National Survey of Chronic Heart Failure in Argentina. Variables in Relation to In-Hospital Mortality Rate (Preliminary Results CONAREC VI)

pp 53-62

Abstract

Methods

Between December 1996 through October 1997, 31 argentine hospital centers participated in a national survey about chronic congestive heart failure (CHF)(> 30 days evolution), to identify variables in relation to in-hospital mortality rate.

Results

During the time of the study, 751 patients were evaluated (mean age 65.5 years, 41% were males). Previous medication (before admission): digital 48%, ACE 58%, diuretics 59%. Only 21.5% were employed, and the New York Heart Association (NYHA) functional class were I-II in 70%. In only 57% of the patients the cause of decompensation was known, and in 20% of it was sudden. At the time of hospitalization 89% were in NYHA III-IV. The etiology of the CHF was coronary artery disease in 30%, hipertensive cardiomyopathy in 21%,valvular heart disease in 17%, idiopathic cardiomyopathy in 14%, and others in the left 18% of patients. The mortality rate was 4.6%. The variables associated with death in the univariate analysis were the habitual NYHA class (p = 0.01), global heart failure (p = 0.005), low systolic (p = 0.003) and diastolic (p = 0.007) blood pressure at the time of admission, hyponatremia (p = 0.02), peripheral hypoperfusion (p = 0.02) and hepatojugular reflux(p = 0.045). In the multivariate analysis were independent variables, NYHA class III-IV before the hospitalization (OR = 3.27, p = 0.038) global heart failure (OR = 11.04, p = 0.023) and hyponatremia (OR 1.14, p = 0.008), length of the illness (OR = 1.02,p = 0.027).

Conclusion

The associated features with in-hospital death rates were preadmission functional class, length of the disease, biventricular heart failure, hyponatremia.