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Heart failure in patients presenting with dyspnoea to the emergency department in the Asia Pacific region: an observational study
OBJECTIVES: To describe demographic features, assessment, management and outcomes of patients who were diagnosed with heart failure after presenting to an emergency department (ED) with a principal symptom of dyspnoea. DESIGN: Planned substudy of the prospective, descriptive cohort study: Asia, Aust...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BMJ Publishing Group
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5337741/ https://www.ncbi.nlm.nih.gov/pubmed/28246137 http://dx.doi.org/10.1136/bmjopen-2016-013812 |
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author | Keijzers, Gerben Kelly, Anne-Maree Cullen, Louise Klim, Sharon Graham, Colin A Craig, Simon Kuan, Win Sen Jones, Peter Holdgate, Anna Lawoko, Charles Laribi, Said |
author_facet | Keijzers, Gerben Kelly, Anne-Maree Cullen, Louise Klim, Sharon Graham, Colin A Craig, Simon Kuan, Win Sen Jones, Peter Holdgate, Anna Lawoko, Charles Laribi, Said |
author_sort | Keijzers, Gerben |
collection | PubMed |
description | OBJECTIVES: To describe demographic features, assessment, management and outcomes of patients who were diagnosed with heart failure after presenting to an emergency department (ED) with a principal symptom of dyspnoea. DESIGN: Planned substudy of the prospective, descriptive cohort study: Asia, Australia and New Zealand Dyspnoea in Emergency Departments (AANZDEM). SETTING: 46 EDs in Australia, New Zealand, Singapore, Hong Kong and Malaysia collected data over 3 72-hour periods in May, August and October 2014. PARTICIPANTS: Patients with an ED diagnosis of heart failure. OUTCOME MEASURES: Outcomes included patient epidemiology, investigations ordered, treatment modalities used and patient outcomes (hospital length of stay (LOS) and mortality). RESULTS: 455 (14.9%) of the 3044 patients had an ED diagnosis of heart failure. Median age was 79 years, half were male and 62% arrived via ambulance. 392 (86%) patients were admitted to hospital. ED diagnosis was concordant with hospital discharge diagnosis in 81% of cases. Median hospital LOS was 6 days (IQR 4–9) and in-hospital mortality was 5.1%. Natriuretic peptide levels were ordered in 19%, with lung ultrasound (<1%) and echocardiography (2%) uncommonly performed. Treatment modalities included non-invasive ventilation (12%), diuretics (73%), nitrates (25%), antibiotics (16%), inhaled β-agonists (13%) and corticosteroids (6%). CONCLUSIONS: In the Asia Pacific region, heart failure is a common diagnosis among patients presenting to the ED with a principal symptom of dyspnoea. Admission rates were high and ED diagnostic accuracy was good. Despite the seemingly suboptimal adherence to investigation and treatment guidelines, patient outcomes were favourable compared with other registries. |
format | Online Article Text |
id | pubmed-5337741 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-53377412017-03-07 Heart failure in patients presenting with dyspnoea to the emergency department in the Asia Pacific region: an observational study Keijzers, Gerben Kelly, Anne-Maree Cullen, Louise Klim, Sharon Graham, Colin A Craig, Simon Kuan, Win Sen Jones, Peter Holdgate, Anna Lawoko, Charles Laribi, Said BMJ Open Emergency Medicine OBJECTIVES: To describe demographic features, assessment, management and outcomes of patients who were diagnosed with heart failure after presenting to an emergency department (ED) with a principal symptom of dyspnoea. DESIGN: Planned substudy of the prospective, descriptive cohort study: Asia, Australia and New Zealand Dyspnoea in Emergency Departments (AANZDEM). SETTING: 46 EDs in Australia, New Zealand, Singapore, Hong Kong and Malaysia collected data over 3 72-hour periods in May, August and October 2014. PARTICIPANTS: Patients with an ED diagnosis of heart failure. OUTCOME MEASURES: Outcomes included patient epidemiology, investigations ordered, treatment modalities used and patient outcomes (hospital length of stay (LOS) and mortality). RESULTS: 455 (14.9%) of the 3044 patients had an ED diagnosis of heart failure. Median age was 79 years, half were male and 62% arrived via ambulance. 392 (86%) patients were admitted to hospital. ED diagnosis was concordant with hospital discharge diagnosis in 81% of cases. Median hospital LOS was 6 days (IQR 4–9) and in-hospital mortality was 5.1%. Natriuretic peptide levels were ordered in 19%, with lung ultrasound (<1%) and echocardiography (2%) uncommonly performed. Treatment modalities included non-invasive ventilation (12%), diuretics (73%), nitrates (25%), antibiotics (16%), inhaled β-agonists (13%) and corticosteroids (6%). CONCLUSIONS: In the Asia Pacific region, heart failure is a common diagnosis among patients presenting to the ED with a principal symptom of dyspnoea. Admission rates were high and ED diagnostic accuracy was good. Despite the seemingly suboptimal adherence to investigation and treatment guidelines, patient outcomes were favourable compared with other registries. BMJ Publishing Group 2017-02-28 /pmc/articles/PMC5337741/ /pubmed/28246137 http://dx.doi.org/10.1136/bmjopen-2016-013812 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Emergency Medicine Keijzers, Gerben Kelly, Anne-Maree Cullen, Louise Klim, Sharon Graham, Colin A Craig, Simon Kuan, Win Sen Jones, Peter Holdgate, Anna Lawoko, Charles Laribi, Said Heart failure in patients presenting with dyspnoea to the emergency department in the Asia Pacific region: an observational study |
title | Heart failure in patients presenting with dyspnoea to the emergency department in the Asia Pacific region: an observational study |
title_full | Heart failure in patients presenting with dyspnoea to the emergency department in the Asia Pacific region: an observational study |
title_fullStr | Heart failure in patients presenting with dyspnoea to the emergency department in the Asia Pacific region: an observational study |
title_full_unstemmed | Heart failure in patients presenting with dyspnoea to the emergency department in the Asia Pacific region: an observational study |
title_short | Heart failure in patients presenting with dyspnoea to the emergency department in the Asia Pacific region: an observational study |
title_sort | heart failure in patients presenting with dyspnoea to the emergency department in the asia pacific region: an observational study |
topic | Emergency Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5337741/ https://www.ncbi.nlm.nih.gov/pubmed/28246137 http://dx.doi.org/10.1136/bmjopen-2016-013812 |
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