Òscar Miró1, Pere Llorens2, Xavier Escalada3, Pablo Herrero4, Javier Jacob5, Víctor Gil6, Carolina Xipell6, Carolina Sánchez6, Sira Aguiló6, Francisco J Martín-Sánchez7. 1. Área de Urgencias, Hospital Clínic, Barcelona; Grupo de Investigación "Urgencias: Procesos y Patologías", IDIBAPS, Barcelona, España. Universidad de Barcelona, España. 2. Servicio de Urgencias, Unidad de Corta Estancia y Hospitalización a Domicilio, Hospital General de Alicante; Departamento de Medicina Clínica, Universidad Miguel Hernández; Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIALFundación FISABIO), Alicante, España. 3. Sistema de Emergències Mèdiques, Barcelona, España. 4. Servicio de Urgencias, Hospital Universitario Central de Asturias, Oviedo, España. 5. Servicio de Urgencias, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España. 6. Área de Urgencias, Hospital Clínic, Barcelona; Grupo de Investigación "Urgencias: Procesos y Patologías", IDIBAPS, Barcelona, España. 7. Servicio de Medicina Preventiva, Hospital Clínico San Carlos, Madrid; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Universidad Complutense de Madrid, España.
Abstract
OBJECTIVES: To study the means of emergency transport used to bring patients with acute heart failure (AHF) to hospital emergency departments (EDs) and explore associations between factors, type of transport, and prehospital care received. MATERIAL AND METHODS: We gathered the following information on patients treated for AHF at 34 Spanish hospital EDs: means of transport used (medicalized ambulance [MA], nonmedicalized ambulance [NMA], or private vehicle) and treatments administered before arrival at the hospital. Twenty-seven independent variables potentially related to type of transport used were also studied. Indicators of AHF severity were triage level assigned in the ED, need for admission, need for intensive care, in-hospital mortality, and 30-day mortality. RESULTS: A total of 6106 patients with a mean (SD) age of 80 years were included; 56.5% were women, 47.2% arrived in PVs, 37.8% in NMAs, and 15.0% in MAs. Use of an ambulance was associated with female sex, age over 80 years, chronic obstructive pulmonary disease, a history of AHF, functional dependency, New York Heart Association class III-IV, sphincteral incontinence, labored breathing, orthopnea, cold skin, and sensory depression or restlessness. Assignment of a MA was directly associated with living alone, a history of ischemic heart disease, cold skin, sensory depression or restlessness, and high temperature; it was inversely associated with a history of falls. The rates of receipt of prehospital treatments and AHF severity level increased with use of MAs vs. NMAs vs. PV. Seventy-three percent of patients transported in MAs received oxygen, 29% received a diuretic, 13.5% a vasodilator, and 4.7% noninvasive ventilation. CONCLUSION: Characteristics of the patient with AHF are associated with the assignment of type of transport to a hospital ED. Assignment appears to be related to severity. Treatment given during MA transport could be increased.
OBJECTIVES: To study the means of emergency transport used to bring patients with acute heart failure (AHF) to hospital emergency departments (EDs) and explore associations between factors, type of transport, and prehospital care received. MATERIAL AND METHODS: We gathered the following information on patients treated for AHF at 34 Spanish hospital EDs: means of transport used (medicalized ambulance [MA], nonmedicalized ambulance [NMA], or private vehicle) and treatments administered before arrival at the hospital. Twenty-seven independent variables potentially related to type of transport used were also studied. Indicators of AHF severity were triage level assigned in the ED, need for admission, need for intensive care, in-hospital mortality, and 30-day mortality. RESULTS: A total of 6106 patients with a mean (SD) age of 80 years were included; 56.5% were women, 47.2% arrived in PVs, 37.8% in NMAs, and 15.0% in MAs. Use of an ambulance was associated with female sex, age over 80 years, chronic obstructive pulmonary disease, a history of AHF, functional dependency, New York Heart Association class III-IV, sphincteral incontinence, labored breathing, orthopnea, cold skin, and sensory depression or restlessness. Assignment of a MA was directly associated with living alone, a history of ischemic heart disease, cold skin, sensory depression or restlessness, and high temperature; it was inversely associated with a history of falls. The rates of receipt of prehospital treatments and AHF severity level increased with use of MAs vs. NMAs vs. PV. Seventy-three percent of patients transported in MAs received oxygen, 29% received a diuretic, 13.5% a vasodilator, and 4.7% noninvasive ventilation. CONCLUSION: Characteristics of the patient with AHF are associated with the assignment of type of transport to a hospital ED. Assignment appears to be related to severity. Treatment given during MA transport could be increased.
Authors: Òscar Miró; V Íctor Gil; Francisco Javier Martín-Sánchez; Javier Jacob; Pablo Herrero; Aitor Alquézar; Lluís Llauger; Sira Aguiló; Gemma Martínez; José Ríos; Alberto Domínguez-Rodríguez; Veli-Pekka Harjola; Christian Müller; John Parissis; W Frank Peacock; Pere Llorens Journal: Clin Res Cardiol Date: 2018-03-28 Impact factor: 5.460
Authors: Òscar Miró; Koji Takagi; Étienne Gayat; Víctor Gil; Pere Llorens; Francisco J Martín-Sánchez; Javier Jacob; Pablo Herrero-Puente; Rosa Escoda; María Pilar López-Díez; Amparo Valero; Marta Fuentes; José M Garrido; Eva Salvo; Miguel A Rizzi; Alfons Aguirre; Lissete Travería Bécquer; Alberto Domínguez-Rodríguez; Joan Padrosa; Gemma Martínez; Mattia Arrigo; Yonathan Freund; Alexandre Mebazaa Journal: Clin Res Cardiol Date: 2019-04-29 Impact factor: 5.460
Authors: Francisco Martín-Rodríguez; Raúl López-Izquierdo; Ancor Sanz-García; Carlos Del Pozo Vegas; Miguel Ángel Castro Villamor; Agustín Mayo-Iscar; José L Martín-Conty; Guillermo José Ortega Journal: J Med Syst Date: 2022-05-21 Impact factor: 4.920
Authors: Pere Llorens; Patricia Javaloyes; Francisco Javier Martín-Sánchez; Javier Jacob; Pablo Herrero-Puente; Víctor Gil; José Manuel Garrido; Eva Salvo; Marta Fuentes; Héctor Alonso; Fernando Richard; Francisco Javier Lucas; Héctor Bueno; John Parissis; Christian E Müller; Òscar Miró Journal: Clin Res Cardiol Date: 2018-05-04 Impact factor: 5.460
Authors: Josep Masip; W Frank Peacok; Mattia Arrigo; Xavier Rossello; Elke Platz; Louise Cullen; Alexandre Mebazaa; Susanna Price; Héctor Bueno; Salvatore Di Somma; Mucio Tavares; Martin R Cowie; Alan Maisel; Christian Mueller; Òsar Miró Journal: Eur Heart J Acute Cardiovasc Care Date: 2022-02-08
Authors: Pia Harjola; Òscar Miró; Francisco J Martín-Sánchez; Xavier Escalada; Yonathan Freund; Andrea Penaloza; Michael Christ; David C Cone; Said Laribi; Markku Kuisma; Tuukka Tarvasmäki; Veli-Pekka Harjola Journal: ESC Heart Fail Date: 2019-11-08
Authors: Veli-Pekka Harjola; Said Laribi; Pia Harjola; Tuukka Tarvasmäki; Cinzia Barletta; Richard Body; Jean Capsec; Michael Christ; Luis Garcia-Castrillo; Adela Golea; Mehmet A Karamercan; Paul-Louis Martin; Òscar Miró; Jukka Tolonen; Oene van Meer; Ari Palomäki; Franck Verschuren Journal: BMC Emerg Med Date: 2022-02-14