PT045 Epidemiological profile of patients with suspected Heart Failure, subjected to BNP test, assisted in the Emergency Room of a Tertiary Hospital in south Brazil

ObjectivesThis study aims to investigate the prevalence of impairment of activities of daily living (ADLs) in older patients with heart failure (HF), and to examine the impact of ADL impairment on readmission after discharge.Design and settingsA prospective cohort study was conducted in patients aged ≥65 years with HF admitted to a tertiary hospital in Vietnam from August 2016 to June 2017. Difficulties with six ADLs were assessed by a questionnaire. Participants were classified into two categories (with and without ADL impairment). The associations of ADL impairment with 3-month readmission were examined using logistic regression models.ResultsThere were 180 participants (mean age 80.6±8.2, 50% female) and 26.1% were classified as having ADL impairment. The most common impaired activity was bathing (21.1%), followed by transferring (20.0%), toileting (12.2%), dressing (8.9%), eating (3.3%), and continence (2.8%). During 3-month follow-up, 32.8% of the participants were readmitted to hospitals (55.3% in participants with ADL impairment, 24.8% in those without ADL impairment, p<0.001). ADL impairment significantly increased the risk of 3-month readmission (adjusted OR 2.75, 95% CI 1.25 to 6.05, p=0.01).ConclusionsIn summary, ADL impairment was common in older hospitalised patients with HF and was associated with increased readmission. These findings suggest further studies on ADL assessment and intervention during transition care for older patients with HF after discharge to prevent readmission.

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Comparison of lung bedside ultrasound and BNP in the diagnosis of acute heart failure in the emergency department

Journal of Research in Clinical Medicine ◽

10.34172/jrcm.2020.050 ◽

2020 ◽

Vol 8 (1) ◽

pp. 50-50

Author(s):

Seyed Hossein Ojaghi Haghighi ◽

Neda Hamed ◽

Shiva Ebrahimi ◽

Jafar Ghobadi ◽

Hoorolnesa Ameli

Keyword(s):

Heart Failure ◽

Emergency Room ◽

Pulmonary Edema ◽

Acute Heart Failure ◽

Lung Ultrasound ◽

P Value ◽

Ultrasound Evaluation ◽

Ultrasound Findings ◽

Medical Advances ◽

B Lines

Introduction: Congestive heart failure is heart muscle failure that causes pulmonary congestion and eventually pulmonary edema, which despite recent medical advances, is still a progressive syndrome with high mortality, the prevalence of which has increased in recent decades. Therefore, in this study we compared lung ultrasound findings in acute heart failure patients with the BNP. Methods: This study was performed in the emergency room of Imam Reza hospital in Tabriz. For patients entering the emergency room after taking a history, both standard gold (BNP) tests and beside ultrasound of the lung were performed. Ultrasound was performed at the same time as obtaining blood sample to ensure that the ultrasound specialist did not know the result of diagnosis. During the ultrasound, if there were multiple B-Lines that were at least 3 mm apart, patient was diagnosed with pulmonary edema due to heart failure. Results: Number of participants in this study was 108 people, 54.6% of whom were men and the rest were women. The correlation coefficient between width and number of kerley lines was 0.79, between NT-pro BNP and width of kerley lines was 0.65 and between NT-pro BNP and number of kerley lines was 0.77, which indicates a significant positive correlation (P value <0.001). Conclusion: The results of present study showed that in patients with acute heart failure, the number and width of kerley lines in pulmonary ultrasound evaluation increase rapidly. There is also a high correlation between number and length of kerley lines with NT-pro BNP serum values.

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Interprofessional collaboration: Reducing readmissions for heart failure patients utilizing a referral process in the emergency room

Heart & Lung ◽

10.1016/j.hrtlng.2015.10.037 ◽

2015 ◽

Vol 44 (6) ◽

pp. 558-559

Author(s):

Amanda B. Thompson ◽

Byran Keith Robinette

Keyword(s):

Heart Failure ◽

Emergency Room ◽

Interprofessional Collaboration ◽

Referral Process ◽

Heart Failure Patients

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Long-term and clinical profile of heart failure with recovered ejection fraction in a non-tertiary hospital

Medicina Clínica (English Edition) ◽

10.1016/j.medcle.2018.11.017 ◽

2019 ◽

Vol 152 (2) ◽

pp. 50-54

Author(s):

Virgilio Martínez-Mateo ◽

Manuel Fernández-Anguita ◽

Laura Cejudo ◽

Eugenia Martín-Barrios ◽

Antonio J. Paule

Keyword(s):

Heart Failure ◽

Ejection Fraction ◽

Tertiary Hospital ◽

Clinical Profile

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Letter to the Editor: Delayed Presentation of Non-COVID-19 Patients During the COVID-19 Pandemic Is Not Limited to Children

Rambam Maimonides Medical Journal ◽

10.5041/rmmj.10447 ◽

2021 ◽

Vol 12 (3) ◽

pp. e0026

Author(s):

Klaus Rose ◽

◽

Oishi Tanjinatus ◽

Jane Grant-Kels ◽

Earl B. Ettienne ◽

...

Keyword(s):

Heart Failure ◽

Down Syndrome ◽

Head And Neck Cancer ◽

Emergency Room ◽

Ewing Sarcoma ◽

Pulmonary Thromboembolism ◽

Young Patients ◽

The Other ◽

Delayed Presentation ◽

Pediatric Department

We read with interest the report about four minors who were diagnosed late with non-COVID-19 diseases during the COVID-19 pandemic. We would like to emphasize that, firstly, such delays are not limited to minors, and secondly, that also in minors should we distinguish the administrative and the physiological meanings of the term “child” and hence distinguish administratively defined “children” who bodily are already mature from those young patients who bodily are indeed still children. The 16-year-old patient that was presented to the emergency room with endocarditis was bodily no longer a child, although administratively and probably also psychologically, due to his Down syndrome, he was still a child. Two of the other patients, one with hemolytic anemia (2.5 years old) and one with Ewing sarcoma (4 years old), were still pre-pubertal children, while the 13-year-old minor with a septic hip was already adolescent. The author of the cited paper works in a pediatric department and reports those patients that he has seen during his work. However, in our view there is nothing specifically pediatric in his observations. Several recent papers discuss delays of diagnosis and treatment of non-COVID-19 diseases during the pandemic, including head and neck cancer, appendicitis, heart failure and septicemia, pulmonary thromboembolism,6 pyelonephritis, and cancer in general.8 Some patients in these papers are administratively still “children,” some are adults, and appendicitis is discussed in both.3,4 The delay the COVID-19 pandemic has caused in the timely diagnosis of various diseases is not a “pediatric” challenge, but a challenge for medicine in general.

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Epidemiological Profile of Skin Diseases in a Tertiary Hospital of Kathmandu: An Annual Census

Nepal Journal of Dermatology Venereology & Leprology ◽

10.3126/njdvl.v19i1.34349 ◽

2021 ◽

Vol 19 (1) ◽

pp. 14-19

Author(s):

Sushil Paudel ◽

Rabindra Sharma ◽

Sudip Dahal ◽

Indu Acharya Paudel

Keyword(s):

Chronic Urticaria ◽

Skin Diseases ◽

Adult Population ◽

Current Trend ◽

Tertiary Hospital ◽

Disease Patterns ◽

Common Diagnosis ◽

Epidemiological Profile ◽

Infective Etiology ◽

Ethical Clearance

Introduction: Skin diseases are eighth most common reasons for outpatient in Nepal, and fourth cause of disability globally. Skin diseases varies with the reason, season and socioeconomic status. As the socioeconomic conditions are changing, so are the disease patterns. We planned to report the current trend of skin diseases in Kathmandu and compare with similar studies in past. Materials and methods: Outpatient department records of Civil Service Hospital from the year 2075 Bikram Sambat were reviewed after ethical clearance from institution review committee and were analyzed after tabulation. Results: Total number of cases were 9886 (4.51% of total hospital attendance). In total 8097 cases were new, males were 4218 (52.1%) and females 3879 (47.9%). Most common diagnosis was eczemas (18.47%), followed by dermatophytosis (15.29%). Eczemas, chronic urticaria, psoriasis and lichen planus were more common in the adult population of more than 30 years. While infections and acne were more common in young adults, 15-30 years, in both the sexes. Tinea was common during summer and so was scabies in males, while in females, melasma peaked in summer and chronic urticaria during spring and winter. Conclusion: The pattern of skin diseases is changing with the time. Diseases of possible allergic and immunologic etiology are increasing and diseases with infective etiology are still a huge burden on society.

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Prevalence, Types and Clinical Presentation of Heart Failure among Hypertensive Patients Seen at a Tertiary Hospital in Dar Es Salaam, Tanzania

International Journal of Clinical Cardiology ◽

10.23937/2378-2951/1410230 ◽

2021 ◽

Vol 8 (3) ◽

Author(s):

Nyaisonga Gervas George ◽

Chillo Pilly

Keyword(s):

Heart Failure ◽

Clinical Presentation ◽

Tertiary Hospital ◽

Dar Es Salaam ◽

Hypertensive Patients

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Epidemiological profile of patients with Calcium Pyrophosphate Deposition (CPPD) Disease at a Tertiary Hospital

10.47660/cbr.2021.2044 ◽

2021 ◽

Author(s):

Adriana Cristiane Machado ◽

Renata Maria Monteiro Pinto ◽

Barbara Luzia Berredo Reis Alexandre ◽

Marina de Azevedo Martins ◽

Paula de Medeiros Nacácio e Silva ◽

...

Keyword(s):

Tertiary Hospital ◽

Calcium Pyrophosphate ◽

Epidemiological Profile

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Abstract TP300: Re-admissions in Patients With First Onset of Stroke - Looking Beyond Organ Systems

Stroke ◽

10.1161/str.48.suppl_1.tp300 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Umer Khan ◽

Chen Hui Yee ◽

Louis S Widjaja ◽

Bernard P Chan ◽

Prakash Paliwal ◽

...

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Care Coordination ◽

Recurrent Stroke ◽

Previous History ◽

Risk Groups ◽

Tertiary Hospital ◽

Targeted Interventions ◽

Organ Systems ◽

Tract Infections

Background: Patients who suffer from a stroke are susceptible to multiple complications, with readmission rates ranging from 20-40% per year, and approximately 25% of readmissions occurring within the first month 1 . Major reasons contributing to readmissions include recurrent stroke (24%), infection (12%), chest pain or myocardial infarction (10%), worsening of stroke symptoms (7%), arrhythmias (7%), and congestive heart failure (3%) 2 . However, additional potentially reversible risk factors have not been extensively studied. Methods: This retrospective study was conducted at a tertiary hospital in Singapore and included 1283 patients who were admitted for stroke between Jan 2014 and Oct 2015. All patients who had previous history of stroke or died on initial presentation were excluded from the study, leaving 957 patients with first stroke presentation. The dates and diagnoses of readmissions in the first 90 days were collected. Elective admissions or readmissions due to recurrent strokes or coronary syndromes were excluded to focus on readmissions due to infections, medication side effects, falls, or care coordination issues. Results: Out of 957 patients, 129 (13.4%) were readmitted within 90 days. 98 (10.2%) were readmitted once in 90 days, while 31 (3.2%) were readmitted multiple (2-7) times. The single readmission group showed a bi-modal distribution with 35.7% of readmissions occurring in the first 15 days, 15.3% in 15-30 days, 34.7% in 30-60 days, and 24.5% in 60-90 days after discharge. In the single readmission group, 36.7% of patients were readmitted for infections (15.3% were urinary tract infections, 21.4% were chest infections), 12.2% were admitted for congestive heart failure symptoms, and 17.3% were admitted for falls or care coordination issues. A majority (59%) of readmitted patients were over the age of 70. 24% of the patients had a middle cerebral artery (MCA) stroke, and 34% had a decrease in function of activities of daily living on discharge. Conclusion: This study helps to highlight high risk groups for readmissions i.e. patients over the age of 70 years, reduction in function on discharge, and patients with MCA strokes, suitable for targeted interventions in order to reduce rate of readmissions in patients with first stroke.

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