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[Cases of heart failure requiring hospitalization]
M T Vila Alonso1, M J Doce García, S Pita Fernández
1Unidad de Epidemiología Clínica y Bioestadística, Hospital Juan Canalejo, A Coruña.
Objective:
To find the characteristics of patients with heart failure requiring admittance to the referral hospital for the A Coruña Health Area.
Design:
Descriptive, crossover and retrospective study.
Setting:
Health area of 500,000 inhabitants.
Patients And Other Participants:
Patients admitted with diagnosis of heart failure (1995; n = 636). A simple randomised sampling was undertaken, stratified by sex (n = 225; alpha = 0.05; accuracy = 6%). Sample size was increased by 25% due to possible losses of information.
Measurements And Main Results:
The most common underlying causes were: ischaemic cardiopathy 36.4%, dilated myocardiopathy 23.6% and hypertension 16.5%. The most common catalysing factors were: infection 32.6% and tachycardia 24.6%. The commonest symptoms were dyspnoea 90.6% and orthopnoea 63.9%. The most frequent sign was crepitus 79.8%, followed by oedemas 58.3%. An echocardiogram was performed on 42.6% and 22% had digoxinaemia. Most common linked pathology was: hypertension 33.5% and COPD 25.0%. After admission the use of diuretics (30%), digoxin (9%) and ACE inhibitors (27%) was increased. 7.7% of patients died. Variables most commonly linked to death were myocardial infarction (OR = 21.8), hyponatraemia (OR = 12.2) and kidney failure (OR = 7.04).
Conclusions:
Given the underlying causes and catalysing factors seen in the results of this study, family doctors play a decisive role in prevention and control of heart failure.