scholarly journals Saharan Dust Events in the Dust Belt -Canary Islands- and the Observed Association with in-Hospital Mortality of Patients with Heart Failure

2020 ◽  
Vol 9 (2) ◽  
pp. 376 ◽  
Author(s):  
Alberto Dominguez-Rodriguez ◽  
Néstor Baez-Ferrer ◽  
Sergio Rodríguez ◽  
Pablo Avanzas ◽  
Pedro Abreu-Gonzalez ◽  
...  

Recent studies have found increases in the cardiovascular mortality rates during poor air quality events due to outbreaks of desert dust. In Tenerife, we collected (2014–2017) data in 829 patients admitted with a heart failure diagnosis in the Emergency Department of the University Hospital of the Canaries. In this region, concentrations of PM10 and PM2.5 are usually low (~20 and 10 µg/m3), but they increase to 360 and 115 μg/m3, respectively, during Saharan dust events. By using statistical tools (including multivariable logistic regressions), we compared in-hospital mortality of patients with heart failure and exposure to PM10 and PM2.5 during dust and no-dust events. We found that 86% of in-hospital heart failure mortality cases occurred during Saharan dust episodes that resulted in PM10 > 50 µg/m3 (interquartile range: 71–96 µg/m3). A multivariate analysis showed that, after adjusting for other covariates, exposure to Saharan dust events associated with PM10 > 50 µg/m3 was an independent predictor of heart failure in-hospital mortality (OR = 2.79, 95% CI (1.066–7.332), p = 0.03). In conclusion, this study demonstrates that exposure to high Saharan dust concentrations is independently associated with in-hospital mortality in patients with heart failure.

2019 ◽  
Vol 72 (1) ◽  
pp. 112-119 ◽  
Author(s):  
Piotr Feusette ◽  
Marek Gierlotka ◽  
Andrzej Tukiendorf ◽  
Joanna Płonka ◽  
Jarosław Bugajski ◽  
...  

Heart failure appears in 2% of the adult population in Europe. One in five people aged 40 years will develop heart failure during their lifetime. Heart failure touch 20,000 people in the Opole province. Heart failure is the second, after acute coronary syndromes, urgent cause of admissions to the Clinic of Cardiology at the University Hospital in Opole. The paper presents the prognosis of hospitalization of patients with heart failure for the years 2015-2050 taking into account the processes of depopulation taking place in our region. The analysis makes it possible to predict that the age group particularly exposed to heart failure in the coming decades will be people who today belong to teenagers and young adults. The article presents current methods of treatment of heart failure. Improvement in the prognosis of patients with heart failure can occur through the implementation of the guidelines for treatment of heart failure recommended by the ESC. This goal is to be achieved by introducing the “Comprehensive care for patients with heart failure (KONS)” program in our country. The shift of the burden of care for patient with heart failure to outpatient unit will result in a significant reduction in the number of hospitalizations.


2014 ◽  
Vol 9 (5-6) ◽  
pp. 227-227
Author(s):  
Ante Matana ◽  
Luka Zaputovic ◽  
Teodora Zaninovic Jurjevic ◽  
Alen Ruzic ◽  
Daniela Malic ◽  
...  

2022 ◽  
Vol 8 ◽  
Author(s):  
Masatake Kobayashi ◽  
Amine Douair ◽  
Stefano Coiro ◽  
Gaetan Giacomin ◽  
Adrien Bassand ◽  
...  

Background: Patients with heart failure (HF) often display dyspnea associated with pulmonary congestion, along with intravascular congestion, both may result in urgent hospitalization and subsequent death. A combination of radiographic pulmonary congestion and plasma volume might screen patients with a high risk of in-hospital mortality in the emergency department (ED).Methods: In the pathway of dyspneic patients in emergency (PARADISE) cohort, patients admitted for acute HF were stratified into 4 groups based on high or low congestion score index (CSI, ranging from 0 to 3, high value indicating severe congestion) and estimated plasma volume status (ePVS) calculated from hemoglobin/hematocrit.Results: In a total of 252 patients (mean age, 81.9 years; male, 46.8%), CSI and ePVS were not correlated (Spearman rho <0 .10, p > 0.10). High CSI/high ePVS was associated with poorer renal function, but clinical congestion markers (i.e., natriuretic peptide) were comparable across CSI/ePVS categories. High CSI/high ePVS was associated with a four-fold higher risk of in-hospital mortality (adjusted-OR, 95%CI = 4.20, 1.10-19.67) compared with low CSI/low ePVS, whereas neither high CSI nor ePVS alone was associated with poor prognosis (all-p-value > 0.10; Pinteraction = 0.03). High CSI/high ePVS improved a routine risk model (i.e., natriuretic peptide and lactate)(NRI = 46.9%, p = 0.02), resulting in high prediction of risk of in-hospital mortality (AUC = 0.85, 0.82-0.89).Conclusion: In patients hospitalized for acute HF with relatively old age and comorbidity burdens, a combination of CSI and ePVS was associated with a risk of in-hospital death, and improved prognostic performance on top of a conventional risk model.


2019 ◽  
Vol 09 (01) ◽  
pp. 42-50
Author(s):  
Camara Youssouf ◽  
Ba Hamidou Oumar ◽  
Sangare Ibrahima ◽  
Toure Karamba ◽  
Coulibaly Souleymane ◽  
...  

ESC CardioMed ◽  
2018 ◽  
pp. 1758-1762
Author(s):  
Pardeep S. Jhund

The clinical history aims to elicit the symptoms that are commonly experienced by patients with heart failure such as dyspnoea, paroxysmal nocturnal dyspnoea, orthopnoea, and fatigue. The history may also provide clues as to the aetiology of heart failure and symptoms that suggest alternative diagnoses. Similarly, signs that are elicited on clinical examination are used to support the diagnosis of heart failure. In addition, they can be used to determine prognosis and assess response to treatment or the need for more intensive treatment. Common signs such as peripheral oedema, jugular venous distension, and pulmonary crackles are less specific for the diagnosis of heart failure than others such as a third heart sound. The presence of some clinical signs may help determine the aetiology of heart failure and indicate other potential diagnoses that may present like heart failure but require very different treatment. While signs and symptoms are used in conjunction with imaging evidence and raised natriuretic peptides to make the diagnosis of heart failure, the electrocardiogram (ECG) still plays a central role. The ECG can be used to determine underlying aetiology (such as evidence of prior myocardial infarction) and guide therapeutic decision-making such as the need for cardiac resynchronization therapy in those with bundle branch block. Information on symptoms, signs, and investigations such as the ECG need to be integrated to ensure the accurate diagnosis and optimal treatment of patients with heart failure.


Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 4482-4482
Author(s):  
Britton Keeshan ◽  
Kimberly Y Lin ◽  
Matthew J O'Connor ◽  
Jill P Ginsberg ◽  
Richard Aplenc ◽  
...  

Abstract Introduction: Cardiomyopathy is a well-described complication of cancer therapy in pediatric patients. However, the prevalence and outcomes of heart failure related hospitalizations in these patients are unknown. We hypothesize that while heart failure related hospitalizations are uncommon in pediatric oncology patients, they are likely associated with increased morbidity and mortality. Methods: We performed retrospective analysis of the Healthcare Cost and Utilization Project Kids' Inpatient Database, a nationwide database of pediatric hospitalizations in the United States, for oncology patients with and without heart failure for years 2000, 2003, 2006, and 2009. Results: Heart failure was identified in 914 of 259,432 (0.4%) pediatric oncology admissions. Patients with heart failure were more likely to be non-white (52.2 vs 43%, p<0.001), less likely to be in the highest income bracket (23.9 vs 27.5%, p=0.014), more likely to have leukemia (40.7 vs 31.3%, p<0.001), and more likely to undergo bone marrow transplantation on admission (5.0 vs 1.6%, p<0.001). Several morbidities were significantly more common in patients with heart failure including respiratory failure [16.4% vs 1.3%, odds ratio (OR) 14.6, 95% CI 12.2-17.4), sepsis (21.9% vs 7.2%, OR 3.6, 95% CI 3.1-4.3), stroke (1.5% vs 0.6%, OR 2.5, 95% CI 1.5-4.3), and renal failure (11.7% vs 1.2%, OR 10.9, 95% CI 8.9-13.3). Length of stay (LOS) and hospital charges were also significantly greater in oncology patients with heart failure patients compared to those without; median LOS 9 (IQR 4-25) vs 4 days (IQR 2-6); median hospital charges $58,023 (IQR 18,835-169,826) vs $18,161 (IQR 8,860-39,640); p<0.001 for both. Hospital mortality was significantly greater in oncology patients with heart failure compared to those without (13.3% vs 1.3%; OR 11.5, 95% CI 9.5-14.0). On multivariable analysis, heart failure was independently associated with hospital mortality in pediatric oncology patients (OR 2.21, 95% CI 1.63-3.00). Conclusion: Heart failure is an uncommon but serious complication in hospitalized pediatric oncology patients. The presence of heart failure was associated with increased morbidities, resource utilization, and mortality. Further study is needed for the prevention and treatment of heart failure in this population. Disclosures Aplenc: Sigma Tau: Honoraria.


BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e049325
Author(s):  
Su Han ◽  
Chuanhe Wang ◽  
Fei Tong ◽  
Ying Li ◽  
Zhichao Li ◽  
...  

ObjectivesLiver dysfunction is prevalent in patients with heart failure (HF) and can lead to poor prognosis. The albumin-bilirubin (ALBI) score is considered as an effective and convenient scoring system for assessing liver function. We analysed the correlation between ALBI and in-hospital mortality in patients with HF.DesignA retrospective cohort study.Setting and participantsA total of 9749 patients with HF (from January 2013 to December 2018) was enrolled and retrospectively analysed.Main outcome measuresThe main outcome is in-hospital mortality.ResultsALBI score was calculated using the formula (log10 bilirubin [umol/L] * 0.66) + (albumin [g/L] * −0.085), and analysed as a continuous variable as well as according to three categories. Following adjustment for multivariate analysis, patients which occurred in-hospital death was remarkably elevated in tertile 3 group (ALBI ≥2.27) (OR 1.671, 95% CI 1.228 to 2.274, p=0.001), relative to the other two groups (tertile 1: ≤2.59; tertile 2: −2.59 to −2.27). Considering ALBI score as a continuous variable, the in-hospital mortality among patients with HF increased by 8.2% for every 0.1-point increase in ALBI score (OR 1.082; 95% CI 1.052 to 1.114; p<0.001). The ALBI score for predicting in-hospital mortality under C-statistic was 0.650 (95% CI 0.641 to 0.660, p<0.001) and the cut-off value of ALBI score was −2.32 with a specificity of 0.630 and a sensitivity of 0.632. Moreover, ALBI score can enhance the predictive potential of NT-pro-BNP (NT-pro-BNP +ALBI vs NT-pro-BNP: C-statistic: z=1.990, p=0.0467; net reclassification improvement=0.4012, p<0.001; integrated discrimination improvement=0.0082, p<0.001).ConclusionsIn patients with HF, the ALBI score was an independent prognosticator of in-hospital mortality. The predictive significance of NT-proBNP +ALBI score was superior to NT-proBNP, and ALBI score can enhance the predictive potential of NT-proBNP.


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