Acute Heart Failure Comorbidome: The Impact of Everything Else
Introduction: Heart failure frequently coexists with several comorbidities. Our aim is to evaluate the prognostic role of various comorbidities in the risk of acute heart failure development. Material and Methods: Comorbidities of patients with acute heart failure were, retrospectively, compared to...
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| Format: | Article |
| Language: | English |
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Ordem dos Médicos
2020-02-01
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| Series: | Acta Médica Portuguesa |
| Subjects: | |
| Online Access: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11051 |
| _version_ | 1797996523246583808 |
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| author | Mariana Alves Meireles João Golçalves João Neves |
| author_facet | Mariana Alves Meireles João Golçalves João Neves |
| author_sort | Mariana Alves Meireles |
| collection | DOAJ |
| description |
Introduction: Heart failure frequently coexists with several comorbidities. Our aim is to evaluate the prognostic role of various comorbidities in the risk of acute heart failure development.
Material and Methods: Comorbidities of patients with acute heart failure were, retrospectively, compared to a control group of patients with chronic heart failure admitted to an Internal Medicine unit in a 2-year period. Logistic regression models were constructed to determine their association with acute heart failure and to develop a comorbidome.
Results: We identified 229 patients with acute heart failure and 201 patients with chronic heart failure. Age and female gender were higher in acute heart failure group (p < 0.001) as was the number of comorbidities (4.0 ± 3.0 vs 4.0 ± 2.0, p = 0.044). Hyperuricemia (odds ratio 2.46, confidence interval 95% 1.41 - 4.31, p = 0.002), obesity (odds ratio 2.22, confidence interval 95% 1.31 - 3.76, p = 0.003), atrial fibrillation (odds ratio 1.93, confidence interval 95% 1.31 - 2.87, p = 0.001), peripheral artery disease (odds ratio 2.12, confidence interval 95% 1.01 - 4.42, p = 0.046) and chronic kidney disease (odds ratio 2.47, confidence interval 95% 1.65 - 3.71, p < 0.001) were associated with acute heart failure. Obesity, atrial fibrillation, peripheral artery disease and chronic kidney disease were identified as independent risk factors. Patients with multiple comorbidities had a superior risk of hospitalization due to heart failure: zero comorbidities – odds ratio 0.43, 95% confidence interval 0.28 - 0.67, p < 0.001; one comorbidity – odds ratio 0.69, 95% confidence interval 0.47 - 1.01, p = 0.057; two comorbidities – odds ratio 1.85, 95% confidence interval 1.11 - 3.08, p = 0.019; ≥ three comorbidities – odds ratio 5.81, 95% confidence interval 2.77 - 12.16, p < 0.001.
Discussion: This study shows an association between several comorbidities and hospital admission due to acute heart failure. The association seems to strengthen in the presence of multiple comorbidities.
Conclusion: A comorbidome is a useful tool to identify comorbidities associated with higher risk of acute heart failure. The identification of vulnerable patients may allow multidimensional interventions to minimize future hospital admissions.
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| first_indexed | 2024-04-11T10:17:43Z |
| format | Article |
| id | doaj.art-c93afc09a031419ea1fc0dcb5855b0ac |
| institution | Directory Open Access Journal |
| issn | 0870-399X 1646-0758 |
| language | English |
| last_indexed | 2024-04-11T10:17:43Z |
| publishDate | 2020-02-01 |
| publisher | Ordem dos Médicos |
| record_format | Article |
| series | Acta Médica Portuguesa |
| spelling | doaj.art-c93afc09a031419ea1fc0dcb5855b0ac2022-12-22T04:29:53ZengOrdem dos MédicosActa Médica Portuguesa0870-399X1646-07582020-02-0133210.20344/amp.110515035Acute Heart Failure Comorbidome: The Impact of Everything ElseMariana Alves Meireles0João Golçalves1João Neves2Internal Medicine Department. Centro Hospitalar do Porto. Porto.Internal Medicine Department. Centro Hospitalar do Porto. Porto.Internal Medicine Department. Centro Hospitalar do Porto. Porto. Introduction: Heart failure frequently coexists with several comorbidities. Our aim is to evaluate the prognostic role of various comorbidities in the risk of acute heart failure development. Material and Methods: Comorbidities of patients with acute heart failure were, retrospectively, compared to a control group of patients with chronic heart failure admitted to an Internal Medicine unit in a 2-year period. Logistic regression models were constructed to determine their association with acute heart failure and to develop a comorbidome. Results: We identified 229 patients with acute heart failure and 201 patients with chronic heart failure. Age and female gender were higher in acute heart failure group (p < 0.001) as was the number of comorbidities (4.0 ± 3.0 vs 4.0 ± 2.0, p = 0.044). Hyperuricemia (odds ratio 2.46, confidence interval 95% 1.41 - 4.31, p = 0.002), obesity (odds ratio 2.22, confidence interval 95% 1.31 - 3.76, p = 0.003), atrial fibrillation (odds ratio 1.93, confidence interval 95% 1.31 - 2.87, p = 0.001), peripheral artery disease (odds ratio 2.12, confidence interval 95% 1.01 - 4.42, p = 0.046) and chronic kidney disease (odds ratio 2.47, confidence interval 95% 1.65 - 3.71, p < 0.001) were associated with acute heart failure. Obesity, atrial fibrillation, peripheral artery disease and chronic kidney disease were identified as independent risk factors. Patients with multiple comorbidities had a superior risk of hospitalization due to heart failure: zero comorbidities – odds ratio 0.43, 95% confidence interval 0.28 - 0.67, p < 0.001; one comorbidity – odds ratio 0.69, 95% confidence interval 0.47 - 1.01, p = 0.057; two comorbidities – odds ratio 1.85, 95% confidence interval 1.11 - 3.08, p = 0.019; ≥ three comorbidities – odds ratio 5.81, 95% confidence interval 2.77 - 12.16, p < 0.001. Discussion: This study shows an association between several comorbidities and hospital admission due to acute heart failure. The association seems to strengthen in the presence of multiple comorbidities. Conclusion: A comorbidome is a useful tool to identify comorbidities associated with higher risk of acute heart failure. The identification of vulnerable patients may allow multidimensional interventions to minimize future hospital admissions. https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11051Heart FailureHospitalizationComorbidityMortality |
| spellingShingle | Mariana Alves Meireles João Golçalves João Neves Acute Heart Failure Comorbidome: The Impact of Everything Else Acta Médica Portuguesa Heart Failure Hospitalization Comorbidity Mortality |
| title | Acute Heart Failure Comorbidome: The Impact of Everything Else |
| title_full | Acute Heart Failure Comorbidome: The Impact of Everything Else |
| title_fullStr | Acute Heart Failure Comorbidome: The Impact of Everything Else |
| title_full_unstemmed | Acute Heart Failure Comorbidome: The Impact of Everything Else |
| title_short | Acute Heart Failure Comorbidome: The Impact of Everything Else |
| title_sort | acute heart failure comorbidome the impact of everything else |
| topic | Heart Failure Hospitalization Comorbidity Mortality |
| url | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11051 |
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