Acute heart failure in the emergency department: a follow-up study

Acute heart failure (AHF) is a major public health issue due to high incidence and poor prognosis. Only a few studies are available on the long-term prognosis and on outcome predictors in the unselected population attending the emergency department (ED) for AHF. We carried out a 1-year follow-up analysis of 1234 consecutive patients from selected Italian EDs from January 2011 to June 2012 for an episode of AHF. Their prognosis and outcome-associated factors were tested by Cox proportional hazard model. Patients\u2019 mean age was 84, with 66.0\ua0% over 80\ua0years and 56.2\ua0% females. Comorbidities were present in over 50\ua0% of cases, principally a history of acute coronary syndrome, chronic obstructive pulmonary disease, diabetes, chronic kidney disease, valvular heart disease. Death occurred within 6\ua0h in 24 cases (1.9\ua0%). At 30-day follow-up, death was registered in 123 cases (10.0\ua0%): 110 cases (89.4\ua0%) died of cardiovascular events and 13 (10.6\ua0%) of non-cardiovascular causes (cancer, gastrointestinal hemorrhages, sepsis, trauma). At 1-year follow-up, all-cause death was recorded in 50.1\ua0% (over 3 out of 4 cases for cardiovascular origin). Six variables (older age, diabetes, systolic arterial pressure\ua0