Demographics and clinical outcomes of patients with acute heart failure : The Acute Heart Failure Registry from the Clinic Ottakring (AHF-COR Registry).

Abstract

Background: Acute heart failure (AHF) significantly contributes to cardiovascular morbidity and mortality, bearing a substantial socioeconomic burden. While the dynamics of chronic heart failure have been extensively explored in global patient cohorts, comprehensive data specific to AHF remain limited.

Methods: This retrospective, single-center, real-world study comprises hospitalized patients with AHF, admitted to a tertiary care hospital in Vienna, Austria, between 1 January 2012 and 31 December 2019. We collected and evaluated baseline characteristics, demographic features and clinical outcomes of our study cohort. The primary aim of this study is to assess the prognostic impact of demographic features on mortality.

Results: Our study encompassed 3156 patients admitted for AHF at a mean age of 77 ± 12 years with 50.7% of patients being male. The N-terminal pro B‑type Natriuretic Peptide (NT-proBNP) levels upon hospital admission were elevated with a median of 5701 ng/l (interquartile range, IQR, 2618-11,581 ng/l). Male patients were younger than females and had a higher cardiovascular comorbidity burden. Heart failure with reduced ejection fraction was more prevalent in male patients (54.2% vs. 32.8%), while females most often exhibited heart failure with preserved ejection fraction (50.5% vs. 29.0%). Most patients presented to the emergency department (85.9%) primarily arriving by ambulance (85.6%) during daylight hours (68.2%). Within 1 year, 27.6% of patients reached the primary endpoint of 1‑year mortality. Compared to international AHF registries, our study population was notably older with comparable in-hospital and 1‑year mortality rates. Among demographic features, admission through the emergency department and arrival by ambulance demonstrated a significant association with both short-term and long-term mortality, while the year of admission, seasonal variation, socioeconomic strength, nighttime, and weekend admission failed to do so.

Conclusion: Our study offers insights into the dynamics of AHF in Vienna, Austria, drawing comparisons to international AHF registries. Admission through the emergency department and arrival by ambulance emerged as significant independent predictors of mortality among demographic features.