Predictors of prolonged hospital stay in patients with acute heart failure

Juan Sebastián Parada Zuluaga, Kelly Marisancén Carrasquilla, Aura María Vélez Granda, C. I. Saldarriaga Giraldo, Álvaro Mauricio Quintero Ossa, Eliana Mabel Cañas Arenas, Adriana María Agudelo

Research output: Contribution to journalArticle in an indexed scientific journalpeer-review

6 Scopus citations

Abstract

Introduction: Acute heart failure is the main cause of hospital admission in adults over 65 years-old. The length of the hospital stay is a determining factor in the increase in the costs of hospital care. Objective: To describe the clinical profile of patients admitted to hospital Cardiovascular Reference Centre due to acute heart failure and to determine the duration of the hospital stay and the predictors of prolonged admission. Methods: A prospective, analytical, observational, cohort study. Results: A total of 251 patients with a diagnosis of acute heart failure were admitted during a six-month period. The median age was 75 years, with a mean left ventricle ejection fraction of 25%, and a Nohria–Stevenson classification: wet-hot 78.9%; wet-cold 15.1%; dry-hot 2.8%, and dry-cold 2.8%. Inotropes were required by 15.9% of patients and vasopressors by 1.2%. The most frequent complications were development of acute kidney disease in 33.1%, and de novo atrial fibrillation in 5.2%. The median hospital stay was 5 days, and 65.7% had a prolonged stay (≥ 7 days). The bivariate analysis showed prolonged stay predictors such as inotrope requirement (RR 2.41; 95% CI; 1.77-3.27, P = .000), a Nohria–Stevenson classification of dry-cold and wet-cold (RR 1.86; 95% CI; 1.33-2.61, P = .001), NYHA classification of III-IV (RR 1.85; 95% CI; 1.06-3.24, P = .017), acute kidney disease (RR 1.82; 95% CI; 1.31-2.55, P = .000), and diabetes mellitus (RR 1.47; 95% CI; 1.05-2.06, P = .026). Conclusion: In a population with a predominance of reduced cardiac function and multiple comorbidities, the median hospital stay due to acute heart failure was 5 days. Predictors of a prolonged stay were identified as inotrope support, a Nohria–Stevenson classification of dry-cold and wet-cold, NYHA III-IV, acute kidney disease, and diabetes mellitus.
Original languageSpanish (Colombia)
Pages (from-to)78-85
Number of pages8
JournalRevista Colombiana de Cardiologia
Volume26
Issue number2
DOIs
StatePublished - 15 Dec 2018
Externally publishedYes

Types Minciencias

  • Artículos de investigación con calidad Q4

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