Development of Acute Decompensated Heart Failure Among Hospital Inpatients: Incidence, Causes and Outcomes.

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  • Additional Information
    • Affiliation:
      Department of Emergency Medicine, Austin Hospital, Melbourne, Vic, Australia
      Department of Medicine, University of Melbourne, Melbourne, Vic, Australia
      Department of Medicine, Austin Hospital, Melbourne, Vic, Australia
      Department of Infectious Diseases, Austin Hospital, Melbourne, Vic, Australia
    • Subject Terms:
    • Subject Terms:
    • Abstract:
      Background: We aimed to investigate the incidence, precipitants, and outcomes of acute decompensated heart failure (ADHF) that develops during the inpatient stay.Methods: We undertook a case-control study in the medical, oncology, surgical, and orthopaedic wards of a tertiary referral hospital (February-May, 2016). Patients aged ≥18 years who developed ADHF during their inpatient stay were enrolled as cases. One control patient was matched to each case by age, gender, presenting complaint/surgery performed and co-morbidities. Multivariate regression was employed to determine variables associated with ADHF.Results: The incidence of ADHF was 1.0% of patients. Eighty cases were well-matched to 80 controls (p>0.05). ADHF precipitants comprised infection (30%), inappropriate intravenous (IV) fluid and medication management (23.8% and 8.8%, respectively), tachyarrhythmia (12.5%), ischaemic heart disease (8.8%), renal failure (1.3%), and other/unclear causes (15%). Three variables were associated with ADHF: not having English as the preferred language (OR 3.5, 95%CI 1.2-9.8), a history of ischaemic heart disease (OR 3.3, 95%CI 1.2-9.1), and the administration of >2000ml of IV fluid on the day before the ADHF (OR 8.3, 95%CI 1.5-48.0). The day before the ADHF, cases were administered significantly more IV fluids than controls (median 2,757.5 versus 975ml, p=0.001). Medication errors mostly related to failure to restart regular diuretics. Cases had significantly greater length of stay (median 15 versus 6 days, p<0.001) and mortality (12.5% versus 1.3%, p=0.01).Conclusions: New onset ADHF is common and a substantial proportion of cases are iatrogenic. Cases experience significantly increased length of hospital stay, morbidity, and mortality.
    • Journal Subset:
      Biomedical; Continental Europe; Europe
    • ISSN:
      1443-9506
    • MEDLINE Info:
      PMID: NLM29519692 NLM UID: 100963739
    • Publication Date:
      20190313
    • Publication Date:
      20190513
    • DOI:
      10.1016/j.hlc.2017.12.004
    • Accession Number:
      134402620
  • Citations
    • ABNT:
      PLANT, L. D. et al. Development of Acute Decompensated Heart Failure Among Hospital Inpatients: Incidence, Causes and Outcomes. Heart, Lung & Circulation, [s. l.], v. 28, n. 3, p. 406–413, 2019. DOI 10.1016/j.hlc.2017.12.004. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=134402620. Acesso em: 30 set. 2020.
    • AMA:
      Plant LD, Taylor DM, Worland T, et al. Development of Acute Decompensated Heart Failure Among Hospital Inpatients: Incidence, Causes and Outcomes. Heart, Lung & Circulation. 2019;28(3):406-413. doi:10.1016/j.hlc.2017.12.004
    • APA:
      Plant, L. D., Taylor, D. M., Worland, T., Puri, A., Ugoni, A., Patel, S. K., Johnson, D. F., & Burrell, L. M. (2019). Development of Acute Decompensated Heart Failure Among Hospital Inpatients: Incidence, Causes and Outcomes. Heart, Lung & Circulation, 28(3), 406–413. https://doi.org/10.1016/j.hlc.2017.12.004
    • Chicago/Turabian: Author-Date:
      Plant, Luke D., David McDonald Taylor, Thomas Worland, Arvind Puri, Antony Ugoni, Sheila K. Patel, Douglas F. Johnson, and Louise M. Burrell. 2019. “Development of Acute Decompensated Heart Failure Among Hospital Inpatients: Incidence, Causes and Outcomes.” Heart, Lung & Circulation 28 (3): 406–13. doi:10.1016/j.hlc.2017.12.004.
    • Harvard:
      Plant, L. D. et al. (2019) ‘Development of Acute Decompensated Heart Failure Among Hospital Inpatients: Incidence, Causes and Outcomes’, Heart, Lung & Circulation, 28(3), pp. 406–413. doi: 10.1016/j.hlc.2017.12.004.
    • Harvard: Australian:
      Plant, LD, Taylor, DM, Worland, T, Puri, A, Ugoni, A, Patel, SK, Johnson, DF & Burrell, LM 2019, ‘Development of Acute Decompensated Heart Failure Among Hospital Inpatients: Incidence, Causes and Outcomes’, Heart, Lung & Circulation, vol. 28, no. 3, pp. 406–413, viewed 30 September 2020, .
    • MLA:
      Plant, Luke D., et al. “Development of Acute Decompensated Heart Failure Among Hospital Inpatients: Incidence, Causes and Outcomes.” Heart, Lung & Circulation, vol. 28, no. 3, Mar. 2019, pp. 406–413. EBSCOhost, doi:10.1016/j.hlc.2017.12.004.
    • Chicago/Turabian: Humanities:
      Plant, Luke D., David McDonald Taylor, Thomas Worland, Arvind Puri, Antony Ugoni, Sheila K. Patel, Douglas F. Johnson, and Louise M. Burrell. “Development of Acute Decompensated Heart Failure Among Hospital Inpatients: Incidence, Causes and Outcomes.” Heart, Lung & Circulation 28, no. 3 (March 2019): 406–13. doi:10.1016/j.hlc.2017.12.004.
    • Vancouver/ICMJE:
      Plant LD, Taylor DM, Worland T, Puri A, Ugoni A, Patel SK, et al. Development of Acute Decompensated Heart Failure Among Hospital Inpatients: Incidence, Causes and Outcomes. Heart, Lung & Circulation [Internet]. 2019 Mar [cited 2020 Sep 30];28(3):406–13. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=134402620