Infection in Patients with Decompensated Heart Failure: In-Hospital Mortality and Outcome

Arq Bras Cardiol. 2018 Mar 12;110(4):364-370. doi: 10.5935/abc.20180037. Print 2018 Apr.
[Article in English, Portuguese]

Abstract

Background: Heart failure (HF) is a syndrome, whose advanced forms have a poor prognosis, which is aggravated by the presence of comorbidities.

Objective: We assessed the impact of infection in patients with decompensated HF admitted to a tertiary university-affiliated hospital in the city of São Paulo.

Methods: This study assessed 260 patients consecutively admitted to our unit because of decompensated HF. The presence of infection and other morbidities was assessed, as were in-hospital mortality and outcome after discharge. The chance of death was estimated by univariate logistic regression analysis of the variables studied. The significance level adopted was P < 0.05.

Results: Of the patients studied, 54.2% were of the male sex, and the mean age ± SD was 66.1 ± 12.7 years. During hospitalization, 119 patients (45.8%) had infection: 88 (33.8%) being diagnosed with pulmonary infection and 39 patients (15.0%), with urinary infection. During hospitalization, 56 patients (21.5%) died, and, after discharge, 36 patients (17.6%). During hospitalization, 26.9% of the patients with infection died vs 17% of those without infection (p = 0.05). However, after discharge, mortality was lower in the group that had infection: 11.5% vs 22.2% (p = 0.046).

Conclusions: Infection is a frequent morbidity among patients with HF admitted for compensation of the condition, and those with infection show higher in-hospital mortality. However, those patients who initially had infection and survived had a better outcome after discharge.

MeSH terms

  • Aged
  • Brazil / epidemiology
  • Cohort Studies
  • Comorbidity
  • Female
  • Heart Failure / complications
  • Heart Failure / mortality*
  • Heart Failure / physiopathology
  • Hospital Mortality*
  • Hospitalization
  • Hospitals, University / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Pneumonia / complications
  • Pneumonia / mortality*
  • Pneumonia / physiopathology
  • Prognosis
  • Statistics, Nonparametric
  • Stroke Volume / physiology
  • Tertiary Care Centers / statistics & numerical data
  • Urinary Tract Infections / complications
  • Urinary Tract Infections / mortality*
  • Urinary Tract Infections / physiopathology