The Early Prediction of Patient Outcomes in Acute Heart Failure: A Retrospective Study
Background: Acute heart failure (AHF) is a major cause of hospitalizations, posing significant challenges to healthcare systems. Despite advancements in management, the rate of poor outcomes remains high globally, emphasizing the need for timely interventions. This study aimed to identify early admi...
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2025-06-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| author | Maria Boesing Justas Suchina Giorgia Lüthi-Corridori Fabienne Jaun Michael Brändle Jörg D. Leuppi |
| author_facet | Maria Boesing Justas Suchina Giorgia Lüthi-Corridori Fabienne Jaun Michael Brändle Jörg D. Leuppi |
| author_sort | Maria Boesing |
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| description | Background: Acute heart failure (AHF) is a major cause of hospitalizations, posing significant challenges to healthcare systems. Despite advancements in management, the rate of poor outcomes remains high globally, emphasizing the need for timely interventions. This study aimed to identify early admission-based factors predictive of poor outcomes in hospitalized AHF patients, in order to contribute to early risk stratification and optimize patient care. Methods: This retrospective single-center study analyzed routine data of adult patients hospitalized for AHF at a public university teaching hospital in Switzerland. Outcomes included in-hospital death, intensive care (ICU) treatment, and length of hospital stay (LOHS). Potential predictors were limited to routine parameters, readily available at admission. Missing predictor data was imputed and predictors were identified by means of multivariable regression analysis. Results: Data of 638 patients (median age 84 years, range 45–101 years, 50% female) were included in the study. In-hospital mortality was 7.1%, ICU admission rate 3.8%, and median LOHS was 8 days (IQR 5–12). Systolic blood pressure ≤ 100 mmHg (Odds ratio (OR) 3.8, <i>p</i> = 0.009), peripheral oxygen saturation ≤ 90% or oxygen supplementation (OR 5.9, <i>p</i> < 0.001), and peripheral edema (OR 2.7, <i>p</i> = 0.044) at hospital admission were identified as predictors of in-hospital death. Furthermore, a stroke or transient ischemic attack in the patient’s history (OR 3.2, <i>p</i> = 0.023) was associated with in-hospital death. ICU admission was associated with oxygen saturation ≤ 90% or oxygen supplementation (OR 22.9, <i>p</i> < 0.001). Factors linked to longer LOHS included oxygen saturation ≤ 90% or oxygen supplementation (IRR 1.2, <i>p</i> < 0.001), recent weight gain (IRR 1.1, <i>p</i> = 0.028), and concomitant chronic kidney disease (IRR 1.2, <i>p</i> < 0.001). Conclusions: This study validated established predictors of AHF outcomes in a Swiss cohort, highlighting the predictive value of poor perfusion status, fluid overload, and comorbidities such as chronic kidney disease. The identified predictors imply potential for developing tools to improve rapid treatment decisions. Future research should focus on the prospective external validation of the identified predictors and the design and validation of risk scores, incorporating these parameters to optimize early interventions and reduce adverse outcomes in AHF. |
| format | Article |
| id | doaj-art-6f1582e50f774a6ea5d960d4a0794bcf |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-06-01 |
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| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj-art-6f1582e50f774a6ea5d960d4a0794bcf2025-08-20T03:32:14ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252025-06-0112723610.3390/jcdd12070236The Early Prediction of Patient Outcomes in Acute Heart Failure: A Retrospective StudyMaria Boesing0Justas Suchina1Giorgia Lüthi-Corridori2Fabienne Jaun3Michael Brändle4Jörg D. Leuppi5University Institute of Internal Medicine, Kantonsspital Baselland, 4410 Liestal, SwitzerlandUniversity Institute of Internal Medicine, Kantonsspital Baselland, 4410 Liestal, SwitzerlandUniversity Institute of Internal Medicine, Kantonsspital Baselland, 4410 Liestal, SwitzerlandUniversity Institute of Internal Medicine, Kantonsspital Baselland, 4410 Liestal, SwitzerlandDepartment of Internal Medicine, Kantonsspital Sankt Gallen, 9000 Sankt Gallen, SwitzerlandUniversity Institute of Internal Medicine, Kantonsspital Baselland, 4410 Liestal, SwitzerlandBackground: Acute heart failure (AHF) is a major cause of hospitalizations, posing significant challenges to healthcare systems. Despite advancements in management, the rate of poor outcomes remains high globally, emphasizing the need for timely interventions. This study aimed to identify early admission-based factors predictive of poor outcomes in hospitalized AHF patients, in order to contribute to early risk stratification and optimize patient care. Methods: This retrospective single-center study analyzed routine data of adult patients hospitalized for AHF at a public university teaching hospital in Switzerland. Outcomes included in-hospital death, intensive care (ICU) treatment, and length of hospital stay (LOHS). Potential predictors were limited to routine parameters, readily available at admission. Missing predictor data was imputed and predictors were identified by means of multivariable regression analysis. Results: Data of 638 patients (median age 84 years, range 45–101 years, 50% female) were included in the study. In-hospital mortality was 7.1%, ICU admission rate 3.8%, and median LOHS was 8 days (IQR 5–12). Systolic blood pressure ≤ 100 mmHg (Odds ratio (OR) 3.8, <i>p</i> = 0.009), peripheral oxygen saturation ≤ 90% or oxygen supplementation (OR 5.9, <i>p</i> < 0.001), and peripheral edema (OR 2.7, <i>p</i> = 0.044) at hospital admission were identified as predictors of in-hospital death. Furthermore, a stroke or transient ischemic attack in the patient’s history (OR 3.2, <i>p</i> = 0.023) was associated with in-hospital death. ICU admission was associated with oxygen saturation ≤ 90% or oxygen supplementation (OR 22.9, <i>p</i> < 0.001). Factors linked to longer LOHS included oxygen saturation ≤ 90% or oxygen supplementation (IRR 1.2, <i>p</i> < 0.001), recent weight gain (IRR 1.1, <i>p</i> = 0.028), and concomitant chronic kidney disease (IRR 1.2, <i>p</i> < 0.001). Conclusions: This study validated established predictors of AHF outcomes in a Swiss cohort, highlighting the predictive value of poor perfusion status, fluid overload, and comorbidities such as chronic kidney disease. The identified predictors imply potential for developing tools to improve rapid treatment decisions. Future research should focus on the prospective external validation of the identified predictors and the design and validation of risk scores, incorporating these parameters to optimize early interventions and reduce adverse outcomes in AHF.https://www.mdpi.com/2308-3425/12/7/236acute heart failurerisk stratificationpatient outcomemortalityintensive carelength of hospital stay |
| spellingShingle | Maria Boesing Justas Suchina Giorgia Lüthi-Corridori Fabienne Jaun Michael Brändle Jörg D. Leuppi The Early Prediction of Patient Outcomes in Acute Heart Failure: A Retrospective Study Journal of Cardiovascular Development and Disease acute heart failure risk stratification patient outcome mortality intensive care length of hospital stay |
| title | The Early Prediction of Patient Outcomes in Acute Heart Failure: A Retrospective Study |
| title_full | The Early Prediction of Patient Outcomes in Acute Heart Failure: A Retrospective Study |
| title_fullStr | The Early Prediction of Patient Outcomes in Acute Heart Failure: A Retrospective Study |
| title_full_unstemmed | The Early Prediction of Patient Outcomes in Acute Heart Failure: A Retrospective Study |
| title_short | The Early Prediction of Patient Outcomes in Acute Heart Failure: A Retrospective Study |
| title_sort | early prediction of patient outcomes in acute heart failure a retrospective study |
| topic | acute heart failure risk stratification patient outcome mortality intensive care length of hospital stay |
| url | https://www.mdpi.com/2308-3425/12/7/236 |
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