Publication: Effects on short term outcome of non-invasive ventilation use in the emergency department to treat patients with acute heart failure: A propensity score-based analysis of the EAHFE Registry.
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Date
2018-03-21
Authors
Miró, Òscar
Martínez, Gemma
Masip, Josep
Gil, Víctor
Martín-Sánchez, Francisco Javier
Llorens, Pere
Herrero-Puente, Pablo
Sánchez, Carolina
Richard, Fernando
Lucas-Invernón, Javier
Advisors
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Abstract
To assess the effects of non-invasive ventilation (NIV) in emergency department (ED) patients with acute heart failure (AHF) on short term outcomes. Patients from the EAHFE Registry (a multicenter, observational, multipurpose, cohort-designed database including consecutive AHF patients in 41 Spanish EDs) were grouped based on NIV treatment (NIV+ and NIV-groups). Using propensity score (PS) methodology, we identified two subgroups of patients matched by 38 covariates and compared regarding 30-day survival (primary outcome). Interaction was investigated for age, sex, ischemic cardiomyopathy, chronic obstructive pulmonary disease, AHF precipitated by an acute coronary syndrome (ACS), AHF classified as hypertensive or acute pulmonary edema (APE), and systolic blood pressure (SBP). Secondary outcomes were intensive care unit (ICU) admission; mechanical ventilation; in-hospital, 3-day and 7-day mortality; and prolonged hospitalization (>7 days). Of 11,152 patients from the EAHFE (age (SD): 80 (10) years; 55.5% women), 718 (6.4%) were NIV+ and had a higher 30-day mortality (HR = 2.229; 95%CI = 1.861-2.670) (p 85 years, p The use of NIV to treat AHF in ED is not associated with improved mortality outcomes and should be cautious in old patients and those with ACS and hypotension.
Description
MeSH Terms
Acute Coronary Syndrome
Acute Disease
Aged
Aged, 80 and over
Cohort Studies
Emergency Service, Hospital
Female
Heart Failure
Hospital Mortality
Humans
Intensive Care Units
Logistic Models
Male
Noninvasive Ventilation
Propensity Score
Pulmonary Disease, Chronic Obstructive
Registries
Risk Factors
Spain
Time Factors
Treatment Outcome
Acute Disease
Aged
Aged, 80 and over
Cohort Studies
Emergency Service, Hospital
Female
Heart Failure
Hospital Mortality
Humans
Intensive Care Units
Logistic Models
Male
Noninvasive Ventilation
Propensity Score
Pulmonary Disease, Chronic Obstructive
Registries
Risk Factors
Spain
Time Factors
Treatment Outcome
DeCS Terms
CIE Terms
Keywords
Acute heart failure, Emergency department, Heart failure, Non-invasive ventilation, Outcome