Insuficiencia cardíaca en hospitales chilenos: resultados del Registro Nacional de Insuficiencia Cardíaca, Grupo ICARO / Cardiac failure in Chilean hospitals: results of the National Registry of Heart Failure, ICARO

ABSTRACT

Background: Heart failure (HF) is a major public health problem. In Chile hospitalized patients due to HF have not been characterized. Aim: To evaluate clinical profile and outcome of patients hospitalized for heart failure in Chilean hospitals. Patients and Methods: Prospective registry of 14 centers. Patients hospitalized for HF in functional class III and IV were included. Epidemiological and clinical data, functional class, type of presentation, decompensation cause, electrocardiogram, echocardiogram, treatment and evolution were registered. Results: Three hundred seventy two patients aged 69±13 years old, 59 percent men, were assessed. The main etiologies of HF were ischemic in 31.6 percent, hypertensive in 35.2 percent, valvular in 14.9 percent and idiopathic in 7.4 percent. There was a history of hypertension 69 percent, diabetes in 35 percent, myocardial infarction in 22 percent, atrial fibrillation (AF) in 28 percent. The presentation form of HF was chronic decompensated in 86 percent, acute in 12 percent, refractory in 2 percent. The causes of decompensation were non compliance with diet or medical prescriptions in 28 percent, infections in 22 percent and AF 17 percent. ECG showed AF in 36 percent and left bundle branch block in 16 percent. Echocardiography was performed in 52 percent of the patients, 69 percent had left ventricular ejection fraction <40 percent. On admission, 39 percent received angiotensin converting enzyme (ACE) inhibitors, 15 percent beta-blocker, 25 percent digoxin, 16 percent spironolactone and 53 percent furosemide. The mean hospital stay was 11±10 days and mortality was 4.5 percent. Conclusions: The elderly is the age group most commonly admitted to hospital due to HF. The main etiologies were ischemic and hypertensive. The main causes for decompensations were noncompliance with diet or medical prescriptions and infections. A significant proportion had a relatively well preserved ventricular systolic function (Rev Méd Chile 2004; 132 655-62).