Short-term outcomes by chronic betablocker treatment in patients presenting to emergency departments with acute heart failure: BB-EAHFE
Por:
Jacob J, Haro A, Tost J, Rossello X, Llorens P, Herrero P, Martín-Sánchez FJ, Gil V, López-Grima ML, Millán J, Aguirre A, Garrido JM, Calvo-Rodríguez R, Pérez-Llantada E, Sánchez-Nicolás JA, Mir M, Rodríguez-Adrada E, Fuentes-De Frutos M, Roset A and Miró Ò
Publicada:
2 nov 2022
Ahead of Print:
1 ago 2022
Resumen:
Aims To evaluate the association between chronic treatment with betablockers (BB) and the severity of decompensation and short-term outcomes of patients with acute heart failure (AHF). Methods and results We consecutively included all patients presenting with AHF to 45 Spanish emergency departments (ED) during six different time-periods between 2007 and 2018. Patients were stratified according to whether they were on chronic treatment with BB at the time of ED consultation. Those receiving BB were compared (adjusted odds ratio-OR-with 95% confidence interval-CI-) with those not receiving BB group in terms of in-hospital and 7-day all-cause mortality, need for hospitalization, and prolonged length of stay (>= 7 days). Among the 17 923 recruited patients (median age: 80 years; 56% women), 7795 (43%) were on chronic treatment with BB. Based on the MEESSI-AHF risk score, those on BB were at lower risk. In-hospital mortality was observed in 1310 patients (7.4%), 7-day mortality in 765 (4.3%), need for hospitalization in 13 428 (75.0%), and prolonged length of stay (43.3%). After adjustment for confounding, those on chronic BB were at lower risk for in-hospital all-cause mortality (OR = 0.85, 95% CI = 0.79-0.92, P < 0.001); 7-day all-cause mortality (OR = 0.77, 95% CI = 0.70-0.85, P < 0.001); need for hospitalization (OR = 0.89, 95% CI = 0.85-0.94, P < 0.001); prolonged length of stay (OR = 0.90, 95% CI = 0.86-0.94, P < 0.001). A propensity matching approach yielded consistent findings. Conclusion In patients presenting to ED with AHF, those on BB had better short-term outcomes than those not receiving BB.
Filiaciones:
Jacob J:
Emergency Department, Hospital Universitari de Bellvitge, Institute of Biomedical Research of Bellvitge (IDIBELL), University of Barcelona (UB), Feixa Llarga s/n, L'Hospitalet de Llobregat 08907, Barcelona, Spain
Haro A:
Emergency Department, Hospital Universitari de Bellvitge, Institute of Biomedical Research of Bellvitge (IDIBELL), University of Barcelona (UB), Feixa Llarga s/n, L'Hospitalet de Llobregat 08907, Barcelona, Spain
Tost J:
Emergency Department, Consorci Hospitalari de Terrassa, 08227 Terrassa, Barcelona, Spain
Rossello X:
Cardiology Department, Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitari Son Espases, 07010 Palma, Spain
Llorens P:
Emergency Department, Short Stay Unit and Hospital at Home, Hospital General de Alicante, Instituto de Investigación Sanitaria y Biómedica de Alicante (ISABIAL), Miguel Hernández University, 03010 Alicante, Spain
Herrero P:
Emergency Department, Hospital Central Asturias, 33011 Oviedo, Spain
Martín-Sánchez FJ:
Emergency Department, Hospital Clínico San Carlos, Universidad Complutense, 28040 Madrid, Spain
Gil V:
Emergency Department, Hospital Clínic, IDIBAPS, University of Barcelona, 08036 Barcelona, Spain
:
Emergency Department, Hospital Doctor Peset, 46017 Valencia, Spain
Millán J:
Emergency Department, Hospital Universitario La Fe, 46009 Valencia, Spain
Aguirre A:
Emergency Department, Hospital del Mar, 08003 Barcelona, Spain
Garrido JM:
Emergency Department, Hospital Virgen de la Macarena, 41009 Sevilla, Spain
Calvo-Rodríguez R:
Emergency Department, Hospital Reina Sofía de Córdoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain
Pérez-Llantada E:
Emergency Department, Hospital Marqués de Valdecilla, 39008 Santander, Spain
Sánchez-Nicolás JA:
Emergency Department, Hospital Reina Sofía, 30003 Murcia, Spain
Mir M:
Emergency Department, Hospital Infanta Leonor, 28031 Madrid, Spain
Rodríguez-Adrada E:
Emergency Department, Hospital Rey Juan Carlos, Móstoles, 28933 Madrid, Spain
Fuentes-De Frutos M:
Emergency Department, Hospital Universitario de Salamanca, 37007 Salamanca, Spain
Roset A:
Emergency Department, Hospital Universitari de Bellvitge, Institute of Biomedical Research of Bellvitge (IDIBELL), University of Barcelona (UB), Feixa Llarga s/n, L'Hospitalet de Llobregat 08907, Barcelona, Spain
Miró Ò:
Emergency Department, Hospital Clínic, IDIBAPS, University of Barcelona, 08036 Barcelona, Spain
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