Key result
Nocturnal dyspnea and pleural effusion at HF diagnosis link to ~57% higher 1-month admission risk.
Why the study?
Little information is available on the symptoms and clinical signs at heart failure diagnosis that predict hospitalisation and mortality.
Cohort (n=557)
Yes
Odds Ratio: 1.57 (95% CI 1.07–2.32)
Absolute Event Rate: 34% vs 18%
p-value: p=0.022
Specific clinical signs at the time of heart failure diagnosis, such as peripheral edema and nocturnal dyspnea, are significant predictors of early hospitalization, while age and pulmonary rales predict 6-month mortality.
Peripheral oedema, nocturnal dyspnoea and pleural effusion at HF diagnosis were associated with early hospitalisation; leaves open whether these signs warrant targeted primary-care interventions.
Little information is available on the predicting factors for hospitalisation and mortality in heart failure. The aim of this study was to determine the symptoms and clinical signs at the time of the diagnosis of heart failure that predict hospitalisation within the first month after diagnosis and mortality within the first six months after diagnosis. Data were prospectively collected during a two-year period by a nationwide network of sentinel family practices. All adult patients for whom the first time the diagnosis of heart failure was clinically suspected were registered. One, six and twelve months after the initial diagnosis, the family physicians completed a follow-up form with questions about the final diagnosis, evolution and outcome. In total 557 patients with confirmed heart failure were recorded (median age = 78 years). Hospitalisation within the first month after the diagnosis was best predicted by peripheral oedema (p = 0.001), nocturnal dyspnoea (p = 0.022) and pleural effusion (p = 0.032) at the time of the diagnosis. Six months after the initial diagnosis the mortality was 19% and after 12 months it was 26%. Mortality within the first six months after the diagnosis was best predicted by age (p < 0.001) and pulmonary rales (p = 0.001). Peripheral oedema appeared more among the survivors (p = 0.035). Peripheral oedema, nocturnal dyspnoea and pleural effusion are highly associated with hospitalisation within the first month after diagnosis.
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Devroey et al. (2010) conducted a cohort in Heart failure (n=557). Nocturnal dyspnoea at diagnosis vs. Absence of nocturnal dyspnoea was evaluated on Hospital admission within the first month after diagnosis (OR 1.57, 95% CI 1.07-2.32, p=0.022). At the time of heart failure diagnosis, nocturnal dyspnoea (OR 1.57) and pleural effusion (OR 1.53) were significantly associated with an increased risk of hospital admission within the first month.
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