Seasonality in Mortality in a Cardiology Department: A Five-Year Analysis in 500 Patients

Cardiology ◽  
2019 ◽  
Vol 142 (2) ◽  
pp. 67-72
Author(s):  
Lourdes Vicent ◽  
Vanesa Bruña ◽  
Carolina Devesa ◽  
Iago Sousa-Casasnovas ◽  
Miriam Juárez ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mortality Rate ◽  
Cause Of Death ◽  
Cardiovascular Mortality ◽  
Hospital Admissions ◽  
Seasonal Trend ◽  
Common Cause ◽  
Refractory Heart Failure ◽  
Cardiology Department ◽  
The Mean

Background: Previous studies have indicated that cardiovascular mortality follows a seasonal trend. The aim of this work was to determine the evolution of mortality throughout the year in a cardiology department. Methods: All admissions and deaths occurring in our Cardiology Department over a 5-year period (2013–2017) were recorded retrospectively. Results: From a total of 17,829 hospital admissions, 500 patients died (2.8%, 0.3 patients/day). The mean age of deceased patients was 74.2 ± 13.1 years, and 186 (37.2%) were women. Mortality ranged from 0.17 deaths/day in August to 0.40 deaths/day in February (p = 0.03), and from 0.20 deaths/day in summer to 0.36 deaths/day in winter (p = 0.001). There was also a trend towards a variation in hospitalizations, with a peak in January (10.5 admissions/day) and the lowest figure in August (7.0 admissions/day), p = 0.047. We found no significant seasonal trend regarding mortality rate with respect to the number of hospital admissions (p = 0.89). The most common cause of death was refractory heart failure (267 patients [65.8%]). A noncardiac cause of death was observed in 134 patients (26.8%). Conclusions: In a cardiology department, there are twice as many deaths in winter as in summer. Hospitalizations also tend to be more frequent in winter than in summer.

scholarly journals Why do frail patients with chronic heart failure die and become hospitalised?

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Sze ◽  
P Pellicori ◽  
J Zhang ◽  
J Weston ◽  
A.L Clark
Keyword(s):  
Heart Failure ◽  
Cause Of Death ◽  
Hospital Admissions ◽  
Average Length ◽  
Significant Proportion ◽  
Length Of Hospital Stay ◽  
Clinical Frailty Scale ◽  
Frail Patients ◽  
Increased Risk

Abstract Background Frailty is common in patients with heart failure (HF) and is associated with increased morbidity and mortality. A better understanding of the causes of hospitalisations and death in frail patients might help to tailor interventional strategies for these at-risk patients. Purpose We studied the cause of death and hospitalisations in ambulatory patients with HF and frailty. Methods We assessed frailty using the clinical frailty scale (CFS) in consecutive HF patients attending a routine follow-up visit. Those with CFS ≥5 were classified as frail. Mortality and hospitalisations were ascertained from medical records (updated systematically using an NHS electronic database), discharge letters, autopsy reports and death certificates. We studied the primary cause of death and hospitalisations within one year of enrolment. Results 467 patients (67% male, median (IQR) age 76 (69–82) years, median (IQR) NT-proBNP 1156 (469–2463) ng/L) were enrolled. 206 (44%) patients were frail. Frail patients were more likely to not receive or receive suboptimal doses of ACEi/ARB and Beta-blockers; while non-frail patients were more likely to be treated with optimal doses. At 1-year follow up, there were 56 deaths and 322 hospitalisations, of which 46 (82%) and 215 (67%) occurred in frail patients. Frailty was associated with an increased risk of all-cause mortality (HR (95% CI): 4.27 (2.60–7.01)) and combined mortality/ hospitalisation (HR (95% CI): 2.85 (2.14–3.80)), all p<0.001. 57% (n=26) of frail patients died of cardiovascular causes (of which 58% were due to HF progression); although deaths due to non-cardiovascular causes (43%, n=20), especially severe infections, were also common (26%, n=12). (Figure 1) The proportion of frail patients who had non-elective hospital admissions within 1 year was more than double that of non-frail patients (46% (n=96) vs 21% (n=54); p<0.001). Compared to non-frail patients, frail patients had more recurrent (≥2) hospitalisations (28% (n=59) vs 9% (n=24); p<0.001) but median (IQR) average length of hospital stay was not significantly different (frail: 6 (4–11) vs non-frail: 6 (2–12) days, p=0.50). A large proportion of hospitalisations (64%, n=137) in frail patients were due to non-cardiovascular causes (of which 34%, 30% and 20% were due to infections, falls and comorbidities respectively). Of cardiovascular hospitalisations (36%, n=78), the majority were due to decompensated HF (67%, n=46). (Figure 1) Conclusion Frailty is common in patients with HF and is associated with an increased risk of mortality and recurrent hospitalisations. A significant proportion suffered non-cardiovascular deaths and hospitalisations. This implies that interventions targeted at HF alone can only have limited impact on outcomes in frail patients. Figure 1 Funding Acknowledgement Type of funding source: None

Abstract 11427: Ethnic Differences in Factors Precipitating Hospital Admissions for Heart Failure in Middle-Eastern Arabs and South Asians: Insights From the Gulf CARE Registry

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Amar M Salam ◽  
Kadhim Sulaiman ◽  
Robert O Bonow ◽  
Jassim Al-Suwaidi ◽  
Khalid AlHabib ◽  
...  
Keyword(s):  
Heart Failure ◽  
Middle East ◽  
Myocardial Ischemia ◽  
Hospital Admissions ◽  
South Asians ◽  
Middle Eastern ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Precipitating Factors ◽  
The Mean

OBJECTIVES: No previous studies have specifically examined the effects of ethnicity on factors precipitating hospital admissions for heart Failure (HF). The aim of the current study was to identify factors precipitating HF hospitalizations peculiar to Middle-Eastern Arab and South Asian ethnicities using a large multinational multicenter Middle-Eastern HF registry in which these two ethnicities are most prevalent. METHODS: From February 2012 to November 2013, consecutive patients hospitalized with HF were enrolled from 47 hospitals in 7 Middle East countries. Identifiable factors contributing to HF hospitalization were pre-specified and captured at admission. Patients were divided into 2 groups according to ethnicity, Arabs and South Asians (referred to as Asians) and the 2 groups were compared. RESULTS: During the study period 5005 patients with HF were enrolled of whom 4989 patients were from the 2 ethnicities under study; 4516 Arabs (90.5%) and 473(9.5%) Asians with the mean age of 60 years for Arabs and 55 years for Asians. The mean left ventricular ejection fraction was 37 % for Arabs compared to 33.8 % for Asians, P=0.001. Among the precipitating factors studied, nonadherence to medications and infections were significantly more prevalent in Arabs compared to Asians (19.9% vs. 13.5% and 15.3% vs.8.5%, both P=0.001) whereas myocardial ischemia and uncontrolled hypertension were significantly more prevalent in Asians (40.4% vs. 25.9% and 11.6% vs.7.8%, both P=0.001). In both groups, however, myocardial ischemia and nonadherence to medications were the commonest two factors precipitating hospital admissions for HF (table). CONCLUSIONS: Our study identifies for the first time important ethnic related differences in precipitating factors for HF hospitalizations among Arabs and Asians living in the Middle-East. The current study underscores the need to consider ethnicity in studies of HF hospitalizations and HF outcomes.

scholarly journals Cardiovascular morbidity and mortality in patients treated with hemodialysis: Epidemiological analysis

2008 ◽  
Vol 65 (12) ◽  
pp. 893-900 ◽  
Author(s):  
Dejan Petrovic ◽  
Biljana Stojimirovic
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Mortality Rate ◽  
Cardiovascular Mortality ◽  
Cardiovascular Complications ◽  
Left Ventricular ◽  
Cardiovascular Morbidity ◽  
Morbidity And Mortality ◽  
Cardiovascular Morbidity And Mortality ◽  
Lv Mass

Background/Aim. Cardiovascular diseases are the leading cause of death in patients treated with hemodialysis (HD). The annual cardiovascular mortality rate in these patients is 9%. Left ventricular (LV) hypertrophy, ischemic heart disease and heart failure are the most prevalent cardiovascular causes of death. The aim of this study was to assess the prevalence of traditional and nontraditional risk factors for cardiovascular complications, to assess the prevalence of cardiovascular complications and overall and cardiovascular mortality rate in patients on HD. Methods. We investigated a total of 115 patients undergoing HD for at least 6 months. First, a cross-sectional study was performed, followed by a two-year follow-up study. Beside standard biochemical parameters, we also determined cardiac troponins and echocardiographic parameters of LV morphology and function (LV mass index, LV fractional shortening, LV ejection fraction). The results were analyzed using the Student's t test and Mann-Whitney U test. Results. The patients with adverse outcome had significantly lower serum albumin (p < 0.01) and higher serum homocystein, troponin I and T, and LV mass index (p < 0.01). Hyperhomocysteinemia, anemia, hypertriglyceridemia and uncontrolled hypertension had the highest prevalence (86.09%, 76.52%, 43.48% and 36.52%, respectively) among all investigated cardiovascular risk factors. Hypertrophy of the LV was presented in 71.31% of the patients and congestive heart failure in 8.70%. Heart valve calcification was found in 48.70% of the patients, pericardial effusion in 25.22% and disrrhythmia in 20.87% of the investigated patients. The average annual overall mortality rate was 13.74%, while average cardiovascular mortality rate was 8.51%. Conclusion. Patients on HD have high risk for cardiovascular morbidity and mortality.

scholarly journals EPIDEMILOGICAL, CLINICAL AND ECHOCARDIOGRAPHIC FEATURES OF HEART FAILURE IN MOROCCO

2021 ◽  
Vol 9 (11) ◽  
pp. 521-526
Author(s):  
A. Maliki Alaoui ◽  
◽  
Y. Fihri ◽  
A. Ben El Mekki ◽  
H. Bouzelmat ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Heart Failure ◽  
Heart Disease ◽  
Ejection Fraction ◽  
Cross Sectional ◽  
Reduced Ejection Fraction ◽  
Cardiology Department ◽  
Common Risk Factors ◽  
The Mean

Heart failure (HF) is a major public issue taking an epidemic dimension globally. Its incidence is continuing to rise because of a growing and aging population. We held a cross-sectional retrospective studyin the cardiology department of Mohamed V military teaching hospital of Rabat in morocco fromSeptember 2019 toSeptember 2021, including 104 patients admitted with HF. The mean age was 68.5 ±10.3year. Hypertension and diabetes mellitus are the most common risk factors. HF with reduced ejection fraction represents about 49%. Forty-four percent had dilated cardiomyopathy. Ischemic heart disease is the first cause of HF.

scholarly journals Mortality in Via Ferrata Emergencies in Austria from 2008 to 2018

2019 ◽  
Vol 17 (1) ◽  
pp. 103 ◽  
Author(s):  
Mathias Ströhle ◽  
Matthias Haselbacher ◽  
Christopher Rugg ◽  
Alex Walpoth ◽  
Ricarda Konetschny ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Mortality Rate ◽  
Cause Of Death ◽  
European Alps ◽  
Limited Data ◽  
Fatal Accidents ◽  
Common Cause ◽  
Actual Incidence

Although the European Alps now have more than 1000 via ferratas, limited data exist on the actual incidence of fatal events in via ferratas and their causes. This retrospective study analysed data from a registry maintained by the Austrian Alpine Safety Board (n = 161,855, per 11 September 2019). Over a 10-year period from 1 November 2008 to 31 October 2018, all persons involved in a via ferrata-related emergency were included (n = 1684), of which 64% were male. Most emergencies were caused by blockage due to exhaustion and/or misjudgement of the climber’s own abilities. Consequently, more than half of all victims were evacuated uninjured. Only 62 (3.7%) via ferrata-related deaths occurred. Falling while climbing unsecured was the most common cause of death, and males had a 2.5-fold higher risk of dying in a via ferrata accident. The mortality rate was highest in technically easy-to-climb sections (Grade A, 13.2%/B, 4.9%), whereas the need to be rescued uninjured was highest in difficult routes (Grade D, 59.9%/E, 62.7%). Although accidents in via ferratas are common and require significant rescue resources, fatal accidents are rare. The correct use of appropriate equipment in technically easy-to-climb routes can prevent the majority of these fatalities.

scholarly journals On-Site Medical Management of Avalanche Victims—A Narrative Review

2021 ◽  
Vol 18 (19) ◽  
pp. 10234
Author(s):  
Simon Rauch ◽  
Giacomo Strapazzon ◽  
Hermann Brugger
Keyword(s):  
Cardiac Arrest ◽  
Mortality Rate ◽  
Cause Of Death ◽  
Medical Management ◽  
Site Management ◽  
Mountain Regions ◽  
Common Cause ◽  
Traumatic Injuries ◽  
Favorable Prognosis ◽  
Air Pocket

Avalanche accidents are common in mountain regions and approximately 100 fatalities are counted in Europe each year. The average mortality rate is about 25% and survival chances are mainly determined by the degree and duration of avalanche burial, the patency of the airway, the presence of an air pocket, snow characteristics, and the severity of traumatic injuries. The most common cause of death in completely buried avalanche victims is asphyxia followed by trauma. Hypothermia accounts for a minority of deaths; however, hypothermic cardiac arrest has a favorable prognosis and prolonged resuscitation and extracorporeal rewarming are indicated. In this article, we give an overview on the pathophysiology and on-site management of avalanche victims.

THE RELATIONSHIP PREDICE SCORE AND MORTALITY 30 DAYS IN CHRONIC HEART FAILURE PATIENTS

2021 ◽  
pp. 207-209
Author(s):  
Dwi Handayani Nasution ◽  
Zainal safri ◽  
Refli Hasan
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Mortality Rate ◽  
Good Treatment ◽  
Heart Failure Patients ◽  
Background Mortality ◽  
The Mean ◽  
Prospective Research ◽  
The Relationship

The Background : Mortality rate of heart failure patients are increasing even they have a good treatment. Therefore, it should be possible to make a prognostic for chronic heart failure patients with use an easy parameter namely predice score. The aim of the study : To assess the ability of the predice score to predict mortality within 30 days in patients with chronic heart failure. The Method : We did this prospective research started from 1st July 2016 until 31st December 2016 with concerned chronic heart failure patients as many as 44 patients. We counted the association grade with use Man whitney U. The Result : The results showed that there was a signicant relationship between predice score and mortality (p = 0.004). The mean predice score in the living subjects was 11.77 (SD: 4.07) Meanwhile, the mean predice score of the subjects who died was 17.18 ( SD:2,85). The Conclusion: Predice Score can be used to predict 30-day mortality in chronic heart failure patients who experience worsening because it is statistically signicant (p<0,05).

scholarly journals Peritoneal Ultrafiltration in Refractory Heart Failure: A Cohort Study

2014 ◽  
Vol 34 (1) ◽  
pp. 64-70 ◽  
Author(s):  
Silvio V. Bertoli ◽  
Claudio Musetti ◽  
Daniele Ciurlino ◽  
Carlo Basile ◽  
Emilio Galli ◽  
...  
Keyword(s):  
Heart Failure ◽  
New York ◽  
Hospital Admissions ◽  
Systolic Pressure ◽  
Heart Association ◽  
Decompensated Heart Failure ◽  
Pulmonary Artery Systolic Pressure ◽  
Refractory Heart Failure ◽  
Stage Renal Disease ◽  
End Stage

IntroductionAcutely decompensated heart failure (HF) in patients with diuretic resistance is often treated with extracorporeal ultrafiltration. Peritoneal ultrafiltration (PUF) has been proposed for the long-term management of severe HF after resolution of the acute episode. The aim of the present study was to evaluate the use of PUF in the treatment of chronic refractory HF in patients without end-stage renal disease.MethodsThis multicenter (10 nephrology departments throughout Italy) retrospective observational study included patients with severe HF refractory to maximized drug treatment. The patients were proposed for PUF because they had experienced at least 3 hospital admissions in the preceding year for acutely decompensated HF requiring extracorporeal ultrafiltration.ResultsOf the 48 study patients (39 men, 9 women; mean age 74 ± 9 years), 30 received 1 nocturnal icodextrin exchange, 5 required 2 daily exchanges, and 13 received 2 – 4 sessions per week of automated peritoneal dialysis. During the first year, renal function remained stable (initial: 20.8 ± 10.0 mL/min/1.73 m2; end: 22.0 ± 13.6 mL/min/1.73 m2), while pulmonary artery systolic pressure declined to 40 ± 6.09 mmHg from 45.5 ± 9.18 mmHg ( p = 0.03), with a significant concomitant improvement in New York Heart Association functional status. Hospitalizations decreased to 11 ± 17 days/patient–year from 43 ± 33 days/ patient–year before the start of PUF ( p < 0.001). The incidence of peritonitis was 1 episode in 45 patient–months. Patient survival was 85% at 1 year and 56% at 2 years.ConclusionsThis study confirms the satisfactory results of using PUF for chronic HF in elderly patients.

scholarly journals Trends in Cardiovascular Mortality Related to Atrial Fibrillation in the United States, 2011 to 2018

2021 ◽  
Author(s):  
Yoshihiro Tanaka ◽  
Nilay S. Shah ◽  
Rod Passman ◽  
Philip Greenland ◽  
Donald M. Lloyd‐Jones ◽  
...  
Keyword(s):  
United States ◽  
Atrial Fibrillation ◽  
Mortality Rate ◽  
Cause Of Death ◽  
Cardiovascular Mortality ◽  
The United States ◽  
Percentage Change ◽  
Annual Percentage Change ◽  
Cardiovascular Morbidity And Mortality ◽  
Average Annual Percentage Change

Background Prevalence of atrial fibrillation (AF) continues to increase and is associated with significant cardiovascular morbidity and mortality. To inform prevention strategies aimed at reducing the burden of AF, we sought to quantify trends in cardiovascular mortality related to AF in the United States. Methods and Results We performed serial cross‐sectional analyses of national death certificate data for cardiovascular mortality related to AF, whereby cardiovascular disease was listed as underlying cause of death and AF as multiple cause of death among adults aged 35 to 84 years using the Centers for Disease Control and Prevention's Wide‐Ranging Online Data for Epidemiologic Research. We calculated age‐adjusted mortality rates per 100 000 population and examined trends over time, estimating average annual percentage change using the Joinpoint Regression Program. Subgroup analyses were performed by race‐sex and across 2 age groups (younger: 35–64 years; older: 65–84 years). A total of 276 373 cardiovascular deaths related to AF were identified in the United States between 2011 and 2018 in decedents aged 35 to 84 years. Age‐adjusted mortality rate increased from 18.0 (95% CI, 17.8–18.2) to 22.3 (95% CI, 22.0–22.4) per 100 000 population between 2011 and 2018. The increase in age‐adjusted mortality rate (average annual percentage change) between 2011 and 2018 was greater among younger decedents (7.4% per year [95% CI, 6.8%–8.0%]) compared with older decedents (3.0% per year [95% CI, 2.6%–3.4%]). Conclusions Cardiovascular deaths related to AF are increasing, especially among younger adults, and warrant greater attention to prevention earlier in the life course.

Acute Coronary Syndrome Admissions and Mortality Rate During COVID-19 Pandemic in Gaza

2020 ◽  
pp. 1-2
Keyword(s):  
Acute Coronary Syndrome ◽  
Mortality Rate ◽  
Hospital Admissions ◽  
Gaza Strip ◽  
Coronary Intervention ◽  
Stemi Patient ◽  
Percent Reduction ◽  
Coronary Syndrome ◽  
Cardiology Department ◽  
Number Of Patients

Background: What is the nature and duration of changes to admissions for different types of acute coronary syndrome (ACS), among patients during coronavirus disease 2019 (COVID-19) pandemic in Gaza? Methods: The investigators analyzed data on hospital admissions in Gaza for types of ACS from August 25-2020, to October 1, 2020, that were recorded in the Alshifa Hospital Cardiology Department Service Admitted Patient Care database. Admissions were classified as ST-elevation myocardial infarction (STEMI) and non-STEACS and we calculate the diagnostic and percutaneous coronary intervention (PCI) rate. Results: Hospital admissions for ACS declined from rate of 99 admissions to 40 admission in 2020in this time, a reduction of 60%. During the period of declining admissions, there were reductions in the number of admissions for all types of ACS, including both STEMI and NON-STEACS, but relative and absolute reductions were larger for NSTEMI, (from 73 patients in 2019 to 26 patients in 2020) with a percent reduction of 64% In parallel, reductions were recorded in the STEMI ( from 26 patients in 2019 to 14 patients in 2020) percent reduction 46 %, the mortality rate for STEMI patient was 4% in 2019 and 21% in 2020, for non-STEMI patient was 0% in 2019 and 4% in 2020. The diagnostic coronary angiography decrease from 130 to 31 cases (76%) and PCI decrease from 35 to 18 cases (49%) during this period Conclusions: We found that significant reduction in the number of patients with ACS who were admitted to the hospital during the pandemic, but increase in mortality rate by 17% in STEMI and 4% in NON-STEACS in Gaza strip

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