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Vol. 100, No. 3, 2003
Issue release date: November 2003
Cardiology 2003;100:136–142
(DOI:10.1159/000073931)

Risk Stratification of In-Hospital Mortality in Patients Hospitalized for Chronic Congestive Heart Failure Secondary to Non-Ischemic Cardiomyopathy

Chen M.-C. · Chang H.-W. · Cheng C.-I. · Chen Y.-H. · Chai H.-T.
aDivision of Cardiology, Chang Gung Memorial Hospital, Kaohsiung, and bDepartment of Biological Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan, ROC

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Abstract

The study population consisted of 234 consecutive patients hospitalized for acute exacerbation of congestive heart failure secondary to non-ischemic cardiomyopathy. Of the 234 patients, there were 55 in-hospital deaths. Their medical records were deliberatively reviewed and the association of 38 clinical, hemodynamic and biochemical variables with in-hospital mortality was evaluated by multiple stepwise logistic regression analysis. The following variables were statistically associated with in-hospital mortality: profound cardiogenic shock, severe hyponatremia, the presence of ventricular arrhythmias, history of stroke, the presence of acute renal failure, and requirement of dobutamine therapy. In stratified analyses, the rates of in-hospital mortality rose rapidly as the number of risk factors increased: 0 risk factors, 2.5%; 1 risk factor, 5.1%; 2 risk factors, 36.4%; 3 risk factors, 75%, and no less than 4 risk factors, 100%. In conclusion, our study identified 6 variables that correlated with in-hospital death in patients with heart failure secondary to non-ischemic cardiomyopathy. The identification of these variables may allow more accurate risk stratification of individuals at risk of in-hospital mortality in this clinical setting.



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References

  1. Cowie MR, Mosterd A, Wood DA, Deckers JW, Poole-Wilson PA, Sutton GC, Grobbee DE: The epidemiology of heart failure. Eur Heart J 1997;18:208–225.
  2. The CONSENSUS Trial Study Group: Effects of enalapril on mortality in severe congestive heart failure. Results of the Cooperative North Scandinavian Enalapril Survival Study. N Engl J Med 1987;316:1429–1435.
  3. Packer M, Fowler MB, Roecker EB, Coats AJ, Katus HA, Krum H, Mohacsi P, Rouleau JL, Tendera M, Staiger C, Holcslaw TL, Amann-Zalan I, DeMets DL: Effect of carvedilol on the mortality of patients with severe chronic heart failure: results of the carvedilol prospective randomized cumulative survival (COPERNICUS) study. Circulation 2002;106:2194–2199.
  4. Lee WH, Packer M: Prognostic importance of serum sodium concentration and its modification by converting-enzyme inhibition in patients with severe chronic heart failure. Circulation 1986;73:257–267.
  5. Kelly TL, Cremo R, Nielsen C, Shabetai R: Prediction of outcome in late-stage cardiomyopathy. Am Heart J 1990;119:1111–1120.
  6. Spinar J, Vítovec J, Spac J, Blaha M, Spinarova L, Toman J: Non-invasive prognostic factors in chronic heart failure. One-year survival of 300 patients with a diagnosis of chronic heart failure due to ischemic heart disease or dilated cardiomyopathy. Int J Cardiol 1996;56:283–288.
  7. The SOLVD Investigators: Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med 1991;325:293–302.
  8. Batin P, Wickens M, McEntegart D, Fullwood L, Cowley AJ: The importance of abnormalities of liver function tests in predicting mortality in chronic heart failure. Eur Heart J 1995;16:1613–1618.
  9. Romeo F, Pelliccia F, Cianfrocca C, Gallo P, Barilla F, Cristofani R, Reale A: Determinants of end-stage idiopathic dilated cardiomyopathy: a multivariate analysis of 104 patients. Clin Cardiol 1989;12:387–392.
  10. Adams KF, Zannad F, Hill C, France N: Clinical definition and epidemiology of advanced heart failure. Am Heart J 1998;135:S204–S215.
  11. Hillege HL, Girbes AR, de Kam PJ, Boomsma F, de Zeeuw D, Charlesworth A, Hampton JR, van Veldhuisen DJ: Renal function, neurohormonal activation and survival in patients with chronic heart failure. Circulation 2000;102:203–210.
  12. Francis GS, Benedict C, Johnstone DE, Kirlin PC, Nicklas J, Liang CS, Kubo SH, Rudin-Toretsky E, Yusuf S: Comparison of neuroendocrine activation in patients with left ventricular dysfunction with and without congestive heart failure: a substudy of the Studies of Left Ventricular Dysfunction. Circulation 1990;82:1724–1729.
  13. Szatalowicz VL, Arnold PE, Chaimovitz C, Bichet D, Berl T, Schrier RW: Radioimmunoassay of plasma arginine vasopressin in hyponatremic patients with congestive heart failure. N Engl J Med 1981;305:263–266.
  14. Meyns B, Sergeant P, Herijgers P, Flameng W, Vanhaecke J, Van Cleemput J, Droogne W, Daenen W: Bridging procedures to heart transplantation. World J Surg 2002;26:212–217.
  15. Leier CV, Binkley PF: Parental inotropic support for advanced congestive heart failure. Prog cardiovasc dis 1998;41:207–224.
  16. Unverferth DV, Magorien RD, Moeschiberger ML, Baker PB, Fetters JK, Leier CV: Factors influencing the one-year mortality of dilated cardiomyopathy. Am J Cardiol 1984;54:147–152.
  17. Huang SK, Messer JV, Denes P: Significance of ventricular tachycardia in idiopathic dilated cardiomyopathy: observations in 35 patients. Am J Cardiol 1983;51:507–512.
  18. Strickberger SA, Hummel JD, Bartlett TG, Frumin HI, Schuger CD, Beau SL, Bitar C, Morady F: Amiodarone versus implantable cardioverter-defibrillator: randomized trial in patients with nonischemic dilated cardiomyopathy and asymptomatic nonsustained ventricular tachycardia-AMIOVIRT. J Am Coll Cardiol 2003;41:1707–1712.
  19. Aronson D, Burger AJ: Concomitant beta-blocker therapy is associated with a lower occurrence of ventricular arrhythmias in patients with decompensated heart failure. J Card Fail 2002;8:79–85.
  20. Leizorovicz A, Lechat P, Cucherat M, Bugnard F: Bisoprolol for the treatment of chronic heart failure: a meta-analysis on individual data of two placebo-controlled studies – CIBIS (Cardiac Insufficiency Bisoprolol Study) and CIBIS II. Am Heart J 2002;143:301–307.
  21. Whisnant JP, Wiebers DO, O’Fallon WM, Sicks JD, Frye RL: Effect of time since onset of risk factors on the occurrence of ischemic stroke. Neurology 2002;58:787–794.
  22. Pullicino PM, Halperin JL, Thompson JL: Stroke in patients with heart failure and reduced left ventricular ejection fraction. Neurology 2000;54:288–294.
  23. Hallstrom AP, Greene HL, Wilkoff BL, Zipes DP, Schron E, Ledingham RB: The Antiarrhythmics versus Implantable Defibrillators Investigators. Relationship between rehospitalization and future death in patients treated for potentially lethal arrhythmias. J Cardiovasc Electrophysiol 2001;12:990–995.


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