ArticleBMC cardiovascular disorders2025
Factors associated with 30-day mortality in patients with acute heart failure presenting to the emergency department: a retrospective cohort study.
Article in BMC cardiovascular disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Vericiguat in the Post-Stabilization Phase of HFrEF: Targeting Residual Risk Across the Ischemia-Decompensation Continuum.International journal of molecular sciences · 2026Review
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Abstract
backgroundAcute heart failure is common in emergency departments, with medical technology promoting longer survival. Despite improvements in medical care, optimal criteria for discharge or admission decisions remain challenging to establish, particularly in resource-limited emergency department (ED) settings.
objectiveTo identify factors associated with 30-day all-cause mortality in patients with acute heart failure.
methodsThis study was a retrospective cohort study conducted in Maharaj Nakorn Chiang Mai Hospital from 2011 to 2018. All patients diagnosed with acute de novo or decompensated heart failure and presenting to the ED were divided into two groups: those who died within 30 days and those who survived beyond 30 days. Factors obtained from medical history taking, physical examination, and laboratory results were compared between the two groups. Cox proportional hazards models were used to determine hazard ratios (HR) and 95% confidence intervals (95% CI).
resultsWe analyzed 1,951 patients diagnosed with acute de novo or decompensated heart failure. The overall 30-day all-cause mortality rate was 11.0%. Multivariable analysis identified seven independent prognostic factors. Six factors were associated with increased 30-day all-cause mortality: respiratory rate >30 breaths/min; HR 1.61 (95% CI 1.03–2.53), systolic blood pressure <90 mmHg; HR 2.25 (95% CI 1.13–4.45), creatinine levels >2 mg/dL; HR 1.61 (95% CI 1.08–2.39), serum sodium levels <135 mEq/L; HR 1.70 (95% CI 1.24–2.34), potassium levels >5.0 mEq/L; HR 1.59 (95% CI 1.02–2.49), and the use of inotropic drugs; HR 2.89 (95% CI 1.50–5.56). Conversely, dyslipidemia was associated with lower 30-day all-cause mortality (HR 0.54, 95% CI 0.36–0.81).
conclusionIndependent predictors of 30-day all-cause mortality included respiratory rate >30 breaths/min, SBP < 90 mmHg, creatinine >2 mg/dL, sodium <135 mEq/L, potassium >5.0 mEq/L, and inotrope use. These factors help identify high-risk patients requiring close monitoring and potential admission.
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