Mustafa GÖK, Mehmet Kamil TEBER, Zülfiye KUZU, Mehmet Zafer AYDIN, Yücel YILMAZ
Anatolian Current Medical Journal - 2026;8(6):1130-1137
Aims: Acute heart failure (AHF) is a major cause of hospitalization, and prolonged hospitalization may reflect greater disease severity and poorer prognosis. We aimed to identify predictors of prolonged hospitalization (>=5 days) and evaluate its association with clinical outcomes. Methods: This retrospective study included 197 consecutive patients hospitalized with AHF. Patients were classified into short-stay (<5 days, n=97) and prolonged-stay (>=5 days, n=100) groups. Clinical, laboratory, echocardiographic, and prognostic variables were compared. Independent predictors were identified using multivariable logistic regression. Clinical outcomes included 30-day emergency department (ED) visits, all-cause mortality or rehospitalization, and total ED visits during follow-up. Results: Chronic kidney disease (33.0% vs. 16.5%, p=0.008) and chronic obstructive pulmonary disease (44.0% vs. 25.8%, p=0.007) were more frequent in the prolonged-stay group. These patients also had lower serum sodium and estimated glomerular filtration rate (eGFR), and higher N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels (all p<0.001). Lower eGFR (OR: 0.96, 95% CI: 0.94-0.98; p<0.001), hyponatremia (OR: 2.45, 95% CI: 1.55-3.88; p=0.002), and higher NT-proBNP (OR: 1.03 per 1000 pg/ml; 95% CI: 1.01-1.06; p=0.024) independently predicted prolonged hospitalization. Prolonged hospitalization was associated with more 30-day ED visits, higher rates of death or rehospitalization, and more ED visits during follow-up (all p<=0.032). Conclusion: Lower eGFR, hyponatremia, and elevated NT-proBNP independently predict prolonged hospitalization in AHF. Longer hospital stay is associated with greater healthcare utilization and worse long-term outcomes, suggesting persistent post-discharge vulnerability.
