Association between the visiting time and the clinical findings on admission in patients with acute heart failure.

Background: There have been few reports about the clinical significance of the time of admission for acute heart failure (AHF). Methods: Five hundred thirty-one patients with AHF admitted to the intensive care unit (ICU) were ana-lyzed. The patients were assigned to either the daytime HF group (n = 195, visited from 08:00 to 20:00, Group D) or nighttime HF group (n = 336, visited from 20:00 to 08:00, Group N). The clinical findings and outcomes were compared between these groups. Results: The systolic blood pressure (SBP), the number of patients with clinical scenario (CS) 1, and the heart rate (HR) were significantly higher in group N (SBP, 171.0±38.9mmHg; CS 1, 80.9%; HR, 116.9±28.0beats/min) than in group D (SBP, 154.2±37.1 mmHg; CS 1, 66.2%; HR, 108.6 ± 31.4 beats/min). The patients in group N were more likely to have orthopnea (91.1%) than those in group D (70.3%). A multivariate logistic regression model identified a SBP >164 mmHg [odds ratio (OR): 2.043; 95% confidence interval (CI): 1.383-3.109], HR >114beats/min (OR: 1.490; 95%CI: 1.001-2.218), and orthopnea (OR: 2.257; 95%CI: 1.377-3.701) to be independently associated with Group N. The length of ICU stay was shorter in group N (5.8 ± 10.5 days) than in group D (7.8 ± 11.5 days). Conclusion: The nighttime HF was characterized by high SBP, high HR, and orthopnea, and the length of ICU stay was shorter in the nighttime HF group. [ABSTRACT FROM AUTHOR]