What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Congestive heart failure (n=4606). Intervention: Contemporary CHF medications. Primary outcome: In-hospital mortality.

What does this research mean for the field?

Use of ACE inhibitors, aspirin, calcium antagonists, beta-blockers, and warfarin is associated with decreased risk of in-hospital mortality among hospitalized CHF patients, though these proven therapies are underutilized, particularly in women and the elderly. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To define contemporary patterns of risk and clinical management among hospitalized patients presenting with acute congestive heart failure.

August 12, 1996Archives of Internal Medicine

Mortality Risk and Patterns of Practice in 4606 Acute Care Patients With Congestive Heart Failure

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Key result

Use of ACE inhibitors, aspirin, calcium antagonists, beta-blockers, and warfarin was associated with decreased risk of in-hospital mortality among 4606 hospitalized CHF patients.

Population

4,606 hospitalized patients with congestive heart failure (CHF) in 1992 and 1993

Design

Cross-sectional

Follow-up

in-hospital

Discussion

Member takes

Implication

Association with lower mortality supports further study in hospitalized CHF; leaves open causal benefits and practice change pending randomized data.

Key Points

To define contemporary patterns of risk and clinical management among hospitalized patients presenting with acute congestive heart failure.
Conducted a cross-sectional medical records audit of 4,606 patients hospitalized with congestive heart failure in 1992 and 1993.
Assessed overall medication prescription patterns and performed logistic regression analysis to identify clinical and therapeutic factors associated with in-hospital mortality.
Total in-hospital mortality was 19%, with congestive heart failure progression being the single leading cause, while noncardiac conditions accounted for 30% of all deaths.
Angiotensin-converting enzyme inhibitors were prescribed to 53% of patients overall but were utilized significantly less frequently in women and patients aged 70 years or older (P < .01).
Logistic regression identified age 70 years or older, magnesium use, and nitrate use as predictors of increased in-hospital mortality, whereas ACE inhibitors, acetylsalicylic acid, calcium antagonists, beta-blockers, and warfarin were associated with decreased mortality risk.

Study Design

Type

Cross-Sectional (n=4,606)

Structured PICO

Population

4,606 hospitalized patients with congestive heart failure (CHF) in 1992 and 1993

Outcome

in-hospital mortalityhard clinical

In the early 1990s, hospitalized CHF patients had a 19% in-hospital mortality rate and suboptimal use of proven therapies, particularly among women and the elderly.

Cite This Study

A 1996 study conducted a cross-sectional in Congestive heart failure (n=4,606). Contemporary CHF medications was evaluated on In-hospital mortality. Use of ACE inhibitors, aspirin, calcium antagonists, beta-blockers, and warfarin was associated with decreased risk of in-hospital mortality among 4606 hospitalized CHF patients.

synapsesocial.com/papers/6a1741103d715b2f195df102 https://doi.org/10.1001/archinte.1996.00440140095009

Topics

Heart failure hospitalization Heart failure HFrEF treatment HFpEF management

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Implication

Association with lower mortality supports further study in hospitalized CHF; leaves open causal benefits and practice change pending randomized data.

Mortality Risk and Patterns of Practice in 4606 Acute Care Patients With Congestive Heart Failure

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Topics

Mortality Risk and Patterns of Practice in 4606 Acute Care Patients With Congestive Heart Failure

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider