Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2022, 166(3):312-321 | DOI: 10.5507/bp.2022.020

The prognosis and therapeutic management of patients hospitalized for heart failure in 2010-2020

Otto Mayer Jr^{a, b}, Jan Bruthans^{a, c}, Simona Bilkova^{a, b}, Jitka Seidlerova^{a, b}, Josef Jirak^d, Jan Filipovsky^{a, b}

^a 2^nd Department of Internal Medicine, Faculty of Medicine, Charles University and University Hospital, Pilsen, Czech Republic

^b Biomedical Center, Faculty of Medicine, Charles University Pilsen, Czech Republic

^c Centre for Cardiovascular Prevention, First Faculty of Medicine, Charles, University and Thomayer's Hospital, Prague, Czech Republic

^d Department of Informatics, University Hospital Pilsen, Czech Republic

Aims: We analyzed the mortality risk and its predictors in patients hospitalized for heart failure (HF).

Methods: Patients discharged from hospitalization for acute decompensation of HF in 2010-2020 and younger than 86 years were followed (n=4097). We assessed the incidence and trends of all-cause death, its main predictors, and the pharmacotherapy recommended at discharge from the hospital.

Results: The 30 days all-cause mortality was in discharged patients 3.2%, while 1-year 20.4% and 5-years 55.4%. We observed a modest trend to decreased 1-year mortality risk over time. Any increase of year of hospitalization by one was associated with about 5% lower risk in the fully adjusted model. Regarding predictors of 1-year mortality risk, a positive association was found for age over 65, history of malignancy, and peak brain natriuretic peptide during hospitalization ≥10times higher than normal concentration. In contrast, as protective factors, we identified LDL ≥1.8 mmol/L, treatment with beta-blockers, renin-angiotensin axis blockers, statins, and implanted cardioverter in the same regression model. The ejection fraction category and primary etiology of HF (coronary artery disease vs. others) did not significantly affect the mortality risk in a fully adjusted model.

Conclusions: Despite advances in cardiovascular disease management over the last two decades, the prognosis of patients hospitalized for heart failure remained highly unfavorable.

Keywords: cardiac decompensation, hospitalization, mortality risk, pharmacotherapy

Received: December 29, 2021; Revised: February 25, 2022; Accepted: April 6, 2022; Prepublished online: April 20, 2022; Published: September 14, 2022  Show citation