Heart Failure Patients Admitted to Intensive Cardiac Care Unit - Characteristics, in-hospital Course and Prognosis - Results from a Large Tertiary Center Registry

Background: Due to the aging population and improved survival from complex cardiovascular and medical conditions, there has been a significant shift in patient characteristics within the context of the intensive cardiac care unit (ICCU), specifically increase in heart failure (HF) patients. The aim of this study was to evaluate the differences between patients with and without HF admitted to a large tertiary ICCU.

Methods: We prospectively evaluated all patients admitted to the Sheba medical center ICCU during the years 2014-2017. Patients were divided into 2 groups (with or without HF) and were compared for baseline characteristics, in hospital-course, and mortality.

Results: Overall 4,317 consecutive patients were evaluated, 836 patients (19%) were hospitalized with HF diagnosis due to ischemic (52%), valvular (12%), non-ischemic cardiomyopathy (18%) and unspecified (18%). HF vs. non-HF patients were older (68 ± 14 vs. 65 ± 15 years), had higher prevalence of women (32% vs. 28%), and higher incidence of prior HF (37% vs. 11%), prior coronary artery disease (49% vs. 32%) and CRTD/AICD implantation (17% vs. 5.5%) (p≤0.001 for all). HF patients had higher prevalence of renal failure (33% vs. 10%), diabetes mellitus (45% vs. 30%) and anemia (18% vs. 7.4%) (p≤0.001 for all). Compare to non HF patients, patients admitted with HF were more likely to undergo mechanical ventilation (5.1% vs. 30%), dialysis (1.4% vs. 8.1%), blood transfusions (2.9% vs. 10%), resuscitation (1.6% vs. 7.1%) and invasive monitoring (20% vs. 54%), and had increased risk for acute renal failure (4.6% vs. 27%) (p

Conclusions: Patients admitted to the ICCU with HF have significantly more comorbidities, a more complicated in-hospital course necessitating intensive interventions and monitoring, resulting in worse prognosis including death than those admitted without HF.