Portal de investigación
Evolution of the clinical profile of patients with acute heart failure treated in Spanish emergency departments
Autores de IIS La Fe
Participantes ajenos a IIS La Fe
- Escoda, R
- Miró Ò
- Martin-Sanchez, FJ
- Jacob, J
- Herrero, P
- Gil, V
- Garrido, JM
- Fuentes, M
- Llorens, P
Grupos
Abstract
Objective: To analyse the changes in epidemiology, outpatient and emergency department clinical care, and outcomes of patients treated for acute heart failure (AHF) in Spanish hospital emergency departments (HEDs) between 2007 and 2014. Method: A multicentre cohort study was conducted that consecutively included patients with AHF diagnosed in 9 HEDs during 4 periods (2007, 2009, 2011 and 2014). The study analysed the changes observed in 20 variables corresponding to baseline data, outpatient care and emergency care data and outcome data. Results: A total of 4,845 patients were included. There were significant changes in 13 variables: there was an increase in patients older than 80 years (2007/2014: 45.9%/55.4%; P<.001) and a decrease in severe functional dependence (28.2%/19.7%; P<.001). In terms of long-term outpatient care, there was an increased use of beta-blockers (44.6%/57.8%; P=.002) and aldosterone antagonists (26.6%/37.7%; P<.05) among patients with reduced ejection fraction and an increase use of echocardiography (42.8%/56.2%; P=.001). The use of digoxin decreased (25.4%/16.9%; P=.005). In terms of emergency care, there was an increase in requests for troponins (54.6%/61.9%; P<.001), natriuretic peptides (7.8%/48.5%; P<.001) and the use of noninvasive ventilation (3.2%/6.9%; P =.004). Requests for endovenous perfusion drugs decreased (diuretics: 21.3%/10.4%; P<.001; nitrates: 21.3%/17.5%; P=.001; vasopressors: 4.2%/1.5%; P<.001). Finally, discharges directly from the emergency department without hospitalization increased (20.0%/25.9%; P<.001), and emergency department readmissions at 30 days decreased (27.3%/17.6%; P=.007). Hospital mortality and mortality at 30 days did not change. Conclusions: Changes in outcomes were detected during a 7-year period in patients with AHF treated in HEDs, with care that was more in line with the clinical guidelines. There are, however, areas for improvement. There was a noteworthy increase in outpatient follow-up without hospitalisation and a reduction in HED readmissions. (C) 2016 Elsevier Espana, S.L.U. and Sociedad Espanola de Medicina Interna (SEMI). All rights reserved.
Datos de la publicación
- ISSN/ISSNe:
- 0014-2565, 1578-1860
- Tipo:
- Article
- Páginas:
- 127-135
- PubMed:
- 27912902
- Enlace a otro recurso:
- www.sciencedirect.com
- Factor de Impacto:
- 0,218 SCImago ℠
- Cuartil:
- Q3 SCImago ℠
REVISTA CLINICA ESPANOLA EDICIONES DOYMA S A
Citas Recibidas en Web of Science: 4
Documentos
- No hay documentos
Filiaciones
Keywords
- Acute heart failure; Emergency department; Treatment; Mortality; Readmission
Proyectos y Estudios Clínicos
EFECTO DE V0251 EN EL VÉRTIGO AGUDO. ESTUDIO ALEATORIZADO, DOBLE CIEGO Y CONTROLADO CON PLACEBO.
Investigador Principal: HERMINIO PÉREZ GARRIGUES
V00251IV2024A
Cita
Escoda R,Miró Ò,Martin FJ,Jacob J,Herrero P,Gil V,Garrido JM,PEREZ MJ,Fuentes M,Llorens P. Evolution of the clinical profile of patients with acute heart failure treated in Spanish emergency departments. Rev Clin Esp. 2017. 217. (3):p. 127-135. IF:1,184. (3).