The burden of heart failure in cardiac intensive care unit: a prospective 7 years analysis

• Published in: ESC Heart Failure 2023-06, Vol.10 (3), p.1615-1622
• Main Authors: Grupper, Avishay, Chernomordik, Fernando, Herscovici, Romana, Mazin, Israel, Segev, Amitai, Beigel, Roy, Matetzky, Shlomi
• Format: Article
• Language: English
• Subjects: Acute Coronary Syndrome - complications; Acute Coronary Syndrome - epidemiology; Acute coronary syndromes; Anemia; Blood transfusions; Burden; Cardiac intensive care unit; Cardiovascular disease; Chronic obstructive pulmonary disease; Coronary vessels; Diabetes; Etiology; Females; Heart attacks; Heart failure; Heart Failure - diagnosis; Heart Failure - epidemiology; Heart Failure - therapy; Hospitalization; Humans; Hypertension; Intensive care; Intensive Care Units; Ischemia; Kidney diseases; Morbidity; Mortality; Non-ST Elevated Myocardial Infarction; Original; Pacemakers; Patients; Prospective Studies; Pulmonary arteries; ST Elevation Myocardial Infarction; Ventilators
• ISSN: 2055-5822; 2055-5822
• DOI: 10.1002/ehf2.14320

Aims The profiles of patients at cardiac intensive care units (CICU) have evolved towards a patient population with an increasing number of co‐morbid medical conditions and acute heart failure (HF). The current study was designed to illustrate the burden of HF patients admitted to CICU, and evaluate patient characteristics, in‐hospital course and outcomes of CICU patients with HF compared with patients with acute coronary syndrome (ACS). Methods and results A prospective study including all consecutive patients admitted to the CICU at a tertiary medical centre between 2014 and 2020. The main outcome was a direct comparison between HF and ACS patients in processes of care, resource use, and outcomes during CICU hospitalization. A secondary analysis compared ischaemic versus non‐ischaemic HF aetiology. Adjusted analysis evaluated parameters associated with prolonged hospitalization. The cohort included 7674 patients with a total annual CICU admissions of 1028–1145 patients. HF diagnosis patients represented 13–18% of the annual CICU admissions and were significantly older with higher incidence of multiple co‐morbidities compared with patients with ACS. HF patients also required more intensive therapies and demonstrated higher incidence of acute complications as compared with ACS patients. Length of stay at the CICU was significantly longer among HF patients compared with patients with ACS (either STEMI or NSTEMI) (6.2 ± 4.3 vs. 4.1 ± 2.5 vs. 3.5 ± 2.1, respectively, P