Bedside predictors of late prognosis in heart failure with reduced ejection fraction patients surviving hospitalization for acute decompensation

Authors : Ömer Doğan, Hasan Barman, Abdullah Ömer Ebeoğlu, Adem Atıcı, Sevval Ilke Ebeoglu, Barış Ikıtımur, Sait Mesut Doğan, Rasim Enar
Pages : 89-99
Doi:10.21673/anadoluklin.1763799
View : 61 | Download : 246
Publication Date : 2026-01-24
Article Type : Research Paper
Abstract :Aim: We aimed to identify predictors of mortality and re-admission for worsening heart failure (HF) in patients hospitalized for acute decompensated HF with reduced EF who survived until discharge. Methods: A total of 767 chronic HF patients with LVEF ≤ 0.40 who were admitted to the hospital for acute decompensation between 2009-2016 and survived until discharge after treatment were enrolled and followed for up to 5 years. The primary end points of the study included cardiovascular death after index hospitalization and re-admission to the hospital for worsening HF. Results: Primary end points of the study were reached in 40% of cases in the form of cardiovascular death and 71% of cases were re-hospitalized for worsening HF during 5-years follow-up after index hospitalization. After multivariate analysis in cox-regression analysis; NYHA (New York Heart Association) class (p<0.001); LVEF (p=0.005); presence of coronary artery disease (p=0.001); basal sodium levels (p=0.008); moderate-severe mitral regurgitation (p<0.001); the use of high-dose iv furosemide in hospital (p=0.002); inotropic infusion (p=0.030); history of the coronary intensive care unit (p=0.01) and mechanical ventilation (p<0.001); and the development of cardiorenal syndrome (p=0.003) were independent predictors of cardiovascular mortality. Conclusions: The accumulation of cardiovascular events within the initial 3-6 months after discharge in advanced heart failure patients who survive the initial hospitalization; highlights the significance of the first 6 months as a critical “period of vulnerability” for the implementation of secondary prevention measures.
Keywords : Kalp yetersizliği, ölüm oranı, prognoz

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