Articles Vol. 65 No. CĐ10 - Bệnh viện Thống Nhất 30/10/2024

28. STUDY ON CHARACTERISTICS AND SHORT-TERM PROGNOSIS OF ACUTE HEART FAILURE IN INPATIENT PATIENTS OVER 85 YEARS OLD

Chau Van Vinh1,2, Nguyen Van Tan1,2,3,4, Ho Thuong Dung1,2
1 Thong Nhat Hospital
2 Bệnh viện Thống Nhất
3 University of Medicine and Pharmacy at Ho Chi Minh City
4 Trường Đại học Y Dược thành phố Hồ Chí Minh
Corresponding author: chauvanvinh1975@gmail.com
DOI: 10.52163/yhc.v65iCD10.1614
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Keywords
Acute Heart Failure (AHF) Heart Failure with reduced EF (HFrEF) Heart Failure with preserved EF (HFpEF)
Abstract

Background: Acute heart failure is the primary reason for hospitalization among the elderly, leading to high mortality rates and healthcare expenses. In Vietnam, research on acute heart failure is limited, particularly in individuals aged 85 and older.

Objective: Survey on characteristics and short-term prognosis of patients over 85 years old hospitalized with acute left heart failure Subject and method: Cross-sectional and longitudinal study.

Results: The 145 patients had an average age of 88.5±3.5 years, with 33.8% being over 90 years old. The mean hospital stay was 8.3±1.3 days. Common underlying diseases in patients over 85 years old included hypertension with a high prevalence (76.6%), dyslipidemia (62.1%), chronic kidney disease (52.4%), vascular disease (45.5%), non-revascularized coronary artery (45.5%), chronic atrial fibrillation (39.6%), and type 2 diabetes (35.9%). The readmission rate within the initial 90 days was 32.4%, with patients with heart failure with reduced EF being 3.7 times more likely to be readmitted than those with preserved EF (OR=3.7, 95% CI: 1.732-8.037). The prescription rate of heart failure medications like ARNI and SGLT2 was restricted to <6.3% and the overall mortality rate in the study was 3.4%.

Conclusion: The readmission rate within the initial 90 days for patients aged over 85. remained high, with the HFrEF patient cohort exhibiting a higher readmission rate compared to the HFpEF patient group.

References
[1]
Felker GM, Teerlink JR (2018), “Diagnosis and Management of Acute Heart Failure”, Braunwald’s Heart Disease A Textbook of Cardiovascular Medicine, pp.1128-288. Google Scholar
[2]
Groenewegen A, Rutten FH, Mosterd A, Hoes AW, (2020). Epidemiology of heart failure. European Journal of Heart Failure. 66. Google Scholar
[3]
McMurray J, DeMets DL, Kober L, et al. (2019). Dapagliflozin and prevention of adverse outcomes in heart failure trial (DAPA-HF): Results Google Scholar
[4]
in nondiabetic patients. Presented at AHA, Philadelphia, PA, 16 November. Google Scholar
[5]
Yancy CW, Jessup M et al (2017), “2017 ACC/AHA/HFSA Focused Update of the 2013 ACC/AHA Guideline for the Management of Heart Failure”, Circulation, 136, pp.137-161. (4). Google Scholar
[6]
Tubaro M, Vranckx P, Price S, and Vrints C, (2018). Acute heart failure: Epidemiology, classification, and pathophysiology. The ESC Textbook of Intensive and Acute Cardiovascular Care. Oxford Medicine Online. Google Scholar
[7]
McDonagh TA, Metra M, Adamo M, Gardner R, et al (2023). 2023 Focused Update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA) of the ESC. European Heart Journal, Volume 44 (37), 1 October 2023, pp.3627–3639. Google Scholar
[8]
Thomas M, James J, Larry A, et al. (2022). 2022 Update to the 2017 ACC Expert Consensus Decision Pathway for Optimization of Heart Failure Treatment: Answers to 10 Pivotal Issues About Heart Failure With Reduced Ejection Fraction. JACC;77(6):772-810. Google Scholar
[9]
Sung SH, Wang TJ, Cheng HM, et al (2018). Clinical Characteristics and Outcomes in the Very Elderly Patients Hospitalized for Acute Heart Failure: Importance of Pharmacologic Guideline Adherence. Scientific Reports 8, pp.14270. Google Scholar
[10]
Ural D, Cavusoglu Y, Eren M, Karauzum K, at al (2016). Diagnosis and management of acute heart failure. Anotal J Cardiol, 15 (11): pp. 860-889. Google Scholar
[11]
Solomon SD, McMurray JJV, Anand IS, et al. (2019). Angiotensin–neprilysin inhibition in heart failure with preserved ejection fraction. N Engl J Med; 381, pp. 1609–20. Google Scholar
[12]
Rosano G, Quek D, Martinez F, (2020), Sodium-glucose Co-transporter 2 Inhibitors in Heart Failure. Cardiac Failure Review; 6:e31. Google Scholar
[13]
Hanon O, Belmin J, Benetos A, Chassagne P, et al (2021). Consensus of experts from the French Society of Geriatrics and Gerontology on the management of heart failure in very old subjects. Arch Cardiovasc Dis;114(3):246-259. Google Scholar
[14]
Maggiona AP, Dahlstrom U, Filippatos G, Chioncel O, et al (2020). EURObservational Research Programme: the Heart Failure Pilot Survey (ESC-HF Pilot). Eur J Heart Fail; 12(10): 1076-84. Google Scholar
[15]
Fonarow GC, Abraham WT, Albert NM, Gattis WA, et al (2014). Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF): rationale and design. Am Heart J. 2014 Jul; 148 (1): 43-51. Google Scholar
[16]
Shoaib A, Farag M, Nasir M, John J, et al (2016). Is the diagnostic coding position of acute heart failure related to mortality? A report from the Euro Heart Failure Survey-1 (EHFS1). Eur J Heart Fail; 2016 May;18(5): 556-63. Google Scholar
[17]
Adams KF Jr, Fonarow GC, Emerman CL, LeJemtel TH, et al (2005). Characteristics and outcomes of patients hospitalized for heart failure in the United States: rationale, design, and preliminary observations from the first 100,000 cases in the Acute Decompensated Heart Failure National Registry (ADHERE). Am Heart J. 2005 Feb;149(2):209-16. Google Scholar
[18]
Mebazaa A, Parissis John, Porcher R, Gayat E, et al (2011). Short-term survival by treatment among patients hospitalized with acute heart failure: the global ALARM-HF registry using propensity scoring methods. Intensive Care Med. 2011 Feb; 37(2): 290-301. Google Scholar
[19]
Maddox MH, Januzzi JL, Allen LA, Breathett K, at al (2024). 2024 ACC Expert Consensus Decision Pathway for Treatment of Heart Failure With Reduced Ejection Fraction: A Report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2024 Apr, 83 (15) 1444–1488. Google Scholar
[20]
Kittleson MM, Panjrath GS, Amancherla K, et al (2023). 2023 ACC Expert Consensus Decision Pathway on Management of Heart Failure With Preserved Ejection Fraction: A Report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol 2023;Apr 19. Google Scholar