Baseline characteristics and hospital mortality in the Acute Heart Failure Database (AHEAD) Main registry

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Authors

ŠPINAR Jindřich PAŘENICA Jiří VÍTOVEC Jiří WIDIMSKÝ Petr LINHART Aleš FEDORCO Marian MALEK Filip ČIHALÍK Čestmír ŠPINAROVÁ Lenka MIKLIK Roman FELŠŐCI Marián BAMBUCH Miroslav DUŠEK Ladislav JARKOVSKÝ Jiří

Year of publication 2011
Type Article in Periodical
Magazine / Source Critical Care
MU Faculty or unit

Faculty of Medicine

Citation
Web http://ccforum.com/content/15/6/R291
Doi http://dx.doi.org/10.1186/cc10584
Field Cardiovascular diseases incl. cardiosurgery
Keywords acute heart failure; AHEAD; in-hospital mortality; prognosis
Description The prognosis of patients hospitalized with acute heart failure (AHF) is poor and risk stratification may help clinicians guide care. The objectives of the Acute Heart Failure Database (AHEAD) registry are to assess patient characteristics, etiology, treatment and outcome of AHF. Methods: The AHEAD main registry includes patients hospitalized for AHF in seven centers with a Catheterization Laboratory Service in the Czech Republic. The data were collected from September 2006 to October 2009. The inclusion criteria for the database adhere to the European guidelines for AHF (2005) and patients were systematically classified according to the basic syndromes, type and etiology of AHF. Results: Of 4,153 patients, 12.7% died during hospitalization. The median length of hospitalization was 7.1 days. De-novo heart failure was seen in 58.3% of the patients. According to the classification of heart failure syndromes, acute decompensated heart failure (ADHF) was reported in 55.3%, hypertensive AHF in 4.4%, pulmonary edema in 18.4%, cardiogenic shock in 14.7%, high output failure in 3.3%, and right heart failure in 3.8%. The mortality of cardiogenic shock was 62.7%, of right AHF 16.7%, of pulmonary edema 7.1%, of high output HF 6.1%, whereas the mortality of hypertensive AHF or ADHF was less than 2.5%. According to multivariate analyses, low systolic blood pressure, low cholesterol level, hyponatremia, hyperkalemia, the use of inotropic agents and norepinephrine were predictive parameters for in-hospital mortality in patients without cardiogenic shock. Severe left ventricular dysfunction and renal insufficiency were predictive parameters for mortality in patients with cardiogenic shock. Invasive ventilation and age over 70 years were the most important predictive factors for mortality in both genders with or without cardiogenic shock. Conclusions: The AHEAD Main registry provides up-to-date information on the etiology, treatment and hospital outcomes of patients hospitalized with AHF. The results highlight the highest risk patients.
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