Publication details

Acute heart failure in pre-hospital care. Results from CARE PRE-H registry

Authors

SVOBODA Jaroslav FELŠŐCI Marián LITTNEROVÁ Simona PAŘENICA Jiří PAVLUŠOVÁ Marie JARKOVSKÝ Jiří ŠPINAR Jindřich

Year of publication 2014
Type Article in Periodical
Magazine / Source Experimental and Clinical Cardiology
MU Faculty or unit

Faculty of Medicine

Citation
Field Cardiovascular diseases incl. cardiosurgery
Keywords Acute; Heart failure; Mortality; Prehospital care
Description Purpose: To describe the profile, management and early outcome of patients with suspect acute heart failure (AHF) in prehospital setting. Methods: Multicenter prospective registry enrolled consecutive data from the emergency medical system (EMS) during the period of 24 moths. Excluded were patients resuscitated or died before the initial EMS contact. Clinical profile, management and outcome were assessed and predictors of 30-day mortality identified. Results: From the 86584 patients the final diagnosis of AHF was established in 1345 (1.6%) of cases. Their median age was 78 years (57;91), the most common comorbid condition was hypertension (67%), signs of pulmonary oedema were present in 46.4%. Mortality at 30 day after the initial medical contact reached 20.7%. The outcome was more favourable in patients with hypertension (OR 0.51, 95% CI 0.361;0.711) and if physicians did not apply furosemide during the transportation to the hospital (OR 0.61, 95% CI 0.407;0.903). Advanced age (with OR 1.05, 95% CI 1.030;1.061), low oxygen saturation (OR 2.18, 95% CI 1.616;2.934) and the need of vasoactive or inotropic support (OR 3.55, 95%CI 1.710;7.391) were significantly associated with increased mortality. Conclusion: Short-term outcome of AHF patients is unfavourable. Study points out important factors influencing outcome that should be taken into account when managing these patients in prehospital area.

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