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Seasonal variation in patients with acute heart failure: prognostic impact of admission in the summer.
- Source :
-
Heart and vessels [Heart Vessels] 2015 Mar; Vol. 30 (2), pp. 193-203. Date of Electronic Publication: 2014 Jan 08. - Publication Year :
- 2015
-
Abstract
- There have been few reports discussing the clinical significance of the season of admission of acute heart failure (AHF) patients. The data of 661 patients with AHF admitted to the intensive care unit were analyzed. Patients were assigned to a summer admission (Group-S, n = 113, between July and September), a winter admission (Group-W, n = 214, between December and February), or to the other seasons admission group (Group-O, n = 334). We evaluated the relationships between the seasonal variations and the clinical profiles, and the long-term prognosis. There were significantly more patients with cardiomyopathy and New York Heart Association class 4, and the serum levels of total bilirubin were significantly higher in Group-S (85.8, 24.8 %, and 0.60 [0.50-0.90]) than in Group-W (75.2, 15.4 %, and 0.60 [0.40-0.78]). The left ventricular ejection fraction on admission was significantly reduced and intravenous administration of dobutamine was used more frequently in Group-S (30.0 [25.0-46.0], 31.9 %) than in Group-W (34.4 [25.2-48.0], 20.6 %) and Group-O (35.0 [25.0-46.0], 19.8 %). The multivariate Cox regression model found that summer admission was independently associated with cardiovascular death (HR: 1.58, 95 % CI 1.01-2.48; p = 0.044) and heart failure (HF) events (HR: 1.55, 95 % CI 1.05-2.28; p = 0.028). The Kaplan-Meier curves showed that the cardiovascular death rate was significantly higher in Group-S than in Group-W and Group-O, and the HF events were significantly higher in Group-S than in Group-O. The summer admission AHF patients included sicker patients, and the prognosis in these patients was worse than in the patients admitted at other times.
- Subjects :
- Acute Disease
Aged
Aged, 80 and over
Chi-Square Distribution
Disease-Free Survival
Female
Health Status
Heart Failure diagnosis
Heart Failure mortality
Heart Failure therapy
Humans
Japan epidemiology
Kaplan-Meier Estimate
Male
Middle Aged
Proportional Hazards Models
Retrospective Studies
Risk Factors
Severity of Illness Index
Time Factors
Treatment Outcome
Heart Failure epidemiology
Patient Admission
Seasons
Subjects
Details
- Language :
- English
- ISSN :
- 1615-2573
- Volume :
- 30
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Heart and vessels
- Publication Type :
- Academic Journal
- Accession number :
- 24398627
- Full Text :
- https://doi.org/10.1007/s00380-013-0461-8