ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG BỆNH NHÂN SUY TIM CẤP NHẬP VIỆN TẠI BỆNH VIỆN CHỢ RẪY

Abstract

Introduction: Patients hospitalized with acute heart failure (AHF) had very high mortality rate, significantly increasing the burden on families and the community. Clinical factors is crucial for devising aggressive treatment strategies aimed at reducing mortality and rehospitalization due to heart failure. Objective: To identify the clinical characteristics of patients hospitalized with acute heart failure. Subjects and Methods: This retrospective study selected records of patients diagnosed with acute heart failure or acute decompensation heart failure at Cho Ray Hospital, from January 2021 to August 2021. Clinical characteristics, laboratory results, and treatment medications were recorded from medical records. Results: A total of 478 records with acute heart failure or acute decompensation heart failure were recorded (mean age of 71 years, 57.7% men). Among these, 33.3% de-novo acute heart failure. Patients with renal dysfunction, chronic anemia, hypertension, diabetes mellitus, and dyslipidemia were 69%, 59.2%, 41.8%, 28.5%, and 21.1%, respectively. The most common symptoms were dyspnea (91.8%), fatigue (70.7%), edema (32.9%), pulmonary rales (52.9%), and third heart sound (24.7%). The heart rate was 98±16 bpm, and NYHA class III/IV was 76.6% (n=366). The mean hemoglobin concentration (Hb) was 120.6 ± 23.2 g/L, and the NT-proBNP level was 7480.47 ± 4856.2 pg/mL. Atrial fibrillation was 16.3%. The mean left ventricular ejection fraction was 42.7 ± 7.1, 42.1% of patients with HFrEF. The three most common causes of heart failure were coronary artery disease (57.7%), hypertensive heart disease (21.5%), and cardiomyopathy (14.4%). Common precipitating factors included non-adherence to medication (19.7%), infection (18.4%), acute coronary syndrome (18%), and uncontrolled hypertension (11.1%). Conclusion: Coronary artery disease was the most common cause of heart failure, and precipitating factors in AHF were non-adherence to medication, infection, and acute coronary syndrome. Patients hospitalized with acute heart failure had a high prevalence of comorbidities.