Alberto Domínguez-Rodríguez1, Néstor Baez-Ferrer2, Sergio Rodríguez3, Pedro Abreu-González4, Magali González-Colaço Harmand5, Veena Amarnani-Amarnani2, Emilio Emilio Cuevas6, Luciano Consuegra-Sánchez7, Silvia Alonso-Pérez8, Pablo Avanzas9, Guillermo Burillo-Putze10. 1. Servicio de Cardiología, Hospital Universitario de Canarias,Tenerife, España. Facultad de Ciencias de La Salud, Universidad Europea de Canarias, Tenerife, España. 2. Servicio de Cardiología, Hospital Universitario de Canarias,Tenerife, España 3. Centro de Investigación Atmosférica de Izaña, AEMET, Tenerife, España. Estación Experimental de Zonas Áridas, CSIC, Almería, España. 4. Departamento de Ciencias Médicas Básicas (Unidad de Fisiología), Universidad de La Laguna, Tenerife, España. 5. UCICEC, Servicio de Farmacología Clínica, Hospital Universitario de Canarias, San Cristóbal de La Laguna, Tenerife, España. 6. Centro de Investigación Atmosférica de Izaña, AEMET, Tenerife, España. 7. Servicio de Cardiología, Hospital General Universitario Santa Lucía, Cartagena, Murcia, España. 8. Escuela de Arquitectura, Universidad Europea de Canarias, Tenerife, España. 9. Hospital Universitario Central de Asturias, Servicio de Cardiología, Oviedo, España. Departamento de Medicina, Universidad de Oviedo, Oviedo, Epsaña. Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, España. 10. Facultad de Ciencias de La Salud, Universidad Europea de Canarias, Tenerife, España. Servicio de Urgencias, Hospital Universitario de Canarias, Tenerife, España.
Abstract
OBJECTIVES: To explore whether episodes of exposure to atmospheric Saharan dust is a risk factor for hospitalization in patients with acute heart failure (AHF) attended in a hospital emergency department (ED). METHODS: Single-center retrospective study of patients with AHF. The cohort was analyzed in 2 groups: ED patients hospitalized with AHF and patients discharged home from the ED. Air pollution on the 5 days leading to ED admission for AHF was recorded as the average concentration of breathable particulate matter with an aerodynamic diameter of no more than 10 µm (PM10) in the following ranges: fine PM (diameter less than 2.5 µm) or coarse PM (diameters between 2.5 and 10 µm). High Saharan dust pollution exposure was defined by mean daily PM10 concentrations between 50 and 200 µg/m3. Multivariable analysis was used to estimate risk for AHF in relation to PM10 exposure in the 5 days before the ED visit. RESULTS: A total of 1097 patients with AHF were treated in the ED; 318 of them (29%) were hospitalized and 779 (71%) were discharged home. Hospitalized patients were older, had more concomitant illnesses, and more episodes of exposure to Saharan dust (P < .0001). Multivariable analysis confirmed the association between Saharan dust exposure and hospital admission in these patients (odds ratio, 2.36; 95% CI, 1.21-4.58; P = .01). CONCLUSION: In the absence of prospective studies, the results of this series suggest that exposure to high levels of Saharan dust (PM10 concentrations between 50 and 200 µg/m3) may be a precipitating factor for hospitalization in AHF episodes.
OBJECTIVES: To explore whether episodes of exposure to atmospheric Saharan dust is a risk factor for hospitalization in patients with acute heart failure (AHF) attended in a hospital emergency department (ED). METHODS: Single-center retrospective study of patients with AHF. The cohort was analyzed in 2 groups: ED patients hospitalized with AHF and patients discharged home from the ED. Air pollution on the 5 days leading to ED admission for AHF was recorded as the average concentration of breathable particulate matter with an aerodynamic diameter of no more than 10 µm (PM10) in the following ranges: fine PM (diameter less than 2.5 µm) or coarse PM (diameters between 2.5 and 10 µm). High Saharan dust pollution exposure was defined by mean daily PM10 concentrations between 50 and 200 µg/m3. Multivariable analysis was used to estimate risk for AHF in relation to PM10 exposure in the 5 days before the ED visit. RESULTS: A total of 1097 patients with AHF were treated in the ED; 318 of them (29%) were hospitalized and 779 (71%) were discharged home. Hospitalized patients were older, had more concomitant illnesses, and more episodes of exposure to Saharan dust (P < .0001). Multivariable analysis confirmed the association between Saharan dust exposure and hospital admission in these patients (odds ratio, 2.36; 95% CI, 1.21-4.58; P = .01). CONCLUSION: In the absence of prospective studies, the results of this series suggest that exposure to high levels of Saharan dust (PM10 concentrations between 50 and 200 µg/m3) may be a precipitating factor for hospitalization in AHF episodes.
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Keywords:
Acute heart failure; Precipitating factors; Saharan dust; Polvo sahariano; Servicio de Urgencias; Emergency health services; Factor precipitante; Insuficiencia cardiaca aguda
Authors: Alberto Dominguez-Rodriguez; Néstor Baez-Ferrer; Sergio Rodríguez; Pablo Avanzas; Pedro Abreu-Gonzalez; Enric Terradellas; Emilio Cuevas; Sara Basart; Ernest Werner Journal: J Clin Med Date: 2020-01-30 Impact factor: 4.241