Survie et prédicteurs de la mortalité intrahospitalière des patients avec d’insuffisance cardiaque aiguë : Perspectives issues d’une cohorte rétrospective monocentrique

Abstract

Context and objective. Acute heart failure (AHF) is a leading cause of hospitalization and in-hospital mortality. The objective of the study was to determine predictors of in-hospital mortality among AHF patients. Methods. in this retrospective cohort study, demographic, clinical, biological, and echocardiographic characteristics of AHF patients were analyzed at the Centre Hospitalier Sud Francilien in Corbeil, France. Cox proportional hazards models were used to identify independent predictors of in-hospital mortality. Results. Data from 293 patients aged 72.4 ± 12.5 years were analyzed. The in-hospital mortality rate was 9.6%. Median hospital stay was 8 days. Kaplan-Meier survival analysis revealed significantly lower survival rates in patients with atrial fibrillation (p = 0.011), cancer (p = 0.006), CKD (p = 0.042), and cardiogenic shock (p < 0.001). In multivariate analysis, hypertension (AHR = 2.39), cancer (AHR = 2.10), CKD (AHR = 2.64), anemia (AHR = 2.59), NT-proBNP levels ≥10,000 pg/ml (AHR = 3.00), right ventricular dysfunction (AHR = 3.52), and cardiogenic shock (AHR = 4.74) were independently associated with mortality. Conclusion. In-hospital mortality in AHF is influenced by a combination of comorbidities, cardiac dysfunction, and hemodynamic compromise. Early detection of high-risk patients through clinical and echocardiographic markers may enhance prognosis and inform therapeutic strategies. Received: February 10th, 2025 Accepted: May 29th, 2025 https://dx.doi.org/10.4314/aamed.v18i4.3