<i>De Novo</i> Acute Heart Failure Versus Acute Decompensated Chronic Heart Failure: Are There Differences in In-Hospital Outcomes and Mortality?
Bibliographic record
Abstract
Background: acute HF (dn-AHF) may have a more severe clinical presentation. Despite extensive research on HF, comparative data on in-hospital outcomes and mortality between these groups are scarce in Latin American countries. The aim of this study was to evaluate differences in in-hospital complications and mortality among patients hospitalized with either dn-AHF or ad-CHF. Methods: An ambispective study was conducted at a tertiary hospital in Colombia, including 780 patients hospitalized for acute HF. Patients were classified as dn-AHF or ad-CHF, and sociodemographic, clinical, and in-hospital outcomes were compared using bivariate analysis. A Firth penalized logistic regression model was used to assess the association between dn-AHF and in-hospital mortality. Results: Of these patients, 39.2% had dn-AHF, and 60.8% had ad-CHF. Median ages were 67 (interquartile range (IQR): 56 - 76) and 66 (IQR: 55 - 79) years, respectively. Both groups had a predominance of reduced left ventricular ejection fraction, with median values of 30% in ad-CHF and 34% in dn-AHF. Ad-CHF patients had more comorbidities, whereas dn-AHF patients showed higher rates of cardiac and non-cardiac complications. Intensive care unit (ICU) admission rates were similar, the need for invasive mechanical ventilation (P < 0.001) and the occurrence of infections (P = 0.049) were significantly more frequent in patients with dn-AHF. In-hospital mortality was higher in dn-AHF than ad-CHF (9.8% vs. 5.5%, P = 0.023). After adjustment, dn-AHF remained independently associated with greater in-hospital mortality (odds ratio (OR): 1.87; 95% confidence interval (CI): 1.07 - 3.31; P = 0.029). Conclusions: Patients with dn-AHF experienced more in-hospital complications and higher mortality than those with ad-CHF, despite similar ICU admission rates and fewer comorbidities. These results highlight the prognostic importance of dn-AHF and underscore the need for early identification, vigilant monitoring, and phenotype-specific management from admission to improve outcomes, particularly among patients with reduced ejection fraction.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".