Clinical characteristics of patients hospitalized for acute heart failure according to hospital arrival timing

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• 作者：Mitsutoshi Oguri ; MD ; PhD^a ; ^{oguricap0909@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Hideki Ishii ; MD ; PhD^b ; Kenichiro Yasuda ; MD^c ; Hiroshi Kawanishi ; MD^c ; Yoshihiro Hanaki ; MD ; PhD^d ; Haruo Kamiya ; MD ; PhD^c ; Tatsuaki Matsubara ; MD ; PhD ; FJCC^e ; Toyoaki Murohara ; MD ; PhD ; FJCC^b
• 关键词：Heart failure ; Patient characteristics ; Prognosis
• 刊名：Journal of Cardiology
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：68
• 期：5
• 页码：379-383
• 全文大小：344 K

文摘

Whether clinical characteristics and outcomes in patients suffering acute heart failure (AHF) vary according to the timing of hospital arrival is unclear. We aimed to evaluate differences between subjects presenting in the daytime and nighttime.

absSec_2">Methods

ar0010">A total of 679 patients with AHF were examined, classified into the two groups from the viewpoint of hospital arrival period into daytime (n = 370; 8 am–6 pm) and nighttime (n = 309; 6 pm–8 am).

absSec_3">Results

ar0015">The prevalence of malnutrition and longer pre-hospital delay (≥48 h) were greater, whereas a previous history of myocardial infarction, proportion of arrival by ambulance, and the frequency of New York Heart Association class IV symptoms, as well as systolic and diastolic blood pressure, and heart rate were lower in subjects presenting in the daytime. Patients with malnutrition defined as 5 ≥ of the Controlling Nutrition Status scores demonstrate a longer pre-hospital delay compared to those without (34.2% vs. 19.9%, p < 0.05). There was no significant difference in the 30-day outcomes but length of stay was significantly longer in subjects presenting in the daytime than in the nighttime. Multivariable logistic regression analysis revealed that systolic blood pressure, malnutrition, and chronic kidney disease were significantly related to prolonged length of stay.

absSec_4">Conclusions

ar0020">Our present results suggest that patients with AHF who present in the daytime may have higher rate of malnutrition status and lower systolic blood pressure compared to those presenting in the nighttime.