Demographics, Precipitating Factors and Treatment in Acute Decompensated Heart Failure

Abstract

Background: Heart failure is a common cause of hospitalization and has a high mortality rate. Data from Internal Medicine Department Buriram Hospital for the past 1 year in 2020-2021 found that the patients being admitted and diagnosed acute decompensated heart failure was 7% of all admissions, 5th ranked among all inpatients. The clinical features of patients with acute decompensated heart failure are therefore important.
Objective: To study the clinical features, precipitating factors, treatment, mortality rate, in acute decompensated heart failure patients.
Material & Methods: A descriptive study, prospective observational cohort design which included acute decompensated heart failure patients at internal medicine ward Buriram Hospital between January 2021 and August 2021 by interviewing history. Clinical features, causes, precipitating factors, treatment, mortality were collected from medical records.
Results: 132 patients, mean age 64 years, 55% male, 53% had ≥3 atherosclerotic cardiovascular risk factors. 87% had New York Heart Association Functional Classification IV. 47% were heart failure with reduced ejection fraction. 30% were acute myocardial infarction. 42% developed acute kidney injury. 29% had clinical sepsis. In-hospital mortality rate was 7.5%. Advanced stage kidney disease is a predictor of in-hospital mortality.
Conclusion: From this study, the acute decompensated heart failure patients were clinically more severe and had a higher mortality than those in the Thai ADHERE Registry. Encourage follow up treatment, modify atherosclerotic risk factors and advice patient educations to reduce infection are recommended to prevent hospitalization and reduce death.