• María Esther Guisado-Espartero, Prado Salamanca-Bautista, Óscar Aramburu-Bodas, Luis Manzano, M Angustias Quesada Simón, Gabriela Ormaechea, Sara Carrascosa García, Marcos Guzmán García, José María Cepeda Rodrigo, Manuel Montero-Pérez-Barquero, Grupo RICA, and Registro RICA.
• Servicio de Medicina Interna, Hospital Infanta Margarita, Cabra (Córdoba), España. Electronic address: guesm53@hotmail.com.
• Med Clin (Barc). 2022 Jan 7; 158 (1): 13-19.

IntroductionThere are few data in the Spanish population about the causes of death in patients admitted to internal medicine departments for heart failure. Their study according to left ventricular ejection fraction (reduced: rEF, mid-range: mEF, and preserved: pEF) could improve the knowledge of patients and their prognosis.MethodsProspective multicentre cohort study of 4144 patients admitted with heart failure to internal medicine departments. Their clinical characteristics, mortality rate and causes were classified according to pEF (≥ 50%), mEF (40%-49%) and rEF (<40%). Patients were followed-up for a median of one year.ResultsThere were 1198 deaths (29%). The cause of death was cardiovascular (CV) in 833 patients (69.5%), mainly heart failure (50%) and sudden cardiac death (7.5%). Non-cardiovascular (NoCV) causes were responsible for 365 deaths (30.5%). The most common NoCV causes were infections (13%). The most frequent and early cause in all groups was heart failure. Patients with pEF, compared to the other groups, had lower risk of sudden cardiac death and higher risk of infections (P <.05). The causes of death in patients with mrEF were closer to those with pEF.ConclusionsThe causes of death in patients with heart failure were different depending on ejection fraction strata. Patients with mEF and pEF, due to their high comorbidity and higher frequency of NoCV death, would require comprehensive management by internal medicine.Copyright © 2020 Elsevier España, S.L.U. All rights reserved.

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