Clinical characteristics and mortality of heart failure. INCAex study

Background and objectives: Heart failure is responsible for a major part of hospital health expenditure and the third cause of cardiovascular death. To describe the evolution of clinical features, and factors related to prognosis of patients admitted due to decompensated heart failure in a region of Extremadura during a period 10 years. Patients and methods: Observational, retrospective and single centre study of consecutive patients admitted due to decompensated heart failure in a general hospital in the province of Badajoz, during the period 2000/2009. Results: A total of 2220 patients with mean age of 76.3 (SD +/- 10.1), being 54% female were included in the study. Stratified into four periods (30 months each), a significant increase in patients over 75 years was observed (55 vs. 71%; P<.001), as well as an increase in the prescription of beta blockers at discharge (12 vs. 34%, P<.001), statins (8 vs. 31%; P<.001), and oral anticoagulants (13 vs. 25%; P<.001). Hospital mortality significantly decreased from 13 to 8% (P<.01), and from 30 to 23% (P<.01) at one year follow:up. Age (HR per year = 1.04 [95% CI: 1.02 to 1.05]), diabetes (HR = 1.35 [95% CI: 1.11 to 1.66]) and chronic renal failure (HR = 1.49 [95% CI: 1.18 to 1.87]) were identified as independent predictors of all-cause mortality at one year of follow-up. Conclusions: Total mortality in patients with decompensated heart failure has declined significantly over the last decade, despite the increasing age. Age, diabetes and chronic renal failure were independent predictors of total mortality at one year. Oral anticoagulation was a protective factor. (C) 2012 Elsevier Espana, S.L. All rights reserved.