Vliv věku, krevního tlaku, body mass indexu, základních laboratorních parametrů a ejekční frakce levé komory na hospitalizační mortalitu hypertoniků s akutním srdečním selháním

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Title in English Influence of age, blood pressure, body mass index, laboratory parameters and left ventricular ejection fraction on in-hospital mortality of patients with hypertension and acute heart failure
Authors

FELŠŐCI Marián PAŘENICA Jiří MIKLÍK Roman JARKOVSKÝ Jiří ŠPINAR Jindřich

Year of publication 2012
Type Article in Periodical
Magazine / Source Cardiology Letters
MU Faculty or unit

Faculty of Medicine

Citation
Field Cardiovascular diseases incl. cardiosurgery
Keywords hypertension; acute heart failure; in-hospital mortality
Attached files
Description Whether generally accepted predictors of in-hospital mortality in patients with acute heart failure (HF) are effective, also in the sub-population with previous hypertension is unclear. Methods: We used patient data from the single university centre that is participating in the Czech HF registry. Within the study period of December 2004 and August 2007 we enrolled 1253 patients with acute HF. After the selection of those with previous hypertension, we tested the influence of age, body mass index (BMI), laboratory parameters, the level of blood pressure (BP) on admission and left ventricular ejection fraction (LVEF) on in-hospital mortality. Results: In-hospital mortality of patients with acute HF and hypertension (n=843, 67%) was 14.0% with the mean length of hospital stay 6.9 days. Patients deceased during hospitalisation were older, with lower haemoglobin level, higher entry and maximal serum creatinine, glycaemia and C-reactive protein (CRP), lower BMI, entry BP and LVEF. In univariate analysis in-hospital mortality was worsened by age [odds ratio (OR) 1.28], BP < 120/80 mmHg at entry (OR 6.40), LVEF less than 20% (OR 2.09), increasing creatinine level (OR 1.29), glycaemia (OR 2.75) or CRP (OR 1.10) and by the positivity of troponin (OR 2.04). A protective influence was found in patients with BMI > 25 kg/m2 (OR 0.48), LVEF more than 41% (OR 0.41), entry BP more than 140/90 mmHg (OR 0.40) with positive influence even in patients with BP more than 180/110 mmHg (OR 0.34).Conclusion: In-hospital mortality of patients with acute HF and previous hypertension is associated with several factors. Probably the most important of these is low blood pressure at admission.
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