PMID- 27995602
OWN - NLM
STAT- MEDLINE
DCOM- 20181126
LR  - 20181126
IS  - 1897-4279 (Electronic)
IS  - 0022-9032 (Linking)
VI  - 75
IP  - 4
DP  - 2017
TI  - Hospitalisation length and prognosis in heart failure patients.
PG  - 323-331
LID - 10.5603/KP.a2016.0183 [doi]
AB  - BACKGROUND: Heart failure (HF) is a chronic disease with poor prognosis, being 
      the final stage of many cardiovascular conditions and often requiring 
      hospitalisation. AIM: The aim of the study was to evaluate the effect of 
      hospitalisation length on prognosis in patients with HF. METHODS: Between 
      February 2012 and January 2013, in 32 cardiology centres in Poland, 1126 HF 
      patients were included in the EURObservational Research Programme on Heart 
      Failure Registry. A total of 765 persons were hospitalised. A follow-up (FU) of 
      414 +/- 121 days was conducted. RESULTS: The median length of hospitalisation was 
      seven days (interquartiles 25th-75th; 4-11), also for new onset (14.5% of 
      patients) and chronic HF (seven days, 5-11 and 4-11, respectively). Patients who 
      died during FU (16.5%) and those who survived were hospitalised for a median of 
      eight days (6-12) and seven days (4-10), respectively (p < 0.001). Patients 
      hospitalised for 8-21 and 22 or more days had an increased risk of death after 
      discharge (hazard ratio [HR] 1.70; 95% confidence interval [CI] 1.16-2.49 and HR 
      2.20; 95% CI 1.04-4.67, respectively) than those hospitalised for up to seven 
      days. Predictors of death in the FU period in multivariate analysis included age 
      (1.02; 95% CI 1.01-1.04), history of chronic kidney disease (CKD) (HR 1.55; 95% 
      CI 1.05-2.30), and New York Heart Association (NYHA) class III (HR 2.52; 95% CI 
      1.22-5.18) and IV (HR 4.77; 95% CI 2.32-9.82) at admission. Patients hospitalised 
      for 22 or more days were more often male (77%), and with a history of CKD (34%). 
      At admission they had lower systolic (118 +/- 25 mm Hg) and diastolic (72 +/- 12 mm 
      Hg) blood pressure, higher NT-proBNP (9191 +/- 8776 pg/mL), lower serum sodium 
      level (137 +/- 5 mmol/l), as well as lower ejection fraction before and during 
      hospital stay (30 +/- 12% and 34 +/- 14%, respectively; p < 0.05 for all factors). 
      Factors that influenced the length of hospital stay included history of CKD (p < 
      0.001), current malignancy (p = 0.026), and infection at admission (p < 0.001). 
      Most of the admitted patients presented NYHA class III (45%). The poorer the NYHA 
      class at admission, the longer the patient's hospital stay (p < 0.001). 54% 
      patients were re-admitted to the hospital during FU. Patients re-admitted and not 
      re-admitted during the one-year FU had the same median duration of the index 
      hospitalisation (seven days; 4-10 and 4-11, respectively; p = 0.957). 
      CONCLUSIONS: Patients with HF hospitalised for 22 or more days, in comparison to 
      patients hospitalised for less than eight days, had double the risk of death 
      during FU. We believe that prolonged hospitalisation might be regarded as a 
      marker of poor prognosis in patients with acute HF.
FAU - Zaprutko, Joanna
AU  - Zaprutko J
AD  - 2nd Department of Cardiology, Poznan University of Medical Sciences, Poznan, 
      Poland. jgrabia@ump.edu.pl.
FAU - Michalak, Michal
AU  - Michalak M
FAU - Nowicka, Anna
AU  - Nowicka A
FAU - Dankowski, Rafal
AU  - Dankowski R
FAU - Drozdz, Jaroslaw
AU  - Drozdz J
FAU - Ponikowski, Piotr
AU  - Ponikowski P
FAU - Opolski, Grzegorz
AU  - Opolski G
FAU - Nessler, Jadwiga
AU  - Nessler J
FAU - Nowalany-Kozielska, Ewa
AU  - Nowalany-Kozielska E
FAU - Szyszka, Andrzej
AU  - Szyszka A
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
DEP - 20161220
PL  - Poland
TA  - Kardiol Pol
JT  - Kardiologia polska
JID - 0376352
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Heart Failure/mortality/*therapy
MH  - Humans
MH  - *Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Poland
MH  - Prognosis
MH  - Registries
OTO - NOTNLM
OT  - heart failure
OT  - length of hospitalisation
OT  - mortality
OT  - prognosis
EDAT- 2016/12/21 06:00
MHDA- 2018/11/27 06:00
CRDT- 2016/12/21 06:00
PHST- 2015/10/29 00:00 [received]
PHST- 2016/10/17 00:00 [accepted]
PHST- 2016/09/29 00:00 [revised]
PHST- 2016/12/21 06:00 [pubmed]
PHST- 2018/11/27 06:00 [medline]
PHST- 2016/12/21 06:00 [entrez]
AID - VM/OJS/KP/10185 [pii]
AID - 10.5603/KP.a2016.0183 [doi]
PST - ppublish
SO  - Kardiol Pol. 2017;75(4):323-331. doi: 10.5603/KP.a2016.0183. Epub 2016 Dec 20.