In-hospital mortality and prognostic factors in patients admitted for new-onset heart failure with preserved or reduced ejection fraction: a prospective observational study Mortalité hospitalière et facteurs pronostiques chez des patients admis pour une première poussée d'insuffisance cardiaque à fraction d'éjection ventriculaire gauche préservée ou altérée : étude prospective observationnelle

Summary Introduction. — Heart failure (HF) is associated with high morbidity and mortality. A significant component of HF-related adverse outcome occurs during hospitalization. Objective. — To assess features and in-hospital outcomes of patients hospitalized for a first episode of HF. Methods. — We prospectively recruited 799 consecutive patients hospitalized for a first episode of HF during 2000 in the Somme department (France). We evaluated in-hospital mortality in this cohort, identified factors predictive for hospital death, and compared the mortality in patients with preserved or reduced ejection fraction (EF). Results. — The mean age of the study population was 75±12 years. EF, assessed in 662 patients (83%), was preserved (≥50%) in 56% of cases. During hospitalization, 64 deaths (8%) were recorded. The major causes of in-hospital death were acute pulmonary oedema (50%) and cardiogenic shock (22%). Coronary artery disease, low systolic blood pressure on admission, increased heart rate on admission, renal failure, reduced EF (<50%) and older age were identified as independent predictors of in-hospital mortality. Patients with preserved EF were older and comprised a greater proportion of women. In-hospital mortality of the reduced EF group was higher than that of the preserved EF group (8.2% versus 2.7%, p=0.002). On multivariable analysis, reduced EF was independently associated with in- hospital death (odds ratio 2.32; 95% confidence interval 1.06-5.11; p=0.03). In propensity- matched patients, in-hospital mortality was higher in the reduced EF group (7.6% versus 2.2%