Estudio de los casos de insuficiencia cardíaca que han requerido ingreso hospitalario

Objective. To find the characteristics of patients with heart failure requiring admittance to the referral hospital for the A Coruña Health Area.Design. Descriptive, crossover and retrospective study.Setting. Health area of 500000 inhabitants.Patients and other participants. Patients admitted with diagnosis of heart failure (1995; n = 636). A simple randomised sampling was undertaken, stratified by sex (n = 225; α = 0.05; accuracy = 6%). Sample size was increased by 25% due to possible losses of information.Measurements and main results. The most common underlying causes were: ischaemic cardiopathy 36.4%, dilated myocardiopathy 23.6% and hypertension 16.5%. The most common catalysing factors were: infection 32.6% and tachycardia 24.6%. The commonest symptoms were dyspnoea 90.6% and orthopnoea 63.9%. The most frequent sign was crepitus 79.8%, followed by oedemas 58.3%. An echocardiogram was performed on 42.6% and 22% had digoxinaemia. Most common linked pathology was: hypertension 33.5% and COPD 25.0%. After admission the use of diuretics (30%), digoxin (9%) and ACE inhibitors (27%) was increased. 7.7% of patients died. Variables most commonly linked to death were myocardial infarction (OR = 21.8), hyponatraemia (OR = 12.2) and kidney failure (OR = 7.04).Conclusions. Given the underlying causes and catalysing factors seen in the results of this study, family doctors play a decisive role in prevention and control of heart failure