Background: Heart Failure (HF) affects approximately 1-2% of the adult population in developed countries, increasing to more than 10% in those over 70 years of age. The aging population and increased survivorship make HF a pathology with continuously increasing prevalence.
Objective: to determine the influence of chronic HF treatment in patients admitted to an observation unit (OU) on 30-day mortality with acute heart failure (AHF) treated in an emergency department (ED).
Method: Analytical, observational, retrospective study with cohort follow-up on patients admitted in Spanish Emergency Departments with an AHF episode. Variables: 30-day mortality, sociodemographic data, comorbidities and risk factors, treatments, clinical and analytical data of the episode and patient outcome. Statistical analysis: univariate and bivariate descriptive analysis. Comparisons were made using chi-square for qualitative variables and t-test for equality of means in quantitative ones. It was considered as chronic HF treatment the following list: Angiotensin receptor blockers (ARBs), ACE inhibitors, Beta-blockers and Mineralocorticoid receptor antagonists. SGLT2 inhibitors were not analysed in this study.
Results: 876 patients were included. Of these, 185 (21,1%) were admitted to the OU and 406 were part of the control group. 63.1% had a previous HF episode without statistically significant differences between groups. Furthermore, statistically differences were not found in chronic treatment. 21 % and 43,2 % of patients from the OU group were treated with ARBs and ACE inhibitors respectively and 45,5% had beta-blockers. 31,9 % of patients from control group had ACE inhibitors previously and 42,6% had beta-blockers as chronic treatment. 30-day mortality from admittance to ED care was 9.4% of the total, corresponding to 11.4% of the OU group and 8.7% of the control group.
Conclusion: Patients with AHF who remain in an OU after the first assistance have an early mortality similar to the control group regardless of previous chronic HF treatment. More than 20% of patients analysed with a previous HF episode do not have optimised chronic HF treatment.