Acute heart failure, bNP levels, deaths and days of hospitalization in patients admitted in a Internal Medicine department: a retrospective study

background Acute heart failure(AHF) is frequently associated to poor prognosis among elderly patients admitted to Internal ad Emergency Medicine departments. Increased brain natriuretic peptide(BNP) levelshave been related to increased mortality in this subset. Aim of this study is to evaluate if among patients who die for AHF, BNP at admis-sion can be associated to the length of hospitalization.Methods We enrolled 400 consecutive patients admitted to our Internal Medicine Department with a clinical diagnosis of AHF. BNP was eva-luated at admission in all the patients, stratified in four categories: patients with BNP less than 100 pg/ml (group 1), BNP 101-500 pg/ml (group 2), BNP 501-1500 pg/ml (group 3) and BNP higher than 1501 pg/ml (group 4). Each patient underwent to a complete diagnostic workup. Patients with BNP levels less than 100 pg/ml or a final diagno-sis other than AHF were excluded. Kaplan-Meier model with log-rank test was used to assess the differences.results 293 patients were suitable for final analysis. Mean age was 80±9.85 years, males representing 58% of the sample. Patients in group 2 had a significantly longer hospitalization (mean: 46.0 days, SE 3.71) than patients in group 3 (mean: 36.7 days, SE 2.51) and group 4 (mean: 22.9 days, SE 1.88) (p<0.05, all ties).conclusion Among elderly patients admitted in an Internal Medicine department who die of AHF, higher BNP levels are associated to ashorter hospitalization due to a faster progression of the pathology and in-hospital death.