Kaufmann Christoph C, Ahmed Amro, Harbich Paul F, Auer Lisa, Weltler Patrick, Burger Achim Leo, Pogran Edita, Geppert Alexander, Huber Kurt, Jäger Bernhard
3rd Medical Department with Cardiology and Intensive Care Medicine, Clinik Ottakring (Wilhelminenhospital), Montleartstraße 37, 1160, Vienna, Austria.
Medical School, Sigmund Freud University, Vienna, Austria.
Wien Klin Wochenschr. 2025 Sep 8. doi: 10.1007/s00508-025-02597-5.
Acute heart failure (AHF) significantly contributes to cardiovascular morbidity and mortality, bearing a substantial socioeconomic burden. While the dynamics of chronic heart failure have been extensively explored in global patient cohorts, comprehensive data specific to AHF remain limited.
This retrospective, single-center, real-world study comprises hospitalized patients with AHF, admitted to a tertiary care hospital in Vienna, Austria, between 1 January 2012 and 31 December 2019. We collected and evaluated baseline characteristics, demographic features and clinical outcomes of our study cohort. The primary aim of this study is to assess the prognostic impact of demographic features on mortality.
Our study encompassed 3156 patients admitted for AHF at a mean age of 77 ± 12 years with 50.7% of patients being male. The N-terminal pro B‑type Natriuretic Peptide (NT-proBNP) levels upon hospital admission were elevated with a median of 5701 ng/l (interquartile range, IQR, 2618-11,581 ng/l). Male patients were younger than females and had a higher cardiovascular comorbidity burden. Heart failure with reduced ejection fraction was more prevalent in male patients (54.2% vs. 32.8%), while females most often exhibited heart failure with preserved ejection fraction (50.5% vs. 29.0%). Most patients presented to the emergency department (85.9%) primarily arriving by ambulance (85.6%) during daylight hours (68.2%). Within 1 year, 27.6% of patients reached the primary endpoint of 1‑year mortality. Compared to international AHF registries, our study population was notably older with comparable in-hospital and 1‑year mortality rates. Among demographic features, admission through the emergency department and arrival by ambulance demonstrated a significant association with both short-term and long-term mortality, while the year of admission, seasonal variation, socioeconomic strength, nighttime, and weekend admission failed to do so.
Our study offers insights into the dynamics of AHF in Vienna, Austria, drawing comparisons to international AHF registries. Admission through the emergency department and arrival by ambulance emerged as significant independent predictors of mortality among demographic features.
急性心力衰竭(AHF)显著增加了心血管疾病的发病率和死亡率,带来了巨大的社会经济负担。虽然慢性心力衰竭的动态变化已在全球患者队列中得到广泛研究,但关于AHF的具体综合数据仍然有限。
这项回顾性、单中心、真实世界研究纳入了2012年1月1日至2019年12月31日期间在奥地利维也纳一家三级护理医院住院的AHF患者。我们收集并评估了研究队列的基线特征、人口统计学特征和临床结局。本研究的主要目的是评估人口统计学特征对死亡率的预后影响。
我们的研究纳入了3156例因AHF入院的患者,平均年龄为77±12岁,其中50.7%为男性。入院时N末端B型利钠肽原(NT-proBNP)水平升高,中位数为5701 ng/l(四分位间距,IQR,2618 - 11581 ng/l)。男性患者比女性患者年轻,心血管合并症负担更高。射血分数降低的心力衰竭在男性患者中更常见(54.2%对32.8%),而女性最常表现为射血分数保留的心力衰竭(50.5%对29.0%)。大多数患者前往急诊科就诊(85.9%),主要在白天(68.2%)通过救护车到达(85.6%)。在1年内,27.6%的患者达到了1年死亡率的主要终点。与国际AHF注册研究相比,我们的研究人群年龄明显更大,但住院死亡率和1年死亡率相当。在人口统计学特征中,通过急诊科入院和乘坐救护车到达与短期和长期死亡率均存在显著关联,而入院年份、季节变化、社会经济实力、夜间和周末入院则未显示出这种关联。
我们的研究深入了解了奥地利维也纳AHF的动态变化,并与国际AHF注册研究进行了比较。在人口统计学特征中,通过急诊科入院和乘坐救护车到达是死亡率的重要独立预测因素。