Association between prehospital time interval and short-term outcome in acute heart failure patients

Masashi Takahashi, Shun Kosaka, Hiroaki Miyata, Tsutomu Yoshikawa, Atsutoshi Takagi, Kazumasa Harada, Takamichi Miyamoto, Tetsuo Sakai, Ken Nagao, Naoki Sato, Morimasa Takayama

研究成果: Article

37 引用 (Scopus)

抄録

Background: Acute heart failure (AHF) is one of the most frequently encountered cardiovascular conditions that can seriously affect the patient's prognosis. However, the importance of early triage and treatment initiation in the setting of AHF has not been recognized. Methods and Results: The Tokyo Cardiac Care Unit Network Database prospectively collected information of emergency admissions to acute cardiac care facilities in 2005-2007 from 67 participating hospitals in the Tokyo metropolitan area. We analyzed records of 1,218 AHF patients transported to medical centers via emergency medical services (EMS). AHF was defined as rapid onset or change in the signs and symptoms of heart failure, resulting in the need for urgent therapy. Patients with acute coronary syndrome were excluded from this analysis. Logistic regression analysis was performed to calculate the risk-adjusted in-hospital mortality. A majority of the patients were elderly (76.1 ± 11.5 years old) and male (54.1%). The overall in-hospital mortality rate was 6.0%. The median time interval between symptom onset and EMS arrival (response time) was 64 minutes (interquartile range [IQR] 26-205 minutes), and that between EMS arrival and ER arrival (transportation time) was 27 minutes (IQR 9-78 minutes). The risk-adjusted mortality increased with transportation time, but did not correlate with the response time. Those who took >45 minutes to arrive at the medical centers were at a higher risk for in-hospital mortality (odds ratio 2.24, 95% confidence interval 1.17-4.31; P =.015). Conclusions: Transportation time correlated with risk-adjusted mortality, and steps should be taken to reduce the EMS transfer time to improve the outcome in AHF patients.

元の言語English
ページ(範囲)742-747
ページ数6
ジャーナルJournal of Cardiac Failure
17
発行部数9
DOI
出版物ステータスPublished - 2011 9
外部発表Yes

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Heart Failure
Emergency Medical Services
Hospital Mortality
Tokyo
Cardiac Care Facilities
Reaction Time
Mortality
Triage
Acute Coronary Syndrome
Signs and Symptoms
Emergencies
Logistic Models
Odds Ratio
Regression Analysis
Databases
Confidence Intervals
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

これを引用

Association between prehospital time interval and short-term outcome in acute heart failure patients. / Takahashi, Masashi; Kosaka, Shun; Miyata, Hiroaki; Yoshikawa, Tsutomu; Takagi, Atsutoshi; Harada, Kazumasa; Miyamoto, Takamichi; Sakai, Tetsuo; Nagao, Ken; Sato, Naoki; Takayama, Morimasa.

:: Journal of Cardiac Failure, 巻 17, 番号 9, 09.2011, p. 742-747.

研究成果: Article

Takahashi, M, Kosaka, S, Miyata, H, Yoshikawa, T, Takagi, A, Harada, K, Miyamoto, T, Sakai, T, Nagao, K, Sato, N & Takayama, M 2011, 'Association between prehospital time interval and short-term outcome in acute heart failure patients', Journal of Cardiac Failure, 巻. 17, 番号 9, pp. 742-747. https://doi.org/10.1016/j.cardfail.2011.05.005
Takahashi, Masashi ; Kosaka, Shun ; Miyata, Hiroaki ; Yoshikawa, Tsutomu ; Takagi, Atsutoshi ; Harada, Kazumasa ; Miyamoto, Takamichi ; Sakai, Tetsuo ; Nagao, Ken ; Sato, Naoki ; Takayama, Morimasa. / Association between prehospital time interval and short-term outcome in acute heart failure patients. :: Journal of Cardiac Failure. 2011 ; 巻 17, 番号 9. pp. 742-747.
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abstract = "Background: Acute heart failure (AHF) is one of the most frequently encountered cardiovascular conditions that can seriously affect the patient's prognosis. However, the importance of early triage and treatment initiation in the setting of AHF has not been recognized. Methods and Results: The Tokyo Cardiac Care Unit Network Database prospectively collected information of emergency admissions to acute cardiac care facilities in 2005-2007 from 67 participating hospitals in the Tokyo metropolitan area. We analyzed records of 1,218 AHF patients transported to medical centers via emergency medical services (EMS). AHF was defined as rapid onset or change in the signs and symptoms of heart failure, resulting in the need for urgent therapy. Patients with acute coronary syndrome were excluded from this analysis. Logistic regression analysis was performed to calculate the risk-adjusted in-hospital mortality. A majority of the patients were elderly (76.1 ± 11.5 years old) and male (54.1{\%}). The overall in-hospital mortality rate was 6.0{\%}. The median time interval between symptom onset and EMS arrival (response time) was 64 minutes (interquartile range [IQR] 26-205 minutes), and that between EMS arrival and ER arrival (transportation time) was 27 minutes (IQR 9-78 minutes). The risk-adjusted mortality increased with transportation time, but did not correlate with the response time. Those who took >45 minutes to arrive at the medical centers were at a higher risk for in-hospital mortality (odds ratio 2.24, 95{\%} confidence interval 1.17-4.31; P =.015). Conclusions: Transportation time correlated with risk-adjusted mortality, and steps should be taken to reduce the EMS transfer time to improve the outcome in AHF patients.",
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AU - Takagi, Atsutoshi

AU - Harada, Kazumasa

AU - Miyamoto, Takamichi

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