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1. Mortality, perioperative complications and surgical timelines in hip fracture patients: Comparison of the Spanish with the non-Spanish Cohort of the HIP ATTACK-1 trial

Author

Veevaete, Laurent, Waroux, Bernard le Polain de, Lavand'homme, Patricia, Cornu, Olivier, Tribak, Karim, Yombi, Jean C, Touil, Nassim, Bhutia, Jigme T, Clinckaert, Carol, Clippeleir, Dirk De, Reul, Maike, Patel, Ameen, Tandon, Vikas, Gauthier, Leslie P, Avram, Victoria R.A., Winemaker, Mitchell, de Beer, Justin, Simpson, Diane L, Worster, Andrew, Alvarado, Kim A, Gregus, Krysten K, Lawrence, Kelly H, Leong, Darryl P, Joseph, Philip G, Magloire, Patrick, Deheshi, Benjamin, Bisland, Stuart, Wood, Thomas J, Tushinski, Daniel M., Wilson, David A.J., Haider, Shariq, Bali, Kamal, Kearon, Clive, Manach, Yannick Le, Adili, Anthony, Tiboni, Maria E, Neary, John D, Cowan, David D, Khanna, Vickas, Zaki, Amna, Farrell, Janet C, MacDonald, Anne Marie, Conen, David, Wong, Steven C.W., Karbassi, Arsha, Wright, Douglas S, Shanthanna, Harsha, Coughlin, Ryan, Khan, Moin, Wikkerink, Spencer, Quraishi, Faraaz A, Lawendy, Abdel-Rahman, Kishta, Waleed, Schemitsch, Emil, Carey, Timothy, Macleod, Mark D, Sanders, David W, Vasarhelyi, Edward, Bartley, Debra, Dresser, George K, Tieszer, Christina, Jenkinson, Richard J, Shadowitz, Steven, Lee, Jacques S, Choi, Stephen, Kreder, Hans J, Nousiainen, Markku, Kunz, Monica R, Tuazon, Ravianne, Shrikumar, Mopina, Ravi, Bheeshma, Wasserstein, David, Stephen, David J.G., Nam, Diane, Henry, Patrick D.G., Wood, Gavin C.A., Mann, Stephen M., Jaeger, Melanie T., Sivilotti, Marco L.A., Smith, Christopher A., Frank, Christopher C., Grant, Heather, Ploeg, Leone, Yach, Jeff D., Harrison, Mark M., Campbell, Aaron R., Bicknell, Ryan T., Bardana, Davide D., Feibel, Robert J., McIlquham, Katie, Gallant, Catherine, Halman, Samantha, Thiruganasambandamoorth, Venkatesh, Ruggiero, Sara, Hadden, William J., Chen, Brian P.J., Coupal, Stephanie A., McMahon, Stephen J., McLean, Lisa M., Shirali, Hemant R., Haider, Syed Y., Smith, Crystal A., Watts, Evan, Santone, David J., Koo, Kevin, Yee, Allan J., Oyenubi, Ademilola N., Nauth, Aaron, Schemitsch, Emil H., Daniels, Timothy R., Ward, Sarah E., Hall, Jeremy A., Ahn, Henry, Whelan, Daniel B., Atrey, Amit, Khoshbin, Amir, Puskas, David, Droll, Kurt, Cullinan, Claude, Payendeh, Jubin, Lefrancois, Tina, Mozzon, Lise, Marion, Travis, Jacka, Michael J., Greene, James, Menon, Matthew, Stiegelmahr, Robert, Dillane, Derek, Irwin, Marleen, Beaupre, Lauren, Coles, Chad P., Trask, Kelly, MacDonald, Shelley, Trenholm, J.A.I., Oxner, William, Richardson, C.G., Dehghan, Niloofar, Sadoughi, Mehdi, Sharma, Achal, White, Neil J., Olivieri, Loretta, Hunt, Stephen B., Turgeon, Thomas R., Bohm, Eric R., Tran, Sarah, Giilck, Stephen M., Hupel, Tom, Guy, Pierre, O'Brien, Peter J., Duncan, Andrew W., Crawford, Gordon A., hou, Junlin, Zhao, Yanrui, Liu, Yang, Shan, Lei, Wu, Anshi, Muñoz, Juan M., Chaudier, Philippe, Douplat, Marion, Fessy, Michel Henri, Piriou, Vincent, Louboutin, Lucie, David, Jean Stephane, Friggeri, Arnaud, Beroud, Sebastien, Fayet, Jean Marie, Landais, Paul, Leung, Frankie Ka Li, Fang, Christian Xinshuo, Yee, Dennis King Hang, Sancheti, Parag K., Pradhan, Chetan V., Patil, Atul A., Puram, Chetan P., Borate, Madhav P., Kudrimoti, Kiran B., Adhye, Bharati A., Dongre, Himanshu V., John, Bobby, Abraham, Valsamma, Pandey, Ritesh A., Rajkumar, Arti, George, Preetha E., Sigamani, Alen, Stephen, Manesh, Chandran, Nitheesh, Ashraf, Mohammed, Georgekutty, A.M., Sulthan, Ahamad S., Adinarayanan, S., Sharma, Deep, Barnawal, Satish P., Swaminathan, Srinivasan, Bidkar, Prasanna U., Mishra, Sandeep K., Menon, Jagdish, M, Niranjan, Zk, Varghese, Hiremath, Santosh A., Nc, Madhusudhan, Jawali, Abhijit, Gnanadurai, Kingsly R., George, Carolin E., Maddipati, Atarao, Kp, Mary, Sharma, Vijay, Farooque, Kamran, Malhotra, Rajesh, Mittal, Samarth, Sawhney, Chavi, Gupta, Babita, Mathur, Purva, Gamangati, Shivanand, Tripathy, Vijaylaxmi, Menon, Prem H., Dhillon, Mandeep S., Chouhan, Devendra K., Patil, Sharanu, Narayan, Ravi, Lal, Purushotham, Bilchod, Prashanth N., Singh, Surya U., Gattu, Uttam V., Dashputra, Ravi P., Rahate, Prashant V., Turiel, Maurizio, Blasio, Giuseppe De, Accetta, Riccardo, Perazzo, Paolo, Stella, Daniele, Bonadies, Marika, Colombo, Chiara, Fozzato, Stefania, Pino, Fabio, Morelli, Ilaria, Colnaghi, Eleonora, Salini, Vincenzo, Denaro, Giuseppe, Beretta, Luigi, Placella, Giacomo, Giardina, Giuseppe, Binda, Mirko, Marcato, Anna, Guzzetti, Luca, Piccirillo, Fabio, Cecconi, Maurizio, Khor, H.M., Lai, Hou Yee, Kumar, C.S., Chee, K.H., Loh, P.S., Tan, Kit Mun, Singh, Simmrat, Foo, Li Lian, Prakasam, Komella, Chaw, Sook Hui, Lee, Meng-Li, Ngim, Joanne H.L., Boon, Huck Wee, Chin, Im Im, Kleinlugtenbelt, Ydo V., Landman, Ellie B.M., Flikweert, Elvira R., Roerdink, Herbert W., Brokelman, Roy B.G., Elskamp-Meijerman, Hannie F., Horst, Maarten R., Cobben, Jan-Hein M.G., Umer, Masood, Begum, Dilshad, Anjum, Anila, Hashmi, Pervaiz M., Ahmed, Tashfeen, Rashid, Haroon U., Khattak, Mujahid J., Rashid, Rizwan H., Lakdawala, Riaz H., Noordin, Shahryar, Juman, Naveed M., Khan, Robyna I., Riaz, Muhammad M., Bokhari, Syedah S., Almas, Ayesha, Wahab, Hussain, Ali, Arif, Khan, Hammad N., Khan, Eraj K., Nur, Aamer Nabi, Janjua, Kholood A., Orakzai, Sajjad H., Khan, Abdus S., Mustafa, Khawaja J., Sohail, Mian A., Umar, Muhammad, Khan, Siddra A., Ashraf, Muhammad, Khan, Muhammad K., Shiraz, Muhammad, Furgan, Ahmad, Ślęczka, Paweł, Dąbek, Piotr, Kumoń, Adam, Satora, Wojciech, Ambroży, Wojciech, Święch, Mariusz, Rycombel, Jacek, Grzelak, Adrian, Nowak- Kózka, Ilona, Gucwa, Jaroslaw, Machala, Waldemar, Ramokgopa, Mmampapatla T., Firth, Gregory B., Karera, Mwalimu, Fourtounas, Maria, Singh, Virsen, Biscardi, Anna, Iqbal, Muhammad N., Campbell, Ryan J., Maluleke, Matimba L., Moller, Carien, Nhlapo, Lerato, Maqungo, Sithombo, Flint, Margot, Nejthardt, Marcin B., Chetty, Sean, Naidoo, Rubendren, Guerra-Farfan, Ernesto, Tomas-Hernandez, Jordi, Garcia-Sanchez, Yaiza, Clua, Miriam Garrido, Molero-Garcia, Vicente, Minguell-Monyart, Joan, Teixidor-Serra, Jordi, Villar-Casares, Maria del Mar, Marsa, Jordi Selga, Porcel-Vazquez, Juan A., Andres-Peiro, Jose-Vicente, Aguilar, Marc, Mestre-Torres, Jaume, Colomina, Maria J., Guilabert, Patricia, Gozalo, M Luisa Paños, Abarca, Luis, Martin, Nuria, Usua, Gemma, Martinez-Ripol, Pedro, Posada, M.A. Gonzalez, Lalueza-Broto, Pilar, Sanchez-Raya, Judith, Camarena, Jorge Nuñez, Fraguas-Castany, Antoni, Balaguer-Castro, Mariano, Torner, Pere, Jornet-Gibert, Montsant, Serrano-Sanz, Jorge, Cámara-Cabrera, Jaume, Salomó-Domènech, Mònica, Yela-Verdú, Christian, Peig-Font, Anna, Ricol, Laura, Carreras-Castañer, Anna, Martínez-Sañudo, Luis, Herranz, Susana, Feijoo-Massó, Carlos, Sianes-Gallén, Mònica, Castillόn, Pablo, Bernaus, Martí, Quintas, Saioa, Gόmez, Olga, Salvador, Jordi, Abarca, Javier, Estrada, Cristina, Novellas, Marga, Torra, Mercè, Dealbert, Alfred, Macho, Oscar, Ivanov, Alexia, Valldosera, Esther, Arroyo, Marta, Pey, Borja, Yuste, Antoni, Mateo, Llorenç, Caso, Julio De, Anaya, Rafael, Higa-Sansone, J.L., Millan, Angelica, Baños, Victoria, Herrera-Mateo, Sergio, Aguado, Hector, Martinez-Municio, Gonzalo, León, Ricardo, Santiago-Maniega, Silvia, Zabalza, Ana, Labrador, Gregorio, Guerado, Enrique, Ramirez-Roldan, Alicia, Cruz, Encarnacion, Cano, Juan R, Bogallo, Jose M, Sangasoongsong, Paphon, Kulachote, Noratep, Sirisreetreerux, Norachart, Pengrung, Nachapan, Chalacheewa, Theerawat, Arnuntasupakul, Vanlapa, Yingchoncharoen, Teerapat, Naratreekoon, Bundit, Kadry, Miriam A, Thayaparan, Surendini, Abdlaziz, Ihab, Aframian, Arash, Imbuldeniya, Arjuna, Movahedi, Roya, Omran, Sherif, Vizcaychipi, Marcela P, Correia, Patricia, Patil, Shashank, Haire, Kevin, Mayor, Amy S.E., Dillingham, Sally, Nicholson, Laura, Elnaggar, Mohamed, John, Joby, Nanjayan, Shashi K, Parker, Martyn J, O'Sullivan, Susan, Marmor, Meir T, Matityahu, Amir, McClellan, Robert T, Comstock, Curt, Ding, Anthony, Toogood, Paul, Slobogean, Gerard, Joseph, Katherine, O'Toole, Robert, Sciadini, Marcus, Ryan, Scott P, Clark, Molly E, Cassidy, Charles, Balonov, Konstantin, Bergese, Sergio D, Phieffer, Laura S, Gonzalez-Zacarias, Alicia A, Marcantonio, Andrew J, Borges, Flavia K., Bhandari, Mohit, Nuñez, Jorge H., Castillon, Pablo, De Caso Rodriguez, Julio, Aguado, Hector J., Popova, Ekaterine, Tonelli, Ana Claudia, Balasubramanian, Kumar, Vincent, Jessica, Harvey, Valerie, Kocaqi, Etri, and Devereaux, P.J.

Published
2024
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2. Ambient temperature and atmospheric pressure at discharge as precipitating factors in immediate adverse events in patients treated for decompensated heart failure

Author

Benito-Lozano, Miguel, López-Ayala, Pedro, Rodríguez, Sergio, Gil, Víctor, Llorens, Pere, Yufera, Ana, Jacob, Javier, Travería-Becker, Lissete, Strebel, Ivo, Lucas-Imbernon, Francisco Javier, Tost, Josep, López-Hernández, Ángeles, Rodríguez, Beatriz, Fuentes, Marta, Sánchez-Ramón, Susana, Herrera-Mateo, Sergio, Aguirre, Alfons, Alonso, M. Isabel, Pavón, José, López-Grima, M. Luisa, Espinosa, Begoña, Mueller, Christian, Burillo-Putze, Guillermo, and Miró, Òscar

Published
2022
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4. Effect of risk of malnutrition on 30-day mortality among older patients with acute heart failure in Emergency Departments

Author

Martín-Sánchez, Francisco Javier, Cuesta Triana, Federico, Rossello, Xavier, Pardo García, Rebeca, Llopis García, Guillermo, Caimari, Francisca, Vidán, María Teresa, Ruiz Artacho, Pedro, González del Castillo, Juan, Llorens, Pere, Herrero, Pablo, Jacob, Javier, Gil, Víctor, Fernández Pérez, Cristina, Gil, Pedro, Bueno, Héctor, Miró, Òscar, Matía Martín, Pilar, Rodríguez Adrada, Esther, Santos, María Carmen, Salgado, Lucía, Brizzi, Berenice Nayla, Docavo, María Luisa, del Mar Suárez-Cadenas, María, Xipell, Carolina, Sánchez, Carolina, Aguiló, Sira, Gaytan, Josep María, Jerez, Alba, Pérez-Durá, María José, Berrocal Gil, Pablo, López-Grima, María Luisa, Valero, Amparo, Aguirre, Alfons, Pedragosa, Maria Àngels, Piñera, Pascual, LázaroAragues, Paula, Sánchez Nicolás, José Andrés, Rizzi, Miguel Alberto, Herrera Mateo, Sergio, Alquezar, Aitor, Roset, Alex, Ferrer, Carles, Llopis, Ferrán, Álvarez Pérez, José María, López Diez, María Pilar, Richard, Fernando, Fernández-Cañadas, José María, Carratalá, José Manuel, Javaloyes, Patricia, Andueza, Juan Antonio, Sevillano Fernández, José Antonio, Romero, Rodolfo, Merlo Loranca, Marta, Álvarez Rodríguez, Virginia, Lorca, María Teresa, Calderón, Luis, Soy Ferrer, Ester, Manuel Garrido, José, and Martín Mojarro, Enrique

Published
2019
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6. Adherence to Mediterranean Diet and All-Cause Mortality After an Episode of Acute Heart Failure: Results of the MEDIT-AHF Study

Author

Alonso, Héctor, Fuentes, Marta, Gil, Cristina, Pérez-Durá, María José, Salvo, Eva, Escoda, Rosa, Xipell, Carolina, Sánchez, Carolina, Gaytan, Josep M., Noval, Antonio, Torres, José M., López-Grima, Maria Luisa, Juan, Maria Angeles, Valero, Amparo, Pedragosa, Maria Àngels, Alonso, Maria Isabel, Ruiz, Francisco, Romero, Rodolfo, Calvache, Roberto, Morante, Carlos, Lorca, Maria Teresa, Mecina, Ana Belen, Tost, Josep, de la Fuente Penco, Belén, López Sánchez, Antònia, Sánchez, Susana, Piñera, Pascual, Garate, Raquel Torres, Alquézar, Aitor, Rizzi, Miguel Alberto, Richard, Fernando, Álvarez Pérez, José María, López Diez, Maria Pilar, Lucas, Javier, Roset, Álex, Rodríguez-Adrada, Esther, Llopis García, Guillermo, Garrido, José Manuel, Fernández-Cañadas, José Maria, Marquina, Víctor, Jiménez, Inmaculada, Javaloyes, Patricia, Vázquez Alvarez, Joaquin, Alonso Morilla, Ana, Irimia, Andrea, Miró, Òscar, Estruch, Ramon, Martín-Sánchez, Francisco J., Gil, Víctor, Jacob, Javier, Herrero-Puente, Pablo, Herrera Mateo, Sergio, Aguirre, Alfons, Andueza, Juan A., and Llorens, Pere

Published
2018
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8. Programa de optimización de antibioterapia en infección urinaria por cepas multirresistentes en el servicio de urgencias.

Author

Ruiz-Ramos, Jesus, Herrera-Mateo, Sergio, Rivera-Martínez, María Alba, Monje-López, Álvaro Eloy, Hernández-Ontiveros, Héctor, Pereia-Batista, Celso Soares, Martinez-Ysasis, Yoleidys Milagros, and Puig-Campmany, Mireia

Abstract

Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2023
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9. Ambient temperature and atmospheric pressure at discharge as precipitating factors in immediate adverse events in patients treated for decompensated heart failure

Author

Instituto de Salud Carlos III, Ministerio de Sanidad (España), European Commission, Novartis, Orion Pharma, Benito‑Lozano, Miguel, López‑Ayala, Pedro, Rodríguez, Sergio, Gil, Víctor, Llorens, Pere, Yufera, Ana, Jacob, Javier, Travería‑Becker, Lissete, Strebe, Ivo, Lucas‑Imbernon, Francisco Javier, Tost, Josep, López‑Hernández, Ángeles, Rodríguez, Beatriz, Fuentes, Marta, Sánchez‑Ramón, Susana, Herrera‑Mateo, Sergio, Aguirre, Alfons, Alonso, M. Isabel, Pavón, José, López‑Grima, M. Luisa, Espinosa, Begoña, Mueller, Christian, Burillo‑Putze, Guillermo, Miró, Òscar, Instituto de Salud Carlos III, Ministerio de Sanidad (España), European Commission, Novartis, Orion Pharma, Benito‑Lozano, Miguel, López‑Ayala, Pedro, Rodríguez, Sergio, Gil, Víctor, Llorens, Pere, Yufera, Ana, Jacob, Javier, Travería‑Becker, Lissete, Strebe, Ivo, Lucas‑Imbernon, Francisco Javier, Tost, Josep, López‑Hernández, Ángeles, Rodríguez, Beatriz, Fuentes, Marta, Sánchez‑Ramón, Susana, Herrera‑Mateo, Sergio, Aguirre, Alfons, Alonso, M. Isabel, Pavón, José, López‑Grima, M. Luisa, Espinosa, Begoña, Mueller, Christian, Burillo‑Putze, Guillermo, and Miró, Òscar

Abstract

To investigate the relationship of ambient temperature and atmospheric pressure (AP) at patient discharge after an episode of acute heart failure (AHF) with very early post-discharge adverse outcomes. We analyzed 14,656 patients discharged after an AHF episode from 26 hospitals in 16 Spanish cities. The primary outcome was the 7-day post-discharge combined adverse event (emergency department –ED- revisit or hospitalization due to AHF, or all-cause death), and secondary outcomes were these three adverse events considered individually. Associations (adjusted for patient and demographic conditions, and length of stay -LOS- during the AHF index episode) of temperature and AP with the primary and secondary outcomes were investigated. We used restricted cubic splines to model the continuous non-linear association of temperature and AP with each endpoint. Some sensitivity analyses were performed. Patients were discharged after a median LOS of 5 days (IQR = 1–10). The highest temperature at discharge ranged from − 2 to 41.6 °C, and AP was from 892 to 1037 hPa. The 7-day post-discharge combined event occurred in 1242 patients (8.4%), with percentages of 7-day ED-revisit, hospitalization and death of 7.8%, 5.1% and 0.9%, respectively. We found no association between the maximal temperature and AP on the day of discharge and the primary or secondary outcomes. Similarly, there were no significant associations when the analyses were restricted to hospitalized patients (median LOS = 7 days, IQR = 4–11) during the index event, or when lag-1, lag-2 or the mean of the 3 post-discharge days (instead of point estimation) of ambient temperature and AP were considered. Temperature and AP on the day of patient discharge are not independently associated with the risk of very early adverse events during the vulnerable post-discharge period in patients discharged after an AHF episode.

Published
2022

12. Factores asociados con el empeoramiento de la función renal durante un episodio de insuficiencia cardiaca aguda y su relación con la mortalidad a corto y largo plazo. Estudio EAHFE - EFRICA

Author

Llauger, Lluuís, Jacob, Javier, Arturo Moreno, Luis, Aguirre Tejedo, Alfons, Martín Mojarro, Enrique, Herrera-Mateo, Sergio, Martínez-Nadal, Gemma, Tost, Josep, Corominas-Lasalle, Gerard, Roset, Àlex, Cardozo, Carlos, Suñén-Cuquerella, Guillem, Alarcón, Brigitte, Romero-Carrete, Juan Carlos, Ruibal, José Carlos, Alquézar Arbé, Aitor, Gil, Víctor, Donea, Ruxandra, Berenguer, Marta, Llorens, Pere, Villanueva-Cutillas, Bernat, Martín-Sánchez, Francisco Javier, Herrero, Pablo, and Miró i Andreu, Òscar

Subjects
Kidney diseases, Mortalitat, Malalties del ronyó, Heart failure, Insuficiència cardíaca, Mortality
Abstract

Objetivo. Identificar los factores asociados con el empeoramiento de la función renal (EFR) y si este se asocia a mayor mortalidad en pacientes que presentan un episodio de insuficiencia cardiaca aguda (ICA). Método: Participaron 7 servicios de urgencias (SU) que incluyeron consecutivamente pacientes con ICA con determinación de creatinina en urgencias y a las 24-48 horas, y se identificaron aquellos con EFR (incremento de creatinina $ 0,3 mg/dL). Entre 47 características clínicas, se identificó las asociadas a EFR. Se investigó la mortalidad por cualquier causa a 30 días (OR) y al final del seguimiento (HR), esta última global y por periodos trimestrales, que se ajustó por las diferencias entre grupos. Se analizaron subgrupos según edad, sexo, creatinina basal, tipo de ICA y grupo de riesgo. Resultados: Se incluyeron 1.627 pacientes, 220 (13,5%) con EFR, los cuales presentaban mayor edad, presión arterial sistólica, crisis hipertensiva como precipitante, tratamiento con morfina e insuficiencia renal crónica, aunque solo esta última se asoció independientemente a EFR (ORajustada = 1,695, IC 95% = 1,264-2,273). La mortalidad a 30 días fue de 13,1% (mayor en pacientes con EFR: 20,9% vs 11,8%, ORajustada = 1,793, IC 95% = 1,207-2,664) y la mortalidad acumulada a 18 meses (tiempo medio de seguimiento 14 meses/paciente) fue del 40,0% (mayor en pacientes con EFR: HRajustada = 1,275, IC 95% = 1,018-1,598). Este incremento de riesgo fue durante el primer trimestre. El análisis de subgrupos no mostró diferencias. Conclusión: La ICA con EFR en las primeras 48 horas posteriores a la atención en el SU se asocia a mayor mortalidad, que se concentra durante el primer trimestre.

Published
2020

13. Accelerated surgery versus standard care in hip fracture (HIP ATTACK): an international, randomised, controlled trial

Author

Borges, Flavia K, primary, Bhandari, Mohit, additional, Guerra-Farfan, Ernesto, additional, Patel, Ameen, additional, Sigamani, Alben, additional, Umer, Masood, additional, Tiboni, Maria E, additional, Villar-Casares, Maria del Mar, additional, Tandon, Vikas, additional, Tomas-Hernandez, Jordi, additional, Teixidor-Serra, Jordi, additional, Avram, Victoria RA, additional, Winemaker, Mitchell, additional, Ramokgopa, Mmampapatla T, additional, Szczeklik, Wojciech, additional, Landoni, Giovanni, additional, Wang, Chew Yin, additional, Begum, Dilshad, additional, Neary, John D, additional, Adili, Anthony, additional, Sancheti, Parag K, additional, Lawendy, Abdel-Rahman, additional, Balaguer-Castro, Mariano, additional, Ślęczka, Paweł, additional, Jenkinson, Richard J, additional, Nur, Aamer Nabi, additional, Wood, Gavin CA, additional, Feibel, Robert J, additional, McMahon, Stephen J, additional, Sigamani, Alen, additional, Popova, Ekaterine, additional, Biccard, Bruce M, additional, Moppett, Iain K, additional, Forget, Patrice, additional, Landais, Paul, additional, McGillion, Michael H, additional, Vincent, Jessica, additional, Balasubramanian, Kumar, additional, Harvey, Valerie, additional, Garcia-Sanchez, Yaiza, additional, Pettit, Shirley M, additional, Gauthier, Leslie P, additional, Guyatt, Gordon H, additional, Conen, David, additional, Garg, Amit X, additional, Bangdiwala, Shrikant I, additional, Belley-Cote, Emilie P, additional, Marcucci, Maura, additional, Lamy, Andre, additional, Whitlock, Richard, additional, Le Manach, Yannick, additional, Fergusson, Dean A, additional, Yusuf, Salim, additional, Devereaux, PJ, additional, Veevaete, Laurent, additional, le Polain de Waroux, Bernard, additional, Lavand'homme, Patricia, additional, Cornu, Olivier, additional, Tribak, Karim, additional, Yombi, Jean Cyr, additional, Touil, Nassim, additional, Reul, Maike, additional, Bhutia, Jigme Tshering, additional, Clinckaert, Carol, additional, De Clippeleir, Dirk, additional, de Beer, Justin, additional, Simpson, Diane L, additional, Worster, Andrew, additional, Alvarado, Kim A, additional, Gregus, Krysten K, additional, Lawrence, Kelly H, additional, Leong, Darryl P, additional, Joseph, Philip G, additional, Magloire, Patrick, additional, Deheshi, Benjamin, additional, Bisland, Stuart, additional, Wood, Thomas J, additional, Tushinski, Daniel M, additional, Wilson, David AJ, additional, Kearon, Clive, additional, Cowan, David D, additional, Khanna, Vickas, additional, Zaki, Amna, additional, Farrell, Janet C, additional, MacDonald, Anne Marie, additional, Wong, Steven CW, additional, Karbassi, Arsha, additional, Wright, Douglas Steven, additional, Shanthanna, Harsha, additional, Coughlin, Ryan, additional, Khan, Moin, additional, Wikkerink, Spencer, additional, Quraishi, Faraaz A, additional, Kishta, Waleed, additional, Schemitsch, Emil, additional, Carey, Timothy, additional, Macleod, Mark D, additional, Sanders, David W, additional, Vasarhelyi, Edward, additional, Bartley, Debra, additional, Dresser, George K, additional, Tieszer, Christina, additional, Shadowitz, Steven, additional, Lee, Jacques S, additional, Choi, Stephen, additional, Kreder, Hans J, additional, Nousiainen, Markku, additional, Kunz, Monica R, additional, Tuazon, Ravianne, additional, Shrikumar, Mopina, additional, Ravi, Bheeshma, additional, Wasserstein, David, additional, Stephen, David JG, additional, Nam, Diane, additional, Henry, Patrick DG, additional, Mann, Stephen M, additional, Jaeger, Melanie T, additional, Sivilotti, Marco LA, additional, Smith, Christopher A, additional, Frank, Christopher C, additional, Grant, Heather, additional, Ploeg, Leone, additional, Yach, Jeff D, additional, Harrison, Mark M, additional, Campbell, Aaron R, additional, Bicknell, Ryan T, additional, Bardana, Davide D, additional, McIlquham, Katie, additional, Gallant, Catherine, additional, Halman, Samantha, additional, Thiruganasambandamoorth, Venkatesh, additional, Ruggiero, Sara, additional, Hadden, William J, additional, Chen, Brian P-J, additional, Coupal, Stephanie A, additional, McLean, Lisa M, additional, Shirali, Hemant R, additional, Haider, Syed Y, additional, Smith, Crystal A, additional, Watts, Evan, additional, Santone, David J, additional, Koo, Kevin, additional, Yee, Allan J, additional, Oyenubi, Ademilola N, additional, Nauth, Aaron, additional, Schemitsch, Emil H, additional, Daniels, Timothy R, additional, Ward, Sarah E, additional, Hall, Jeremy A, additional, Ahn, Henry, additional, Whelan, Daniel B, additional, Atrey, Amit, additional, Khoshbin, Amir, additional, Puskas, David, additional, Droll, Kurt, additional, Cullinan, Claude, additional, Payendeh, Jubin, additional, Lefrancois, Tina, additional, Mozzon, Lise, additional, Marion, Travis, additional, Jacka, Michael J, additional, Greene, James, additional, Menon, Matthew, additional, Stiegelmahr, Robert, additional, Dillane, Derek, additional, Irwin, Marleen, additional, Beaupre, Lauren, additional, Coles, Chad P, additional, Trask, Kelly, additional, MacDonald, Shelley, additional, Trenholm, J Andrew I, additional, Oxner, William, additional, Richardson, C Glen, additional, Dehghan, Niloofar, additional, Sadoughi, Mehdi, additional, Sharma, Achal, additional, White, Neil J, additional, Olivieri, Loretta, additional, Hunt, Stephen B, additional, Turgeon, Thomas R, additional, Bohm, Eric R, additional, Tran, Sarah, additional, Giilck, Stephen M, additional, Hupel, Tom, additional, Guy, Pierre, additional, O'Brien, Peter J, additional, Duncan, Andrew W, additional, Crawford, Gordon A, additional, Zhou, Junlin, additional, Zhao, Yanrui, additional, Liu, Yang, additional, Shan, Lei, additional, Wu, Anshi, additional, Muñoz, Juan Manuel, additional, Chaudier, Philippe, additional, Douplat, Marion, additional, Fessy, Michel Henri, additional, Piriou, Vincent, additional, Louboutin, Lucie, additional, David, Jean Stephane, additional, Friggeri, Arnaud, additional, Beroud, Sebastien, additional, Fayet, Jean Marie, additional, Leung, Frankie Ka Li, additional, Fang, Christian Xinshuo, additional, Yee, Dennis King Hang, additional, Sancheti, Parag Kantilal, additional, Pradhan, Chetan Vijay, additional, Patil, Atul Ashok, additional, Puram, Chetan Prabhakar, additional, Borate, Madhav Pandurang, additional, Kudrimoti, Kiran Bhalchandra, additional, Adhye, Bharati Anil, additional, Dongre, Himanshu Vijaykumar, additional, John, Bobby, additional, Abraham, Valsamma, additional, Pandey, Ritesh Arvind, additional, Rajkumar, Arti, additional, George, Preetha Elizabeth, additional, Stephen, Manesh, additional, Chandran, Nitheesh, additional, Ashraf, Mohammed, additional, Georgekutty, AM, additional, Sulthan, Ahamad Shaheel, additional, Adinarayanan, S, additional, Sharma, Deep, additional, Barnawal, Satish Prasad, additional, Swaminathan, Srinivasan, additional, Bidkar, Prasanna Udupi, additional, Mishra, Sandeep Kumar, additional, Menon, Jagdish, additional, M, Niranjan, additional, K, Varghese Zachariah, additional, Hiremath, Santosh Angad, additional, NC, Madhusudhan, additional, Jawali, Abhijit, additional, Gnanadurai, Kingsly Robert, additional, George, Carolin Elizabeth, additional, Maddipati, Tatarao, additional, KP, Mary KP, additional, Sharma, Vijay, additional, Farooque, Kamran, additional, Malhotra, Rajesh, additional, Mittal, Samarth, additional, Sawhney, Chavi, additional, Gupta, Babita, additional, Mathur, Purva, additional, Gamangati, Shivanand, additional, Tripathy, Vijaylaxmi, additional, Menon, Prem Haridas, additional, Dhillon, Mandeep S, additional, Chouhan, Devendra K, additional, Patil, Sharanu, additional, Narayan, Ravi, additional, Lal, Purushotham, additional, Bilchod, Prashanth Nabhirajappa, additional, Singh, Surya Udai, additional, Gattu, Uttam Vaidya, additional, Dashputra, Ravi Prabhakar, additional, Rahate, Prashant Vitthal, additional, Turiel, Maurizio, additional, De Blasio, Giuseppe, additional, Accetta, Riccardo, additional, Perazzo, Paolo, additional, Stella, Daniele, additional, Bonadies, Marika, additional, Colombo, Chiara, additional, Fozzato, Stefania, additional, Pino, Fabio, additional, Morelli, Ilaria, additional, Colnaghi, Eleonora, additional, Salini, Vincenzo, additional, Denaro, Giuseppe, additional, Beretta, Luigi, additional, Placella, Giacomo, additional, Giardina, Giuseppe, additional, Binda, Mirko, additional, Marcato, Anna, additional, Guzzetti, Luca, additional, Piccirillo, Fabio, additional, Cecconi, Maurizio, additional, Khor, HM, additional, Lai, Hou Yee, additional, Kumar, CS, additional, Chee, KH, additional, Loh, PS, additional, Tan, Kit Mun, additional, Singh, Simmrat, additional, Foo, Li Lian, additional, Prakasam, Komella, additional, Chaw, Sook Hui, additional, Lee, Meng-Li, additional, Ngim, Joanne HL, additional, Boon, Huck Wee, additional, Chin, Im Im, additional, Kleinlugtenbelt, Ydo V, additional, Landman, Ellie BM, additional, Flikweert, Elvira R, additional, Roerdink, Herbert W, additional, Brokelman, Roy B.G., additional, Elskamp-Meijerman, Hannie F, additional, Horst, Maarten R, additional, Cobben, Jan-Hein MG, additional, Anjum, Anila, additional, Hashmi, Pervaiz Mehmood, additional, Ahmed, Tashfeen, additional, Rashid, Haroon Ur, additional, Khattak, Mujahid Jamil, additional, Rashid, Rizwan Haroon, additional, Lakdawala, Riaz Hussain, additional, Noordin, Shahryar, additional, Juman, Naveed Muhammed, additional, Khan, Robyna Irshad, additional, Riaz, Muhammad Mehmood, additional, Bokhari, Syedah Saira, additional, Almas, Ayesha, additional, Wahab, Hussain, additional, Ali, Arif, additional, Khan, Hammad Naqi, additional, Khan, Eraj Khurshid, additional, Janjua, Kholood Abid, additional, Orakzai, Sajjad Hassan, additional, Khan, Abdus Salam, additional, Mustafa, Khawaja Junaid, additional, Sohail, Mian Amjad, additional, Umar, Muhammad, additional, Khan, Siddra Ahmed, additional, Ashraf, Muhammad, additional, Khan, Muhammad Kashif, additional, Shiraz, Muhammad, additional, Furgan, Ahmad, additional, Dąbek, Piotr, additional, Kumoń, Adam, additional, Satora, Wojciech, additional, Ambroży, Wojciech, additional, Święch, Mariusz, additional, Rycombel, Jacek, additional, Grzelak, Adrian, additional, Gucwa, Jaroslaw, additional, Machala, Waldemar, additional, Ramokgopa, Mmampapatla Thomas, additional, Firth, Gregory Bodley, additional, Karera, Mwalimu, additional, Fourtounas, Maria, additional, Singh, Virsen, additional, Biscardi, Anna, additional, Iqbal, Muhammad Nasir, additional, Campbell, Ryan Jonathan, additional, Maluleke, Matimba Lenny, additional, Moller, Carien, additional, Nhlapo, Lerato, additional, Maqungo, Sithombo, additional, Flint, Margot, additional, Nejthardt, Marcin B, additional, Chetty, Sean, additional, Naidoo, Rubendren, additional, Garrido Clua, Miriam, additional, Molero-Garcia, Vicente, additional, Minguell-Monyart, Joan, additional, Selga Marsa, Jordi, additional, Porcel-Vazquez, Juan A, additional, Andres-Peiro, Jose-Vicente, additional, Aguilar, Marc, additional, Mestre-Torres, Jaume, additional, Colomina, Maria J, additional, Guilabert, Patricia, additional, Paños Gozalo, M Luisa, additional, Abarca, Luis, additional, Martin, Nuria, additional, Usua, Gemma, additional, Martinez-Ripol, Pedro, additional, Gonzalez Posada, MA, additional, Lalueza-Broto, Pilar, additional, Sanchez-Raya, Judith, additional, Nuñez Camarena, Jorge, additional, Fraguas-Castany, Antoni, additional, Torner, Pere, additional, Jornet-Gibert, Monsant, additional, Serrano-Sanz, Jorge, additional, Cámara-Cabrera, Jaume, additional, Salomó-Domènech, Mònica, additional, Yela-Verdú, Christian, additional, Peig-Font, Anna, additional, Ricol, Laura, additional, Carreras-Castañer, Anna, additional, Martínez-Sañudo, Luis, additional, Herranz, Susana, additional, Feijoo-Massó, Carlos, additional, Sianes-Gallén, Mònica, additional, Castillón, Pablo, additional, Bernaus, Martí, additional, Quintas, Saioa, additional, Gómez, Olga, additional, Salvador, Jordi, additional, Abarca, Javiera, additional, Estrada, Cristina, additional, Novellas, Marga, additional, Torra, Mercè, additional, Dealbert, Alfred, additional, Macho, Oscar, additional, Ivanov, Alexia, additional, Valldosera, Esther, additional, Arroyo, Marta, additional, Pey, Borja, additional, Yuste, Antoni, additional, Mateo, Llorenç, additional, De Caso, Julio, additional, Anaya, Rafael, additional, Higa-Sansone, JL, additional, Millan, Angelica, additional, Baños, Victoria, additional, Herrera-Mateo, Sergio, additional, Aguado, Hector J, additional, Martinez-Municio, Gonzalo, additional, León, Ricardo, additional, Santiago-Maniega, Silvia, additional, Zabalza, Ana, additional, Labrador, Gregorio, additional, Guerado, Enrique, additional, Cruz, Encarnacion, additional, Cano, Juan Ramon, additional, Bogallo, Jose Manuel, additional, Sa-ngasoongsong, Paphon, additional, Kulachote, Noratep, additional, Sirisreetreerux, Norachart, additional, Pengrung, Nachapan, additional, Chalacheewa, Theerawat, additional, Arnuntasupakul, Vanlapa, additional, Yingchoncharoen, Teerapat, additional, Naratreekoon, Bundit, additional, Kadry, Miriam Adel, additional, Thayaparan, Surendini, additional, Abdlaziz, Ihab, additional, Aframian, Arash, additional, Imbuldeniya, Arjuna, additional, Bentoumi, Souad, additional, Omran, Sherif, additional, Vizcaychipi, Marcela Paola, additional, Correia, Patricia, additional, Patil, Shashank, additional, Haire, Kevin, additional, Mayor, Amy SE, additional, Dillingham, Sally, additional, Nicholson, Laura, additional, Elnaggar, Mohamed, additional, John, Joby, additional, Nanjayan, Shashi Kumar, additional, Parker, Martyn J, additional, O'Sullivan, Susan, additional, Marmor, Meir T, additional, Matityahu, Amir, additional, McClellan, Robert Trigg, additional, Comstock, Curt, additional, Ding, Anthony, additional, Toogood, Paul, additional, Slobogean, Gerard, additional, Joseph, Katherine, additional, O'Toole, Robert, additional, Sciadini, Marcus, additional, Ryan, Scott P, additional, Clark, Molly E, additional, Cassidy, Charles, additional, Balonov, Konstantin, additional, Bergese, Sergio D, additional, Phieffer, Laura S, additional, Gonzalez Zacarias, Alicia A, additional, Marcantonio, Andrew J, additional, Borges, Flavia K, additional, Dragic-Taylor, Sanela, additional, Maxwell, Chelsea, additional, Molnar, Sarah, additional, Wells, Jennifer R, additional, Ofori, Sandra N, additional, Yang, Stephen S, additional, Wang, Michael K, additional, Duceppe, Emmanuelle, additional, Spence, Jessica, additional, Vasquez, Javiera P, additional, Marcano-Fernández, Francesc, additional, Ham, Hyungjoo, additional, Prada, Carlos, additional, Yung, Terence CH, additional, Sanz Pérez, Isidro, additional, Bosch, Michael J, additional, Prystajecky, Michael R, additional, Chowdhury, Chinmoy, additional, Khan, James S, additional, Stella, Steffan F, additional, Heidary, Behrouz, additional, Tran, Allen, additional, Wawrzycka-Adamczyk, Katarzyna, additional, Chen, Yu Chiao Peter, additional, González-Osuna, Aránzazu, additional, Biedroń, Grzegorz, additional, Wludarczyk, Anna, additional, Lefebvre, Marco, additional, Ernst, Jaclyn A, additional, Staffhorst, Bas, additional, Woodfine, Jason D, additional, Alwafi, Emad M, additional, Mrkobrada, Marko, additional, Parlow, Simon, additional, Roberts, Robin, additional, McAlister, Finlay, additional, Sackett, David, additional, and Wright, James, additional

Published
2020
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14. Eventos adversos en pacientes con insuficiencia cardiaca aguda clasificados de bajo riesgo por la escala MEESSI y dados de alta desde urgencias: cuantificación y predictibilidad

Author

Miró i Andreu, Òscar, Gil, Víctor, Rosselló, Xavier, Martín Sánchez, Francisco Javier, Llorens, Pere, Jacob, Javier, Herrero, Pablo, Herrera Mateo, Sergio, Richard, Fernando, Escoda, Rosa, Fuentes, Marta, Martín Mojarro, Enrique, Llauger, Lluis, Bueno, Héctor, Pocock, Stuart J., and Grupo ICA-SEMES

Subjects
Hospital care, Mortalitat, Heart failure, Insuficiència cardíaca, Mortality, Assistència hospitalària, Urgències mèdiques, Medical emergencies
Abstract

Objetivo. Investigar la tasa de eventos adversos en pacientes con insuficiencia cardiaca aguda (ICA) clasificados de bajo riesgo por la escala MEESSI y dados de alta desde urgencias, la capacidad discriminativa de dicha escala para estos eventos en dichos pacientes y las variables asociadas. Método. Se estratificó el riesgo de los pacientes del Registro EAHFE (cohortes 2-5) mediante la escala MEESSI y se analizaron los clasificados de bajo riesgo dados de alta desde urgencias. Se investigó la mortalidad por cualquier causa a 30 días (M-30d), la revisita a urgencias por ICA a 7 días (REV-7d) y la revisita a urgencias u hospitalización por ICA a 30 días (REV-H-30d). Se calculó el área bajo la curva (ABC) de la característica operativa del receptor (COR) de la escala MEESSI para estos eventos. Se analizó la relación entre 42 variables y RV-7d y RV-H-30d mediante regresión logística multivariable. Resultados. Se incluyeron 1028 pacientes. La M-30d fue 1,6% (IC 95%: 0,9-2,5), la REV-7d fue 8,0% (6,4-9,8) y la REV-H-30d fue 24,7% (22,1-25,7). El ABC ROC de la puntuación MEESSI para discriminar estos eventos adversos fue 0,69 (0,58-0,80), 0,56 (0,49-0,63) y 0,54 (0,50-0,59), respectivamente. Se asociaron con RV-7d: tratamiento diurético crónico (OR 2,45; 1,01-5,98), hemoglobina < 110 g/L (1,68; 1,02-2,75) y tratamiento diurético intravenoso en urgencias (0,53; 0,31-0,90). Se asociaron con REV-H-30d: arteriopatía periférica (1,74; 1,01-3,00), episodios previos de ICA (1,42; 1,02-1,98), tratamiento crónico con inhibidores de receptores mineralocorticoides (1,71; 1,09-2,67), índice de Barthel en urgencias < 90 puntos (1,48; 1,07-2,06) y tratamiento diurético intravenoso en urgencias (0,58; 0,40-0,84). Conclusiones. Los pacientes con ICA de bajo riesgo dados de alta desde urgencias presentan tasas de eventos adversos cercanas a los estándares recomendados internacionalmente. La escala MEESSI, diseñada para predecir M-30d, tiene escasa capacidad predictiva para REV-7d y REV-H-30d en los pacientes de bajo riesgo. Este estudio describe otros factores asociados a tales eventos.

Published
2019

15. Patients with acute heart failure discharged from the emergency department and classified as low risk by the MEESSI score (multiple risk estimate based on the Spanish emergency department scale): prevalence of adverse events and predictability

Author

Miro, Oscar, Gil, Victor, Rossello, Xavier, Javier Martin-Sanchez, Francisco, Llorens, Pere, Jacob, Javier, Herrero, Pablo, Herrera Mateo, Sergio, Richard, Fernando, Escoda, Rosa, Fuentes, Marta, Martin Mojarro, Enrique, Llauger, Lluis, HECTOR BUENO, Pocock, Stuart, Gil, Cristina, Garmila, Pablo, Rodriguez Adrada, Esther, Perdigones, Javier, Escobar, Luis, Xipell, Carolina, Sanchez, Carolina, Ma Gaytan, Josep, Jose Perez-Dura, Maria, Pavon, Jose, Bella Alvarez, Ana, Noval, Antonio, Torres, Jose M., Luisa Lopez-Grima, Maria, Valero, Amparo, Angeles Juan, Marian, Aguirre, Alfons, Angels Pedragosa, Maria, Isabel Alonso, Maria, Ruiz, Francisco, Miguel Franco, Jose, Diaz, Elena, Belen Mecina, Ana, Tost, Josep, Sanchez, Susana, Pinera, Pascual, Torres Garate, Raquel, Alberto Rizzi, Miguel, Herrera, Sergio, Cabello, Irene, Alvarez Perez, Jose Maria, Lopez Diez, Maria Pilar, Vasquez Alvarez, Joaquin, Alonso Morilla, Ana, Irimia, Andrea, Marquina, Victor, Jimenez, Inmaculada, Hernandez, Nestor, Ramos, Sergio, Lopez, Ana, Antonio Andueza, Juan, Romero, Rodolfo, Calvache, Roberto, Teresa Lorca, Maria, Calderon, Luis, Amores Arriaga, Beatriz, Sierra, Beatriz, Traver Becquer, Lisette, Corominas La Salle, Gerard, Aguera Urbano, Carmen, and Soy Ferrer, Ester

Subjects
Hospitalization, Emergency department, Acute heart failure, Mortality, Emergency revisits, Risk assessment
Abstract

Objective. To determine the rate of adverse events in patients with acute heart failure (AHF) who were discharged from the emergency department (ED) after classification as low risk according to MEESSI score (multiple risk estimate based on the Spanish ED scale), to analyze the ability of the score to predict events, and to explore variables associated with adverse events. Methods. Patients in the EAHFE registry (Epidemiology of Acute Heart Failure in EDs) were stratified according to risk indicated by MEESSI score in order to identify those considered at low risk on discharge. All-cause 30-day mortality and revisits related to AHF within 7 days and 30 days were recorded. The area under the receiver operating characteristic curve (AUC) was calculated for the MEESSI score's ability to predict these events. Associations between 42 variables and 7-day and 30-day revisits to the ED were analyzed by multivariable logistic regression. Results. A total of 1028 patients were included. The 30-day mortality rate was 1.6% (95% CI, 0.9%-2.5%). The 7-day and 30-day revisit rates were 8.0% (95% CI, 6.4%-9.8%) and 24.7% (95% CI, 22.1%-25.7%), respectively. The AUCs for MEESSI score discrimination between patients with and without these outcomes were as follows: 30-day mortality, 0.69 (95% CI, 0.58-0.80); 7-day revisiting, 0.56 (95% CI, 0.49-0.63); and 30-day revisiting, 0.54 (95% CI, 0.50-0.59). Variables associated with 7-day revisits were long-term diuretic treatment (odds ratio [OR], 2.45; 95% CI, 1.01-5.98), hemoglobin concentration less than 110 g/L (OR, 1.68; 95% CI, 1.02-2.75), and intravenous diuretic treatment in the ED (OR, 0.53; 95% CI, 0.31-0.90). Variables associated with 30-day revisits were peripheral artery disease (OR, 1.74; 95% CI, 1.01-3.00), prior history of an AHF episode (OR, 1.42; 95% CI, 1.02-1.98), long-term mineralocorticoid receptor antagonist treatment (OR, 1.71; 95% CI, 1.09-2.67), Barthel index less than 90 points in the ED (OR, 1.48; 95% CI, 1.07-2.06), and intravenous diuretic treatment in the ED (OR, 0.58; 95% CI, 0.40-0.84). Conclusions. Patients with AHF who are at low risk for adverse events on discharge from our EDs have event rates that are near internationally recommended targets. The MEESSI score, which was designed to predict 30-day mortality, is a poor predictor of 7-day or 30-day revisiting in these low-risk patients. We identified other factors related to these events.

Published
2019

16. Prognostic value of chest radiographs in patients with acute heart failure: the Radiology in Acute Heart Failure (RAD-ICA) study

Author

Llorens, Pere, Javaloyes, Patricia, Masip, Josep (Masip i Utset), Gil, Victor, Herrero Puente, Pablo, Martín Sánchez, Francisco Javier, Jacob, Javier, Garrido, José Manuel, Herrera Mateo, Sergio, López Díez, María Pilar, Concepcion-Aramendia, Luis, Miró i Andreu, Òscar, and Grupo ICA-SEMES

Subjects
Radiography, Pronòstic mèdic, Radiografia, Chest, Heart failure, Insuficiència cardíaca, Prognosis, Urgències mèdiques, Tòrax, Medical emergencies
Abstract

Objective. To determine whether chest radiographs can contribute to prognosis in patients with acute heart failure (AHF). Methods. Consecutive patients with AHF were enrolled by the participating emergency departments. Radiographic variables assessed were the presence or absence of evidence of cardiomegaly and pleural effusion and the pulmonary parenchymal pattern observed (vascular redistribution, interstitial edema, and/or alveolar edema). We gathered variables for the AHF episode and the patient's baseline state. Outcomes were in-hospital and 1-year mortality; hospital stay longer than 7 days, and a composite of events within 30 days of discharge (revisit, rehospitalization, and/or death). Crude and adjusted hazard ratios were calculated for the 3 categories of radiographic variables. The variables were also studied in combination. Results. A total of 2703 patients with a mean (SD) age of 81 (19) years were enrolled; 54.5% were women. Cardiomegaly was observed in 1711 cases (76.8%) and pleural effusion in 992 (36.7%). A pulmonary parenchymal pattern was observed in all cases, as follows: vascular redistribution in 1672 (61.9%), interstitial edema in 629 (23.3%) and alveolar edema in 402 (14.9%). The adjusted hazard ratios showed that cardiomegaly lacked prognostic value. However, the presence of pleural effusion was associated with a 23% (95% CI, 2%-49%) higher rate of the 30-day composite outcome; in-hospital mortality was 89% (30%-177%) higher in the presence of alveolar edema, and 1-year mortality was 38% (14%-67%) higher in association with vascular redistribution. The results for the variables in combination were consistent with the results for individual variables. Conclusions: A diagnostic chest radiograph can also contribute to the prediction of adverse events. Pleural effusion is associated with a higher rate of events after discharge, and alveolar edema is associated with higher mortality.

Published
2019

17. Adherence to Mediterranean Diet and All-Cause Mortality After an Episode of Acute Heart Failure: Results of the MEDIT-AHF Study

Author

Miró, Òscar, Estruch, Ramón, Martín-Sánchez, Francisco J., Gil, Víctor, Jacob, Javier, Herrero-Puente, Pablo, Herrera Mateo, Sergio, Aguirre Tejedo, Alfons, Andueza, Juan A., Llorens, Pere, and ICA-SEMES Research Group

Subjects
Cor -- Malalties, Mediterranean diet, Acute heart failure, Heart failure, Cardiovascular disease, Dieta -- Mediterrània, Regió de la, Diet, Outcome
Abstract

OBJECTIVES: The authors sought to evaluate clinical outcomes of patients after an episode of acute heart failure (AHF) according to their adherence to the Mediterranean diet (MedDiet). BACKGROUND: It has been proved that MedDiet is a useful tool in primary prevention of cardiovascular diseases. However, it is unknown whether adherence to MedDiet is associated with better outcomes in patients who have already experienced an episode of AHF. METHODS: We designed a prospective study that included consecutive patients diagnosed with AHF in 7 Spanish emergency departments (EDs). Patients were included if they or their relatives were able to answer a 14-point score of adherence to the MedDiet, which classified patients as adherents (≥9 points) or nonadherents (≤8 points). The primary endpoint was all-cause mortality at the end of follow-up, and secondary endpoints were 1-year ED revisit without hospitalization, rehospitalization, death, and a combined endpoint of all these variables for patients discharged after the index episode. Unadjusted and adjusted hazard ratios (HRs) were calculated. RESULTS: We included 991 patients (mean age of 80 ± 10 years, 57.8% women); 523 (52.9%) of whom were adherent to the MedDiet. After a mean follow-up period of 2.1 ± 1.3 years, no differences were observed in survival between adherent and nonadherent patients (HR of adherents [HRadh] = 0.86; 95% confidence interval [CI]: 0.73 to 1.02). The 1-year cumulative ED revisit for the whole cohort was 24.5% (HRadh = 1.10; 95% CI: 0.84 to 1.42), hospitalization 43.7% (HRadh = 0.74; 95% CI: 0.61 to 0.90), death 22.7% (HRadh = 1.05; 95% CI: 0.8 to 1.38), and combined endpoint 66.8% (HRadh = 0.89; 95% CI: 0.76 to 1.04). Adjustment by age, hypertension, peripheral arterial disease, previous episodes of AHF, treatment with statins, air-room pulsioxymetry, and need for ventilation support in the ED rendered similar results, with no statistically significant differences in mortality (HRadh = 0.94; 95% CI: 0.80 to 1.13) and persistence of lower 1-year hospitalization for adherents (HRadh = 0.76; 95% CI: 0.62 to 0.93). CONCLUSIONS: Adherence to the MedDiet did not influence long-term mortality after an episode of AHF, but it was associated with decreased rates of rehospitalization during the next year.

Published
2018

18. Long-term prognostic value of functional status and delirium in emergency patients with decompensated heart failure

Author

Puig Mireia, Rizzi Miguel Alberto, Herrera Mateo Sergio, Torres Olga Herminia, Ruiz Domingo, Alquezar Aitor, Piñera Pascual, and Benito Salvador

Subjects
medicine.medical_specialty, Emergency department, Proportional hazards model, business.industry, Hazard ratio, Delirium, Heart failure, Functional status, Long-term prognosis, Context (language use), 030204 cardiovascular system & hematology, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Epidemiology, medicine, 030212 general & internal medicine, medicine.symptom, business, Survival analysis
Abstract

Heart failure (HF) is prevalent in older adults and is associated with impaired physical and cognitive function. However, these factors are rarely included in studies about long-term prognosis of HF. The aim of the study was to determine whether functional status and delirium at admission (prevalent delirium) would predict 1-year mortality in patients with decompensated HF (DHF). We performed a prospective observational study in adult patients with DHF attended at two Spanish Emergency Departments (ED) in the context of the Epidemiology Acute HF Emergency project. Functional status was assessed by Barthel Index (BI) and prevalent delirium by the Brief Confusion Assessment Method within the first 24 h of admission. We used Kaplan-Meier survival curves for delirium and multivariable Cox regression models to estimated hazard ratio (HR) and survival probability for death while adjusting for six potential confounders. We enrolled 239 patients (age 81.7 +/- 9.4 years, women 61.1%). BI < 60 was 23.4 and 14.6% of patients had delirium. Age (HR 1.046 CI 95% 1.014-1.080, p < 0.004) and BI (HR 0.979 CI 95% 0.972-0.979, p < 0.001) were independently associated with 1-year mortality. In patients without severe functional dependence at admission, delirium (HR 3.579 CI 95% 1.730-7.403, p < 0.001) and age (HR 1.051 CI 95% 1.014-1.090, p = 0.007) independently predicted long-term mortality. Age and functional dependence are strong predictors of long-term mortality in patients with DHF. In patients without severe functional dependence, delirium-a potentially modifiable risk factor-identified a subgroup of patients with higher mortality. Evaluating functional status and delirium in ED could improve decision-making and future care of patients with DHF.

Published
2017

19. Factores asociados con el empeoramiento de la función renal durante un episodio de insuficiencia cardiaca aguda y su relación con la mortalidad a corto y largo plazo: estudio EAHFE - EFRICA.

Author

Llauger, Lluís, Jacob, Javier, Moreno, Luis Arturo, Aguirre, Alfons, Martín-Mojarro, Enrique, Romero-Carrete, Juan Carlos, Martínez-Nadal, Gemma, Tost, Josep, Corominas-Lasalle, Gerard, Roset, Àlex, Cardozo, Carlos, Suñén-Cuquerella, Guillem, Alarcón, Brigitte, Herrera-Mateo, Sergio, Ruibal, José Carlos, Alquézar-Arbé, Aitor, Gil, Víctor, Donea, Ruxandra, Berenguer, Marta, and Llorens, Pere

Published
2020

20. Adherence to Mediterranean Diet and All-Cause Mortality After an Episode of Acute Heart Failure

Author

Miró, Òscar, primary, Estruch, Ramon, additional, Martín-Sánchez, Francisco J., additional, Gil, Víctor, additional, Jacob, Javier, additional, Herrero-Puente, Pablo, additional, Herrera Mateo, Sergio, additional, Aguirre, Alfons, additional, Andueza, Juan A., additional, Llorens, Pere, additional, Alonso, Héctor, additional, Fuentes, Marta, additional, Gil, Cristina, additional, Pérez-Durá, María José, additional, Salvo, Eva, additional, Escoda, Rosa, additional, Xipell, Carolina, additional, Sánchez, Carolina, additional, Gaytan, Josep M., additional, Noval, Antonio, additional, Torres, José M., additional, López-Grima, Maria Luisa, additional, Juan, Maria Angeles, additional, Valero, Amparo, additional, Pedragosa, Maria Àngels, additional, Alonso, Maria Isabel, additional, Ruiz, Francisco, additional, Romero, Rodolfo, additional, Calvache, Roberto, additional, Morante, Carlos, additional, Lorca, Maria Teresa, additional, Mecina, Ana Belen, additional, Tost, Josep, additional, de la Fuente Penco, Belén, additional, López Sánchez, Antònia, additional, Sánchez, Susana, additional, Piñera, Pascual, additional, Garate, Raquel Torres, additional, Alquézar, Aitor, additional, Rizzi, Miguel Alberto, additional, Richard, Fernando, additional, Álvarez Pérez, José María, additional, López Diez, Maria Pilar, additional, Lucas, Javier, additional, Roset, Álex, additional, Rodríguez-Adrada, Esther, additional, Llopis García, Guillermo, additional, Garrido, José Manuel, additional, Fernández-Cañadas, José Maria, additional, Marquina, Víctor, additional, Jiménez, Inmaculada, additional, Javaloyes, Patricia, additional, Vázquez Alvarez, Joaquin, additional, Alonso Morilla, Ana, additional, and Irimia, Andrea, additional

Published
2018
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26. Accelerated Surgery Versus Standard Care in Hip Fracture (HIP ATTACK-1): A Kidney Substudy of a Randomized Clinical Trial

Author

Borges, Flavia K., Devereaux, P.J., Cuerden, Meaghan, Sontrop, Jessica M., Bhandari, Mohit, Guerra-Farfán, Ernesto, Patel, Ameen, Sigamani, Alben, Umer, Masood, Neary, John, Tiboni, Maria, Tandon, Vikas, Ramokgopa, Mmampapatla Thomas, Sancheti, Parag, Lawendy, Abdel-Rahman, Balaguer-Castro, Mariano, Jenkinson, Richard, Ślęczka, Paweł, Nur, Aamer Nabi, Wood, Gavin C.A., Feibel, Robert J., McMahon, John Stephen, Biccard, Bruce M., Ortalda, Alessandro, Szczeklik, Wojciech, Wang, Chew Yin, Tomás-Hernández, Jordi, Vincent, Jessica, Harvey, Valerie, Pettit, Shirley, Balasubramanian, Kumar, Slobogean, Gerard, Garg, Amit X., Veevaete, Laurent, le Polain de Waroux, Bernard, Lavand'homme, Patricia, Cornu, Olivier, Tribak, Karim, Yombi, Jean C., Touil, Nassim, Bhutia, Jigme T., Clinckaert, Carol, De Clippeleir, Dirk, Reu, Maike, Patel, Ameen, Tandon, Vikas, Gauthier, Leslie P., Avram, Victoria RA., Winemaker, Mitchell, Tushinski, Daniel M., de Beer, Justin, Worster, Andrew, Simpson, Diane L., Alvarado, Kim A., Gregus, Krysten K., Lawrence, Kelly H., Leong, Darryl P., Joseph, Philip G., Magloire, Patrick, Deheshi, Benjamin, Bisland, Stuart, Wood, Thomas J., Wilson, David AJ., Ofori, Sandra N., Spence, Jessica, Duceppe, Emmanuelle, Tiboni, Maria E., Neary, John D., Adili, Anthony, Cowan, David D., Khanna, Vickas, Zaki, Amna, Farrell, Janet C., MacDonald, Anne Marie, Conen, David, Wong, Steven CW., Karbassi, Arsha, Wright, Douglas S., Shanthanna, Harsha, Ganame, Javier, Cheung, Andrew, Coughlin, Ryan, Khan, Moin, Wikkerink, Spencer, Quraishi, Faraaz A., Lawendy, Abdel-Rahman, Kishta, Waleed, Schemitsch, Emil, Carey, Timothy, Macleod, Mark D., Sanders, David W., Vasarhelyi, Edward, Bartley, Debra, Dresser, George K., Tieszer, Christina, Jenkinson, Richard J., Shadowitz, Steven, Lee, Jacques S., Choi, Stephen, Kreder, Hans J., Nousiainen, Markku, Kunz, Monica R., Tuazon, Ravianne, Shrikumar, Mopina, Ravi, Bheeshma, Wasserstein, David, Stephen, David J.G., Nam, Diane, Henry, Patrick D.G., Wood, Gavin CA., Mann, Stephen M., Jaeger, Melanie T., Sivilotti, Marco LA., Smith, Christopher A., Frank, Christopher C., Grant, Heather, Ploeg, Leone, Yach, Jeff D., Harrison, Mark M., Campbell, Aaron R., Bicknell, Ryan T., Bardana, Davide D., Feibel, Robert J., McIlquham, Katie, Gallant, Catherine, Halman, Samantha, Thiruganasambandamoorth, Venkatesh, Ruggiero, Sara, Hadden, William J., Chen, Brian PJ., Coupal, Stephanie A., McMahon, Stephen J., McLean, Lisa M., Shirali, Hemant R., Haider, Syed Y., Smith, Crystal A., Watts, Evan, Santone, David J., Koo, Kevin, Yee, Allan J., Oyenubi, Ademilola N., Nauth, Aaron, Schemitsch, Emil H., Daniels, Timothy R., Ward, Sarah E., Hall, Jeremy A., Ahn, Henry, Whelan, Daniel B., Atrey, Amit, Khoshbin, Amir, Puskas, David, Droll, Kurt, Cullinan, Claude, Payendeh, Jubin, Lefrancois, Tina, Mozzon, Lise, Marion, Travis, Jacka, Michael J., Greene, James, Menon, Matthew, Stiegelmahr, Robert, Dillane, Derek, Irwin, Marleen, Beaupre, Lauren, Coles, Chad P., Trask, Kelly, MacDonald, Shelley, Trenholm, J.A.I., Oxner, William, Richardson, C.G., Dehghan, Niloofar, Sadoughi, Mehdi, Sharma, Achal, White, Neil J., Olivieri, Loretta, Hunt, Stephen B., Turgeon, Thomas R., Bohm, Eric R., Tran, Sarah, Giilck, Stephen M., Hupel, Tom, Guy, Pierre, O'Brien, Peter J., Duncan, Andrew W., Crawford, Gordon A., Zhou, Junlin, Zhao, Yanrui, Liu, Yang, Shan, Lei, Wu, Anshi, Muñoz, Juan M., Chaudier, Philippe, Douplat, Marion, Fessy, Michel Henri, Piriou, Vincent, Louboutin, Lucie, David, Jean Stephane, Friggeri, Arnaud, Viste, Anthony, Vacheron, Charles Hervé, Li Leung, Frankie Ka, Fang, Christian Xinshuo, Hang Yee, Dennis King, Sancheti, Parag K., Pradhan, Chetan V., Patil, Atul A., Puram, Chetan P., Borate, Madhav P., Kudrimoti, Kiran B., Adhye, Bharati A., Dongre, Himanshu V., John, Bobby, Abraham, Valsamma, Pandey, Ritesh A., Rajkumar, Arti, George, Preetha E., Sigamani, Alben, Stephen, Manesh, Chandran, Nitheesh, Ashraf, Mohammed, Georgekutty, A.M., Sulthan, Ahamad S., Adinarayanan, S., Sharma, Deep, Barnawal, Satish P., Swaminathan, Srinivasan, Bidkar, Prasanna U., Mishra, Sandeep K., Menon, Jagdish, Niranjan, M., Varghese, Z.K., Hiremath, Santosh A., Madhusudhan, N.C., Jawali, Abhijit, Gnanadurai, Kingsly R., George, Carolin E., Maddipati, Tatarao, Mary, K.P., Sharma, Vijay, Farooque, Kamran, Malhotra, Rajesh, Mittal, Samarth, Sawhney, Chavi, Gupta, Babita, Mathur, Purva, Gamangati, Shivanand, Tripathy, Vijaylaxmi, Menon, Prem H., Dhillon, Mandeep S., Chouhan, Devendra K., Patil, Sharanu, Narayan, Ravi, Lal, Purushotham, Bilchod, Prashanth N., Singh, Surya U., Gattu, Uttam V., Dashputra, Ravi P., Rahate, Prashant V., Turiel, Maurizio, Accetta, Riccardo, Perazzo, Paolo, Stella, Daniele, Bonadies, Marika, Colombo, Chiara, De Blasio, Giuseppe, Fozzato, Stefania, Pino, Fabio, Morelli, Ilaria, Ortalda, Alessandro, De Donato, Francesco, Colnaghi, Eleonora, Salini, Vincenzo, Placella, Giacomo, Giardina, Giuseppe, Lombardi, Gaetano, Marcato, Anna, Guzzetti, Luca, Rivetti, Ilaria, Greco, Massimiliano, Khor, H.M., Lai, Hou Yee, Kumar, C.S., Chee, K.H., Loh, P.S., Tan, Kit Mun, Singh, Simmrat, Foo, Li Lian, Prakasam, Komella, Chaw, Sook Hui, Lee, Meng-Li, Ngim, Joanne HL., Boon, Huck Wee, Chin, Im Im, Kleinlugtenbelt, Ydo V., Landman, Ellie BM., Flikweert, Elvira R., Roerdink, Herbert W., Brokelman, Roy BG., Elskamp-Meijerman, Hannie F., Staffhorst, Bas, Cobben, Jan-Hein MG., Umer, Masood, Begum, Dilshad, Anjum, Anila, Hashmi, Pervaiz M., Ahmed, Tashfeen, Rashid, Haroon U., Khattak, Mujahid J., Rashid, Rizwan H., Lakdawala, Riaz H., Noordin, Shahryar, Juman, Naveed M., Khan, Robyna I., Riaz, Muhammad M., Bokhari, Syedah S., Almas, Ayesha, Wahab, Hussain, Ali, Arif, Khan, Hammad N., Khan, Eraj K., Nur, Aamer Nabi, Janjua, Kholood A., Orakzai, Sajjad H., Khan, Abdus S., Mustafa, Khawaja J., Sohail, Mian A., Umar, Muhammad, Khan, Siddra A., Ashraf, Muhammad, Khan, Muhammad K., Shiraz, Muhammad, Furgan, Ahmad, Ślęczka, Paweł, Dąbek, Piotr, Kumoń, Adam, Satora, Wojciech, Ambroży, Wojciech, Święch, Mariusz, Rycombel, Jacek, Grzelak, Adrian, Nowak-Kózka, Ilona, Gucwa, Jaroslaw, Machala, Waldemar, Ramokgopa, Mmampapatla T., Firth, Gregory B., Karera, Mwalimu, Fourtounas, Maria, Singh, Virsen, Biscardi, Anna, Iqbal, Muhammad N., Campbell, Ryan J., Maluleke, Matimba L., Moller, Carien, Nhlapo, Lerato, Maqungo, Sithombo, Flint, Margot, Nejthardt, Marcin B., Chetty, Sean, Venter, Stephen, Guerra-Farfan, Ernesto, Tomas-Hernandez, Jordi, Garcia-Sanchez, Yaiza, Clua, Miriam Garrido, Molero-Garcia, Vicente, Teixidor-Serra, Jordi, Villar-Casares, Maria del Mar, Marsa, Jordi Selga, Porcel-Vazquez, Juan A., Andres- Peiro, Jose-Vicente, Mestre-Torres, Jaume, Guilabert, Patricia, Paños Gozalo, M Luisa, Abarca, Luis, Martin, Nuria, Usua, Gemma, Lalueza-Broto, Pilar, Sanchez-Raya, Judith, Nuñez Camarena, Jorge, Fraguas-Castany, Antoni, Piedra Calle, Carlos, Leiva, Diego Soza, Carrasco, Maria Garcia, Balaguer-Castro, Mariano, Jornet-Gibert, Montsant, Monfort-Mira, Montserrat, Gasset-Teixidor, Alfons, Marcano-Fernández, Francesc Antoni, Simó- Sánchez, Isabel, Mari-Alfonso, Begoña, Yela-Verdú, Christian, Pellejero-García, Raúl, Casas-Codina, Júlia, Iglesias- Sanjuan, Ruben, Balcells-Nolla, Pau, Vila-Sánchez, Oriol, de Bustos, Mercè Bertrana, Castillón, Pablo, Bernaus, Martí, Quintas, Saioa, Gómez, Olga, Salvador, Jordi, Abarca, Javier, Estrada, Cristina, Novellas, Marga, Anglès, Francesc, Dealbert, Alfred, Macho, Oscar, Ivanov, Alexia, Valldosera, Esther, Arroyo, Marta, Pey, Borja, Yuste, Antoni, Mateo, Llorenç, De Caso, Julio, Anaya, Rafael, Higa-Sansone, J.L., Millan, Angelica, Baños, Victoria, Herrera-Mateo, Sergio, Aguado, Hector J., García-Virto, Virginia, Simón-Pérez, Clarisa, Chavez, Sergio, Bragado, María, Plata, María, Guerado, Enrique, Cruz, Encarnacion, Cano, Juan R., Bogallo, Jose M., Sa-ngasoongsong, Paphon, Kulachote, Noratep, Sirisreetreerux, Norachart, Pengrung, Nachapan, Chalacheewa, Theerawat, Arnuntasupakul, Vanlapa, Yingchoncharoen, Teerapat, Naratreekoon, Bundit, Kadry, Miriam A., Thayaparan, Surendini, Babu, Victor, Aframian, Arash, Bentoumi, Souad, Sayan, Amrinder, Abdlaziz, Ihab, Vizcaychipi, Marcela P., Correia, Patricia, Patil, Shashank, Haire, Kevin, Mayor, Amy SE., Dillingham, Sally, Nicholson, Laura, Brooke, Ben T., John, Joby, Nanjayan, Shashi K., Parker, Martyn J., O'Sullivan, Susan, Marmor, Meir T., Matityahu, Amir, McClellan, Robert T., Comstock, Curt, Ding, Anthony, Toogood, Paul, Slobogean, Gerard, O’Toole, Robert, Sciadini, Marcus, Nascone, Jason, O’Hara, Nathan, Ryan, Scott P., Clark, Molly E., Cassidy, Charles, Balonov, Konstantin, Weaver, Tristan, Phieffer, Laura S., Bergese, Sergio D., Marcantonio, Andrew J., Devereaux, P.J., Bhandari, Mohit, Borges, Flavia K., Balasubramanian, Kumar, Bangdiwala, Shrikant I., Harvey, Valerie, McGillion, Michael H., Pettit, Shirley, Vincent, Jessica, Vincent, Jessica, Harvey, Valerie, Dragic-Taylor, Sanela, Maxwell, Chelsea, Molnar, Sarah, Pettit, Shirley, Wells, Jennifer R., Forget, Patrice, Borges, Flavia K., Landais, Paul, Sigamani, Alben, Landoni, Giovanni, Wang, Chew Yin, Szczeklik, Wojciech, Biccard, Bruce M., Popova, Ekaterine, Moppett, Iain K., Moppett, Iain K., Roberts, Robin, Chairperson, McAlister, Finlay, Sackett, David, and Wright, James

Published
2022
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29. Comparison of different strategies for short-term death prediction in the infected older patient

Author

Cecilia Yanez, Maria, Salido Mota, Manuel, Fuentes Ferrer, Manuel, Julian-Jimenez, Agustin, Pinera, Pascual, Llopis, Ferran, Gamazo Del Rio, Julio, Ortiz Zarate, Mikel Martinez, Angel Estella, Javier Martin-Sanchez, Francisco, Gonzalez Del Castillo, Juan, Herrero Puente, Pablo, Rubio Diaz, Rafael, Moya Olmeda, Diana, Lopez Izquierdo, Raul, Sanchez Nicolas, Jose Andres, Alvarez Hurtado, Angel Aurelio, Del Pozo Vegas, Carlos, Gallardo Bautista, Jose, Javier Candel, Francisco, Cobanera Echebarria, Borja, Roman, Francisco, Llorens, Pere, Perales, Ramon, Onate, Javier, Mora Ordonez, Begona, Fragero, Eva, Ortega, Mar, Burillo, Guillermo, Gomez Hernandez, Carolina, Jesus Arranz, Maria, Juarez, Ricardo, Ferreras Amez, Jose Maria, Muro, Eva, Perez Ordono, Luis, Garcia Criado, Jorge, Wernitz, Andres, Del Arco, Carmen, Marchena Yglesias, Pablo Javier, Ruiz, Francisco, Garcia Castrillo, Luis, Alonso, Hector, Salido, Manuel, Rodriguez Miranda, Belen, Ruiz Grinspan, Martin, Guardiola Tey, Josep Maria, Herrera Mateo, Sergio, Mateo Roca, Miriam, Jose Ezponda, Francisco, Diez, Elena, Gracia Garcia, Francisco, Huarte, Itziar, Gayoso Martin, Sara, Cubillo Moreno, Maria, Juarez Sosa, Silvia, La Chica, Ana, Ferre Losa, Carles, Del Rio Navarro, Rigoberto, Iglesias Vela, Marta, Maestro Gilmartin, Luis Miguel, Avellaneda Martinez, Carlos, Alvarez Rodriguez, Virginia, Fernandez Rodriguez, Manuel, Guiu Marti, Alexandra Maria, Salmeron Beliz, Octavio J., Flores Quesada, Silvia, Troiano Ungerer, Osvaldo, Cano Rodriguez, Tania, Lapuerta Irigoyen, Luis, Andonegui, Carmen, Cortes, Nieves, Munoz Gamito, Gema, Valle Borrego, Beatriz, Arranz Betegon, Maria, Sierra Moreno, Angel, Chanovas Borras, Manel R., Urraca Gamaury, Ainhoa, Cruzado Quevedo, Jesus, Carpio Munoz, Veronica, Marchante Tejada, Cristobal, Menchaca, Bakarne, Modol Deltell, Josep Maria, Macias Lopez, Angel, Angeles Lecinera, Maria, Sarra Moreto, Salvador, Suero Mendez, Coral, Pendon Fernandez, Salvador, Rodriguez, Raimundo, Cardenete Aljama, Miguel Angel, Fernandez Rivas, Maite, Amador, Luis, Cobo Munoz, Jose Eduardo, Carrasco, Elena, Rodriguez Salazar, David, Nunez Orantos, Maria Jose, and Rodriguez Adrada, Esther

Subjects
sepsis, qSOFA, emergency, SIRS, infected older patient, prognosis, mortality
Abstract

Objective. The aim of this study was to determine the utility of a post hoc lactate added to SIRS and qSOFA score to predict 30-day mortality in older non-severely dependent patients attended for infection in the Emergency Department (ED). Methods. We performed an analytical, observational, prospective cohort study including patients of 75 years of age or older, without severe functional dependence, attended for an infectious disease in 69 Spanish ED for 2-day three seasonal periods. Demographic, clinical and analytical data were collected. The primary outcome was 30-day mortality after the index event. Results. We included 739 patients with a mean age of 84.9 (SD 6.0) years; 375 (50.7%) were women. Ninety-one (12.3%) died within 30 days. The AUC was 0.637 (IC 95% 0.587-0.688; p= 2 and 0.698 (IC 95% 0.635- 0.761; p= 2. Comparing receiver operating characteristic (ROC) there was a better accuracy of qSOFA vs SIRS (p=0.041). Both scales improve the prognosis accuracy with lactate inclusion. The AUC was 0.705 (IC95% 0.652-0.758; p

30. Impact of geriatric assessment variables on 30-day mortality among older patients with acute heart failure

Author

Javier Martin-Sanchez, Francisco, Rodriguez-Adrada, Esther, Teresa Vidan, Maria, Diez Villanueva, Pablo, Llopis Garcia, Guillermo, Gonzalez Del Castillo, Juan, Alberto Rizzi, Miguel, Alquezar, Aitor, Herrera Mateo, Sergio, Pinera, Pascual, Sanchez Nicolas, Jose Andres, Lazaro Aragues, Paula, Llorens, Pere, Herrero, Pablo, Jacob, Javier, Gill, Victor, Fernandez, Cristina, HECTOR BUENO, and Miro, Oscar

Subjects
Disability, Frailty, Patients, Confusional state, Mortalitat, Acute heart failure, Heart failure, Insuficiència cardíaca, Pacients, Mortality, Older people, Persones grans
Abstract

Objective. To study the impact of geriatric assessment variables on 30-day mortality among older patients with acute heart failure (AHF). Methods. Retrospective analysis of cases in the OAK Registry (Older Acute Heart Failure Key Data), a prospectively compiled database of consecutive patients aged 65 years or older treated for AHF in 3 Spanish emergency departments over a 4-month period (November-December 2011 and January-February 2014). The patients underwent a geriatric assessment adapted for emergency department use on weekdays between 8 AM and 10 PM. Demographic, clinical, laboratory, and geriatric assessment variables were recorded. The geriatric variables were concurrent diseases; polypharmacy; frailty; functional, social, and cognitive status at baseline; results of screening for confusional state, cognitive impairment, and depression; and nutritional status. The primary outcome was all-cause mortality at 30 days. Results. We included 565 patients with a mean (SD) age of 83 (7.1) years; 346 (61.6%) were women. Sixty-five (11.5%) died within 30 days. Independent factors associated with 30-day mortality were acute confusional state (adjusted odds ratio [aOR], 2.2; 95% CI, 1.0-4.8; P=.04), acute illness (aOR, 1.8; 95% CI, 0.9-3.4; P=.05), loss of appetite in the past 3 months (aOR, 1.8; 95% CI, 1.0-3.4; P=.04), frailty (aOR, 2.0, 95% CI, 1.0-4.1; P=.05), and severe disability (aOR, 4.4; 95% CI, 1.9-11.4; P=.01). Conclusions. Certain geriatric variables should be considered when assessing short-term risk in older patients with AHF.

33. Worsening renal function during an episode of acute heart failure and its relation to short- and long-term mortality: associated factors in the Epidemiology of Acute Heart Failure in Emergency Departments- Worsening Renal Function study.

Author

Llauger L, Jacob J, Arturo Moreno L, Aguirre A, Martín-Mojarro E, Romero-Carrete JC, Martínez-Nadal G, Tost J, Corominas-Lasalle G, Roset À, Cardozo C, Suñén-Cuquerella G, Alarcón B, Herrera-Mateo S, Ruibal JC, Alquézar-Arbé A, Gil V, Donea R, Berenguer M, Llorens P, Villanueva-Cutillas B, Martín-Sánchez FJ, Herrero P, and Miró Ò

Subjects
Acute Disease, Emergency Service, Hospital, Humans, Kidney physiology, Prognosis, Heart Failure epidemiology
Abstract

Objectives: To identify factors associated with worsening renal function (WRF) and explore associations with higher mortality in patients with acute heart failure (AHF)., Material and Methods: Seven emergency departments (EDs) in the EAHFE-EFRICA study (Spanish acronym for Epidemiology of AHF in EDs - WRF in AHF) consecutively included patients with AHF and creatinine levels determined in the ED and between 24 and 48 hours later. Patients with WRF were identified by an increase in creatinine level of 0.3 mg/dL or more. Forty-seven clinical characteristics were explored to identify those associated with WRF. To analyze for 30-day all-cause mortality we calculated odds ratios (ORs). To analyze mortality at the end of follow-up and by trimester, adjusted for between-group differences, we calculated hazard ratios (HRs). The data were analyzed by subgroups according to age, sex, baseline creatinine levels, AHF type, and risk group., Results: A total of 1627 patients were included. The subgroup of 220 (13.5%) with WRF were older, had higher systolic blood pressure, were more often treated with morphine, and had chronic renal failure; there was also a higher rate of hypertensive crisis as the trigger for AHF in patients with WRF. However, only chronic renal failure was independently associated with WRF (adjusted OR, 1.695; 95% CI, 1.264-2.273). The rate of 30-day mortality was 13.1% overall but higher in patients with WRF (20.9% vs 11.8% in patients without WRF; adjusted OR, 1.793; 95% CI, 1.207-2.664). Accumulated mortality at 18 months (average follow-up time, 14 mo/patient) was 40.0% overall but higher in patients with WRF (adjusted HR, 1.275; 95% CI, 1.018-1.598). Increased risk was greater in the first trimester. Subgroup analyses revealed no differences., Conclusion: AHF with WRF in the first 48 hours after ED care is associated with higher mortality, especially in the first trimester after the emergency.

Published
2020

34. Prognostic value of chest radiographs in patients with acute heart failure: the Radiology in Acute Heart Failure (RAD-ICA) study.

Author

Llorens P, Javaloyes P, Masip J, Gil V, Herrero-Puente P, Martín-Sánchez FJ, Jacob J, Garrido JM, Herrera-Mateo S, López Díez MP, Concepción-Aramendia L, and Miró Ò

Subjects
Acute Disease, Aged, 80 and over, Cardiomegaly diagnostic imaging, Cardiomegaly mortality, Emergency Service, Hospital, Female, Heart Failure mortality, Hospital Mortality, Humans, Length of Stay, Lung blood supply, Lung diagnostic imaging, Male, Patient Readmission, Pleural Effusion diagnostic imaging, Pleural Effusion mortality, Prognosis, Pulmonary Edema diagnostic imaging, Pulmonary Edema mortality, Time Factors, Heart Failure diagnostic imaging, Radiography, Thoracic
Abstract

Objectives: To determine whether chest radiographs can contribute to prognosis in patients with acute heart failure (AHF)., Material and Methods: Consecutive patients with AHF were enrolled by the participating emergency departments. Radiographic variables assessed were the presence or absence of evidence of cardiomegaly and pleural effusion and the pulmonary parenchymal pattern observed (vascular redistribution, interstitial edema, and/or alveolar edema). We gathered variables for the AHF episode and the patient's baseline state. Outcomes were in-hospital and 1-year mortality; hospital stay longer than 7 days, and a composite of events within 30 days of discharge (revisit, rehospitalization, and/or death). Crude and adjusted hazard ratios were calculated for the 3 categories of radiographic variables. The variables were also studied in combination., Results: A total of 2703 patients with a mean (SD) age of 81 (19) years were enrolled; 54.5% were women. Cardiomegaly was observed in 1711 cases (76.8%) and pleural effusion in 992 (36.7%). A pulmonary parenchymal pattern was observed in all cases, as follows: vascular redistribution in 1672 (61.9%), interstitial edema in 629 (23.3%) and alveolar edema in 402 (14.9%). The adjusted hazard ratios showed that cardiomegaly lacked prognostic value. However, the presence of pleural effusion was associated with a 23% (95% CI, 2%-49%) higher rate of the 30- day composite outcome; in-hospital mortality was 89% (30%-177%) higher in the presence of alveolar edema, and 1-year mortality was 38% (14%-67%) higher in association with vascular redistribution. The results for the variables in combination were consistent with the results for individual variables., Conclusion: A diagnostic chest radiograph can also contribute to the prediction of adverse events. Pleural effusion is associated with a higher rate of events after discharge, and alveolar edema is associated with higher mortality.

Published
2019

35. Patients with acute heart failure discharged from the emergency department and classified as low risk by the MEESSI score (multiple risk estimate based on the Spanish emergency department scale): prevalence of adverse events and predictability.

Author

Miró Ò, Gil V, Rosselló X, Martín-Sánchez FJ, Llorens P, Jacob J, Herrero P, Herrera Mateo S, Richard F, Escoda R, Fuentes M, Martín Mojarro E, Llauger L, Bueno H, and Pocock S

Subjects
Acute Disease, Adult, Aged, Aged, 80 and over, Female, Follow-Up Studies, Heart Failure mortality, Heart Failure therapy, Hospitalization statistics & numerical data, Humans, Logistic Models, Male, Middle Aged, Odds Ratio, Prognosis, Recurrence, Registries, Retrospective Studies, Risk Assessment, Spain, Emergency Service, Hospital standards, Heart Failure diagnosis, Patient Discharge standards, Severity of Illness Index
Abstract

Objectives: To determine the rate of adverse events in patients with acute heart failure (AHF) who were discharged from the emergency department (ED) after classification as low risk according to MEESSI score (multiple risk estimate based on the Spanish ED scale), to analyze the ability of the score to predict events, and to explore variables associated with adverse events., Methods: Patients in the EAHFE registry (Epidemiology of Acute Heart Failure in EDs) were stratified according to risk indicated by MEESSI score in order to identify those considered at low risk on discharge. All-cause 30-day mortality and revisits related to AHF within 7 days and 30 days were recorded. The area under the receiver operating characteristic curve (AUC) was calculated for the MEESSI score's ability to predict these events. Associations between 42 variables and 7-day and 30-day revisits to the ED were analyzed by multivariable logistic regression., Results: A total of 1028 patients were included. The 30-day mortality rate was 1.6% (95% CI, 0.9%-2.5%). The 7-day and 30-day revisit rates were 8.0% (95% CI, 6.4%-9.8%) and 24.7% (95% CI, 22.1%-25.7%), respectively. The AUCs for MEESSI score discrimination between patients with and without these outcomes were as follows: 30-day mortality, 0.69 (95% CI, 0.58-0.80); 7-day revisiting, 0.56 (95% CI, 0.49-0.63); and 30-day revisiting, 0.54 (95% CI, 0.50-0.59). Variables associated with 7-day revisits were long-term diuretic treatment (odds ratio [OR], 2.45; 95% CI, 1.01-5.98), hemoglobin concentration less than 110 g/L (OR, 1.68; 95% CI, 1.02-2.75), and intravenous diuretic treatment in the ED (OR, 0.53; 95% CI, 0.31-0.90). Variables associated with 30-day revisits were peripheral artery disease (OR, 1.74; 95% CI, 1.01-3.00), prior history of an AHF episode (OR, 1.42; 95% CI, 1.02-1.98), long-term mineralocorticoid receptor antagonist treatment (OR, 1.71; 95% CI, 1.09-2.67), Barthel index less than 90 points in the ED (OR, 1.48; 95% CI, 1.07-2.06), and intravenous diuretic treatment in the ED (OR, 0.58; 95% CI, 0.40-0.84)., Conclusion: Patients with AHF who are at low risk for adverse events on discharge from our EDs have event rates that are near internationally recommended targets. The MEESSI score, which was designed to predict 30-day mortality, is a poor predictor of 7-day or 30-day revisiting in these low-risk patients. We identified other factors related to these events.

Published
2019

36. Diagnosis of pulmonary embolism in the elderly: adherence to guidelines and age-adjusted D-dimer concentration values.

Author

Lozano-Polo L, Puig-Campmany M, Herrera-Mateo S, Mateo-Roca M, Santos-Rodríguez JA, and Benito-Vales S

Subjects
Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Biomarkers blood, Computed Tomography Angiography, Emergency Service, Hospital statistics & numerical data, Female, Health Status Indicators, Humans, Male, Middle Aged, Practice Guidelines as Topic, Pulmonary Embolism blood, Reference Values, Retrospective Studies, Spain, Young Adult, Emergency Service, Hospital standards, Fibrin Fibrinogen Degradation Products metabolism, Guideline Adherence statistics & numerical data, Pulmonary Embolism diagnosis
Abstract

Objectives: . The main purpose was to assess our emergency department's level of adherence to clinical practice guidelines (CPGs) for the diagnosis of pulmonary embolism in different age groups. The secondary aims were to study the utility and estimated the number of avoidable CT angiography with this approach of age-adjusted D-dimer concentrations in combination with the Wells score in the diagnosis of pulmonary embolism., Material and Methods: Retrospective observational study of a series of hemodynamically stable patients suspected of having pulmonary embolism in the emergency department of a tertiary care university hospital in 2012. Cases were identified in hospital discharge records on the basis of orders for D-dimer assays and computed tomography (CT) angiography of pulmonary arteries justified by suspicion of pulmonary embolism. We analyzed the degree of adherence to CPGs according to age groups, calculated the specificity and sensitivity of combining age-adjusted D-dimer test results and the Wells score, and estimated the number of potentially avoidable CT angiography procedures., Results: We found a total of 785 patients (mean age, 69 years; range, 18-97 years) suspected of having pulmonary embolism; 403 (51.3%) were women. Significant differences were detected in adherence to CPGs, depending on which clinical prediction models were used and patient age (50 years or younger, 69.7%-76.5% adherence; 65-74 years, 32.3%-53.2%; 75-84 years, 29.1%-46.8%; 85-89 years, 32.7%-41.8%; and 90 years or older, 24.4%-46.7%). Adherence was increased when D-dimer test result and the simplified Wells score were combined (increments of 10.4%, 8.0%, 13.6%, 11.1%, respectively in the following age groups: 65-74 years, 75-84 years, 85-89 years, and 90 years or older). Using an ageadjusted D-dimer cut-point increased diagnostic specificity (34.2% without such a cut-point vs 45.8% with one). The positive predictive value of the test also increased when an age-adjusted D-dimer cut-point was used (to 11.4%, from 9.6% without age adjustement). Seventy CT angiograph procedures (12.5%) could have been avoided by using age-adjusted cut-points., Conclusion: We observed different degrees of age-related adherence to CPGs in cases in which pulmonary embolism was suspected. Using the simplified Wells score combined with an age-adjusted cut-point for D-dimer assay positivity improved the specificity and positive predictive value of the D-dimer assessment in comparison with standard practice. Using age-adjusted D-dimer cut-points could decrease the number of pulmonary artery CT angiograms required.

Published
2018

37. Impact of geriatric assessment variables on 30-day mortality among older patients with acute heart failure.

Author

Martín-Sánchez FJ, Rodríguez-Adrada E, Vidán MT, Díez Villanueva P, Llopis García G, González Del Castillo J, Alberto Rizzi M, Alquézar A, Herrera Mateo S, Piñera P, Sánchez Nicolás JA, Lázaro Aragues P, Llorens P, Herrero P, Jacob J, Gil V, Fernández C, Bueno H, and Miró Ò

Subjects
Activities of Daily Living, Acute Disease, Aged, Aged, 80 and over, Emergency Service, Hospital, Female, Frail Elderly, Heart Failure diagnosis, Humans, Male, Nutritional Status, Registries, Retrospective Studies, Risk Factors, Geriatric Assessment, Heart Failure mortality
Abstract

Objetive: To study the impact of geriatric assessment variables on 30-day mortality among older patients with acute heart failure (AHF)., Methods: Retrospective analysis of cases in the OAK Registry (Older Acute Heart Failure Key Data), a prospectively compiled database of consecutive patients aged 65 years or older treated for AHF in 3 Spanish emergency departments over a 4-month period (November-December 2011 and January-February 2014). The patients underwent a geriatric assessment adapted for emergency department use on weekdays between 8 AM and 10 PM. Demographic, clinical, laboratory, and geriatric assessment variables were recorded. The geriatric variables were concurrent diseases; polypharmacy; frailty; functional, social, and cognitive status at baseline; results of screening for confusional state, cognitive impairment, and depression; and nutritional status. The primary outcome was all-cause mortality at 30 days., Results: We included 565 patients with a mean (SD) age of 83 (7.1) years; 346 (61.6%) were women. Sixty-five (11.5%) died within 30 days. Independent factors associated with 30-day mortality were acute confusional state (adjusted odds ratio [aOR], 2.2; 95% CI, 1.0–4.8; P=.04), acute illness (aOR, 1.8; 95% CI, 0.9–3.4; P=.05), loss of appetite in the past 3 months (aOR, 1.8; 95% CI, 1.0–3.4; P=.04), frailty (aOR, 2.0, 95% CI, 1.0–4.1; P=.05), and severe disability (aOR, 4.4; 95% CI, 1.9–11.4; P=.01)., Conclusions: Certain geriatric variables should be considered when assessing short-term risk in older patients with AHF.

Published
2018

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