Mazzarone, T.; Morelli, V.; Giusti, A.; Bianco, M.G.; Maccioni, L.; Cargiolli, C.; Guarino, D.; Virdis, A.; Okoye, C. Predicting In-Hospital Acute Heart Failure Worsening in the Oldest Old: Insights from Point-of-Care Ultrasound. J. Clin. Med.2023, 12, 7423.
Mazzarone, T.; Morelli, V.; Giusti, A.; Bianco, M.G.; Maccioni, L.; Cargiolli, C.; Guarino, D.; Virdis, A.; Okoye, C. Predicting In-Hospital Acute Heart Failure Worsening in the Oldest Old: Insights from Point-of-Care Ultrasound. J. Clin. Med. 2023, 12, 7423.
Mazzarone, T.; Morelli, V.; Giusti, A.; Bianco, M.G.; Maccioni, L.; Cargiolli, C.; Guarino, D.; Virdis, A.; Okoye, C. Predicting In-Hospital Acute Heart Failure Worsening in the Oldest Old: Insights from Point-of-Care Ultrasound. J. Clin. Med.2023, 12, 7423.
Mazzarone, T.; Morelli, V.; Giusti, A.; Bianco, M.G.; Maccioni, L.; Cargiolli, C.; Guarino, D.; Virdis, A.; Okoye, C. Predicting In-Hospital Acute Heart Failure Worsening in the Oldest Old: Insights from Point-of-Care Ultrasound. J. Clin. Med. 2023, 12, 7423.
Abstract
The decompensation trajectory check is a basic step to assess the clinical course and to plan future therapy in hospitalized patients with acute heart failure (ADHF). Due to the atypical presentation and clinical complexity, trajectory checks can be challenging in the oldest old patients with acute HF. Point of care ultrasound (POCUS) proved to be helpful in the clinical decision-making of patients with dyspnea, but no study has attempted to verify its effectiveness in predicting determinants of HF in-hospital worsening. In this single-center prospective study, we consecutively enrolled patients aged 75 or older hospitalized with acutely decompensated HF in a tertiary care hospital. All the patients underwent complete clinical examination, blood tests, and POCUS including Lung Ultrasound, Focused Cardiac Ultrasound, Pleural Effusion score (PEFs), and Inferior Vena Cava (IVC) assessment. Out of 184 patients hospitalized with ADHF enrolled in the study, sixty experienced HF in-hospital worsening. No differences were found among patients with HF worsening and controls in terms of age, gender, frailty, and left ventricular ejection fraction. By multivariable logistic analysis, total PEFs [aOR: 1.15 (CI95% 1.02– 1.33), p = 0.043], and IVC collapsibility [aOR: 0.90 (CI95% 0.83 – 0.95), p = 0.039] emerged as independent predictors of acute HF worsening after extensive adjustment for potential confounders.
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