Details

Autor(en) / Beteiligte

• Miró, Òscar
• Martínez, Gemma
• Masip, Josep
• Gil, Víctor
• Martín-Sánchez, Francisco Javier
• Llorens, Pere
• Herrero-Puente, Pablo
• Sánchez, Carolina
• Richard, Fernando
• Lucas-Invernón, Javier
• Garrido, José Manuel
• Mebazaa, Alexandre
• Ríos, José
• Peacock, W. Frank
• Hollander, Judd E.
• Jacob, Javier
• Fuentes, Marta
• Gil, Cristina
• Alonso, Héctor
• Garmila, Pablo
• Adrada, Esther Rodríguez
• Escoda, Rosa
• Xipell, Carolina
• Gaytan, Josep Mª.
• Salvo, Eva
• Pérez-Durá, María José
• Noval, Antonio
• Torres, José M.
• Gómez, Maria Ángeles Juan
• López-Grima, María Luisa
• Valero, Amparo
• Aguirre, Alfons
• Pedragosa, Maria Àngels
• Alonso, Maria Isabel
• Ruiz, Francisco
• Franco, José Miguel
• Diaz, Elena
• Mecina, Ana Belén
• Tost, Josep
• Sánchez, Susana
• Piñera, Pascual
• Garate, Raquel Torres
• Alquezar, Aitor
• Rizzi, Miguel Alberto
• Herrera, Sergio
• Cabello, Irene
• Pérez, José María Álvarez
• Diez, Maria Pilar López
• Alvarez, Joaquin Vázquez
• Gonzalez, Marta Sánchez
• Román, Jose Juan Gil
• Carratalá, José Manuel
• Brouzet, Benjamin
• Marquina, Víctor
• Jiménez, Inmaculada
• Hernández, Néstor
• Román, Francisco
• Andueza, Juan Antonio
• Romero, Rodolfo
• Calvache, Roberto
• Lorca, Maria Teresa
• Calderón, Luis
• Arriaga, Beatriz Amores
• Sierra, Beatriz
• Mojarro, Enrique Martín
• Bécquer, Lisette Travería
• Garcia, Lluís Llauger
• LaSalle, Gerard Corominas
• Urbano, Carmen Agüera
• Ferrer, Ester Soy

Titel

Effects on short term outcome of non-invasive ventilation use in the emergency department to treat patients with acute heart failure: A propensity score-based analysis of the EAHFE Registry

Ist Teil von

• European journal of internal medicine, 2018-07, Vol.53, p.45-51

Ort / Verlag

Netherlands: Elsevier B.V

Erscheinungsjahr

2018

Quelle

MEDLINE

Beschreibungen/Notizen

• To assess the effects of non-invasive ventilation (NIV) in emergency department (ED) patients with acute heart failure (AHF) on short term outcomes. Patients from the EAHFE Registry (a multicenter, observational, multipurpose, cohort-designed database including consecutive AHF patients in 41 Spanish EDs) were grouped based on NIV treatment (NIV+ and NIV–groups). Using propensity score (PS) methodology, we identified two subgroups of patients matched by 38 covariates and compared regarding 30-day survival (primary outcome). Interaction was investigated for age, sex, ischemic cardiomyopathy, chronic obstructive pulmonary disease, AHF precipitated by an acute coronary syndrome (ACS), AHF classified as hypertensive or acute pulmonary edema (APE), and systolic blood pressure (SBP). Secondary outcomes were intensive care unit (ICU) admission; mechanical ventilation; in-hospital, 3-day and 7-day mortality; and prolonged hospitalization (>7 days). Of 11,152 patients from the EAHFE (age (SD): 80 (10) years; 55.5% women), 718 (6.4%) were NIV+ and had a higher 30-day mortality (HR = 2.229; 95%CI = 1.861–2.670) (p < 0.001). PS matching provided 2 groups of 490 patients each with no significant differences in 30-day mortality (HR = 1.239; 95%CI = 0.905–1.696) (p = 0.182). Interaction analysis suggested a worse effect of NIV on elderly patients (>85 years, p < 0.001), AHF associated with ACS (p = 0.045), and SBP < 100 mmHg (p < 0.001). No significant differences were found in the secondary endpoints except for more prolonged hospitalizations in NIV+ patients (OR = 1.445; 95%CI = 1.122–1.862) (p = 0.004). The use of NIV to treat AHF in ED is not associated with improved mortality outcomes and should be cautious in old patients and those with ACS and hypotension. •NIV is a treatment commonly used for treatment in Acute Pulmonary Oedema.•The use of NIV is associated with an unclear improvement in mortality.•NIV-AHF study concludes that NIV is not associated with improved mortality.•NIV must be used with caution in old patients, patients with hypotension and ACS.