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Influence of the length of hospitalisation in post-discharge outcomes in patients with acute heart failure: Results of the LOHRCA study

Fecha de publicación:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Miro, O
  • Padrosa, J
  • Takagi, K
  • Gayat, E
  • Gil, V
  • Llorens, P
  • Martin-Sanchez, FJ
  • Herrero-Puente, P
  • Jacob, J
  • Montero, MM
  • Tost, J
  • Diez, MPL
  • Traveria, L
  • Torres-Garate, R
  • Alonso, MI
  • Aguera, C
  • Valero, A
  • Javaloyes, P
  • Peacock, WF
  • Bueno, H
  • Mebazaa, A
  • Fuentes, M
  • Gil, C
  • Alonso, H
  • Garmila, P
  • Garcia, GL
  • Yanez-Palma, MC
  • Lopez, SI
  • Escoda, R
  • Xipell, C
  • Sanchez, C
  • Gaytan, JM
  • Pavon, J
  • Noval, A
  • Torres, JM
  • Lopez-Grima, ML
  • Juan, MA
  • Aguirre, A
  • Morales, JE
  • Maso, SM
  • Ruiz, F
  • Franco, JM
  • Mecina, AB
  • Sanchez, S
  • Carbajosa, V
  • Pinera, P
  • Nicolas, JAS
  • Garate, RT
  • Alquezar, A
  • Rizzi, MA
  • Herrera, S
  • Roset, A
  • Cabello, I
  • Richard, F
  • Perez, JMA
  • Alvarez, JV
  • Garcia, BP
  • Gonzalez, MGGYS
  • Marquina, V
  • Jimenez, I
  • Hernandez, N
  • Brouzet, B
  • Ramos, S
  • Lopez, A
  • Andueza, JA
  • Romero, R
  • Ruiz, M
  • Calvache, R
  • Lorca, MT
  • Calderon, L
  • Arriaga, BA
  • Sierra, B
  • Mojarro, EM
  • Becquer, LT
  • Burillo, G
  • Garcia, LL
  • LaSalle, GC
  • Urbano, CA
  • Soto, ABG
  • Padial, ED
  • Ferrer, ES
  • Garrido, M
  • Lucas, FJ
  • Gaya, R
  • Bibiano, C
  • Mir, M
  • Rodriguez, B
  • Sanchez, N
  • Carballo, JL
  • Rodriguez-Adrada, E
  • Rodriguez, B
  • ICA-SEMES Res Grp

Grupos

Abstract

Objective: To investigate the relationship between length of hospitalisation (LOH) and post-discharge outcomes in acute heart failure (AHF) patients and to ascertain whether there are different patterns according to department of initial hospitalisation. Methods: Consecutive AHF patients hospitalised in 41 Spanish centres were grouped based on the LOH (< 6/6-10/11-15/ > 15 days). Outcomes were defined as 90-day post-discharge all-cause mortality, AHF readmissions, and the combination of both. Hazard ratios (HRs), adjusted by chronic conditions and severity of decompensation, were calculated for groups with LOH > 6 days vs. LOH < 6 days (reference), and stratified by hospitalisation in cardiology, internal medicine, geriatrics, or short-stay units. Results: We included 8563 patients (mean age: 80 (SD = 10) years, 55.5% women), with a median LOH of 7 days (IQR 4-11): 2934 (34.3%) had a LOH < 6 days, 3184 (37.2%) 6-10 days, 1287 (15.0%) 11-15 days, and 1158 (13.5%) > 15 days. The 90-day post-discharge mortality was 11.4%, readmission 32.2%, and combined end-point 37.4%. Mortality was increased by 36.5% (95%CI = 13.0-64.9) when LOH was 11-15 days, and by 72.0% (95%CI = 42.6-107.5) when > 15 days. Conversely, no differences were found in readmission risk, and the combined end-point only increased 21.6% (95%CI = 8.4-36.4) for LOH > 15 days. Stratified analysis by hospitalisation departments rendered similar post-discharge outcomes, with all exhibiting increased mortality for LOH > 15 days and no significant increments in readmission risk. Conclusions: Short hospitalisations are not associated with worse outcomes. While post-discharge readmissions are not affected by LOH, mortality risk increases as the LOH lengthens. These findings were similar across hospitalisation departments.

Datos de la publicación

ISSN/ISSNe:
0953-6205, 1879-0828

EUROPEAN JOURNAL OF INTERNAL MEDICINE  ELSEVIER SCIENCE BV

Tipo:
Article
Páginas:
24-32
PubMed:
31451322
Factor de Impacto:
1,017 SCImago ℠
Cuartil:
Q2 SCImago ℠

Citas Recibidas en Web of Science: 5

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Keywords

  • Acute heart failure; Length of hospitalisation; Post-discharge outcomes; Vulnerability phase; Mortality; Readmission

Campos de Estudio

Proyectos y Estudios Clínicos

PRAGMATIC, CONTROLLED, INTERNATIONAL STUDY CONDUCTED IN SEVERAL CENTRES ON THE SAFETY AND THERAPEUTIC EFFECT OF A HYDROXYLETHYL-STARCH (HES) SOLUTION VERSUS AN ELECTROLYTE SOLUTION IN TRAUMA PATIENTS.

Investigador Principal: ÓSCAR DÍAZ CAMBRONERO

HC-G-H-1505 . 2018

EFECTO DE V0251 EN EL VÉRTIGO AGUDO. ESTUDIO ALEATORIZADO, DOBLE CIEGO Y CONTROLADO CON PLACEBO.

Investigador Principal: HERMINIO PÉREZ GARRIGUES

V00251IV2024A

PERFIL DE RIESGO DE LOS PACIENTES CON ETV EN HOSPITALES ESPAÑOLES ATENDIDOS EN LOS SERVICIOS DE URGENCIAS E IMPACTO ASISTENCIAL: REGISTRO ESPHERIA.

Investigador Principal: MARÍA JOSÉ PÉREZ DURÁ

ESPHERIA

PLANIFICACIÓN DEL ALTA DESDE URGENCIAS PARA REDUCIR REINGRESOS A 30 DÍAS EN MAYORES FRÁGILES CON INSUFICIENCIA CARDÍACA AGUDA: ENSAYO CLÍNICO ALEATORIZADO POR CONGLOMERADOS PAREADO.

Investigador Principal: CARMEN GARGALLO MAICAS

DEED FRAIL-AHF . 2019

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