Predictive factors of survivals with congestive heart failure at medical units in Maharaj nakorn Si thammarat hospital

Abstract

              Objective:To identify the risk factors associated with survival in congestive heart failure at medical wards. Methods : A retrospective review of medical records of 730patients who were diagnoses as congestive heart failure in ICD-10 as I-500 between October 2013-september 2015 was conducted. Fifteen factors were included in univariate and only significant factors were included in multivariate analyses. Results : Population study were conducted730 patients with average age about 66.3 years old(female 403persons in average age 69.5 years old and male 326persons with average age 61.8 years old ).Underlying disease diabetes 43.4% hypertension64.8%and Chronic renal failure30.7%.were reported. Eighty three point seven percent of all admissions were survive .From multivariate analysis,predicted risk factors were associated with Dyslipidemia(P=.029) Chronic renal failure (P<0.001) thalassemia (P=0.27) First presentation as infection(P<0.001) acute myocardial infarction (P<0.001) Septic shock (P<0.001) Pneumonia (P<0.001) medical treatment: Plavix(P<0.001) statin(P=0.008) antiarhhythmic drugs (P<0.001) antianginal (P<0.001) antimicrobial agent(P<0.001) Insulin administration (P<0.001) high dose Lasix(P<0.001) serum Cr ≥1.3mg/dL(P<0.001)and serum albumin<3g/dL (P=0.002). From logistic regression analysis,factors associated with mortality were dyslipidemia(Adj.OR0.4395%CI(0.2,0.94))acute myocardial infarction(Adj.OR .5195%CI(2.43,29.81)) antiarrhythmic drug (Adj.OR 26.82 95%CI(8.77,82.01))serum albumin<3g/dL (Adj.OR1.79 95% CI(1.03,3.12)). Conclusion:Factors as acute myocardial infarction and antiarrhythmic drugs were independent predictive factors increased mortality.