Editor's choice- impact of identifying precipitating factors on 30-day mortality in acute heart failure patients
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- dc.contributor.author Rosselló, Xavier
- dc.contributor.author Gil, Víctor
- dc.contributor.author Escoda, Rosa
- dc.contributor.author Jacob, Javier
- dc.contributor.author Aguirre Tejedo, Alfons
- dc.contributor.author Martín-Sánchez, Francisco J.
- dc.contributor.author Llorens, Pere
- dc.contributor.author Herrero-Puente, Pablo
- dc.contributor.author Alquézar, Aitor
- dc.contributor.author Raposeiras-Roubín, Sergio
- dc.contributor.author Wussler, Desiree
- dc.contributor.author Müller, Christian E.
- dc.contributor.author Gayat, Etienne
- dc.contributor.author Mebazaa, Alexandre
- dc.contributor.author Miró, Òscar
- dc.contributor.author ICA-SEMES Research Group
- dc.date.accessioned 2019-12-18T11:37:23Z
- dc.date.available 2019-12-18T11:37:23Z
- dc.date.issued 2019
- dc.description.abstract BACKGROUND: The aim of this study was to describe the prevalence and prognostic value of the most common triggering factors in acute heart failure. METHODS: Patients with acute heart failure from 41 Spanish emergency departments were recruited consecutively in three time periods between 2011 and 2016. Precipitating factors were classified as: (a) unrecognized; (b) infection; (c) atrial fibrillation; (d) anaemia; (e) hypertension; (f) acute coronary syndrome; (g) non-adherence; and (h) two or more precipitant factors. Unadjusted and adjusted logistic regression models were used to assess the association between 30-day mortality and each precipitant factor. The risk of dying was further evaluated by week intervals over the 30-day follow-up to assess the period of higher vulnerability for each precipitant factor. RESULTS: Approximately 69% of our 9999 patients presented with a triggering factor and 1002 died within the first 30 days (10.0%). The most prevalent factors were infection and atrial fibrillation. After adjusting for 11 known predictors, acute coronary syndrome was associated with higher 30-day mortality (odds ratio (OR) 1.87; 95% confidence interval (CI) 1.02-3.42), whereas atrial fibrillation (OR 0.75; 95% CI 0.56-0.94) and hypertension (OR 0.34; 95% CI 0.21-0.55) were significantly associated with better outcomes when compared to patients without precipitant. Patients with infection, anaemia and non-compliance were not at higher risk of dying within 30 days. These findings were consistent across gender and age groups. The 30-day mortality time pattern varied between and within precipitant factors. CONCLUSIONS: Precipitant factors in acute heart failure patients are prevalent and have a prognostic value regardless of the patient's gender and age. They can be managed with specific treatments and can sometimes be prevented.
- dc.format.mimetype application/pdf
- dc.identifier.citation Rossello X, Gil V, Escoda R, Jacob J, Aguirre A, Martín F, et al. Editor's Choice- Impact of identifying precipitating factors on 30-day mortality in acute heart failure patients. Eur Heart J Acute Cardiovasc Care. 2019;8(7):667–680. DOI 10.1177/2048872619869328
- dc.identifier.doi http://dx.doi.org/10.1177/2048872619869328
- dc.identifier.issn 2048-8726
- dc.identifier.uri http://hdl.handle.net/10230/43199
- dc.language.iso eng
- dc.publisher SAGE Publications
- dc.rights Rossello X, Gil V, Escoda R, Jacob J, Aguirre A, Martín F, et al. ,Editor's Choice- Impact of identifying precipitating factors on 30-day mortality in acute heart failure patients. Eur Heart J Acute Cardiovasc Care. 2019;8(7):667–680. DOI 10.1177/2048872619869328
- dc.rights.accessRights info:eu-repo/semantics/openAccess
- dc.subject.keyword Acute heart failure
- dc.subject.keyword Mortality
- dc.subject.keyword Outcome
- dc.subject.keyword Precipitant factors
- dc.title Editor's choice- impact of identifying precipitating factors on 30-day mortality in acute heart failure patients
- dc.type info:eu-repo/semantics/article
- dc.type.version info:eu-repo/semantics/acceptedVersion