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

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.