PROGNOSTIC INDICATORS FOR FIRST AND REPEATED HOSPITALIZATIONS IN HEART FAILURE PATIENTS WITH REDUCED LEFT VENTRICULAR EJECTION FRACTION

PROGNOSTIC INDICATORS FOR FIRST AND REPEATED HOSPITALIZATIONS IN HEART FAILURE PATIENTS WITH REDUCED LEFT VENTRICULAR EJECTION FRACTION

Heart failure with reduced ejection fraction (HFrEF) is a progressive clinical syndrome defined by changes in the myocardial structure, which lead to predominant systolic myocardial function impairment, with a left ventricle ejection of fraction ≤40%. The rehospitalization burden in HFrEF patients (...

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Bibliographic Details
Published in:Collegium antropologicum Vol. 44; no. 3; p. 139
Main Authors: Selthofer-Relatić, Kristina, Tomić, Mato, Stažić, Anto, Arambašić, Jerko, Kralik, Kristina, Mirat, Jure
Format: Journal Article Paper
Language:English
Published: Zagreb Institute for Anthropological Research 2020
Hrvatsko antropološko društvo
Subjects:
Aging
Atrial fibrillation
atrial fibrillation, arterial hypertension, coronary heart disease, echocardiography, diabetes mellitus, heart failure, patient readmission
Biological markers
Cardiovascular disease
Cardiovascular diseases
Comorbidity
Coronary artery disease
Diabetes
Ejection fraction
Etiology
Gender differences
Health care expenditures
Heart failure
Hospitalization
Hypertension
Inflammation
Medical diagnosis
Pneumonia
Quality of life
Risk factors
Statistical analysis
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Summary:Heart failure with reduced ejection fraction (HFrEF) is a progressive clinical syndrome defined by changes in the myocardial structure, which lead to predominant systolic myocardial function impairment, with a left ventricle ejection of fraction ≤40%. The rehospitalization burden in HFrEF patients (pts) remains very high, with poor quality of life, increased mortality and large healthcare expenditures. In this research project, we investigated the risk factors for first and repeated hospitalization in pts with HFrEF. This retrospective study included 50 adult pts with a diagnosis of HFrEF and who were within the age range of 55 to 89 years old and of both sexes. Demographic and clinical data (HFrEF etiology, renal function parameters, complete blood count, markers of inflammation, electrocardiogram, troponin I, NTproBNP, echocardiographic parameters and comorbidities data) were collected from the pts' medical histories. Statistical analysis was performed via Fischer's exact test, the Shapiro-Wilk test and the Spearman correlation coefficient. This study included 70% male and 30% female HFrEF pts. Males were younger in both group of pts and had a higher incidence of rehospitalization. The most important HFrEF etiologic risk factors are arterial hypertension (82%), coronary heart disease (54%), atrial fibrillation (52%) and diabetes mellitus (40%). The most important noncardiac comorbidity related with the first HFrEF hospitalization is pneumonia (P=0.03), while progression of left ventricle systolic and diastolic dysfunction is related to rehospitalization risk (left ventricle end systolic diameter, P=0.003; diastolic dysfunction degree, P=0.04). The troponin level was associated with an increased risk of rehospitalization, but this was not statistically significant at this sample size (troponin I, p=0.10). Following the first and repeated hospitalizations of HFrEF pts, comorbidities, ageing and gender difference are crucial to HFrEF development, while echocardiographic parameters and biomarkers critically affect HFrEF rehospitalization risk.
Bibliography:247640
ISSN:0350-6134
1848-9486
DOI:10.5671/ca.44.3.5