What is the clinical evidence from this study?

Study design: Observational. Population: Acute Heart Failure (n=1263). Intervention: Standard of care. Primary outcome: All-cause intrahospital mortality.

January 1, 2015Open Access

I Brazilian Registry of Heart Failure - Clinical Aspects, Care Quality and Hospitalization Outcomes

Key Result

The BREATHE registry demonstrated a high all-cause intrahospital mortality rate of 12.6% among patients admitted with acute heart failure in Brazil, alongside low prescription rates of evidence-based therapies.

Study Design

Type

Observational (n=1,263)

Multicenter

Yes

PICO

Population

Acute Heart Failure (n=1,263)

Intervention / Comparator

Standard of care

Primary Outcome

All-cause intrahospital mortality

Limitations

Diagnosis of acute HF was based only on the Boston criteria and the date of onset of symptoms was not defined, preventing differentiation between new acute HF and exacerbation of chronic HF.
High number of missing data for variables whose completion was not mandatory.

Abstract

BACKGROUND: Heart failure (HF) is one of the leading causes of hospitalization in adults in Brazil. However, most of the available data is limited to unicenter registries. The BREATHE registry is the first to include a large sample of hospitalized patients with decompensated HF from different regions in Brazil. OBJECTIVE: Describe the clinical characteristics, treatment and prognosis of hospitalized patients admitted with acute HF. METHODS: Observational registry study with longitudinal follow-up. The eligibility criteria included patients older than 18 years with a definitive diagnosis of HF, admitted to public or private hospitals. Assessed outcomes included the causes of decompensation, use of medications, care quality indicators, hemodynamic profile and intrahospital events. RESULTS: A total of 1,263 patients (64±16 years, 60% women) were included from 51 centers from different regions in Brazil. The most common comorbidities were hypertension (70.8%), dyslipidemia (36.7%) and diabetes (34%). Around 40% of the patients had normal left ventricular systolic function and most were admitted with a wet-warm clinical-hemodynamic profile. Vasodilators and intravenous inotropes were used in less than 15% of the studied cohort. Care quality indicators based on hospital discharge recommendations were reached in less than 65% of the patients. Intrahospital mortality affected 12.6% of all patients included. CONCLUSION: The BREATHE study demonstrated the high intrahospital mortality of patients admitted with acute HF in Brazil, in addition to the low rate of prescription of drugs based on evidence.

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