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 2.3 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
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
Revista clinica espanola
Revista clinica espanola 医学-医学:内科
CiteScore
4.40
自引率
6.90%
发文量
73
审稿时长
28 days
期刊介绍: Revista Clínica Española published its first issue in 1940 and is the body of expression of the Spanish Society of Internal Medicine (SEMI). The journal fully endorses the goals of updating knowledge and facilitating the acquisition of key developments in internal medicine applied to clinical practice. Revista Clínica Española is subject to a thorough double blind review of the received articles written in Spanish or English. Nine issues are published each year, including mostly originals, reviews and consensus documents.
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