Identifying Preventable Causes of Worsening Heart Failure: A Single-Center Retrospective Analysis

Background: Heart failure (HF) is a complex condition characterized by acute or chronic deterioration in heart function. The incidence of heart failure is on the rise in both developed and developing countries. Despite advancements in treatment, the 5-year mortality rate remains close to 60%, surpassing the mortality rates of many malignancies. Moreover, heart failure imposes significant economic burdens on healthcare systems due to the necessity of lifelong treatment, frequent hospitalizations, and the utilization of complex and costly device treatments. In this study, we aimed to investigate the factors contributing to decompensation in patients presenting to the emergency department with decompensated heart failure. Methods: Patients with or without a previous diagnosis of heart failure, who presented to the emergency department with symptoms of acute heart failure between March 2015 and May 2017 were included in this retrospective study. Demographic and clinical characteristics were recorded. The causes of worsening heart failure and their distribution were investigated. Results: Cardiac decompensation was attributed to a single etiological factor in 154 out of 229 cases, while it was multifactorial in 75 cases. Factors contributing to decompensation included treatment noncompliance in 41 cases, NSAID use in 1 case, endocrine disorders in 3 cases, acute kidney injury (AKI) or chronic AKI in 21 cases, pulmonary embolism (PE) in 1 case, acute coronary syndrome (ACS) in 41 cases, arrhythmia in 29 cases (18 atrial fibrillation, 12 atrioventricular block, 2 bradycardia, 5 ventricular tachycardia, 1 supraventricular tachycardia, 1 atrial flutter), anemia in 20 cases, volume overload-hypertension in 18 cases, digitalis intoxication in 1 case, and infection-inflammation in 139 cases. Conclusions: Addressing preventable risk factors can lead to a reduction in healthcare expenditures and an improvement in both life expectancy and quality of life for patients.