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  3. Prognostic value of chest radiographs in patients with acute heart failure: the Radiology in Acute Heart Failure (RAD-ICA) study

Prognostic value of chest radiographs in patients with acute heart failure: the Radiology in Acute Heart Failure (RAD-ICA) study

Fecha de publicación:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Llorens, P
  • Javaloyes, P
  • Masip, J
  • Gil, V
  • Herrero-Puente, P
  • Martin-Sanchez, FJ
  • Jacob, J
  • Garrido, JM
  • Herrera-Mateo, S
  • Diez, MPL
  • Concepcion-Aramendia, L
  • Miro, O
  • Fuentes, M
  • Gil, C
  • Alonso, H
  • Perez-Llantada, E
  • Garcia, GL
  • Cadenas, MS
  • Escoda, R
  • Xipell, C
  • Sanchez, C
  • Pavon, J
  • Noval, A
  • Torres, JM
  • Lopez-Grima, ML
  • Valero, A
  • Juan, MA
  • Aguirre, A
  • Pedragosa, MA
  • Maso, SM
  • Alonso, MI
  • Ruiz, F
  • Franco, JM
  • Mecina, AB
  • Tost, J
  • Berenguer, M
  • Donea, R
  • Ramon, SS
  • Rodriguez, VC
  • Pinera, P
  • Nicolas, JAS
  • Garate, RT
  • Alquezar-Arbe, A
  • Rizzi, MA
  • Herrera, S
  • Roset, A
  • Cabello, I
  • Haro, A
  • Richard, F
  • Perez, JMA
  • Puente, PH
  • Alvarez, JV
  • Garcia, BP
  • Garcia, MG
  • Gonzalez, MS
  • Marquina, V
  • Jimenez, I
  • Hernandez, N
  • Brouzet, B
  • Espinosa, B
  • Gil, A
  • Andueza, JA
  • Romero, R
  • Ruiz, M
  • Calvache, R
  • Serralta, MTL
  • Jave, LEC
  • Arriaga, BA
  • Bergua, BS
  • Mojarro, EM
  • Jimenez, BSA
  • Becquer, LT
  • Burillo, G
  • Garcia, LL
  • LaSalle, CC
  • Urbano, CA
  • Soto, ABG
  • Padial, ED
  • Ferrer, ES
  • Munoz, MA
  • Lucas-Imbernon, FJ
  • Gaya, R
  • Bibiano, C
  • Mir, M
  • Rodriguez, B
  • Carballo, JL
  • Rodriguez-Adrada, E
  • Miranda, BR
  • Martin, MV
  • Grp ICA-SEMES

Grupos

Abstract

Objective. To determine whether chest radiographs can contribute to prognosis in patients with acute heart failure (AHF). Methods. Consecutive patients with AHF were enrolled by the participating emergency departments. Radiographic variables assessed were the presence or absence of evidence of cardiomegaly and pleural effusion and the pulmonary parenchymal pattern observed (vascular redistribution, interstitial edema, and/or alveolar edema). We gathered variables for the AHF episode and the patient's baseline state. Outcomes were in-hospital and 1-year mortality; hospital stay longer than 7 days, and a composite of events within 30 days of discharge (revisit, rehospitalization, and/or death). Crude and adjusted hazard ratios were calculated for the 3 categories of radiographic variables. The variables were also studied in combination. Results. A total of 2703 patients with a mean (SD) age of 81 (19) years were enrolled; 54.5% were women. Cardiomegaly was observed in 1711 cases (76.8%) and pleural effusion in 992 (36.7%). A pulmonary parenchymal pattern was observed in all cases, as follows: vascular redistribution in 1672 (61.9%), interstitial edema in 629 (23.3%) and alveolar edema in 402 (14.9%). The adjusted hazard ratios showed that cardiomegaly lacked prognostic value. However, the presence of pleural effusion was associated with a 23% (95% CI, 2%-49%) higher rate of the 30day composite outcome; in-hospital mortality was 89% (30%-177%) higher in the presence of alveolar edema, and 1-year mortality was 38% (14%-67%) higher in association with vascular redistribution. The results for the variables in combination were consistent with the results for individual variables. Conclusions. A diagnostic chest radiograph can also contribute to the prediction of adverse events. Pleural effusion is associated with a higher rate of events after discharge, and alveolar edema is associated with higher mortality.

Datos de la publicación

ISSN/ISSNe:
1137-6821, 2386-5857

EMERGENCIAS  SANIDAD EDICIONES

Tipo:
Article
Páginas:
318-326
DOI:
PubMed:
31625303
Factor de Impacto:
0,373 SCImago ℠
Cuartil:
Q2 SCImago ℠

Citas Recibidas en Web of Science: 8

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Keywords

  • Acute heart failure; Emergency department; Chest radiograph; Prognosis

Proyectos y Estudios Clínicos

PRAGMATIC, CONTROLLED, INTERNATIONAL STUDY CONDUCTED IN SEVERAL CENTRES ON THE SAFETY AND THERAPEUTIC EFFECT OF A HYDROXYLETHYL-STARCH (HES) SOLUTION VERSUS AN ELECTROLYTE SOLUTION IN TRAUMA PATIENTS.

Investigador Principal: ÓSCAR DÍAZ CAMBRONERO

HC-G-H-1505 . 2018

EFECTO DE V0251 EN EL VÉRTIGO AGUDO. ESTUDIO ALEATORIZADO, DOBLE CIEGO Y CONTROLADO CON PLACEBO.

Investigador Principal: HERMINIO PÉREZ GARRIGUES

V00251IV2024A

PERFIL DE RIESGO DE LOS PACIENTES CON ETV EN HOSPITALES ESPAÑOLES ATENDIDOS EN LOS SERVICIOS DE URGENCIAS E IMPACTO ASISTENCIAL: REGISTRO ESPHERIA.

Investigador Principal: MARÍA JOSÉ PÉREZ DURÁ

ESPHERIA

PLANIFICACIÓN DEL ALTA DESDE URGENCIAS PARA REDUCIR REINGRESOS A 30 DÍAS EN MAYORES FRÁGILES CON INSUFICIENCIA CARDÍACA AGUDA: ENSAYO CLÍNICO ALEATORIZADO POR CONGLOMERADOS PAREADO.

Investigador Principal: CARMEN GARGALLO MAICAS

DEED FRAIL-AHF . 2019

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