Precipitating Factors Predict Length of Stay More Than 1 Day in Acute Decompensated Heart Failure Patients Visiting Emergency Department
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Abstract
Background: Patients with acute decompensated heart failure have different precipitating factors. Therefore, there will be a different length of hospital stays.
Objective: To identify precipitating factors in acute decompensated heart failure patients that predict the length of stay of more than 1 day.
Methods: A retrospective cohort study collected data of acute decompensated heart failure patients who were not dead and not inserted an endotracheal tube in the first 6 hours who came to the emergency department of Ramathibodi Hospital during 2016 to 2017. Collected data from the characteristics of patients, underlying diseases, medical signs, vital signs and laboratory in the emergency department, and factors stimulating acute decompensated heart failure in patients. Logistic regressions were used for data analysis.
Results: Of all 213 patients, 151 patients stayed in the hospital for more than 1 day and 62 patients in less than 1 day. Precipitating factors that predict more than 1 day of hospital stay are arrhythmia and acute coronary syndrome. Precipitating factor that predicts less than 1 day of hospital stay is noncompliance with medications. After adjusting by sex, age, comorbid, and NYHA class, precipitating factors that predict more than 1 day of hospital stay is an arrhythmia (OR, 7.46; 95% CI, 2.09 - 26.60).
Conclusions: Patients who precipitate acute decompensated heart failure by arrhythmia have probably more than 1 day of hospital stay. In the case of hospital bed limit, this group of patients should be considered as inpatients.
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