。
