Profile of patients hospitalized in intensive cardiac care units in France: ADDICT-ICCU registry.

Cardiovascular disease Epidemiology In-hospital major adverse outcomes Intensive cardiac care unit Management

Journal

Archives of cardiovascular diseases
ISSN: 1875-2128
Titre abrégé: Arch Cardiovasc Dis
Pays: Netherlands
ID NLM: 101465655

Informations de publication

Date de publication:
11 Feb 2024
Historique:
received: 26 08 2023
revised: 12 12 2023
accepted: 13 12 2023
medline: 29 2 2024
pubmed: 29 2 2024
entrez: 28 2 2024
Statut: aheadofprint

Résumé

Intensive cardiac care units (ICCU) were initially developed to monitor ventricular arrhythmias after myocardial infarction. In recent decades, ICCU have diversified their activities. To determine the type of patients hospitalized in ICCU in France. We analysed the characteristics of patients enrolled in the ADDICT-ICCU registry (NCT05063097), a prospective study of consecutive patients admitted to ICCU in 39 centres throughout France from 7th-22nd April 2021. In-hospital major adverse events (MAE) (death, resuscitated cardiac arrest and cardiogenic shock) were recorded. Among 1499 patients (median age 65 [interquartile range 54-74] years, 69.6% male, 21.7% diabetes mellitus, 64.7% current or previous smokers), 34.9% had a history of coronary artery disease, 11.7% atrial fibrillation and 5.2% cardiomyopathy. The most frequent reason for admission to ICCU was acute coronary syndromes (ACS; 51.5%), acute heart failure (AHF; 14.1%) and unexplained chest pain (6.8%). An invasive procedure was performed in 36.2%. "Advanced" ICCU therapies were required for 19.9% of patients (intravenous diuretics 18.4%, non-invasive ventilation 6.1%, inotropic drugs 2.3%). No invasive procedures or advanced therapies were required in 44.1%. Cardiac computed tomography or magnetic resonance imaging was carried out in 12.3% of patients. The median length of ICCU hospitalization was 2.0 (interquartile range 1.0-4.0) days. The mean rate of MAE was 4.5%, and was highest in patients with AHF (10.4%). ACS remains the main cause of admissions to ICCU, with most having a low rate of in-hospital MAE. Most patients experience a brief stay in ICCU before being discharged home. AHF is associated with highest death rate and with higher resource consumption.

Sections du résumé

BACKGROUND BACKGROUND
Intensive cardiac care units (ICCU) were initially developed to monitor ventricular arrhythmias after myocardial infarction. In recent decades, ICCU have diversified their activities.
AIM OBJECTIVE
To determine the type of patients hospitalized in ICCU in France.
METHODS METHODS
We analysed the characteristics of patients enrolled in the ADDICT-ICCU registry (NCT05063097), a prospective study of consecutive patients admitted to ICCU in 39 centres throughout France from 7th-22nd April 2021. In-hospital major adverse events (MAE) (death, resuscitated cardiac arrest and cardiogenic shock) were recorded.
RESULTS RESULTS
Among 1499 patients (median age 65 [interquartile range 54-74] years, 69.6% male, 21.7% diabetes mellitus, 64.7% current or previous smokers), 34.9% had a history of coronary artery disease, 11.7% atrial fibrillation and 5.2% cardiomyopathy. The most frequent reason for admission to ICCU was acute coronary syndromes (ACS; 51.5%), acute heart failure (AHF; 14.1%) and unexplained chest pain (6.8%). An invasive procedure was performed in 36.2%. "Advanced" ICCU therapies were required for 19.9% of patients (intravenous diuretics 18.4%, non-invasive ventilation 6.1%, inotropic drugs 2.3%). No invasive procedures or advanced therapies were required in 44.1%. Cardiac computed tomography or magnetic resonance imaging was carried out in 12.3% of patients. The median length of ICCU hospitalization was 2.0 (interquartile range 1.0-4.0) days. The mean rate of MAE was 4.5%, and was highest in patients with AHF (10.4%).
CONCLUSIONS CONCLUSIONS
ACS remains the main cause of admissions to ICCU, with most having a low rate of in-hospital MAE. Most patients experience a brief stay in ICCU before being discharged home. AHF is associated with highest death rate and with higher resource consumption.

Identifiants

DOI: 10.1016/j.acvd.2023.12.009 PMID: 38418306
pubmed: 38418306
pii: S1875-2136(24)00024-X
doi: 10.1016/j.acvd.2023.12.009
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Published by Elsevier Masson SAS.

Auteurs

Emmanuel Gall (E)

Department of Cardiology, hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, University of Paris, Inserm U-942, 10, rue Ambroise-Paré, 75010 Paris, France.

Théo Pezel (T)

Department of Cardiology, hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, University of Paris, Inserm U-942, 10, rue Ambroise-Paré, 75010 Paris, France.

Benoît Lattuca (B)

Department of Cardiology, Nîmes University Hospital, Montpellier University, Nîmes, France.

Kenza Hamzi (K)

Department of Cardiology, hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, University of Paris, Inserm U-942, 10, rue Ambroise-Paré, 75010 Paris, France.

Etienne Puymirat (E)

Department of Cardiology, hôpital européen Georges-Pompidou (HEGP), Paris, France.

Nicolas Piliero (N)

Department of Cardiology, CHU de Grenoble-Alpes, Grenoble, France.

Antoine Deney (A)

Cardiac Care Unit, Rangueil University Hospital, Toulouse, France.

Charles Fauvel (C)

Department of Cardiology, CHU de Rouen, University, UNIROUEN, U1096, 76000 Rouen, France.

Victor Aboyans (V)

Dupuytren University Hospital, Inserm 1094, Limoges, France.

Guillaume Schurtz (G)

Department of Cardiology, University Hospital of Lille, Lille, France.

Claire Bouleti (C)

University Hospital of Poitiers, 86000 Poitiers, France.

Julien Fabre (J)

Department of Cardiology, University Hospital of Martinique, 97261 Fort-de-France, France.

Amine El Ouahidi (A)

Department of Cardiology, University Hospital of Brest, 29609 Brest cedex, France.

Christophe Thuaire (C)

Department of Cardiology, centre hospitalier de Chartres, 28630 Le Coudray, France.

Damien Millischer (D)

Department of Cardiology, hôpital Montfermeil, 93370 Montfermeil, France.

Nathalie Noirclerc (N)

Department of Cardiology, centre hospitalier Annecy-Genevois, 1, avenue de l'Hôpital, 74370 Epagny Metz-Tessy, France.

Clément Delmas (C)

Intensive Cardiac Care Unit, Rangueil University Hospital, Toulouse, France.

François Roubille (F)

Department of Cardiology, INI-CRT, CHU de Montpellier, PhyMedExp, université de Montpellier, Inserm, CNRS, 3429 Montpellier, France.

Jean-Guillaume Dillinger (JG)

Department of Cardiology, hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, University of Paris, Inserm U-942, 10, rue Ambroise-Paré, 75010 Paris, France.

Patrick Henry (P)

Department of Cardiology, hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, University of Paris, Inserm U-942, 10, rue Ambroise-Paré, 75010 Paris, France. Electronic address: patrick.henry@aphp.fr.

Classifications MeSH