Predictors of In-Hospital Mortality in Acute
Decompensated Heart Failure (Thai ADHERE)
Worachat Moleerergpoom MD*, Kriengrai Hengrussamee MD**,
Dilok Piyayotai MD***, Woravut Jintapakorn MD****,
Pradub Sukhum MD*****, Rapeephon Kunjara-Na-Ayudhya MD******,
Thouantosaporn Suwanjutah MD*******, Prasart Laothavorn MD********
Affiliation :
* Division of Cardiology, Department of Medicine, Police General Hospital, Pathumwan, Bangkok, Thailand
** Department of cardiology Chest Disease Institute, Nonthaburi, Thailand
*** Division of Cardiology, Faculty of Medicine, Thammasat University, Klongluang, Patumthani, Thailand
**** Cardiology Division, Department of Medicine, Songklanagarind Hospital, Hat-Yai Songkhla, Thailand
***** Bangkok Heart Institute, Bangkok General Hospital, Bangkok, Thailand
****** Cardiology Unit, Vichaiyuth Hospital, Bangkok, Thailand
******* Heart Center, Phyatai 2 Hospital,Phyathai, Bangkok Thailand
******** Cardiovascular Division, Department of Medicine, Pramongkutklao Hospital, Bangkok, Thailand
Background : Heart failure had emerged as a major public health problem and became the leading cause of hospitalization.
The Acute Decompensated Heart Failure National Registry (ADHERE) of US patients hospitalized with a primary diagnosis
of acute decompensated heart Failure (ADHF) had been reported worldwide for the risk stratification and predicting
In-hospital mortality.
Objective : Identify clinical risk factors or treatment procedures that could predict In-hospital mortality in Thai patients
with ADHF.
Material and Method: Thai ADHERE is a multicenter, observational, prospective study. The data were collected via
web-based electronic data capture and analyzed. Two thousand forty one hospitalization episodes involving 1,671 patients
in the 18 participating hospitals between March 2006 and September 2007 were analyzed. All clinical factors associated
with In-hospital mortality identified by univariated analysis were further analyzed by Logistic regression model.
Results : One hundred thirteen patients died during the hospitalization period with overall mortality rate of 5.5%. Systolic
blood pressure <90 mmHg, creatinine >2.0 mg/dL, history of stroke/TIA, and NYHA class IV were independent risk
factors for In-hospital mortality with adjusted OR (95% CI) = 3.45 (1.77-6.79), 1.99 (1.30-3.05), 1.85 (1.11-3.08) and 1.69
(1.08-2.64) respectively. Hypertensive cause of CHF, prior use of lipid lowering drug, and hemoglobin level were associated
with lower risk, adjusted OR (95% CI) = 0.35 (0.15-0.81), 0.51 (0.34-0.78) and 0.90 (0.82-0.98) respectively.
Conclusion : The clinical predictors for In-hospital mortality of Thai ADHERE that associated with worse outcome were
systolic blood pressure <90 mmHg, creatinine >2.0 mg/dL, history of stroke/TIA, and NYHA class IV. Hypertensive cause
of CHF, prior use of lipid lowering drug, and hemoglobin were associated favorable outcome.
Keywords : Predictors, In-hospital mortality, Thai-ADHERE
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