Clinical and socio-demographic characteristics of patients hospitalized due to acute heart failure at Hospital El Carmen and prognosis evaluation at 6 months

Abstract

Objective: To describe the clinical, social and demographic characteristics of the patients hospitalized at the Coronary Care Unit (CCU) and define their influence on 6-month prognosis. Materials and methods: A prospective observational registry was carried out at Hospital El Carmen including patients between July 1, 2019 and December 31, 2019, of those patients who entered the coronary unit with the main diagnosis of acute heart failure. Data were collected on the characteristics of patients, type of acute heart failure, social variables, auxiliary tests and treatment prior to admission, hospital and pre-discharge. Follow-up was carried out until June 30, 2020 by telephone, face-to-face in the office and through the digital clinical history system of the medical insurance of public employees
(SISAO per its acronym in Spanish) to analyze therapeutic adherence and re-hospitalizations for heart failure. Statistical analysis: Qualitative variables are expressed as percentages and 95% confidence interval (95% CI). Quantitative variables were expressed as mean and standard deviation for the variables with Gaussian distribution or median and interquartile range, for variables with non-Gaussian distribution. Discrete variables were analyzed through contingency tables and continuous variables by t-test. A value of p <0.05 was considered significant. Epi Info 7.2 and SPSS 25 were used. Results: There were 23 patients admitted. The mean age was 70.5 years (SD 9). From them, 91% were retired, 52% were married or living with a partner and the rest divorced, separated or widowed. Regarding the level of education, 86% had only a primary stage. Regarding economic income, 65% received less than 25 thousand pesos per month. All the patients had a family member to go to for emergency help; 63% fulfilled the characteristics of social vulnerability. It is noted that the main form of presentation was decompensated chronic heart failure, the predominant etiology of heart failure was ischemic and the main reason for decompensation was due to disease progression and discontinuation of medication. Hospital mortality was 8.7%. At the completion of the follow-up period, 89.47% of the patients complied with the medication prescribed at discharge or equivalent (that is, therapeutic adherence) and the rate of re-hospitalizations for acute HF was 13.64%. Conclusion: Heart failure continues to be a challenge for clinical management today, since patients are an elderly population, polymedicated and with important variables of social vulnerability that influence the number of re-hospitalizations, and thus become a factor to have in mind when treating our patients.