Baseline characteristics and hospital mortality in the Acute Heart Failure Database (AHEAD) Main registry
Abstract
Prognosis of patients hospitalized with acute heart failure (AHF) is poor and risk stratification may help clinicians guide care. The objectives of the Acute Heart Failure Database (AHEAD) registry are to assess patient characteristics, aetiology, treatment and outcome of AHF.
The AHEAD Main registry includes patients hospitalised for AHF in 7 centres with a Cath Lab Service in Czech Republic. The data were collected from September 2006 till October 2009.
The inclusion criteria for the database adhere to the European guidelines for AHF (2005) and patients were systematically classified according to the basic syndromes, type and aetiology of AHF. Of 4,153 patients, 12.7% patients died during hospitalisation.
The median length of hospitalisation was 7.1 days. Mean age of patients was 71.5+/-12.4 years; males were younger (68.6+/-12.4 years) compared with females (75.5+/-11.5 years) (P<0.001).
De-novo heart failure was seen in 58.3% of patients. According to the classification of heart failure syndromes, acute decompensated heart failure (ADHF) was reported in 55.3%, hypertensive AHF in 4.4%, pulmonary oedema in 18.4%, cardiogenic shock in 14.7%, high output failure in 3.3%, and right heart failure in 3.8%.
The mortality of cardiogenic shock was 62.7%, of right AHF 16.7%, of pulmonary oedema 7.1%, of high output HF 6.1%, whereas the mortality of hypertensive AHF or ADHF was < 2.5%. According to multivariate analyses, low systolic blood pressure, low cholesterol level, hyponatraemia, hyperkalaemia, the use of inotropic agents and norepinefrine were predictive parameters for in-hospital mortality in patients without cardiogenic shock.
Severe left ventricle dysfunction and renal insufficiency were predictive parameters for mortality in patients with cardiogenic shock. Invasive ventilation and age over 70 years were the most important predictive factors of mortality for both genders with or without cardiogenic shock.