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
| Autor: | Lionel Nace, Françoise Barbé, Sylvain Salignac, Jean M Virion, Faiez Zannad, Tahar Chouihed, Aurélien Buessler, Adrien Bassand, Patrick Rossignol, Deborah Jaeger, Nicolas Girerd |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty emergency department mortality predictors acute heart failure Population Observational analysis Renal function 030204 cardiovascular system & hematology Kidney 03 medical and health sciences 0302 clinical medicine Medicine Humans In patient 030212 general & internal medicine Hospital Mortality education Aged Retrospective Studies Aged 80 and over Heart Failure education.field_of_study business.industry Research Retrospective cohort study General Medicine Emergency department medicine.disease Prognosis Dyspnea basic laboratory test parameters Heart failure Hyperglycemia Emergency medicine Cohort Acute Disease Emergency Medicine Female France business Emergency Service Hospital Hyponatremia |
| Zdroj: | BMJ Open |
| ISSN: | 2044-6055 |
| Popis: | ObjectivesTo 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.DesignRetrospective observational study.SettingEmergency Department of the University Hospital of Nancy. Data were collected from August 2013 to October 2015.ParticipantsThe analysis included 405 patients with AHF admitted for acute dyspnoea in an emergency department.ResultsThe population was elderly (mean age 82 years), 20.1% had hyponatraemia, 45.1% had hyperglycaemia and 48.6% had eGFR 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 2(OR=1.97 (1.00 to 3.80), p=0.04*) were all identified as significant independent predictors of in-hospital death.ConclusionsResults 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 numberNCT02800122. |
| Databáze: | OpenAIRE |
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