Prehospital arterial hypercapnia in acute heart failure is associated with admission to acute care units and emergency room length of stay: a retrospective cohort study
Autor: | Catherine G. Zimmermann-Ivoll, Laurent Suppan, Florian Rey, Mathias Fabre, François Sarasin, Christophe Fehlmann, Birgit Gartner |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Adult
medicine.medical_specialty Critical Care medicine.medical_treatment lcsh:Special situations and conditions Vital signs 030204 cardiovascular system & hematology Arterial blood gas law.invention Hypercapnia 03 medical and health sciences 0302 clinical medicine law Acute care Intensive care medicine Intubation Humans Prehospital Retrospective Studies ddc:616 Heart Failure ddc:617 business.industry lcsh:RC952-1245 lcsh:Medical emergencies. Critical care. Intensive care. First aid Acute heart failure 030208 emergency & critical care medicine Retrospective cohort study lcsh:RC86-88.9 Length of Stay medicine.disease Intensive care unit Intensive Care Units Heart failure Emergency medicine Emergency Medicine medicine.symptom business Emergency Service Hospital Research Article |
Zdroj: | BMC Emergency Medicine, Vol 21, Iss 1, Pp 1-7 (2021) BMC Emergency Medicine BMC emergency medicine, Vol. 21, No 1 (2021) P. 14 |
ISSN: | 1471-227X |
Popis: | Background Acute Heart Failure (AHF) is a common condition that often presents with acute respiratory distress and requires urgent medical evaluation and treatment. Arterial hypercapnia is common in AHF and has been associated with a higher rate of intubation and non-invasive ventilation in the Emergency Room (ER), but its prognostic value has never been studied in the prehospital setting. Methods A retrospective study was performed on the charts of all patients taken care of by a physician-staffed prehospital mobile unit between June 2016 and September 2019 in Geneva. After approval by the ethics committee, charts were screened to identify all adult patients with a diagnosis of AHF in whom a prehospital arterial blood gas (ABG) sample was drawn. The main predictor was prehospital hypercapnia. The primary outcome was the admission rate in an acute care unit (ACU, composite of intensive care and high-dependency units). Secondary outcomes were ER length of stay (LOS), orientation from ER (intensive care unit, high-dependency unit, general ward, discharge home), intubation rate at 24 h, hospital LOS and hospital mortality. Results A total of 106 patients with a diagnosis of AHF were analysed. Hypercapnia was found in 61 (58%) patients and vital signs were more severely altered in this group. The overall ACU admission rate was 48%, with a statistically significant difference between hypercapnic and non-hypercapnic patients (59% vs 33%, p = 0.009). ER LOS was shorter in hypercapnic patients (5.4 h vs 8.9 h, p = 0.016). Conclusions There is a significant association between prehospital arterial hypercapnia, acute care unit admission, and ER LOS in AHF patients. |
Databáze: | OpenAIRE |
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