ĐẶC ĐIỂM LÂM SÀNG VÀ SIÊU ÂM TIM Ở BỆNH NHÂN SUY TIM CẤP NHẬP VIỆN CÓ BIẾN CỐ TỬ VONG VÀ TÁI NHẬP VIỆN 30 NGÀY SAU XUẤT VIỆN

Abstract

Background: Patients admitted to hospital with acute heart failure are at increased risk of readmission and mortality post-discharge. Identifying patients with acute heart failure at high risk for readmission or death after hospital discharge will enable the optimization of treatment and management. Objectives: To describe clinical characteristics and echocardiography findings in patients admitted for acute heart failure with 30-day readmission or death after discharge. Methods: Retrospective study, surveying acute heart failure patients in the Cardiology Department at Cho Ray Hospital from October 2021 to May 2022. Results: From October 2021 to May 2022, there were 27 patients among 111 hospitalized patients with acute heart failure (accounting for 24.3%) who had an event of all-cause death or re-hospitalization within 30 days after discharge. The mean age was 63.7 ± 16.2 years and the proportion of men accounted for 51.9% (n = 14). The common medical history was hypertension accounted for 55.6% (n = 15), dyslipidemia accounted for 51.9% (n = 14), coronary heart disease accounted for 44.4% (n = 12) and chronic heart failure accounted for 40.7% (n = 11). Median hospital stay was 8 (6 - 13) days. The classification of dyspnea according to NYHA at hospital discharge of the most patients was NYHA III with 48.1% (n = 13). The most common cause of heart failure was ischemic cardiomyopathy accounting for 70.4% (n = 19). The common classification of acute heart failure was acute pulmonary edema with 51.9% (n = 14) and acute decompensated heart failure with 40.7% (n = 13). Pre-discharge echocardiography of 27 patients recorded a median LVEF(%) of 36 (32 - 43) and the most common LVEF-based classification was heart failure with reduced ejection fraction. (HFrEF) with 18 cases (66.7%). 25 cases (92.6%) had left ventricular hypertrophy on echocardiography and the most common valvular injury was moderate-severe mitral regurgitation, accounting for 62.9% (n = 17). The most common diastolic dysfunction was grade III with 15 cases (55.6%). Conclusion: Patients with acute heart failure hospitalized at the Cardiology Department of Cho Ray Hospital have a high rate of death and re-admission within 30 days after discharge. Clinical features include the most common cause of heart failure is ischemic cardiomyopathy, the most common classification of acute heart failure is acute pulmonary edema, and the most common LVEF classification is HFrEF. The most common echocardiographic features were left ventricular hypertrophy, moderate-severe mitral regurgitation, high mean E/e' value, and grade III left ventricular diastolic dysfunction.