Abstract 11404: Impact of Infection-Related Hospital Admissions With Heart Failure on Clinical Outcomes: Insights From the Gulf CARE Study
OBJECTIVES: Although community acquired infections (CAI) are one of the most common causes for hospitalization of patients with heart failure (HF), yet very few studies have systematically examined the impact of CAI on the immediate and long term outcomes in patients with HF. The aim of the current study was to study patients hospitalized with HF due to CAI and subsequent immediate and 1 year clinical outcomes using a large multinational multicenter registry from the Middle-East.
METHODS: From February, 2012 to November, 2013, consecutive patients hospitalized with HF were enrolled from 47 hospitals in 7 Middle East countries. Patients with CAI precipitating HF were identified on admission and compared to a control group with no infection. Clinical features and outcomes were examined.
RESULTS: During the study period 5005 patients with HF were enrolled of whom 731 (8.9%) had CAI identified as the precipitating factor for admission. Compared to patients with no infection, patients with CAI were 2 years younger, had a higher rates of underlying chronic obstructive airway disease/ asthma (16.1% vs. 9%), underlying valvular heart disease (21.2% vs. 12.2%) and atrial fibrillation (15.3% vs. 11.6%) and a higher left ventricular ejection fraction on echocardiography (mean 39% vs.36%). They were more likely to require mechanical ventilation (12% vs.7.9%) and had a longer length of stay (17 days vs. 12 days) [All P=0.001]. Hospitalizations due to infections compared to other indications were associated with increased in-hospital and 1-year mortality rates (9.3% vs. 5.7%, p=0.001, and 14.2% vs. 11.1%, p=0.02, respectively). On multivariate analysis, hospitalization with CAI was and independent predictor of in-hospital (OR 1.87 [95% CI 1.36-2.56], p= 0.001) and 1-year mortality (OR 1.38 [95% CI 1.05-1.8], p = 0.019).
CONCLUSIONS: Community acquired infections are associated with increased mortality rates in patients with HF and increase hospital stay. Early and effective treatment of CAI in patients with HF is recommended to attempt to reduce the high mortality and burden of HF in these patients.
Author Disclosures: A.M. Salam: None. K. Sulaiman: None. J. Al-Suwaidi: None. K. AlHabib: None. W. Almahmeed: None. A. Alsheikh-Ali: Other Research Support; Modest; Medtronic, Behringer Ingelheim. Honoraria; Modest; Boehringer Ingelheim, Bayer, Pfizer. A. Al-Motarreb: None. P. Panduranga: None. H. AlFaleh: None. A. Elasfar: None. N. Bazargani: None. M. Ridha: None. B. Bulbanat: None. M. Al-Jarallah: None. H. Amin: None. N. Asaad: None. R. Singh: None. M. Yacoub: None.
- © 2014 by American Heart Association, Inc.