Comparision of the treatment and short-term and one-year prognosis from acute heart failure in tertiary hospitals versus secondary hospitals-findings from Beijing Acute Heart Failure Registry (Beijing AHF Registry)
- VernacularTitle:比较北京地区不同级别医院急性心力衰竭临床治疗现状及短期和一年预后——Beijing AHF Registry研究
- Author:
Xiaolu SUN
1
;
Guogan WANG
;
Jian QIN
;
Chunsheng LI
;
Xuezhong YU
;
Hong SHEN
;
Lipei YANG
;
Yan FU
;
Yaan ZHENG
;
Bin ZHAO
;
Dongmin YU
;
Fujun QIN
;
Degui ZHOU
;
Ying LI
;
Fujun LIU
;
Wei LI
;
Wei ZHAO
;
Yanmin YANG
;
Huiqiong TAN
;
Litian YU
;
Xin GAO
;
Zheng WANG
;
Ming JIN
;
Hong ZENG
;
Yi LI
;
Guoxing WANG
;
Hong ZHOU
;
Xin WANG
;
Yan LIU
;
Fen XU
;
Zhiqiang LI
;
Lisheng YANG
;
Aichun JIN
;
Pengbo WANG
;
Sijia WANG
;
Ruohua YAN
;
Leyu LIN
;
Fusheng WANG
;
Hui LIU
Author Information
- Keywords: Acute heart failure; Prognosis; Treatment; Mortality; Emergency department
- From: Chinese Journal of Emergency Medicine 2018;27(1):85-92
- CountryChina
- Language:Chinese
- Abstract: Objective To assess and compare the incidence,clinical characteristics,treatment,and prognosis of acute heart failure patients from different grades hospitals in Beijing.Methods In this prospective internet prognosis registered study (Beijing AHF Registry),a total of 3 335 consecutive patients admitted to 14 emergency departments in Beijing from January 1st 2011 to September 23rd 2012 were enrolled.According to hospital grade,these patients were divided into two groups,349 patients were from secondary hospitals,and 2 956 patients were from tertiary hospitals.Results Among the 3 335 patients,the medium age was 71 (58,79) years,and male accounted for 53.16％.The most common underlying disease were coronary disease (43.27％),hypertension (17.73％),cardiomyopathy (16.07％) etc.The average treatment time in Emergency Department was 66.82 h.The emergency department mortality rate was 3.81％ (127 cases).The 30-day and 1-year cumulative all-cause mortality were 15.3％ and 32.27％,respectively.The 30-day and 1-year cumulative all-cause readmission were 15.64％ and 46.89％,respectively.Compared with patients in tertiary hospitals,patients in secondary hospitals had more onset acute heart failure patients (63.64％ vs.49.93％),shorter emergency department treatment time (12 h vs.41 h),lower discharge rate (3.43％ vs.37.45％) and emergency department mortality(1.58％ vs.4.09％).Compared with those in tertiary hospitals,1-year cumulative all-cause mortality (25.6％ vs.33.2％),cardiovascular disease mortality (20.2％ vs.26.0％),aggravated heart failure mortality (22.4％ vs.28.8％) were lower in secondary hospitals.Following propensity score matching,compared to tertiary hospitals,patients in secondary hospitals showed lower utilization rate of beta-blockers and ACEFARB (4.51％ vs.28.17％,1.41％ vs.9.58％),except the pironolactone.Conclusion Acute heart failure in emergency department is associated with a high mortality rate and readmission rate.There is still a big gap between guidelines recommend medication current treatments for acute heart failure.
