Clinical and laboratory characteristics of short-term mortality in Egyptian patients with acute heart failure.

Objective: To identify the clinical and laboratory predictors of short-term mortality in patients with acute heart failure (AHF).

Subjects and methods: We conducted a prospective, single center study on 120 consecutive patients presented with acute heart failure to the emergency department. All patients had clinical, laboratory, electrocardiographic and echocardiographic evaluation. Short-term mortality was reported within 30 days of presentation.

Results: Mean age was 59.29 ± 10.1 years, 55.8% were males and 50.8% were smokers. The common AHF presentations were dyspnea (91.7%), chest tightness (62.5%) and lower limb edema (54.2%). Ischemic heart disease, diabetes and hypertension were present in 72.5%, 43.3% and 35% of patients, respectively.Short-term mortality was reported in 29 patients (24.16%); most of them died in-hospital (19 patients, 65.52%). The following parameters were significantly associated with short-term mortality: hypoxia ( P  < 0.001), tachycardia ( P  < 0.01), raised jugular venous pressure (JVP) ( P  < 0.001), low systolic blood pressure ( P  < 0.01), prolonged PR interval ( P  < 0.007), atrial fibrillation (AF) ( P  < 0.038), left bundle branch block (LBBB) ( P  < 0.04), impaired kidney function ( P  < 0.007), anemia ( P  < 0.029), hyponatremia ( P  < 0.006), hypoalbuminemia ( P  < 0.005), dilated left ventricle (LV) ( P  < 0.001), low LV ejection fraction (LVEF) ( P  < 0.001), and dilated left atrium (LA) ( P  < 0.002).ROC curve analysis showed that low LVEF (≤24%), dilated LV end diastolic diameter (LVESD) ≥ 66.5 mm, dilated LV end systolic diameter (LVESD) ≥ 53.5 mm, dilated LA diameter ≥ 48 mm, increased serum creatinine ≥ 1.6 mg/dl, and decreased serum albumin ≤ 3 g/dl can significantly predict short-term mortality in patients with acute heart failure.

Conclusion: Variable clinical, laboratory, electrocardiographic and echocardiographic parameters were associated with short-term mortality. Our study showed that low LVEF, dilated LV diameter, dilated LA diameter, impaired kidney function and low serum albumin can predict short-term mortality in patients with acute heart failure.