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August 7, 2019European Journal of Heart Failure

Departments Involved During the First Episode of Acute Heart Failure and Subsequent Emergency Department Revisits and Rehospitalisations: An Outlook Through the NOVICA Cohort

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Key result

Uncontrolled disease occurred in 31% of patients during the first year after a first episode of acute heart failure, and was independently associated with age >80 years (OR 1.80; 95% CI 1.17-2.77).

Why the study?

The natural history of patients after a first episode of acute heart failure requiring emergency department consultation—including revisits, admitting departments, and factors linked to difficult disease control—was investigated.

Population

505 consecutive patients with a first episode of acute heart failure across four EDs

Design

Multicentre cohort study

Follow-up

Mean 2.4 years

Authors

ÒMÒscar MiróASAna García SarasolaCFCarolina Fuenzalida

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Overview

Suggests closer post-discharge monitoring for octogenarians after initial acute HF; hypothesis-generating for targeted control strategies.

Study Design

Type

Cohort (n=505)

Multicenter

Yes

Structured PICO

P
Population
505 consecutive patients with a first episode of acute heart failure requiring emergency department consultation, followed for a mean of 2.4 years.
O
Outcome
Frequency of ED visits and hospitalisations, departments admitting patients, and factors associated with difficult disease control ('uncontrolled disease' during the first year after FEAHF, defined as ED visits ≥ 3, hospitalisations ≥ 2 for AHF, or death)composite

Main Result

Odds Ratio: 1.8 (95% CI 1.17–2.77)

Following a first episode of acute heart failure, patients experience high rates of ED revisits and hospitalizations across multiple departments, with advanced age, low systolic blood pressure, and anemia predicting poor disease control.

Cite This Study

Miró et al. (2019) conducted a cohort in Acute heart failure (n=505). Age > 80 years, systolic blood pressure < 110 mmHg, and anaemia vs. Absence of these risk factors was evaluated on Uncontrolled disease during the first year after first episode of acute heart failure (ED visits ≥ 3, hospitalisations ≥ 2, or death) (OR 1.80, 95% CI 1.17-2.77). Uncontrolled disease occurred in 31% of patients during the first year after a first episode of acute heart failure, and was independently associated with age >80 years (OR 1.80; 95% CI 1.17-2.77).

synapsesocial.com/papers/6a62ff46a98bc91ae4c1a190https://doi.org/10.1002/ejhf.1567
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1EuroHeart Failure Survey II (EHFS II): a survey on hospitalized acute heart failure patients: description of population2006 · 1,305 citations
  2. 2Hospitalization for Recently Diagnosed Versus Worsening Chronic Heart Failure2017 · 92 citations
  3. 3Outcomes of de novo and acute decompensated heart failure patients according to ejection fraction2017 · 52 citations
  4. 4Clinical Phenotypes and Outcome of Patients Hospitalized for Acute Heart Failure: The ESC Heart Failure Long-Term Registry2017 · 573 citations
  5. 5Predicting 30-Day Mortality for Patients With Acute Heart Failure in the Emergency Department2017 · 196 citations