• Francisco Javier Martín-Sánchez, Virginia Carbajosa, Pere Llorens, Pablo Herrero, Javier Jacob, María José Pérez-Dura, Héctor Alonso, José Manuel Torres Murillo, Manuel Garrido, María Luisa López-Grima, Pascual Piñera, Francisco Epelde, Aitor Alquezar, Cristina Fernández, Oscar Miró, and en representación del grupo ICA-SEMES.
• Servicio de Urgencias, Hospital Clínico San Carlos Madrid, España; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, España. Electronic address: fjjms@hotmail.com.
• Med Clin (Barc). 2014 Sep 15; 143 (6): 245-51.

Background And ObjectiveTo study the factors associated with prolonged hospitalization in patients admitted for acute heart failure (AHF) in Spanish short-stay units (SSUs).Patients And MethodsThis was a multicentre, multipurpose cohort study with prospective follow-up including all patients admitted for AHF in the 11 SSUs of the EAHFE registry. Demographic data, previous illness, baseline cardiorespiratory and functional status, acute episode and admission and follow up variables at 60 days were recorded. The primary outcome was prolonged hospitalization in the SSU (>72h). A logistic regression model was used to control the effects of confounding factors.ResultsEight-hundred and nineteen patients were included with a mean age of 80.9 (SD 8.4) years, 483 (59.0%) being women. The median length stay was 3.0 (IQR 2.0-5.0) days with an in-hospital mortality of 2.7%. The independent factors associated with prolonged hospitalization were the coexistence of chronic obstructive pulmonary disease (odds ratio [OR] 1.56; 95% IC 1.02-2.38; P=.040) and anaemia (OR 1.72; 95% CI 1.21-2.44; P=.002), basal oxygen saturation<90% on arrival to the Emergency Department (OR 2.21, 95% CI 1.51-3.23; P<.001), hypertensive episode as the precipitating factor of the AHF (protective factor OR 0.49; 95% CI 0.26-0.93; P=.028) and admission on Thursday (OR 1.90; 95% CI 1.19-3.05; P=.008). There were no significant differences between both groups regarding to in-hospital mortality (2.4 vs. 3.0%), mortality (4.1 vs. 4.2%) or revisit at 60 days (18.4 vs. 21.6%).ConclusionsSeveral factors including hypertensive episode, insufficiency respiratory, anaemia, chronic obstructive pulmonary disease, and admission on Thursday should be taken into account in patients with AHF admitted in SSU stay to avoid prolonged hospitalization.Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

33 keywords...

hide…