The emergency department arrival mode and its relations to ED management and 30-day mortality in acute heart failure: an ancillary analysis from the EURODEM study.
Acute heart failure
Arrival mode
Emergency medical services
Management
Prognosis
Ventilatory support
Journal
BMC emergency medicine
ISSN: 1471-227X
Titre abrégé: BMC Emerg Med
Pays: England
ID NLM: 100968543
Informations de publication
Date de publication:
14 02 2022
14 02 2022
Historique:
received:
08
03
2021
accepted:
22
01
2022
entrez:
15
2
2022
pubmed:
16
2
2022
medline:
19
4
2022
Statut:
epublish
Résumé
Acute heart failure patients are often encountered in emergency departments (ED) from 11% to 57% using emergency medical services (EMS). Our aim was to evaluate the association of EMS use with acute heart failure patients' ED management and short-term outcomes. This was a sub-analysis of a European EURODEM study. Data on patients presenting with dyspnoea were collected prospectively from European EDs. Patients with ED diagnosis of acute heart failure were categorized into two groups: those using EMS and those self-presenting (non- EMS). The independent association between EMS use and 30-day mortality was evaluated with logistic regression. Of the 500 acute heart failure patients, with information about the arrival mode to the ED, 309 (61.8%) arrived by EMS. These patients were older (median age 80 vs. 75 years, p < 0.001), more often female (56.4% vs. 42.1%, p = 0.002) and had more dementia (18.7% vs. 7.2%, p < 0.001). On admission, EMS patients had more often confusion (14.2% vs. 2.1%, p < 0.001) and higher respiratory rate (24/min vs. 21/min, p = 0.014; respiratory rate > 30/min in 17.1% patients vs. 7.5%, p = 0.005). The only difference in ED management appeared in the use of ventilatory support: 78.3% of EMS patients vs. 67.5% of non- EMS patients received supplementary oxygen (p = 0.007), and non-invasive ventilation was administered to 12.5% of EMS patients vs. 4.2% non- EMS patients (p = 0.002). EMS patients were more often hospitalized (82.4% vs. 65.9%, p < 0.001), had higher in-hospital mortality (8.7% vs. 3.1%, p = 0.014) and 30-day mortality (14.3% vs. 4.9%, p < 0.001). The use of EMS was an independent predictor of 30-day mortality (OR = 2.54, 95% CI 1.11-5.81, p = 0.027). Most acute heart failure patients arrive at ED by EMS. These patients suffer from more severe respiratory distress and receive more often ventilatory support. EMS use is an independent predictor of 30-day mortality.
Sections du résumé
BACKGROUND
Acute heart failure patients are often encountered in emergency departments (ED) from 11% to 57% using emergency medical services (EMS). Our aim was to evaluate the association of EMS use with acute heart failure patients' ED management and short-term outcomes.
METHODS
This was a sub-analysis of a European EURODEM study. Data on patients presenting with dyspnoea were collected prospectively from European EDs. Patients with ED diagnosis of acute heart failure were categorized into two groups: those using EMS and those self-presenting (non- EMS). The independent association between EMS use and 30-day mortality was evaluated with logistic regression.
RESULTS
Of the 500 acute heart failure patients, with information about the arrival mode to the ED, 309 (61.8%) arrived by EMS. These patients were older (median age 80 vs. 75 years, p < 0.001), more often female (56.4% vs. 42.1%, p = 0.002) and had more dementia (18.7% vs. 7.2%, p < 0.001). On admission, EMS patients had more often confusion (14.2% vs. 2.1%, p < 0.001) and higher respiratory rate (24/min vs. 21/min, p = 0.014; respiratory rate > 30/min in 17.1% patients vs. 7.5%, p = 0.005). The only difference in ED management appeared in the use of ventilatory support: 78.3% of EMS patients vs. 67.5% of non- EMS patients received supplementary oxygen (p = 0.007), and non-invasive ventilation was administered to 12.5% of EMS patients vs. 4.2% non- EMS patients (p = 0.002). EMS patients were more often hospitalized (82.4% vs. 65.9%, p < 0.001), had higher in-hospital mortality (8.7% vs. 3.1%, p = 0.014) and 30-day mortality (14.3% vs. 4.9%, p < 0.001). The use of EMS was an independent predictor of 30-day mortality (OR = 2.54, 95% CI 1.11-5.81, p = 0.027).
CONCLUSION
Most acute heart failure patients arrive at ED by EMS. These patients suffer from more severe respiratory distress and receive more often ventilatory support. EMS use is an independent predictor of 30-day mortality.
Identifiants
pubmed: 35164693
doi: 10.1186/s12873-022-00574-z
pii: 10.1186/s12873-022-00574-z
pmc: PMC8842939
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
27Investigateurs
Patrick Plaisance
(P)
Ghanima Al Dandachi
(GA)
Maxime Maignan
(M)
Dominique Pateron
(D)
Christelle Hermand
(C)
Cindy Tessier
(C)
Pierre-Marie Roy
(PM)
Lucie Bucco
(L)
Nicolas Duytsche
(N)
Pablo Garmilla
(P)
Giorgio Carbone
(G)
Roberto Cosentini
(R)
Sorana Truță
(S)
Natalia Hrihorișan
(N)
Diana Cimpoeșu
(D)
Luciana Rotaru
(L)
Alina Petrică
(A)
Mariana Cojocaru
(M)
Silvia Nica
(S)
Rodica Tudoran
(R)
Cristina Vecerdi
(C)
Monica Puticiu
(M)
Titus Schönberger
(T)
Constant Coolsma
(C)
Maarten Baggelaar
(M)
Noortje Fransen
(N)
Crispijn van den Brand
(C)
Doutsje Idzenga
(D)
Maaike Maas
(M)
Myriam Franssen
(M)
Charlotte Mackaij Staal
(CM)
Lot Schutte
(L)
Marije de Kubber
(M)
Lisette Mignot-Evers
(L)
Ursula Penninga-Puister
(U)
Joyce Jansen
(J)
Jeroen Kuijten
(J)
Marna Bouwhuis
(M)
Adam Reuben
(A)
Jason Smith
(J)
Shammi Ramlakhan
(S)
Melanie Darwent
(M)
James Gagg
(J)
Liza Keating
(L)
Santosh Bongale
(S)
Elaine Hardy
(E)
Jeff Keep
(J)
Heather Jarman
(H)
Steven Crane
(S)
Olakunle Lawal
(O)
Taj Hassan
(T)
Alasdair Corfield
(A)
Matthew Reed
(M)
Felicitas Geier
(F)
Yvonne Smolarsky
(Y)
Sabine Blaschke
(S)
Clemens Kill
(C)
Andreas Jerrentrup
(A)
Christian Hohenstein
(C)
Felix Rockmann
(F)
Tanja Brünnler
(T)
Alexandre Ghuysen
(A)
Marc Vranckx
(M)
Mehmet A Karamercan
(MA)
Mehmet Ergin
(M)
Zerrin D Dundar
(ZD)
Yusuf A Altuncu
(YA)
Ibrahim Arziman
(I)
Mucahit Avcil
(M)
Yavuz Katirci
(Y)
Hanna Suurmunne
(H)
Liisa Kokkonen
(L)
Juha Valli
(J)
Minna Kiljunen
(M)
Jukka Tolonen
(J)
Sanna Kaye
(S)
Mikko Mäkelä
(M)
Juhani Metsäniitty
(J)
Eija Vaula
(E)
Informations de copyright
© 2022. The Author(s).
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