scholarly journals Trends and Clinical Impact of Gastrointestinal Endoscopic Procedures on Acute Heart Failure in Spain (2002–2017)

2021 ◽  
Vol 10 (3) ◽  
pp. 546
Author(s):  
Manuel Méndez-Bailón ◽  
Rodrigo Jiménez-García ◽  
Nuria Muñoz-Rivas ◽  
Valentín Hernández-Barrera ◽  
José Maria de Miguel-Yanes ◽  
...  
Keyword(s):  
Heart Failure ◽  
Iron Deficiency ◽  
Hospital Mortality ◽  
Red Blood Cell Transfusion ◽  
Deficiency Anemia ◽  
Gastrointestinal Neoplasms ◽  
Logistic Regression Models ◽  
Patients With Heart Failure ◽  
Icd 10 ◽  
Heart Failure Decompensation

Introduction: Heart failure decompensation can be triggered by many factors, including anemia. In cases of iron deficiency anemia or iron deficiency without anemia, endoscopic studies are recommended to rule out the presence of gastrointestinal neoplasms or other associated bleeding lesions. Objectives: The aims of this study were to (i) examine trends in the incidence, clinical characteristics, and in-hospital outcomes of patients hospitalized with heart failure from 2002 to 2017 who underwent esophagogastroduodenoscopy (EGD) and/or colonoscopy, and to (ii) identify factors associated with in-hospital mortality (IHM) among patients with heart failure who underwent an EGD and/or a colonoscopy. Methods: We conducted an observational retrospective epidemiological study using the Spanish National Hospital Discharge Database (SNHDD) between 2002 and 2017. We included hospitalizations of patients with a primary discharge diagnosis of heart failure. Cases were reviewed if there was an ICD-9-CM or ICD-10 procedure code for EGD or colonoscopy in any procedure field. Multivariable logistic regression models were constructed to identify predictors of IHM among HF patients who underwent an EGD or colonoscopy. Results: A total of 51,187 (1.32%) non-surgical patients hospitalized with heart failure underwent an EGD and another 72,076 (1.85%) patients had a colonoscopy during their admission. IHM was significantly higher in those who underwent an EGD than in those who underwent a red blood cell transfusion (OR 1.10; 95%CI 1.04–1.12). However, the use of colonoscopy seems to decrease the probability of IHM (OR 0.45; 95%CI 0.41–0.49). In patients who underwent a colonoscopy, older age seems to increase the probability of IHM. However, EGD was associated with a lower mortality (OR 0.60; 95% CI 0.55–0.64). Conclusion: In our study, a decrease in the number of gastroscopies was observed in relation to colonoscopy in patients with heart failure. The significant ageing of the hospitalized HF population seen over the course of the study could have contributed to this. Both procedures seemed to be associated with lower in-hospital mortality, but in the case of colonoscopy, the risk of in-hospital mortality was higher in elderly patients with heart failure and associated neoplasms. Colonoscopy and EGD seemed not to increase IHM in patients with heart failure.

scholarly journals Predictors of hospitalizations for heart failure decompensation in patients with comorbid occupational chronic obstructive pulmonary disease

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
L.A Shpagina ◽  
O.S Kotova ◽  
I.S Shpagin ◽  
G.V Kuznetsova ◽  
N.V Kamneva ◽  
...  
Keyword(s):  
Heart Failure ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Chronic Obstructive ◽  
Length Of Service ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Patients With Heart Failure ◽  
Occupational Copd ◽  
Heart Failure Decompensation

Abstract Background Heart failure decompensation requiring hospitalization is an important event, associated with mortality and investigating its predictors is topical problem. Chronic obstructive pulmonary disease (COPD) is a common comorbidity for heart failure. Both conditions share common molecular mechanisms such as systemic inflammation. COPD is heterogeneous and subpopulations with different inflammation patterns may interact with heart failure in different manner. Airway inflammation in occupational COPD may differs from COPD in tobacco smokers. Additionally cardiotoxicity of industrial chemicals influence heart failure features. Despite this biological plausibility, heart failure and occupational COPD comorbidity is not studied enough. Purpose To reveal predictors of hospitalizations for heart failure decompensation in patients with heart failure and occupational COPD comorbidity. Methods Occupational COPD patients (n=115) were investigated in a prospective cohort observational study. Comparison group – 115 tobacco smokers with COPD. Control group – 115 healthy persons. Controls were selected by propensity score matching, covariates were COPD duration, age and gender. Then COPD groups were stratified according to heart failure. Working conditions, echocardiography, spirometry, pulsoxymetry, 6-mitute walking test were done. Molecular markers of tissue damage – chemokine ligand 18 (CCL 18), lactate dehydrogenase, cardiac troponin T, N-terminal pro-B-type natriuretic peptide (NT pro-BNP), protein S100 beta, von Willebrand factor were measured in serum by ELISA. Follow up after initial assessment was 12 month. Predictors were determined by Cox proportional hazards regression with ROC analysis. Results Heart failure rate in occupational COPD patients were higher – 54.8% versus 36.5% in tobacco smokers with COPD, p<0.05. Heart failure with preserved ejection fraction was predominant – 40.9%. Prevalence of biventricular heart failure was 38.3%, isolated right heart failure – 13%, left heart failure – 2.6%. Cumulative hospitalization rate in occupational COPD with heart failure group was higher than in comparison group, 17.5% and 9.5% respectively, p=0.01. In Cox proportional hazards regression model predictors of hospitalizations for heart failure decompensation during 12 months in this group were length of service (HR 1.22, 95% CI: 1.03–2.5), aromatic hydrocarbons concentration at workplaces air (HR 1.4, 95% CI: 1.15–1.96), serum protein S100 beta (HR 1.10, 95% CI: 1.02–1.87), SaO2 (HR 1.2, 95% CI: 1.06–2.13). Area under the ROC curve was 0.82. Conclusion Length of service, aromatic hydrocarbons concentration at workplaces air, serum protein S100 beta, SaO2 are considered to be independent risk factors of heart failure decompensation required hospitalization in patients with heart failure and occupational COPD comorbidity. Funding Acknowledgement Type of funding source: None

scholarly journals Impairment in activities of daily living and readmission in older patients with heart failure: a cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e044416
Author(s):  
Tan Van Nguyen ◽  
Huyen Thanh Dang ◽  
Mason Jenner Burns ◽  
Hiep HH Dao ◽  
Tu Ngoc Nguyen
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Older Patients ◽  
Tertiary Hospital ◽  
Logistic Regression Models ◽  
Hospitalised Patients ◽  
Patients With Heart Failure ◽  
The Impact

ObjectivesThis study aims to investigate the prevalence of impairment of activities of daily living (ADLs) in older patients with heart failure (HF), and to examine the impact of ADL impairment on readmission after discharge.Design and settingsA prospective cohort study was conducted in patients aged ≥65 years with HF admitted to a tertiary hospital in Vietnam from August 2016 to June 2017. Difficulties with six ADLs were assessed by a questionnaire. Participants were classified into two categories (with and without ADL impairment). The associations of ADL impairment with 3-month readmission were examined using logistic regression models.ResultsThere were 180 participants (mean age 80.6±8.2, 50% female) and 26.1% were classified as having ADL impairment. The most common impaired activity was bathing (21.1%), followed by transferring (20.0%), toileting (12.2%), dressing (8.9%), eating (3.3%), and continence (2.8%). During 3-month follow-up, 32.8% of the participants were readmitted to hospitals (55.3% in participants with ADL impairment, 24.8% in those without ADL impairment, p<0.001). ADL impairment significantly increased the risk of 3-month readmission (adjusted OR 2.75, 95% CI 1.25 to 6.05, p=0.01).ConclusionsIn summary, ADL impairment was common in older hospitalised patients with HF and was associated with increased readmission. These findings suggest further studies on ADL assessment and intervention during transition care for older patients with HF after discharge to prevent readmission.

Impact of Underlying Congestive Heart Failure on In-Hospital Outcomes in Patients with Septic Shock

2021 ◽  
pp. 088506662110614
Author(s):  
Mohinder R. Vindhyal ◽  
Liuqiang (Kelsey) Lu ◽  
Sagar Ranka ◽  
Prakash Acharya ◽  
Zubair Shah ◽  
...  
Keyword(s):  
Heart Failure ◽  
Septic Shock ◽  
Congestive Heart Failure ◽  
Hospital Mortality ◽  
Secondary Analysis ◽  
Kidney Injury ◽  
Cross Sectional ◽  
Increased Risk ◽  
Icd 10 ◽  
Nationwide Readmission Database

Purpose: Septic shock (SS) manifests with profound circulatory and cellular metabolism abnormalities and has a high in-hospital mortality (25%-50%). Congestive heart failure (CHF) patients have underlying circulatory dysfunction and compromised cardiac reserve that may place them at increased risk if they develop sepsis. Outcomes in patients with CHF who are admitted with SS have not been well studied. Materials and Method: Retrospective cross sectional secondary analysis of the Nationwide Readmission Database (NRD) for 2016 and 2017. ICD-10 codes were used to identify patients with SS during hospitalization, and then the cohort was dichotomized into those with and without an underlying diagnosis of CHF. Results: Propensity match analyses were performed to evaluate in-hospital mortality and clinical cardiovascular outcomes in the 2 groups. Cardiogenic shock patients were excluded from the study. A total of 578,629 patients with hospitalization for SS were identified, of whom 19.1% had a coexisting diagnosis of CHF. After propensity matching, 81,699 individuals were included in the comparative groups of SS with CHF and SS with no CHF. In-hospital mortality (35.28% vs 32.50%, P < .001), incidence of ischemic stroke (2.71% vs 2.53%, P = .0032), and acute kidney injury (69.9% vs 63.9%, P = .001) were significantly higher in patients with SS and CHF when compared to those with SS and no CHF. Conclusions: This study identified CHF as a strong adverse prognosticator for inpatient mortality and several major adverse clinical outcomes. Study findings suggest the need for further investigation into these findings’ mechanisms to improve outcomes in patients with SS and underlying CHF.

scholarly journals Iron Therapy in Patients with Heart Failure and Iron Deficiency: Review of Iron Preparations for Practitioners

2016 ◽  
Vol 17 (3) ◽  
pp. 183-201 ◽  
Author(s):  
Marcin Drozd ◽  
Ewa A. Jankowska ◽  
Waldemar Banasiak ◽  
Piotr Ponikowski
Keyword(s):  
Heart Failure ◽  
Iron Deficiency ◽  
Iron Therapy ◽  
Patients With Heart Failure

A heart failure care optimisation project in the north of Scotland

2020 ◽  
Vol 15 (9) ◽  
pp. 1-9
Author(s):  
Marianne O'Hara ◽  
Amanda Smith ◽  
Emma Foster ◽  
Stephen J Leslie
Keyword(s):  
Heart Failure ◽  
Medical Therapy ◽  
Real Life ◽  
Optimal Medical Therapy ◽  
Reduced Ejection Fraction ◽  
Heart Failure Care ◽  
The North ◽  
Patients With Heart Failure ◽  
Icd 10 ◽  
Project Data

Introduction: This project aimed to assess and optimise the treatment of all patients with heart failure with reduced ejection fraction (HFrEF). Methods: Consecutive patients discharged with a heart failure code (ICD-10) between April 2014 and July 2017 were included. The medical records were reviewed to ensure optimal medical therapy and in cases where this was not being received, a process of ‘active optimisation’ was initiated. Results: Out of 656 patients, 139 were identified as eligible for guideline-directed treatment, 129 (93%) of which were receiving optimal medical therapy. Of these, 47 (36%) were deemed to be optimised but were not on full guideline-directed therapy owing to contraindication, intolerance, comorbidities or non-compliance. Conclusion: The project data reflect real-world patients and practice and highlight a tension between guideline-based care and real-life (realistic) medicine.

scholarly journals Effect of right bundle branch block on in-hospital mortality in patients with heart failure

2014 ◽  
Vol 9 (5-6) ◽  
pp. 227-227
Author(s):  
Ante Matana ◽  
Luka Zaputovic ◽  
Teodora Zaninovic Jurjevic ◽  
Alen Ruzic ◽  
Daniela Malic ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Mortality ◽  
Right Bundle Branch Block ◽  
Bundle Branch Block ◽  
Patients With Heart Failure

scholarly journals A Combination of Chest Radiography and Estimated Plasma Volume May Predict In-Hospital Mortality in Acute Heart Failure

2022 ◽  
Vol 8 ◽  
Author(s):  
Masatake Kobayashi ◽  
Amine Douair ◽  
Stefano Coiro ◽  
Gaetan Giacomin ◽  
Adrien Bassand ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Mortality ◽  
Natriuretic Peptide ◽  
Plasma Volume ◽  
Risk Model ◽  
Hospital Death ◽  
Pulmonary Congestion ◽  
Patients With Heart Failure ◽  
High Prediction ◽  
Score Index

Background: Patients with heart failure (HF) often display dyspnea associated with pulmonary congestion, along with intravascular congestion, both may result in urgent hospitalization and subsequent death. A combination of radiographic pulmonary congestion and plasma volume might screen patients with a high risk of in-hospital mortality in the emergency department (ED).Methods: In the pathway of dyspneic patients in emergency (PARADISE) cohort, patients admitted for acute HF were stratified into 4 groups based on high or low congestion score index (CSI, ranging from 0 to 3, high value indicating severe congestion) and estimated plasma volume status (ePVS) calculated from hemoglobin/hematocrit.Results: In a total of 252 patients (mean age, 81.9 years; male, 46.8%), CSI and ePVS were not correlated (Spearman rho &lt;0 .10, p &gt; 0.10). High CSI/high ePVS was associated with poorer renal function, but clinical congestion markers (i.e., natriuretic peptide) were comparable across CSI/ePVS categories. High CSI/high ePVS was associated with a four-fold higher risk of in-hospital mortality (adjusted-OR, 95%CI = 4.20, 1.10-19.67) compared with low CSI/low ePVS, whereas neither high CSI nor ePVS alone was associated with poor prognosis (all-p-value &gt; 0.10; Pinteraction = 0.03). High CSI/high ePVS improved a routine risk model (i.e., natriuretic peptide and lactate)(NRI = 46.9%, p = 0.02), resulting in high prediction of risk of in-hospital mortality (AUC = 0.85, 0.82-0.89).Conclusion: In patients hospitalized for acute HF with relatively old age and comorbidity burdens, a combination of CSI and ePVS was associated with a risk of in-hospital death, and improved prognostic performance on top of a conventional risk model.

scholarly journals Expert consensus regarding treatment of iron deficiency in stable and decompensated patients with heart failure

Kardiologiia ◽  
2021 ◽  
Vol 61 (4) ◽  
pp. 73-78
Author(s):  
Yu. V. Mareev ◽  
S. R. Gilarevsky ◽  
Yu. L. Begrambekova ◽  
Yu. M. Lopatin ◽  
A. A. Garganeeva ◽  
...  
Keyword(s):  
Heart Failure ◽  
Iron Deficiency ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ferric Carboxymaltose ◽  
Ventricular Ejection Fraction ◽  
Patients With Heart Failure ◽  
High Prevalence ◽  
Acute Decompensation

In recent years there has been significant interest in treating iron deficiency (ID) in patients with heart failure (HF) due to its high prevalence and detrimental effects in this population. As stated in the 2020 Russain HF guidelines, Intravenous ferric carboxymaltose remains the only proven therapy for ID.This document was prompted by the results from the recent AFFIRM-AHF trial which demonstrates that treatment of ID after acute HF decompensation reduces the risk of future decompensations. Experts have concluded that in HF patients with acute decompensation, a left ventricular ejection fraction of < 50% and ID, Intravenous ferric carboxymaltose reduces future HF hospitalisations. Patients with stable HF may also benefit from treatment of ID to improve quality of life and alleviate symptoms.  It is, therefore, reasonable to screen for and treat ID in patients with HF.

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