Buscar en
Medicina Clínica (English Edition)
Toda la web
Inicio Medicina Clínica (English Edition) Causes of death in hospitalized patients in internal medicine departments with h...
Journal Information
Vol. 158. Issue 1.
Pages 13-19 (January 2022)
Share
Share
Download PDF
More article options
ePub
Visits
0
Vol. 158. Issue 1.
Pages 13-19 (January 2022)
Original article
Causes of death in hospitalized patients in internal medicine departments with heart failure according to ejection fraction. RICA registry
Causas de muerte en pacientes hospitalizados en servicios de medicina interna por insuficiencia cardíaca según la fracción de eyección. Registro RICA
Visits
...
María Esther Guisado-Esparteroa,
Corresponding author
guesm53@hotmail.com

Corresponding authors.
, Prado Salamanca-Bautistab,
Corresponding author
pradosalamanca@gmail.com

Corresponding authors.
, Óscar Aramburu-Bodasb, Luis Manzanoc, M. Angustias Quesada Simónd, Gabriela Ormaecheae, Sara Carrascosa Garcíaf, Marcos Guzmán Garcíag, José María Cepeda Rodrigoh, Manuel Montero-Pérez-Barqueroi, on behalf of the investigators of the RCIA Registry
a Servicio de Medicina Interna, Hospital Infanta Margarita, Cabra (Córdoba), Spain
b Servicio de Medicina Interna, Hospital Universitario Virgen Macarena, Universidad de Sevilla, Sevilla, Spain
c Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal, Universidad de Alcalá (IRYCIS), Madrid, Spain
d Servicio de Medicina Interna, Hospital Universitario La Paz, Madrid, Spain
e Servicio de Medicina Interna, Hospital de Clínicas Dr. Manuel Quintela, Montevideo, Uruguay
f Servicio de Medicina Interna, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
g Servicio de Medicina Interna, Hospital San Juan de la Cruz, Jaén, Spain
h Servicio de Medicina Interna, Hospital Vega Baja, Orihuela (Alicante), Spain
i Servicio de Medicina Interna, IMIBIC/Hospital Reina Sofía, Universidad de Córdoba, Córdoba, Spain
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (1)
Tables (4)
Table 1. Characteristics of deceased and living patients according to ejection fraction group.
Table 2. Characteristics of patients who died due to cardiovascular and non-cardiovascular causes according to ejection fraction group.
Table 3. Causes of mortality during follow-up (397 days) according to ejection fraction group.
Table 4. Multivariate mortality analysis (Cox regression) according to ejection fraction group.
Show moreShow less
Abstract
Introduction

There are few data in the Spanish population about the causes of death in patients admitted to Internal Medicine departments for heart failure (HF). Their study according to left ventricular ejection fraction (reduced: rEF, mid-range: mEF, and preserved: pEF) could improve the knowledge of patients and their prognosis.

Methods

Prospective multicentre cohort study of 4144 patients admitted with HF to Internal Medicine departments. Their clinical characteristics, mortality rate and causes were classified according to pEF (≥50%), mEF (40%–49%) and rEF (<40%). Patients were followed-up for a median of one year.

Results

There were 1198 deaths (29%). The cause of death was cardiovascular (CV) in 833 patients (69.5%), mainly HF (50%) and sudden cardiac death (SCD, 7.5%). Non-cardiovascular (Non-CV) causes were responsible for 365 deaths (30.5%). The most common Non-CV causes were infections (13%). The most frequent and early cause in all groups was HF. Patients with pEF, compared to the other groups, had lower risk of SCD and higher risk of infections (P < .05). The causes of death in patients with mrEF were closer to those with pEF.

Conclusions

The causes of death in patients with HF were different depending on EF strata. Patients with mEF and pEF, due to their high comorbidity and higher frequency of NoCV death, would require comprehensive management by Internal Medicine.

Keywords:
Heart failure
Cause of death
Ejection fraction
Intermediate ejection fraction
Comorbidity
Resumen
Introducción

Los datos disponibles de las causas de muerte en pacientes ingresados por Insuficiencia Cardíaca (IC) en Servicios de Medicina Interna y en población española según Fracción de eyección (FE) reducida (FER), preservada (FEP) e intermedia (FEI) son escasos. Su estudio puede mejorar el conocimiento de estos pacientes y su pronóstico.

Métodos

Estudio de cohortes multicéntrico y prospectivo de 4144 pacientes que ingresaron por IC en unidades de Medicina Interna. Se registraron sus características clínicas, tasa de fallecimientos y sus causas agrupados según FEP (≥ 50%), FEI (40%–49%) y FER (<40%) durante una mediana de seguimiento de un año.

Resultados

Se registraron 1198 fallecimientos (29%), de los que 833 fallecieron por causas cardiovasculares (CV) (69,5%), fundamentalmente por IC (50%) y por muerte súbita (MS) (7,5%); y 365 por causas no cardiovasculares (NoCV) (30,5%), principalmente por infecciones (13%). La causa más frecuente y temprana en todos los grupos fue la IC. Los pacientes con FEP tenían menor tasa de MS y mayor de infecciones (P < ,05). Las causas de muerte en FEI fueron más parecidas a las de FEP.

Conclusiones

Las causas de muerte en pacientes con IC fueron diferentes dependiendo del tipo de FE. Los pacientes con FEI y FEP, por su elevada comorbilidad y mayor frecuencia de muerte NoCV, son los que más se beneficiarían de un manejo integral por parte de Medicina Interna.

Palabras clave:
Insuficiencia cardíaca
Causas de muerte
Fracción de eyección
Fracción de eyección intermedia
Comorbilidad

Article

These are the options to access the full texts of the publication Medicina Clínica (English Edition)
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Medicina Clínica (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
Tools
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos