Serveur d'exploration sur les relations entre la France et l'Australie

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Heart failure in patients presenting with dyspnoea to the emergency department in the Asia Pacific region: an observational study

Identifieur interne : 000B04 ( Main/Exploration ); précédent : 000B03; suivant : 000B05

Heart failure in patients presenting with dyspnoea to the emergency department in the Asia Pacific region: an observational study

Auteurs : Gerben Keijzers [Australie] ; Anne-Maree Kelly [Australie] ; Louise Cullen [Australie] ; Sharon Klim [Australie] ; Colin A. Graham [Hong Kong] ; Simon Craig [Australie] ; Win Sen Kuan [Singapour] ; Peter Jones [Nouvelle-Zélande] ; Anna Holdgate [Australie] ; Charles Lawoko [Australie] ; Said Laribi [France]

Source :

RBID : PMC:5337741

Abstract

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.


Url:
DOI: 10.1136/bmjopen-2016-013812
PubMed: 28246137
PubMed Central: 5337741


Affiliations:


Links toward previous steps (curation, corpus...)


Le document en format XML

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<title xml:lang="en" level="a" type="main">Heart failure in patients presenting with dyspnoea to the emergency department in the Asia Pacific region: an observational study</title>
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<addr-line>Department of Emergency Medicine</addr-line>
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<institution>Royal Brisbane and Women's Hospital</institution>
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<addr-line>Herston, Queensland</addr-line>
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<country>Australia</country>
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<country xml:lang="fr">Australie</country>
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<addr-line>Department of Emergency Medicine</addr-line>
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<institution>National University Health System</institution>
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<addr-line>Singapore</addr-line>
,
<country>Singapore</country>
</nlm:aff>
<country xml:lang="fr">Singapour</country>
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<addr-line>Department of Emergency Medicine</addr-line>
,
<institution>Auckland City Hospital</institution>
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<addr-line>Auckland</addr-line>
,
<country>New Zealand</country>
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<country xml:lang="fr">Nouvelle-Zélande</country>
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<name sortKey="Holdgate, Anna" sort="Holdgate, Anna" uniqKey="Holdgate A" first="Anna" last="Holdgate">Anna Holdgate</name>
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,
<institution>Liverpool Hospital</institution>
,
<addr-line>Sydney, New South Wales</addr-line>
,
<country>Australia</country>
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<country xml:lang="fr">Australie</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<addr-line>Sydney, New South Wales</addr-line>
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<country>Australia</country>
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<country xml:lang="fr">Australie</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<name sortKey="Lawoko, Charles" sort="Lawoko, Charles" uniqKey="Lawoko C" first="Charles" last="Lawoko">Charles Lawoko</name>
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<addr-line>Director, Industry Doctoral Training Centre, ATN Universities, Australia</addr-line>
</nlm:aff>
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<wicri:regionArea>Director, Industry Doctoral Training Centre, ATN Universities</wicri:regionArea>
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<name sortKey="Laribi, Said" sort="Laribi, Said" uniqKey="Laribi S" first="Said" last="Laribi">Said Laribi</name>
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<nlm:aff id="af18">
<addr-line>Department of Emergency Medicine</addr-line>
,
<institution>Tours University Hospital</institution>
,
<addr-line>Paris</addr-line>
,
<country>France</country>
</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<front>
<div type="abstract" xml:lang="en">
<sec>
<title>Objectives</title>
<p>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.</p>
</sec>
<sec>
<title>Design</title>
<p>Planned substudy of the prospective, descriptive cohort study: Asia, Australia and New Zealand Dyspnoea in Emergency Departments (AANZDEM).</p>
</sec>
<sec>
<title>Setting</title>
<p>46 EDs in Australia, New Zealand, Singapore, Hong Kong and Malaysia collected data over 3 72-hour periods in May, August and October 2014.</p>
</sec>
<sec>
<title>Participants</title>
<p>Patients with an ED diagnosis of heart failure.</p>
</sec>
<sec>
<title>Outcome measures</title>
<p>Outcomes included patient epidemiology, investigations ordered, treatment modalities used and patient outcomes (hospital length of stay (LOS) and mortality).</p>
</sec>
<sec>
<title>Results</title>
<p>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%).</p>
</sec>
<sec>
<title>Conclusions</title>
<p>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.</p>
</sec>
</div>
</front>
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