Facteurs pronostiques et issue vitale chez des patients réhospitalisés pour insuffisance cardiaque aiguë : perspectives issues d’une étude de cohorte rétrospective monocentrique

Abstract

Context and objective. Re-hospitalized acute heart failure (AHF) patients' in-hospital mortality and associated factors are unclear. This study aimed to determine prognostic factors and outcomes in these patients. Methods. A retrospective cohort study (January 2021 - October 2024) was conducted at the Centre Hospitalier Sud Francilien. Re-hospitalized AHF patients were analyzed for key data. Cox regression identified mortality predictors. Results. A total of 182 patients (mean age 77.6±11.7 years; 121 (66.5%) male) were included. In-hospital mortality was 41.2%, with a median survival of 9 days. Hypertension (59.9%) and diabetes (44.5%) were the most common cardiovascular risk factors (CVRF). Atrial fibrillation (60.4%) was the main comorbidity. Independent mortality predictors included hypertension (HRa=3.76; p=0.001), cancer (HRa=2.84; p=0.014), chronic obstructive pulmonary disease (HRa=2.50; p=0.020), transition to intensive care unit (HRa=3.32; p=0.006), NT-proBNP ≥10,000 pg/mL (HRa=2.02; p=0.008), high-sensitivity C-reactive protein ≥6 mg/dL (HRa=2.25; p=0.018), and cardiogenic shock (HRa=2.36; p=0.005). Conclusion. Re-hospitalized AHF patients face a high early mortality. Factors such as specific CVRF, comorbidities, and hemodynamic instability, as well as elevated biomarkers of ventricular wall stress and systemic inflammation are key determinants of in-hospital mortality for these patients. These findings underscore the importance of early risk stratification and individualized care. Received: April 1st, 2025 Accepted: May 28th, 2025 https://dx.doi.org/10.4314/aamed.v18i4.2