Details

Autor(en) / Beteiligte

• Llorens, Pere
• Javaloyes, Patricia
• Martín-Sánchez, Francisco Javier
• Jacob, Javier
• Herrero-Puente, Pablo
• Gil, Víctor
• Garrido, José Manuel
• Salvo, Eva
• Fuentes, Marta
• Alonso, Héctor
• Richard, Fernando
• Lucas, Francisco Javier
• Bueno, Héctor
• Parissis, John
• Müller, Christian E.
• Miró, Òscar

Titel

Time trends in characteristics, clinical course, and outcomes of 13,791 patients with acute heart failure

Ist Teil von

• Clinical research in cardiology, 2018-10, Vol.107 (10), p.897-913

Ort / Verlag

Berlin/Heidelberg: Springer Berlin Heidelberg

Erscheinungsjahr

2018

Quelle

MEDLINE

Beschreibungen/Notizen

• Objectives To analyse time trends in patient characteristics, clinical course, hospitalisation rate, and outcomes in acute heart failure along a 10-year period (2007–2016). Methods The EAHFE registry has prospectively collected 13,971 consecutive AHF patients diagnosed in 41 Spanish emergency departments (EDs) at five different time points (2007/2009/2011/2014/2016). Eighty patient-related variables and outcomes were described and statistically significant changes along time were evaluated. We also compared our data with large ED- and hospital-based registries. Results Compared to other large registries, our patients were older [80 (10) years], more frequently women (55.5%), and had a higher prevalence of hypertension (83.5%) and a lower prevalence of ischaemic cardiomyopathy (29.4%). De novo AHF was observed in 39.6%. 63.6% showed some degree of functional dependence and 56.1% had preserved left ventricular ejection fraction (LVEF). 56.8% of the patients arrived at the ED by ambulance, 4.5% arrived hypotensive, and 21.3% hypertensive. Direct discharge from the ED home was seen in 24.9%, and internal medicine (32.5%) and cardiology (15.8%) were the main hospital destinations. Triggers for decompensation were identified in 75.4%, the most being frequent infection (35.2%) and rapid atrial fibrillation (14.7%). The AHF phenotypes were: warm/wet 82.0%, warm/dry 6.2%, cold/wet 11.1%, and cold/dry 0.7%. The length of hospitalisation was 9.3 (8.6) days, and in-hospital, 30-day, and 1-year all-cause mortality were 7.8, 10.2 and 30.3%, respectively; and 30-day re-hospitalisation and ED revisit due to AHF were 16.9 and 24.8%, respectively. Thirty-nine of the eighty characteristics studied showed significant changes over time, while all outcomes remained unchanged along the 10-year period. Conclusions The EAHFE Registry is the first European ED-based registry describing the characteristics, clinical course, and outcomes of a cohort resembling the universe of patients with AHF. Significant changes were observed over time in some aspects of AHF characteristics and management, but not in outcomes.