Factors Affecting Mortality in Heart Failure Patients

Introduction Globally, heart failure (HF) is a leading cause of morbidity and mortality as well as healthcare expenditure in people older than 65 years of age. Worldwide, the prevalence of HF ranges from 1-7% depending on the country and after its diagnosis, survival rates are 50% at 5 years and 10% at 10 years. This study aims to determine which factors in HF can predict mortality, to inform methods of reducing HF mortality for future research. Study Method A retrospective analysis of patients admitted with HF to South Western Sydney Local Health District from 2012 to 2015 was conducted. The mean follow-up period was 3 years. Univariate analysis was performed on factors previously correlated to mortality in HF, including age (separated into groups =70 years old), left ventricular ejection fraction (LVEF), electrolytes, atrial fibrillation (AF), anaemia (defined by WHO criteria as Results On univariate analysis, significant variables included CKD (p = 0.001; OR = 2.1; CI [1.5-2.9]); anaemia (p = 0.002; OR = 1.6; CI [1.2-2.2]); CNCI (p = 0.001; OR = 0.6; CI [0.4-0.8]); age (p = 0.043; OR =1.5; CI [1.0-2.3]) and ACEIs (p = 0.049; OR = 0.7; CI [0.6-1.0]. Other factors such as LVEF, electrolytes, AF, betablockers, spironolactone, diuretics and ARBs were not statistically significant. Logistic regression analysis of significant factors showed CKD was the most important factor (p = 0.001; OR = 2.0; CI [1.5-2.8]) followed by CNCI (p = 0.001; OR = 0.6; CI [0.4-0.8]) and anaemia (p = 0.018; OR = 1.4; CI [1.1-2.0]). Age (p = 0.073) and ACEI (p = 0.127) were not significant when accounting for confounding factors. Conclusion The most important predictor of mortality in HF was chronic renal impairment. CNC intervention was previously viewed considered to alleviate morbidity, but when examined, was shown to decrease mortality as well in HF patients. Anaemia, which is an easily treatable condition, was a significant factor contributing to death, and should be a point of further investigation. Even though ACEI and age were significant on univariate analysis, when corrected for other factors, they had no influence on outcome.