Clinical Characteristics, Precipitation causes and Therapy of Patients with Acute Heart Failure in A General Hospital

Abstract

Purposes: To study the clinical characteristics, precipitating factors, treatment, mortality rate, and the rate of discharge or transfer for patients with acute heart failure treated at Phraputtabhat Hospital, and to utilize the data obtained from this study to develop a medical service system for heart disease care at the hospital.

Study design: A retrospective descriptive study.

Materials and Methods: The sample consisted of all patients aged 18 and over diagnosed with acute heart failure admitted to the inpatient ward at Phraputtabhat Hospital, Saraburi Province, from September 1, 2023, to October 31, 2024. Data were collected retrospectively from hospital medical records by extracting data from electronic databases. The data were analyzed and presented in percentage form of the total patients.

Main findings: A total of 328 patients with acute heart failure were included, with 174 females (53.05%) and 154 males (46.95%). The average age was 62.71 years. The majority had a history of heart failure (58.23%), with high prevalence of comorbidities such as hypertension (71.65%) and diabetes mellitus (45.12%). The primary presenting symptom was dyspnea (98.48%), with abnormal lung sounds (crepitation) in 86.89%. Chest X-ray often showed cardiomegaly (89.33%) and pulmonary congestion/cephalization (81.4%).The main triggering factors included fluid retention (salt water retention) at 62.5%, followed by bloodstream infections (sepsis) at 20.73%. Others included prior echocardiogram (11.28%), coronary bypass surgery (CABG) (1.83%), and coronary artery stenting (0%).The discharge rate was 86.89%, transfer rate was 1.21%, and mortality rate was 11.89%. The average hospital stay was 6.14 days, with a median of 3 days. The number of hospital days per year was 1.26 days, with a median of 1 day.

Conclusion and Recommendations: Patients with acute heart failure in this general hospital had an average age of 62.71 years, with nearly equal distribution between males and females. Most had chronic non-communicable comorbidities, and the presenting symptom was dyspnea. Few had prior imaging confirmation of cardiomegaly. The most common triggering factor was excess salt and water intake, followed by infections. The mortality rate was higher than the average reported in other studies, but the transfer rate was low. The researchers recommend improving care quality and establishing a dedicated heart failure clinic to enhance treatment efficacy.