Hyponatraemia, hyperglycaemia and worsening renal function at first blood sample on emergency department admission as predictors of in-hospital death in patients with dyspnoea with suspected acute heart failure: retrospective observational analysis of the PARADISE cohort
OBJECTIVES: To assess the prognostic value of hyponatraemia, hyperglycaemia and impaired estimated glomerular filtration rate (eGFR) in predicting in-hospital death in patients with acute heart failure (AHF) admitted for acute dyspnoea in the emergency department. DESIGN: Retrospective observational...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BMJ Publishing Group
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5884345/ https://www.ncbi.nlm.nih.gov/pubmed/29602842 http://dx.doi.org/10.1136/bmjopen-2017-019557 |
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author | Chouihed, Tahar Buessler, Aurélien Bassand, Adrien Jaeger, Deborah Virion, Jean Marc Nace, Lionel Barbé, Françoise Salignac, Sylvain Rossignol, Patrick Zannad, Faiez Girerd, Nicolas |
author_facet | Chouihed, Tahar Buessler, Aurélien Bassand, Adrien Jaeger, Deborah Virion, Jean Marc Nace, Lionel Barbé, Françoise Salignac, Sylvain Rossignol, Patrick Zannad, Faiez Girerd, Nicolas |
author_sort | Chouihed, Tahar |
collection | PubMed |
description | OBJECTIVES: To assess the prognostic value of hyponatraemia, hyperglycaemia and impaired estimated glomerular filtration rate (eGFR) in predicting in-hospital death in patients with acute heart failure (AHF) admitted for acute dyspnoea in the emergency department. DESIGN: Retrospective observational study. SETTING: Emergency Department of the University Hospital of Nancy. Data were collected from August 2013 to October 2015. PARTICIPANTS: The analysis included 405 patients with AHF admitted for acute dyspnoea in an emergency department. RESULTS: The population was elderly (mean age 82 years), 20.1% had hyponatraemia, 45.1% had hyperglycaemia and 48.6% had eGFR <50 mL/min/1.73 m(2). Sixty-one patients (15.1%) died in hospital, mostly due to cardiac aetiology (58.3%). In multivariable analysis adjusted for key potential confounders, adjusted hyponatraemia (OR=2.40, (1.16 to 4.98), p=0.02), hyperglycaemia (OR=2.00, 1.06 to 3.76, p=0.03) and eGFR <50 mL/min/1.73 m(2) (OR=1.97 (1.00 to 3.80), p=0.04*) were all identified as significant independent predictors of in-hospital death. CONCLUSIONS: Results of basic routine laboratory tests (hyponatraemia, hyperglycaemia and impaired eGFR) performed on admission in the emergency department are independently associated with in-hospital death. These inexpensive tests, performed as early as patient admission in the emergency department, could allow the early identification of patients admitted for AHF who are at high risk of in-hospital death. TRIAL REGISTRATION NUMBER: NCT02800122. |
format | Online Article Text |
id | pubmed-5884345 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-58843452018-04-06 Hyponatraemia, hyperglycaemia and worsening renal function at first blood sample on emergency department admission as predictors of in-hospital death in patients with dyspnoea with suspected acute heart failure: retrospective observational analysis of the PARADISE cohort Chouihed, Tahar Buessler, Aurélien Bassand, Adrien Jaeger, Deborah Virion, Jean Marc Nace, Lionel Barbé, Françoise Salignac, Sylvain Rossignol, Patrick Zannad, Faiez Girerd, Nicolas BMJ Open Emergency Medicine OBJECTIVES: To assess the prognostic value of hyponatraemia, hyperglycaemia and impaired estimated glomerular filtration rate (eGFR) in predicting in-hospital death in patients with acute heart failure (AHF) admitted for acute dyspnoea in the emergency department. DESIGN: Retrospective observational study. SETTING: Emergency Department of the University Hospital of Nancy. Data were collected from August 2013 to October 2015. PARTICIPANTS: The analysis included 405 patients with AHF admitted for acute dyspnoea in an emergency department. RESULTS: The population was elderly (mean age 82 years), 20.1% had hyponatraemia, 45.1% had hyperglycaemia and 48.6% had eGFR <50 mL/min/1.73 m(2). Sixty-one patients (15.1%) died in hospital, mostly due to cardiac aetiology (58.3%). In multivariable analysis adjusted for key potential confounders, adjusted hyponatraemia (OR=2.40, (1.16 to 4.98), p=0.02), hyperglycaemia (OR=2.00, 1.06 to 3.76, p=0.03) and eGFR <50 mL/min/1.73 m(2) (OR=1.97 (1.00 to 3.80), p=0.04*) were all identified as significant independent predictors of in-hospital death. CONCLUSIONS: Results of basic routine laboratory tests (hyponatraemia, hyperglycaemia and impaired eGFR) performed on admission in the emergency department are independently associated with in-hospital death. These inexpensive tests, performed as early as patient admission in the emergency department, could allow the early identification of patients admitted for AHF who are at high risk of in-hospital death. TRIAL REGISTRATION NUMBER: NCT02800122. BMJ Publishing Group 2018-03-30 /pmc/articles/PMC5884345/ /pubmed/29602842 http://dx.doi.org/10.1136/bmjopen-2017-019557 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. 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 Chouihed, Tahar Buessler, Aurélien Bassand, Adrien Jaeger, Deborah Virion, Jean Marc Nace, Lionel Barbé, Françoise Salignac, Sylvain Rossignol, Patrick Zannad, Faiez Girerd, Nicolas Hyponatraemia, hyperglycaemia and worsening renal function at first blood sample on emergency department admission as predictors of in-hospital death in patients with dyspnoea with suspected acute heart failure: retrospective observational analysis of the PARADISE cohort |
title | Hyponatraemia, hyperglycaemia and worsening renal function at first blood sample on emergency department admission as predictors of in-hospital death in patients with dyspnoea with suspected acute heart failure: retrospective observational analysis of the PARADISE cohort |
title_full | Hyponatraemia, hyperglycaemia and worsening renal function at first blood sample on emergency department admission as predictors of in-hospital death in patients with dyspnoea with suspected acute heart failure: retrospective observational analysis of the PARADISE cohort |
title_fullStr | Hyponatraemia, hyperglycaemia and worsening renal function at first blood sample on emergency department admission as predictors of in-hospital death in patients with dyspnoea with suspected acute heart failure: retrospective observational analysis of the PARADISE cohort |
title_full_unstemmed | Hyponatraemia, hyperglycaemia and worsening renal function at first blood sample on emergency department admission as predictors of in-hospital death in patients with dyspnoea with suspected acute heart failure: retrospective observational analysis of the PARADISE cohort |
title_short | Hyponatraemia, hyperglycaemia and worsening renal function at first blood sample on emergency department admission as predictors of in-hospital death in patients with dyspnoea with suspected acute heart failure: retrospective observational analysis of the PARADISE cohort |
title_sort | hyponatraemia, hyperglycaemia and worsening renal function at first blood sample on emergency department admission as predictors of in-hospital death in patients with dyspnoea with suspected acute heart failure: retrospective observational analysis of the paradise cohort |
topic | Emergency Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5884345/ https://www.ncbi.nlm.nih.gov/pubmed/29602842 http://dx.doi.org/10.1136/bmjopen-2017-019557 |
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