Clinical Trajectories and Outcomes of Acute Heart Failure in Internal Medicine: A Real-World Single-Centre Study

Kaplinsky, Edgardo J.; Comajuan, Silvia Masmitjà; Martínez, Josefa Torres; Iglesias, Ana Serrado; Cuartero Guerrero, Daniel; Ayma, Francesc Planas; Zurita, Lourdes; Tolchinsky Wiesen, Gustavo; Moreno Ariño, Esther; Comas, Àngels Fumàs; Carod Pérez, Cristina

doi:10.14712/18059694.2026.5

Acta Medica > Archive > 2025, Vol. 68 > Issue 4 > Clinical Trajectories and Outcomes of…

Acta Med. 2025, 68: 142-150

https://doi.org/10.14712/18059694.2026.5

Clinical Trajectories and Outcomes of Acute Heart Failure in Internal Medicine: A Real-World Single-Centre Study

Edgardo J. Kaplinsky^a

, Silvia Masmitjà Comajuan^a, Josefa Torres Martínez^b, Ana Serrado Iglesias^b, Daniel Cuartero Guerrero^b, Francesc Planas Ayma^a, Lourdes Zurita^a, Gustavo Tolchinsky Wiesen^b, Esther Moreno Ariño^c, Àngels Fumàs Comas^d, Cristina Carod Pérez^e

^aCardiology Unit, Hospital Municipal de Badalona, Barcelona, Spain
^bInternal Medicine Department, Hospital Municipal de Badalona, Barcelona, Spain
^cEmergency Department, Hospital Municipal de Badalona, Barcelona, Spain
^dManagement Control and Process Unit, Badalona Serveis Assistencials, Barcelona, Spain
^eHealthcare Management, Badalona Serveis Assistencials, Barcelona, Spain

Received September 28, 2025
Accepted January 6, 2026

Purpose: To analyze the clinical characteristics and outcomes of patients with acute heart failure (AHF) admitted to an internal medicine department (IMD), with a focus on their trajectories, risk factors, and rehospitalisation/mortality rate. Methods: This retrospective cohort study included 410 hospitalisations (280 patients; 28% readmissions) for AHF during 2023. Diagnosis was validated using the European Society of Cardiology age-specific NT-proBNP thresholds and echocardiographic criteria. Baseline clinical and laboratory data were analyzed, prognostic markers were identified, and a risk algorithm was developed. Results: Mean patient age was 82 years (54% women). Most cases involved nonischemic etiology (80%) and HF with preserved ejection fraction (HFpEF, 69%). Frequent comorbidities included hypertension (85%), diabetes (45%), atrial fibrillation (44%), and multiple non-cardiac conditions. In-hospital mortality was 19.6%; 30-day readmission was 9.9%. Three clinical trajectories (index/first hospitalisation) were identified: single admission (n: 169), rehospitalisation (with/without death) (n: 73), and in-hospital death (n: 38). Prognostic markers included advanced age, elevated NT-proBNP, renal dysfunction, anemia, and non-cardiac cause of HF decompensation. Conclusions: This elderly IMD-HF cohort, mainly female and multimorbid, showed high HFpEF prevalence and adverse outcomes. NT-proBNP, renal function, haemoglobin, and non-cardiac causes of HF decompensation were key prognostic indicators.