Acute heart failure: Factors associated with mortality. San José Hospital, July 2007 - August 2008 Bogotá D.C. Colombia.

Insuficiencia cardíaca aguda: Factores asociados con mortalidad. Hospital de San José, julio 2007 - agosto 2008 Bogotá D.C. Colombia.

Introduction: heart failure (HF) is a condition that generates a good number of hospitalizations and whose prevalence has increased in recent decades. However, it has not been possible to define a classification system based on the predictors of poor prognosis in patients who require hospitalization and who could die during it. Objectives: to describe patients with acute heart failure and define what factors may be associated with mortality from decompensated HF in those admitted to the emergency room of the Hospital of San José de Bogotá. Methods: prospective descriptive study in the period from July 2007 to August 2008, of the patients who admitted with decompensated HF to the emergency service, evaluation of associated factors through a collection instrument and analysis of data through association measures. Results: 129 patients entered the study. A mortality of 4.2% was found in the group with decompensated HF, high creatinine values, high systolic blood pressure and no gender distribution difference. Fifty percent had a diagnosis of coronary heart disease and the most frequent echocardiographic findings showed reduced ejection fraction, diastolic dysfunction and mitral valve insufficiency. Discussion: the results are comparable with the world population, but a longer term follow-up and other variables that have been shown to be associated with the fatal outcome need to be taken into account. Abbreviations: IC, heart failure; EC, coronary disease; ECHO, echocardiogram (s).

1. Organización Mundial de la Salud. Enfermedades cardiovasculares [monografía en internet]. Nueva York: OMS; 2007 [citado 30 Jun. 2009]. Disponible en: http://www.who.int/mediacentre/factsheets/fs317/es/index.html

2. Luthi JC, McClellan WM, Fitzgerald D, Krumholz HM, Delaney RJ. Multi-State Collaborative Congestive Heart Failure Study Group. Mortality associated with the quality of care of patients hospitalized with congestive heart failure. Int J Qual Health Care. 2002; 14(1):15-24.

3. McKee PA, Castelli WP, McNamara PM. The natural history of congestive heart failure: the Framingham study; N Engl J Med. 1971; 285(6):1441-46.

4. Cortina A, Cortina R. Insuficiencia cardíaca: marcadores pronósticos de mortalidad. Cardiovasc Risk Factors. 2001; 10(1): 15-20

5. Fonarow GC, Adams KF Jr, Abraham WT, Yancy CW, Boscardin WJ. ADHERE Scientific Advisory Committee. Study Group, and Investigators. Risk stratification for in-hospital mortality in acutely decompensated heart failure: classification and regression tree analysis. JAMA 2005; 293(5):572-80.

6. Teo K, Montague T, Ackman M. Clinical quality improvement network investigators: mortality risk and patterns of practice in 4606 acute care patients with congestive heart failure: the relative importance of age, sex, and medical therapy. Arch Intern Med. 1996; 156(15): 1669-73.

7. Nieminen MS, Bohm M, Cowie MR. Executive summary of the guidelines on the diagnosis and treatment of acute heart failure: the task force on acute heart failure of the European Society of Cardiology. Eur Heart J. 2005; 26(3):384-416.

8. Fonarow GC. Epidemiology and risk stratification in acute heart failure. Am Heart J. 2008; 155(4):200-7.

9. Abraham WT, Fonarow GC, Albert NM. Predictors of in-hospital mortality in patients hospitalized for heart fFailure. J Am Coll Cardiol. 2008; 52(4): 347–56.

10. Ospina AV, Gamarra HG. Características clínicas y epidemiológicas de la insuficiencia cardiaca en el Hospital Universitario Ramón González Valencia de Bucaramanga, Colombia. Salud UIS. 2004; 36(2):125-31.

11. García R, Casas JP, Silva F. Factores predictores de mortalidad en pacientes con insuficiencia cardiaca. Acta Med Colomb. 2002; 27(4):322-31.

12. Colombia. Ministerio de Protección Social. Situación de salud en Colombia: indicadores básicos [monografía en Internet]. Bogotá : El Ministerio; 2007 [citado 30 Jun. de 2009]. Disponible en:http://www.minproteccionsocial.gov.co/vBecontent/NewsDetail.asp?ID=15895&IDCompany=3

13. Yancy CW, Lopatin M. Clinical presentation, management and in-hospital outcomes of patients admitted with acute decompensated heart failure with preserved systolic function a report from the Acute Decompensated Heart Failure National Registry (ADHERE) Database. J Am Coll Cardiol. 2006; 47(2): 76–84.

14. Cleland JGF, Swedberg K, Follath F, Komajda M, Cohen-Solal A, Aguilar A , Dietz R, Gavazzi A. The EuroHeart Failure Survey programme—a survey on the quality of care among patients with heart failure in Europe. Part 2: treatment. Eur. Heart J. 2003; 24(5):442-63.

15. O’Connor CM, Stough WG. Demographics, clinical characteristics, and outcomes of patients hospitalized for decompensated heart failure: observations from the IMPACT-HF registry. J Card Fail. 2005 Apr;11(3):200-5

16. Fonarow GC, Abraham WT, Albert NM, et al. Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF): rationale and design. Am Heart J 2004; 148(1): 43-51.