Predictors of 30-day mortality in patients admitted to ED for acute heart failure

被引:5
作者
Matthieu, Marchetti [1 ]
Antoine, Benedetti [1 ]
Olivier, Mimoz [1 ,2 ]
Jean-Yves, Lardeur [1 ]
Jeremy, Guenezan [1 ,2 ]
Nicolas, Marjanovic [1 ,2 ]
机构
[1] Univ Hosp Poitiers, Emergency Dept, 2 Rue Mil, F-86000 Poitiers, France
[2] Univ Poitiers, Sch Med, F-86000 Poitiers, France
关键词
Acute heart failure; Mortality; Emergency; Natriuretic brain peptide; BRAIN NATRIURETIC PEPTIDE; IN-HOSPITAL MORTALITY; 6-MONTH MORTALITY; ADMISSION; RISK; DIAGNOSIS; SURVIVAL; PROGRAM; DEATH; ESC;
D O I
10.1016/j.ajem.2016.11.050
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objectives: Acute heart failure (AHF) is a leading cause of admission in emergency departments (ED). It is associated with significant in-hospital mortality, suggesting that there is room for improvement of care. Our aims were to investigate clinical patterns, biological characteristics and determinants of 30-day mortality. Methods: We conducted a single site, retrospective review of adult patients (>= 18 years) admitted to ED for AHF over a 12-month period. Data collected included demographics, clinical, biological and outcomes data. Epidemiologic data were collected at baseline, and patients were followed up during a 30-day period. Results: There were a total of 322 patients. Mean age was 83.9 +/- 9.1 years, and 47% of the patients were men. Among them, 59 patients (18.3%) died within 30 days of admission to the ED. The following three characteristics were associated with increased mortality: age > 85 years (OR = 1.5[95% CI:0.8-2.7], p = 0.01), creatinine clearance <30 mL/min (OR = 2.6[95% CI:1.4-5], p < 0.001) and Nt-proBNP >5000 pg/mL (OR = 2.2[95% CI:1.2-4], p < 0.001). The best Nt-proBNP cut-off value to predict first-day mortality was 9000 pg/mL (area under the curve (AUC) [95% CI] of 0.790 [0.634-0.935], p < 0.001). For 7-day mortality, it was 7900 pg/mL (0.698 [0.578-0.819], p < 0.001) and for 30-day mortality, 5000 pg/mL (0.667 [0.576-0.758], p < 0.001). Conclusions: Nt-proBNP level on admission, age and creatinine clearance, are predictive of 30-day mortality in adult patients admitted to ED for AHF. (C) 2016 Elsevier Inc. All rights reserved.
引用
收藏
页码:444 / 447
页数:4
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