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. 2013;6(4):440-5.
Epub 2013 Dec 25.

Clinical, biological, echocardiographic and therapeutic determinants of the length of hospital stay of patients with acute heart failure

A C Nechita  1 , V Enache  1 , A M Stroi  2 , R L Ploesteanu  3 , C Delcea  3 , C S Stamate  1
Affiliations

Clinical, biological, echocardiographic and therapeutic determinants of the length of hospital stay of patients with acute heart failure

A C Nechita et al. J Med Life. 2013.

Abstract

Hypothesis: The length of hospital stay (LOS) is a unanimously accepted measure of risk and treatment efficacy for in-patients.

Purpose: Our aim was to identify the parameters with predictive value for the LOS of patients with acute heart failure (AHF).

Methods: We analyzed 125 patients consecutively admitted to our clinic with a slight male predominance (54.4%) and a mean age of 71.54 years. Patients were divided into groups according to the clinical form at presentation and left ventricular function. Mean LOS was of 8.74 days.

Results: Patients with LVEF<30% had a significantly higher LOS compared to those with LVEF>30% (F(2)=6.54, p<0.05). The same difference was discovered for those who received inotropic support (p<0.001), i.v. loop diuretic>140mg (p<0.001) as well as for those with QRS>160ms (p<0.05) or LBBB. The linear regression equation exposed a single significant statistical model indicating that the need for vasopressor amines, mean diuretic dose and PAAT<90msec explain 56% of the variance of LOS F(3.46)=20.55, p<0.001. The highest contribution to the model was achieved by the need for vasopressor amines (β=0.66), with a unique contribution of 42% to the variance of the number of days of stay. The mean dose of diuretic had β=0.27 and a unique contribution to the model of 7.2%, followed by PAAT<90 msec with β=0.26 and a unique contribution to the model of 7%.

Conclusions: LOS is influenced by numerous parameters, some specific to certain clinical forms of AHF while others are independent, which is why evaluations on larger groups of patients are further needed.

Keywords: LOS; acute heart failure; left ventricle ejection fraction; length of stay; pulmonary artery acceleration time.

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Figures

Table 1
Table 1
General data, clinical and electrocardiographic characteristics
Table 2
Table 2
Laboratory parameters and classes of medication used in treating AHF
Table 3
Table 3
Echocardiographic characteristics according to the clinical form ar presentation and LVEF (mean±SD)
Fig.1
Fig.1
Mean length of stay according to the clinical form at presentation and LVEF
Fig.2
Fig.2
Mean length of stay according to the QRS duration and LVEF
Fig.3
Fig.3
Mean length of stay according to QRS and LVEF
Fig.4
Fig.4
Mean length of stay according to the clinical form at presentation
See this image and copyright information in PMC

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