Length of stay in patients admitted for acute heart failure
Por:
Martin-Sanchez, FJ, Carbajosa, V, Llorens, P, Herrero, P, Jacob, J, Miro, O, Fernandez, C, Bueno, H, Calvo, E, Casado, JMR, Rizzi M.A., Gil, Cristina
Publicada:
1 may 2016
Resumen:
Objective: To identify the factors associated with prolonged length of hospital stay in patients admitted for acute heart failure.
Methods: Multipurpose observational cohort study including patients from the EAHFE registry admitted for acute heart failure in 25 Spanish hospitals. Data were collected on demographic and clinical variables and on the day and place of admission. The primary outcome was length of hospital stay longer than the median.
Results: We included 2,400 patients with a mean age of 79.5 (9.9) years; of these, 1,334 (55.6%) were women. Five hundred and ninety (24.6%) were admitted to the short stay unit (SSU), 606 (25.2%) to cardiology, and 1,204 (50.2%) to internal medicine or gerontology. The mean length of hospital stay was 7.0 (RIC 4-11) days. Fifty-eight (2.4%) patients died and 562 (23.9%) were readmitted within 30 days after discharge. The factors associated with prolonged length of hospital stay were chronic pulmonary disease; being a device carrier; having an unknown or uncommon triggering factor; the presence of renal insufficiency, hyponatremia and anaemia in the emergency department; not being admitted to an SSU or the lack of this facility in the hospital; and being admitted on Monday, Tuesday or Wednesday. The factors associated with length of hospital stay <= 7days were hypertension, having a hypertensive episode, or a lack of treatment adherence. The area under the curve of the mixed model adjusted to the center was 0.78 (95% CI: 0.76-0.80; p < 0.001).
Conclusions: A series of factors is associated with prolonged length of hospital stay and should be taken into account in the management of acute heart failure. (C) 2016 SESPAS. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Filiaciones:
Martin-Sanchez, FJ:
Hosp Clin San Carlos, Serv Urgencias, Madrid, Spain
Univ Complutense Madrid, Fac Med, Madrid, Spain
Hosp Clin San Carlos IdISSC, Inst Invest Sanitaria, Madrid, Spain
Carbajosa, V:
Hosp Univ Rio Hortega, Serv Urgencias, Valladolid, Spain
Llorens, P:
Hosp Gen Univ Alicante, Serv Urgencias UCE, Alicante, Spain
Hosp Gen Univ Alicante, UHD, Alicante, Spain
Herrero, P:
Hosp Univ Cent Asturias, Serv Urgencias, Oviedo, Spain
Jacob, J:
IDIBELL, Hosp Univ Bellvitge, Serv Urgencias, Lhospitalet De Llobregat, Barcelona, Spain
Miro, O:
Hosp Clin Barcelona, Area Urgencias, Barcelona, Spain
IDIBAPS, Grp Invest Urgencias Proc & Patol, Barcelona, Spain
Fernandez, C:
Univ Complutense Madrid, Fac Med, Madrid, Spain
Hosp Clin San Carlos IdISSC, Inst Invest Sanitaria, Madrid, Spain
Hosp Clin San Carlos, Serv Med Prevent, Madrid, Spain
Bueno, H:
Univ Complutense Madrid, Fac Med, Madrid, Spain
CNIC, Madrid, Spain
Hosp Univ 12 Octubre, Inst Invest I 12, Madrid, Spain
Hosp Univ 12 Octubre, Serv Cardiol, Madrid, Spain
Calvo, E:
Univ Complutense Madrid, Fac Med, Madrid, Spain
Hosp Clin San Carlos, Serv Med Interna, Madrid, Spain
Casado, JMR:
Univ Complutense Madrid, Fac Med, Madrid, Spain
Rizzi M.A.:
Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
Gil, Cristina :
Hospital Universitario de Salamanca, Spain
Gold, Green Published
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