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ORIGINAL ARTICLE
Year : 2017  |  Volume : 130  |  Issue : 16  |  Page : 1894-1901

Characteristics, Management, and Outcomes of Acute Heart Failure in the Emergency Department: A Multicenter Registry Study with 1-year Follow-up in a Chinese Cohort in Beijing


1 Emergency and Critical Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
2 Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037; Department of Emergency, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
3 Department of Emergency, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
4 Department of Emergency, Beijing Chao Yang Hospital, Beijing 100020, China
5 Department of Emergency, Peking Union Medical College Hospital, Beijing 100032, China
6 Department of Emergency, The General Hospital of Chinese People's Liberation Army, Beijing 100853, China
7 Department of Emergency, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
8 Department of Emergency, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
9 Department of Emergency, Peking University Third Hospital, Beijing 100083, China
10 Department of Emergency, Beijing Jishuitan Hospital, Beijing 100035, China
11 Department of Emergency, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
12 Department of Emergency, Fangshan District Liangxiang Hospital, Beijing 102400, China
13 Department of Emergency, The Hospital of Shunyi District, Beijing 101300, China
14 Department of Emergency, People's Hospital of Beijing Daxing District, Beijing 102600, China
15 Department of Emergency, The Luhe Teaching Hospital of the Capital Medical University, Beijing 101100, China
16 Medical Research and Biometrics Centre, National Centre for Cardiovascular Diseases, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences, Xishan Institute of Fuwai Hospital, Beijing 102300, China
17 Information Technology Centre, Fuwai Hospital, Beijing 100037, China
18 Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
19 Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037; Heart Center, First Hospital of Tsinghua University, Beijing 100016, China
20 Department of Medicine and Therapeutics, School of Life Sciences, The Chinese University of Hong Kong, Hong Kong 999077, China

Correspondence Address:
Guo-Gan Wang
Emergency and Critical Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0366-6999.211880

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Background: The emergency department (ED) has a pivotal influence on the management of acute heart failure (AHF), but data concerning current ED management are scarce. This Beijing AHF Registry Study investigated the characteristics, ED management, and short- and long-term clinical outcomes of AHF. Methods: This prospective, multicenter, observational study consecutively enrolled 3335 AHF patients who visited 14 EDs in Beijing from January 1, 2011, to September 23, 2012. Baseline data on characteristics and management were collected in the EDs. Follow-up data on death and readmissions were collected until November 31, 2013, with a response rate of 92.80%. The data were reported as median (interquartile range) for the continuous variables, or as number (percentage) for the categorical variables. Results: The median age of the enrolled patients was 71 (58–79) years, and 46.84% were women. In patients with AHF, coronary heart disease (43.27%) was the most common etiology, and myocardium ischemia (30.22%) was the main precipitant. Most of the patients in the ED received intravenous treatments, including diuretics (79.28%) and vasodilators (74.90%). Fewer patients in the ED received neurohormonal antagonists, and 25.94%, 31.12%, and 33.73% of patients received angiotensin converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers, and spironolactone, respectively. The proportions of patients who were admitted, discharged, left against medical advice, and died were 55.53%, 33.58%, 7.08%, and 3.81%, respectively. All-cause mortalities at 30 days and 1 year were 15.30% and 32.27%, respectively. Conclusions: Substantial details on characteristics and ED management of AHF were investigated. The clinical outcomes of AHF patients were dismal. Thus, further investigations of ED-based therapeutic approaches for AHF are needed.


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