Prognostic implications of emergency department determination of B-type natriuretic peptide in patients with acute heart failure: the PICASU-2 study

被引：0

作者：

Miro, Oscar ^{[1
,2
]}

Jacob, Javier ^{[3
]}

Martin-Sanchez, Francisco Javier ^{[4
]}

Herrero, Pablo ^{[5
]}

Pavon, Jose ^{[6
]}

Jose Perez-Dura, Maria ^{[7
]}

Noval, Antonio ^{[8
]}

Segura, Fernando ^{[9
]}

Richard, Fernando ^{[10
]}

Gimenez, Antonio ^{[11
]}

Gil, Cristina ^{[12
]}

Alonso, Hector ^{[13
]}

Ruiz, Martin ^{[14
]}

Garrido, Manuel ^{[15
]}

Gil Roman, Jose Juan ^{[5
]}

Aguirre, Alfons ^{[16
]}

Manuel Torres, Jost ^{[17
]}

Ruiz, Francisco ^{[18
]}

Perello, Rafael ^{[1
,2
]}

Villena, Henrique ^{[19
]}

Gil, Victor ^{[1
,2
]}

Llorens, Pere ^{[20
,21
]}

机构：

[1] Hosp Clin Barcelona, Area Urgencias, Barcelona 08036, Spain

[2] IDIBAPS, Grp Invest Urgencias Proc & Patol, Barcelona, Spain

[3] Hosp Univ Bellvitge, Serv Urgencias, Barcelona, Spain

[4] Hosp Clin San Carlos, Serv Urgencias, Madrid, Spain

[5] Hosp Univ Cent Asturias, Serv Urgencias, Oviedo, Spain

[6] Hosp Dr Negrin, Serv Urgencias, Las Palmas Gran Canaria, Spain

[7] Hosp La Fe Valencia, Serv Urgencias, Valencia, Spain

[8] Hosp Insular Las Palmas, Serv Urgencias, Las Palmas Gran Canaria, Spain

[9] Hosp Virgen de la Victoria, Serv Urgencias, Malaga, Spain

[10] Hosp Gen Yague, Serv Urgencias, Burgos, Spain

[11] Hosp Miguel Servet, Serv Urgencias, Zaragoza, Spain

[12] Hosp Univ Salamanca, Serv Urgencias, Salamanca, Spain

[13] Hosp Marques Valdecilla, Serv Urgencias, Santander, Spain

[14] Hosp Alcorcon, Serv Urgencias, Madrid, Spain

[15] Hosp Virgen de la Macarena, Serv Urgencias, Seville, Spain

[16] Hosp del Mar, Serv Urgencias, Barcelona, Spain

[17] Hosp Reina Sofia Cordoba, Serv Urgencias, Cordoba, Spain

[18] Hosp Valme, Serv Urgencias, Seville, Spain

[19] Hosp Clin Univ Santiago de Connpostela, Serv Urgencias, Santiago De Compostela, Spain

[20] Hosp Gen Alicante, Serv Urgencias, Alicante, Spain

[21] Hosp Gen Alicante, Unidad Corta Estancia, Alicante, Spain

来源：

EMERGENCIAS | 2011年 / 23卷 / 06期

关键词：

Acute heart failure; Emergency health services; B-type natriuretic peptide (BNP); Clinical course; Mortality; Emergency department revisits; NT-PROBNP; NONINVASIVE VENTILATION; CLINICAL-OUTCOMES; ACUTE DYSPNEA; MANAGEMENT; CARE; GUIDELINES; MORTALITY; ADMISSION; DIAGNOSIS;

D O I：

暂无

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Objective: To investigate whether hospital emergency department measurement of B-type natriuretic peptide (BNP) in patients with acute heart failure is beneficial in terms of patient outcomes and according to hospital category (availability or not of BNP testing in the emergency department). Methods: PICASU-2 is an analytical multicenter retrospective study of patients with acute heart failure according to the Framingham criteria, with follow-up of cohorts. Baseline Data and data pertaining to each acute heart failure episode were collected. Outcome measures were in-hospital mortality, 30-day mortality, and revisits to the emergency department within 30 days. Cases were classified as having a record of BNP measurement or not. Hospital emergency departments were classified as not having the resources for emergency BNP measurement (type A hospital), having the possibility of testing selectively (type B), and testing for BNP more generally (>50% of patients) (type C). Results: Nineteen hospital emergency departments contributed data on 2423 patients, 32.4% of whom had BNP measurements; by hospital category, 34.7% of the patients were from type A facilities, 34.6% were from type B, and 30.7% were from type C. In-hospital mortality was 7.2%, 30-day mortality was 8.1%, and 24% of the patients revisited within 30 days. Neither the measurement of BNP nor the fact of BNP measurement availability in the emergency department was associated with a better clinical outcome. Likewise no significant associations were found after adjustment for patient status in stable condition or characteristics of the acute episode. When patients who were discharged directly from the emergency department were analyzed separately, again no associations with outcomes were found. Conclusion: In the absence of a well-established protocol for managing episodes of acute heart failure according to BNP levels, emergency measurement of this peptide does not seem to contribute to improving outcome for these patients. [Emergencias 2011;23:437-446]

引用

页码：437 / 446

页数：10

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