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Association between prehospital arterial hypercapnia and mortality in acute heart failure: a retrospective cohort study

BACKGROUND: Acute Heart Failure (AHF) is a potentially lethal pathology and is often encountered in the prehospital setting. Although an association between prehospital arterial hypercapnia in AHF patients and admission in high-dependency and intensive care units has been previously described, there...

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Autores principales: Fabre, Mathias, Fehlmann, Christophe A., Boczar, Kevin E., Gartner, Birgit, Zimmermann-Ivol, Catherine G., Sarasin, François, Suppan, Laurent
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8571671/
https://www.ncbi.nlm.nih.gov/pubmed/34742243
http://dx.doi.org/10.1186/s12873-021-00527-y
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author Fabre, Mathias
Fehlmann, Christophe A.
Boczar, Kevin E.
Gartner, Birgit
Zimmermann-Ivol, Catherine G.
Sarasin, François
Suppan, Laurent
author_facet Fabre, Mathias
Fehlmann, Christophe A.
Boczar, Kevin E.
Gartner, Birgit
Zimmermann-Ivol, Catherine G.
Sarasin, François
Suppan, Laurent
author_sort Fabre, Mathias
collection PubMed
description BACKGROUND: Acute Heart Failure (AHF) is a potentially lethal pathology and is often encountered in the prehospital setting. Although an association between prehospital arterial hypercapnia in AHF patients and admission in high-dependency and intensive care units has been previously described, there is little data to support an association between prehospital arterial hypercapnia and mortality in this population. METHODS: This was a retrospective study based on electronically recorded prehospital medical files. All adult patients with AHF were included. Records lacking arterial blood gas data were excluded. Other exclusion criteria included the presence of a potentially confounding diagnosis, prehospital cardiac arrest, and inter-hospital transfers. Hypercapnia was defined as a PaCO(2) higher than 6.0 kPa. The primary outcome was in-hospital mortality, and secondary outcomes were 7-day mortality and emergency room length of stay (ER LOS). Univariable and multivariable logistic regression models were used. RESULTS: We included 225 patients in the analysis. Prehospital hypercapnia was found in 132 (58.7%) patients. In-hospital mortality was higher in patients with hypercapnia (17.4% [23/132] versus 6.5% [6/93], p = 0.016), with a crude odds-ratio of 3.06 (95%CI 1.19–7.85). After adjustment for pre-specified covariates, the adjusted OR was 3.18 (95%CI 1.22–8.26). The overall 7-day mortality was also higher in hypercapnic patients (13.6% versus 5.5%, p = 0.044), and ER LOS was shorter in this population (5.6 h versus 7.1 h, p = 0.018). CONCLUSION: Prehospital hypercapnia is associated with an increase in in-hospital and 7-day mortality in patient with AHF.
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spelling pubmed-85716712021-11-08 Association between prehospital arterial hypercapnia and mortality in acute heart failure: a retrospective cohort study Fabre, Mathias Fehlmann, Christophe A. Boczar, Kevin E. Gartner, Birgit Zimmermann-Ivol, Catherine G. Sarasin, François Suppan, Laurent BMC Emerg Med Research BACKGROUND: Acute Heart Failure (AHF) is a potentially lethal pathology and is often encountered in the prehospital setting. Although an association between prehospital arterial hypercapnia in AHF patients and admission in high-dependency and intensive care units has been previously described, there is little data to support an association between prehospital arterial hypercapnia and mortality in this population. METHODS: This was a retrospective study based on electronically recorded prehospital medical files. All adult patients with AHF were included. Records lacking arterial blood gas data were excluded. Other exclusion criteria included the presence of a potentially confounding diagnosis, prehospital cardiac arrest, and inter-hospital transfers. Hypercapnia was defined as a PaCO(2) higher than 6.0 kPa. The primary outcome was in-hospital mortality, and secondary outcomes were 7-day mortality and emergency room length of stay (ER LOS). Univariable and multivariable logistic regression models were used. RESULTS: We included 225 patients in the analysis. Prehospital hypercapnia was found in 132 (58.7%) patients. In-hospital mortality was higher in patients with hypercapnia (17.4% [23/132] versus 6.5% [6/93], p = 0.016), with a crude odds-ratio of 3.06 (95%CI 1.19–7.85). After adjustment for pre-specified covariates, the adjusted OR was 3.18 (95%CI 1.22–8.26). The overall 7-day mortality was also higher in hypercapnic patients (13.6% versus 5.5%, p = 0.044), and ER LOS was shorter in this population (5.6 h versus 7.1 h, p = 0.018). CONCLUSION: Prehospital hypercapnia is associated with an increase in in-hospital and 7-day mortality in patient with AHF. BioMed Central 2021-11-06 /pmc/articles/PMC8571671/ /pubmed/34742243 http://dx.doi.org/10.1186/s12873-021-00527-y Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Fabre, Mathias
Fehlmann, Christophe A.
Boczar, Kevin E.
Gartner, Birgit
Zimmermann-Ivol, Catherine G.
Sarasin, François
Suppan, Laurent
Association between prehospital arterial hypercapnia and mortality in acute heart failure: a retrospective cohort study
title Association between prehospital arterial hypercapnia and mortality in acute heart failure: a retrospective cohort study
title_full Association between prehospital arterial hypercapnia and mortality in acute heart failure: a retrospective cohort study
title_fullStr Association between prehospital arterial hypercapnia and mortality in acute heart failure: a retrospective cohort study
title_full_unstemmed Association between prehospital arterial hypercapnia and mortality in acute heart failure: a retrospective cohort study
title_short Association between prehospital arterial hypercapnia and mortality in acute heart failure: a retrospective cohort study
title_sort association between prehospital arterial hypercapnia and mortality in acute heart failure: a retrospective cohort study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8571671/
https://www.ncbi.nlm.nih.gov/pubmed/34742243
http://dx.doi.org/10.1186/s12873-021-00527-y
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