Abstract
BackgroundAcute decompensated heart failure (ADHF) is a life-threatening disease that requires emergent intervention. Although noninvasive positive pressure ventilation (NPPV) is crucial for treating ADHF, the earliest time point for administering NPPV remains unknown. In this study, we hypothesized that early NPPV administration for patients with acute heart failure in the emergency department (ED) would lead to a better outcome.MethodologyThis is a single-center retrospective cohort study at an ED of a community hospital in Japan. The data were collected from consecutive patients who were administered NPPV for ADHF in the ED from April 2016 to September 2018. The primary exposure was the timing of NPPV administration (within 30 minutes versus over 30 minutes after arrival). The primary outcome was 30-day mortality.ResultsA total of 115 patients were included in this study. Overall, the median age was 78 (interquartile range [IQR] = 70-84 years), and 63 (54.9%) patients were male. The median time from the arrival at the ED to NPPV administration for the patients was 14 minutes (IQR = 8-30 minutes). Overall, 72% (83/115) of the patients were categorized as early administration group (<30 minutes). The total 30-day mortality was 7.0% (8/115), and the total tracheal intubation rate was 11% (13/115). Early NPPV administration for patients with ADHF was associated with lower 30-day mortality (3.6% vs. 16%; p = 0.04) and shorter length of oxygenation (four days vs. seven days; p < 0.01). Multivariate logistic regression test showed that 30-day mortality was significantly lower in the early treatment group (adjusted odds ratio = 0.19; 95% confidential interval = 0.04-0.90).ConclusionsAlthough further investigation is needed, early NPPV administration for patients with ADHF in the ED was associated with lower 30-day mortality.
Highlights
Acute decompensated heart failure (ADHF) is a life-threatening disease and a common medical emergency that accounts for up to one million hospital admissions for acute conditions each year in the United States [1]
noninvasive positive pressure ventilation (NPPV) administration for patients with ADHF was associated with lower 30-day mortality (3.6% vs. 16%; p = 0.04) and shorter length of oxygenation
Further investigation is needed, early NPPV administration for patients with ADHF in the emergency department (ED) was associated with lower 30-day mortality
Summary
Acute decompensated heart failure (ADHF) is a life-threatening disease and a common medical emergency that accounts for up to one million hospital admissions for acute conditions each year in the United States [1]. Because in-hospital mortality associated with ADHF is still high [2], establishing effective treatment is an important issue worldwide. Both the American Heart Association (AHA) and the European Society of Cardiology (ESC) guidelines recommend the use of noninvasive positive pressure ventilation (NPPV) for patients with ADHF [3,4]. Acute decompensated heart failure (ADHF) is a life-threatening disease that requires emergent intervention. We hypothesized that early NPPV administration for patients with acute heart failure in the emergency department (ED) would lead to a better outcome
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.