Naslov
Clinical and Epidemiological Characteristics of Patients with Acute Heart Failure: Gender - Dependent Survey

Autori
Bodrožić-Džakić, Tomislava ; Potočnjak, Ines ; Šmit, Ivana ; Milošević, Milan ; Degoricija, Vesna

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, pp prezentacija, znanstveni

Izvornik
6th Mediterrannian Congress of Emergency Medicine / - , 2011

Skup
6th Mediterrannian Congress of Emergency Medicine

Mjesto i datum
Kos, Grčka, 10.09.2011. - 14.09.2011

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
acute heart failure ; management ; outcome

Sažetak
Aim: Heart failure (HF) is one of the leading causes of death worldwide. The aim of present study was to investigate clinical and epidemiological characteristics of the Emergency Department (ED) patients (pts) presenting with acute HF (AHF). Methods: In the Sisters of Mercy University Hospital there were 22, 713 ED pts in year 2010, 1, 526 (6.7%) with diagnosis of AHF. Prospective, observational study included 726 AHF patients treated during six months period. Symptoms, comorbidities, physical findings, clinical presentation of AHF, APACHE II and SAPS II were recorded. Results: Out of 726 pts there were 317 (43.6%) males and 409 (56.3 %) females, who presented with dyspnea (85.5%), fatigue (61.1%), orthopnea (53.1%), and chest pain (24.9%), without significant difference in hospital outcome. There were statistically significant differences in comorbidities and clinical presentation between males and females, Table 1. Females had higher blood pressure (32.8:20.7% ; p<0.001) and atrial fibrillation (AF) incidence (53:44.4% ; p=0.028) on admission, were treated with digoxin more frequently (38.3:28.2% ; p=0.011) ; presented with hypertensive AHF (26.7:19.7% ; p=0.046), Fig.1, with higher SAPS II score (28.5:26.6 points ; p<0.001) and had more urinary infections (13.3:7.0% ; p=0.006). Frequency of dilatative cardiomyopathy (15.5:5.9% ; p<0.001), lower ejection fraction (39.1:45.4% ; p=0.003), dilatation of all four heart chambers (18.3:6.3% ; p=0.022), and clinical presentation of AHF following acute coronary syndrome (ACS) (5.7:2.2% ; p=0.046) were higher in males. Males also presented more frequently with right-sided pleural effusion (PE) (16.8:14.7 ; p=0.002), bilateral PE (19.0:14.0% ; p=0.019), and hepatomegaly (36.9:16.0% ; p=0.002. There were more cigarette smokers (27.1:11.5% ; p<0.001) and COPD pts (32.0:21.2% ; p<0.001) among males. Conclusion: Early identification and treatment of gender dependent comorbidities and clinical presentation of AHF could improve life quality of AHF pts and help to treat them more efficiently. Early identification and tenacious treatment of hypertension and AF in females, and ACS and COPD in males might improve outcome of AHF pts.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA