Factors Associated with 30-Day Mortality Among Acute Heart Failure Patient in the Emergency Department, Siriraj Hospital

Wichayada Rangabpai; Noppaket Pongthanawisut; Netiporn Thirawattanasoot; Onlak Ruangsomboon; Chinnapat Laohachanvanich; Arissa Phothisirisakulwong; Wansiri Chaisirin

Authors

Wichayada Rangabpai Department of Emergency Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University
Noppaket Pongthanawisut Department of Emergency Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University
Netiporn Thirawattanasoot Department of Emergency Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University
Onlak Ruangsomboon Department of Emergency Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University
Chinnapat Laohachanvanich Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University
Arissa Phothisirisakulwong Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University
Wansiri Chaisirin Department of Emergency Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University

Keywords:

Acute heart failure, 30-day mortality, emergency department

Abstract

Introduction
Acute heart failure is a significant global public health problem with an annual mortality rate of 10%. To investigate the predictive factors for mortality in acute heart failure patients can lead to improvement of patient care, including enhancing quality of life, reducing readmission rate, and reducing mortality.
Objective
To identify risk factors that impact the 30-day mortality rate among acute heart failure patients who visited the emergency department, Siriraj Hospital
Method
We conducted this retrospective case-control study on patients with acute heart failure who visited Siriraj Hospital. We collected data from June 1, 2018, to December 31, 2022, and used univariate analysis to identify factors influencing 30-day mortality. We further analyzed the significant factors through multiple logistic regression analysis.
Results
Among 450 acute heart failure patients, 300 patients survived (control group), and 150 patients died within 30 days (case group). Multiple logistic regression analysis identified significant risk factors for 30-day mortality, including valvular heart disease (adjusted OR 1.91, 95% CI 1.08–3.39) and cardiogenic shock (adjusted OR 3.30, 95% CI 1.56–7.12). On the contrary, systolic blood pressure (adjusted OR 0.99, 95% CI 0.98–0.99) and pre-existing statin use (adjusted OR 0.56, 95% CI 0.33–0.94) associated with decreased 30-day mortality.
Conclusion
The significant factors associated with 30-day mortality in acute heart failure patients included valvular heart disease, and cardiogenic shock. Meanwhile, systolic blood pressure and pre-existing use of statins were the protective factors that reduced the likelihood of 30-day mortality.

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