Villalba Noel Lorenzo, Ballesteros Belén Chiva, Álvarez Laura De Pedro, Mainar Pamen Delgado, Sánchez Ángel Nieto, Martínez Javier Marco, Manuel Elpidio Calvo, Bailon Manuel Méndez
Service de Médecine Interne, Diabète et Maladies Métaboliques, Hôpitaux Universitaires de Strasbourg, France.
Service de Médecine Interne, Hôpital Universitaire San Carlos, Madrid, Espagne.
Pan Afr Med J. 2019 Dec 17;34:202. doi: 10.11604/pamj.2019.34.202.17356. eCollection 2019.
Heart failure (HF) is a health problem in Spain where the prevalence rate for this disease is correlated with aging. Heart failure-related mortality and hospital readmissions are high. The purpose of this study was to evaluate the clinical features of patients with HF hospitalized in the Department of Internal Medicine as well as factors associated with readmission and intra-hospital mortality.
We conducted a cross-sectional, descriptive, and retrospective study based on the review of the clinical records of patients with primary diagnosis of HF in the Basic Minimum Set of Data (BMSD, Conjunto Mínimo Básico de Datos),who were discharged from the Department of Internal Medicine of the San Carlos Clinical Hospital (HCSC) in 2014.
The study involved 199 patients, with an average age of 82.7 years (61.8% were females); 85% of them had left ventricular ejection fraction (LVEF) > 40%, with an average pro-BNP of 9.101,3 pg/ml and 64.3% had ongoing atrial fibrillation. Thirty point two percent of patients were readmitted within 30 days, with an average rate of readmission/year of 1.45 (±0.86). Twenty five percent of patients died during the follow-up period in hospital. Among factors associated with intra-hospital mortality, older age was an associated variable (OR 1,050)(1,002-1,101) (p = 0.04). The most important factors associated with early readmission were polypharmacy (p = 0.024) as well as pluripathology based on Ollero criteria 4,974 (1,396-17,730) (p = 0.024). Patients hospitalized for HF in our Department are elderly patients treated with polymedication.
Patients hospitalized for cardiac insufficiency are older and are characterized by pluripathology and polypharmacy. Short-term prognosis is associated with high rates of readmission and mortality in hospitalmainly for patients suffering from kidney disease and/or neurological disorders.
心力衰竭（HF）是西班牙的一个健康问题，该国这种疾病的患病率与老龄化相关。与心力衰竭相关的死亡率和住院再入院率很高。本研究的目的是评估在内科住院的心力衰竭患者的临床特征以及与再入院和院内死亡率相关的因素。
我们基于对2014年从圣卡洛斯临床医院（HCSC）内科出院的、在基本最小数据集（BMSD，Conjunto Mínimo Básico de Datos）中初步诊断为心力衰竭的患者临床记录的回顾，进行了一项横断面、描述性和回顾性研究。
该研究纳入了199名患者，平均年龄为82.7岁（61.8%为女性）；其中85%的患者左心室射血分数（LVEF）>40%，脑钠肽前体平均为9101.3 pg/ml，64.3%的患者患有持续性心房颤动。30.2%的患者在30天内再次入院，平均每年再入院率为1.45（±0.86）。25%的患者在随访期间在医院死亡。在与院内死亡率相关的因素中，年龄较大是一个相关变量（OR 1.050）（1.002 - 1.101）（p = 0.04）。与早期再入院相关的最重要因素是多重用药（p = 0.024）以及基于奥列罗标准的多种疾病4974（1396 - 17730）（p = 0.024）。我们科室因心力衰竭住院的患者是接受多种药物治疗的老年患者。
因心脏功能不全住院的患者年龄较大，其特征是患有多种疾病和多重用药。短期预后与高再入院率和院内死亡率相关，主要发生在患有肾脏疾病和/或神经系统疾病的患者中。
