More than 10% of patients hospitalized for HF have worsening symptoms

Approximately 10 percent to 15 percent of patients had worsening heart failure or died within five days of being admitted into a hospital for acute heart failure, according to a pooled analysis of clinical trials.

Lead researcher Beth A. Davison, PhD, of Momentum Research in Durham, N.C., and colleagues found worsening heart failure was associated with a longer length of hospital stay and higher risk for readmission and death.

They published their findings in the Journal of the American College of Cardiology: Heart Failure on May 1.

Davison et al examined data from the PROTECT and RELAX-AHF phase 2 and 3 studies. They defined worsening heart failure as worsening signs and/or symptoms of heart failure that required intensification of intravenous therapy or mechanical support.

The analysis included a total of 3,734 patients who participated in one of the four trials. Within five days of hospitalization, between 9.6 percent and 14.5 percent of patients had died or sustained worsening heart failure.

The mean length of stay in the hospital was between eight and nine days, while 9.3 percent to 18.6 percent of patients had died through 180 days following hospitalization.

Based on a multivariable analysis, the predictors of worsening heart failure included higher blood urea nitrogen, respiratory rate, hematocrit and systolic blood pressure. Patients who had worsening heart failure stayed in the hospital an average of 5.7 days longer than those who did not experience worsening heart failure.

Researchers said information was not available on previous hospitalizations for heart failure and biomarkers such as lymphocyte percentage, troponin and natriuretic peptides. They also could not evaluate symptoms and signs of heart failure when they occurred during nights and weekends.