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Revista Uruguaya de Medicina Interna

Print version ISSN 2393-6797On-line version ISSN 2393-6797


ESTRADA ESCOBAR, Silvana; ALVAREZ ROCHA, Pablo; FLORIO LEGNANI, Lucía  and  ORMAECHEA GORRICHO, Gabriela. Causes of death of patients with heart failure with reduced ejection fraction in follow-up by a multidisciplinary program. Rev. Urug. Med. Int. [online]. 2019, vol.4, n.3, pp.17-25.  Epub Dec 01, 2019. ISSN 2393-6797.


Heart failure is a pathology with high prevalence. In advanced stages its survival is less than 50% at 4 years. Few data are available about morbidity and mortality in Uruguay. The multidisciplinary unit of heart failure at Hospital de Clínicas (UMIC) develops a management program through a specialized out-patient service. The objective of this study is to know causes of death of the UMIC cohort and analyze possible associated factors.

Material and methods:

Descriptive, observational, retrospective cohort study. The vital status of the patients admitted and registered from October 2003 to September 2016 was verified through passive and active data collection. The degree of certification was established through the death certificate. Characteristics of death subjects were analyzed. Causes of death were differentiated in cardiac and non-cardiac and predictors associated to the different causes of death were analyzed.


From 1041 patients, 182 deaths were recorded in the period studied. The average age was 69 ± 5 years with males ‘predominance (3/1). Median survival was 2.6 years since recruitment.

In 99 patients (61%), cardiac death was documented, 35% of them as sudden death, 56% CI and 8% fatal myocardial infarction. Non-cardiac causes were infectious in 59%, neoplasia in 18%, stroke in 14% and other causes in 8%. A positive association was found between the presence of neoplasia and non-cardiac death (OR 7.56, 95% CI 1.93-29.67, p = 0.004).


This is a first publication describing causes of death in a cohort of patients with HF in Uruguay with an annual mortality rate of 5.6% with a high incidence of non-cardiac deaths. The presence of neoplasia was associated with higher non-cardiac mortality.

Keywords : Heart failure; death; mortality; tracking programs.

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