Francisco Javier Martín-Sánchez1, Virginia Carbajosa2, Pere Llorens3, Pablo Herrero4, Javier Jacob5, María José Pérez-Dura6, Héctor Alonso7, José Manuel Torres Murillo8, Manuel Garrido9, María Luisa López-Grima10, Pascual Piñera11, Francisco Epelde12, Aitor Alquezar13, Cristina Fernández14, Oscar Miró15. 1. Servicio de Urgencias, Hospital Clínico San Carlos Madrid, España; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, España. Electronic address: fjjms@hotmail.com. 2. Servicio de Urgencias, Hospital Universitario Río Hortega, Valladolid, España. 3. Servicio de Urgencias-UCE y UHD, Hospital General Universitario de Alicante, Alicante, España. 4. Servicio de Urgencias, Hospital Universitario Central de Asturias, Oviedo, Asturias, España. 5. Servicio de Urgencias, Hospital Universitari de Bellvitge, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España. 6. Servicio de Urgencias, Hospital La Fe, Valencia, España. 7. Servicio de Urgencias, Hospital Marqués de Valdecilla, Santander, España. 8. Servicio de Urgencias, Hospital Reina Sofía, Córdoba, España. 9. Servicio de Urgencias, Hospital Virgen Macarena, Sevilla, España. 10. Servicio de Urgencias, Hospital Doctor Peset, Valencia, España. 11. Servicio de Urgencias, Hospital Reina Sofía, Murcia, España. 12. Servicio de Urgencias, Hospital Univeristari Parc Taulí, Sabadell, Barcelona, España. 13. Servicio de Urgencias, Hospital de la Santa Creu i Sant Pau, Barcelona, España. 14. Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, España; Servicio de Medicina Preventiva, Hospital Clínico San Carlos, Madrid, España. 15. Área de Urgencias, Hospital Clínic, Barcelona, España; Grupo de investigación Urgencias: procesos y patologías, Institut d'Investigacions Biomèdiques Ausgust Pi i Sunyer (IDIBAPS), Barcelona, España.
Abstract
BACKGROUND AND OBJECTIVE: To study the factors associated with prolonged hospitalization in patients admitted for acute heart failure (AHF) in Spanish short-stay units (SSUs). PATIENTS AND METHODS: This was a multicentre, multipurpose cohort study with prospective follow-up including all patients admitted for AHF in the 11 SSUs of the EAHFE registry. Demographic data, previous illness, baseline cardiorespiratory and functional status, acute episode and admission and follow up variables at 60 days were recorded. The primary outcome was prolonged hospitalization in the SSU (>72h). A logistic regression model was used to control the effects of confounding factors. RESULTS: Eight-hundred and nineteen patients were included with a mean age of 80.9 (SD 8.4) years, 483 (59.0%) being women. The median length stay was 3.0 (IQR 2.0-5.0) days with an in-hospital mortality of 2.7%. The independent factors associated with prolonged hospitalization were the coexistence of chronic obstructive pulmonary disease (odds ratio [OR] 1.56; 95% IC 1.02-2.38; P=.040) and anaemia (OR 1.72; 95% CI 1.21-2.44; P=.002), basal oxygen saturation<90% on arrival to the Emergency Department (OR 2.21, 95% CI 1.51-3.23; P<.001), hypertensive episode as the precipitating factor of the AHF (protective factor OR 0.49; 95% CI 0.26-0.93; P=.028) and admission on Thursday (OR 1.90; 95% CI 1.19-3.05; P=.008). There were no significant differences between both groups regarding to in-hospital mortality (2.4 vs. 3.0%), mortality (4.1 vs. 4.2%) or revisit at 60 days (18.4 vs. 21.6%). CONCLUSIONS: Several factors including hypertensive episode, insufficiency respiratory, anaemia, chronic obstructive pulmonary disease, and admission on Thursday should be taken into account in patients with AHF admitted in SSU stay to avoid prolonged hospitalization.
BACKGROUND AND OBJECTIVE: To study the factors associated with prolonged hospitalization in patients admitted for acute heart failure (AHF) in Spanish short-stay units (SSUs). PATIENTS AND METHODS: This was a multicentre, multipurpose cohort study with prospective follow-up including all patients admitted for AHF in the 11 SSUs of the EAHFE registry. Demographic data, previous illness, baseline cardiorespiratory and functional status, acute episode and admission and follow up variables at 60 days were recorded. The primary outcome was prolonged hospitalization in the SSU (>72h). A logistic regression model was used to control the effects of confounding factors. RESULTS: Eight-hundred and nineteen patients were included with a mean age of 80.9 (SD 8.4) years, 483 (59.0%) being women. The median length stay was 3.0 (IQR 2.0-5.0) days with an in-hospital mortality of 2.7%. The independent factors associated with prolonged hospitalization were the coexistence of chronic obstructive pulmonary disease (odds ratio [OR] 1.56; 95% IC 1.02-2.38; P=.040) and anaemia (OR 1.72; 95% CI 1.21-2.44; P=.002), basal oxygen saturation<90% on arrival to the Emergency Department (OR 2.21, 95% CI 1.51-3.23; P<.001), hypertensive episode as the precipitating factor of the AHF (protective factor OR 0.49; 95% CI 0.26-0.93; P=.028) and admission on Thursday (OR 1.90; 95% CI 1.19-3.05; P=.008). There were no significant differences between both groups regarding to in-hospital mortality (2.4 vs. 3.0%), mortality (4.1 vs. 4.2%) or revisit at 60 days (18.4 vs. 21.6%). CONCLUSIONS: Several factors including hypertensive episode, insufficiency respiratory, anaemia, chronic obstructive pulmonary disease, and admission on Thursday should be taken into account in patients with AHF admitted in SSU stay to avoid prolonged hospitalization.
Authors: Mahdi Khoshchehreh; Elliott M Groves; David Tehrani; Alpesh Amin; Pranav M Patel; Shaista Malik Journal: Int J Cardiol Date: 2016-02-17 Impact factor: 4.164
Authors: Camilla Strøm; Jakob S Stefansson; Maria Louise Fabritius; Lars S Rasmussen; Thomas A Schmidt; Janus C Jakobsen Journal: Cochrane Database Syst Rev Date: 2018-08-13