西班牙急诊科诊断为急性心力衰竭的老年患者的流行病学、临床管理和短期疗效:EDEN-34 研究结果。

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS
Ò. Miró , P. Llorens , S. Aguiló , A. Alquézar-Arbé , C. Fernández , G. Burillo-Putze , N. Canadell Marcos , A. Arce Marañón , G. Sánchez Oms , J. González del Castillo , en representación de los investigadores de la red SIESTA (Spanish Investigators in Emergency Situations TeAm)
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引用次数: 0

摘要

方法纳入一周内在西班牙 52 家急诊室就诊的所有年龄≥ 65 岁的患者,并选择确诊为急性心力衰竭(AHF)的患者。在住院患者中,收集出院时确诊为 AHF 的患者。作为不良事件,收集了院内和 30 天死亡率以及出院后 30 天的综合不良事件(死亡或住院)。我们计算了人口统计学变量、基线状态和到达急诊室时的常数与死亡率和出院后 30 天不良事件的调整赔率比(OR)。86%的患者在出院时已确诊为急性肾功能衰竭。30天的总死亡率为10.7%,院内死亡率为7.9%,合并死亡率为15.6%。院内和 30 天死亡率与动脉低血压(调整后 OR:74.0,95%CI:5.39-1015.和 42.6,3.74-485)和低氧血症(2.14,1.27-3.61;1.87,1.19-2.93)、到达急诊室时需要协助行走(2.24,1.04-4.83;和2.48,1.27-4.86)和年龄(每10年递增;1.54,1.04-2.29;和1.60,1.13-2.28)。结论高血压是急诊室就诊的老年患者的常见诊断。功能障碍、年龄、低血压和低氧血症是与死亡率最相关的因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Aspectos epidemiológicos, manejo clínico y resultados a corto plazo en pacientes mayores diagnosticados de insuficiencia cardiaca aguda en urgencias en España: resultados del estudio EDEN-34

Objective

To estimate the incidence of acute heart failure (AHF) diagnosis in elderly patients in emergency departments (ED), diagnostic confirmation in hospitalized patients, and short-term adverse events.

Methods

All patients aged ≥ 65 years attended in 52 Spanish EDs during 1 week were included and those diagnosed with AHF were selected. In hospitalized patients, those diagnosed with AHF at discharge were collected. As adverse events, in-hospital and 30-day mortality, and combined adverse event (death or hospitalization) at 30 days post-discharge were collected. Adjusted odds ratios (OR) for association of demographic variables, baseline status and constants at ED arrival with mortality and 30-day post-discharge adverse event were calculated.

Results

We included 1,155 patients with AHF (annual incidence: 26.5 per 1000 inhabitants ≥ 65 years, 95%CI: 25.0-28.1). In 86% the diagnosis of AHF was known at discharge. Overall 30-day mortality was 10.7% and in-hospital mortality was 7.9%, and the combined event in 15.6%. In-hospital and 30-day mortality was associated with arterial hypotension (adjusted OR: 74.0, 95%CI: 5.39-1015. and 42.6, 3.74-485, respectively and hypoxemia (2.14, 1.27-3.61; and 1.87, 1.19-2.93) on arrival at the ED and requiring assistance with ambulation (2.24, 1.04-4.83; and 2.48, 1.27-4.86) and age (per 10-year increment; 1.54, 1.04-2.29; and 1.60, 1.13-2.28). The combined post-discharge adverse event was not associated with any characteristic.

Conclusions

AHF is a frequent diagnosis in elderly patients consulting in the ED. The functional impairment, age, hypotension and hypoxemia are the factors most associated with mortality.

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来源期刊
ACS Applied Bio Materials
ACS Applied Bio Materials Chemistry-Chemistry (all)
CiteScore
9.40
自引率
2.10%
发文量
464
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