The emergency department arrival mode and its relations to ED management and 30-day mortality in acute heart failure: an ancillary analysis from the EURODEM study

Pia Harjola; Tuukka Tarvasmäki; On Behalf of the EURODEM Study Group; Cinzia Barletta; Richard Body; Jean Capsec; Michael Christ; Luis Garcia-Castrillo; Adela Golea; Mehmet A. Karamercan; Paul Louis Martin; Òscar Miró; Jukka Tolonen; Oene van Meer; Ari Palomäki; Franck Verschuren; Veli Pekka Harjola; Said Laribi; Patrick Plaisance; Ghanima Al Dandachi; Maxime Maignan; Dominique Pateron; Christelle Hermand; Cindy Tessier; Pierre Marie Roy; Lucie Bucco; Nicolas Duytsche; Pablo Garmilla; Giorgio Carbone; Roberto Cosentini; Sorana Truță; Natalia Hrihorișan; Diana Cimpoeșu; Luciana Rotaru; Alina Petrica; Mariana Cojocaru; Silvia Nica; Rodica Tudoran; Cristina Vecerdi; Monica Puticiu; Titus Schönberger; Constant Coolsma; Maarten Baggelaar; Noortje Fransen; Crispijn van den Brand; Doutsje Idzenga; Maaike Maas; Myriam Franssen; Charlotte Mackaij Staal; Joyce Jansen; Marna Bouwhuis

doi:10.1186/s12873-022-00574-z

The emergency department arrival mode and its relations to ED management and 30-day mortality in acute heart failure: an ancillary analysis from the EURODEM study

Pia Harjola^*, Tuukka Tarvasmäki, On Behalf of the EURODEM Study Group, Cinzia Barletta, Richard Body, Jean Capsec, Michael Christ, Luis Garcia-Castrillo, Adela Golea, Mehmet A. Karamercan, Paul Louis Martin, Òscar Miró, Jukka Tolonen, Oene van Meer, Ari Palomäki, Franck Verschuren, Veli Pekka Harjola, Said Laribi, Patrick Plaisance, Ghanima Al DandachiMaxime Maignan, Dominique Pateron, Christelle Hermand, Cindy Tessier, Pierre Marie Roy, Lucie Bucco, Nicolas Duytsche, Pablo Garmilla, Giorgio Carbone, Roberto Cosentini, Sorana Truță, Natalia Hrihorișan, Diana Cimpoeșu, Luciana Rotaru, Alina Petrica, Mariana Cojocaru, Silvia Nica, Rodica Tudoran, Cristina Vecerdi, Monica Puticiu, Titus Schönberger, Constant Coolsma, Maarten Baggelaar, Noortje Fransen, Crispijn van den Brand, Doutsje Idzenga, Maaike Maas, Myriam Franssen, Charlotte Mackaij Staal, Joyce Jansen, Marna Bouwhuis

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Background: Acute heart failure patients are often encountered in emergency departments (ED) from 11% to 57% using emergency medical services (EMS). Our aim was to evaluate the association of EMS use with acute heart failure patients’ ED management and short-term outcomes. Methods: This was a sub-analysis of a European EURODEM study. Data on patients presenting with dyspnoea were collected prospectively from European EDs. Patients with ED diagnosis of acute heart failure were categorized into two groups: those using EMS and those self-presenting (non- EMS). The independent association between EMS use and 30-day mortality was evaluated with logistic regression. Results: Of the 500 acute heart failure patients, with information about the arrival mode to the ED, 309 (61.8%) arrived by EMS. These patients were older (median age 80 vs. 75 years, p < 0.001), more often female (56.4% vs. 42.1%, p = 0.002) and had more dementia (18.7% vs. 7.2%, p < 0.001). On admission, EMS patients had more often confusion (14.2% vs. 2.1%, p < 0.001) and higher respiratory rate (24/min vs. 21/min, p = 0.014; respiratory rate > 30/min in 17.1% patients vs. 7.5%, p = 0.005). The only difference in ED management appeared in the use of ventilatory support: 78.3% of EMS patients vs. 67.5% of non- EMS patients received supplementary oxygen (p = 0.007), and non-invasive ventilation was administered to 12.5% of EMS patients vs. 4.2% non- EMS patients (p = 0.002). EMS patients were more often hospitalized (82.4% vs. 65.9%, p < 0.001), had higher in-hospital mortality (8.7% vs. 3.1%, p = 0.014) and 30-day mortality (14.3% vs. 4.9%, p < 0.001). The use of EMS was an independent predictor of 30-day mortality (OR = 2.54, 95% CI 1.11–5.81, p = 0.027). Conclusion: Most acute heart failure patients arrive at ED by EMS. These patients suffer from more severe respiratory distress and receive more often ventilatory support. EMS use is an independent predictor of 30-day mortality.

Original language	English
Article number	27
Journal	BMC Emergency Medicine
Volume	22
Issue number	1
DOIs	https://doi.org/10.1186/s12873-022-00574-z
Publication status	Published - 14 Feb 2022

Bibliographical note

Funding Information:
PH has received funding from Department of Emergency Medicine and Services, Helsinki University Hospital for the analysis of the data and the writing of the manuscript. For the remaining authors none were declared. Open access is funded by Helsinki University Library.

Publisher Copyright: © 2022, The Author(s).

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Harjola, P., Tarvasmäki, T., On Behalf of the EURODEM Study Group, Barletta, C., Body, R., Capsec, J., Christ, M., Garcia-Castrillo, L., Golea, A., Karamercan, M. A., Martin, P. L., Miró, Ò., Tolonen, J., van Meer, O., Palomäki, A., Verschuren, F., Harjola, V. P., Laribi, S., Plaisance, P., ... Bouwhuis, M. (2022). The emergency department arrival mode and its relations to ED management and 30-day mortality in acute heart failure: an ancillary analysis from the EURODEM study. BMC Emergency Medicine, 22(1), Article 27. https://doi.org/10.1186/s12873-022-00574-z

@article{1199dfeee50f44f8a3af23332a0a746d,

title = "The emergency department arrival mode and its relations to ED management and 30-day mortality in acute heart failure: an ancillary analysis from the EURODEM study",

abstract = "Background: Acute heart failure patients are often encountered in emergency departments (ED) from 11% to 57% using emergency medical services (EMS). Our aim was to evaluate the association of EMS use with acute heart failure patients{\textquoteright} ED management and short-term outcomes. Methods: This was a sub-analysis of a European EURODEM study. Data on patients presenting with dyspnoea were collected prospectively from European EDs. Patients with ED diagnosis of acute heart failure were categorized into two groups: those using EMS and those self-presenting (non- EMS). The independent association between EMS use and 30-day mortality was evaluated with logistic regression. Results: Of the 500 acute heart failure patients, with information about the arrival mode to the ED, 309 (61.8%) arrived by EMS. These patients were older (median age 80 vs. 75 years, p < 0.001), more often female (56.4% vs. 42.1%, p = 0.002) and had more dementia (18.7% vs. 7.2%, p < 0.001). On admission, EMS patients had more often confusion (14.2% vs. 2.1%, p < 0.001) and higher respiratory rate (24/min vs. 21/min, p = 0.014; respiratory rate > 30/min in 17.1% patients vs. 7.5%, p = 0.005). The only difference in ED management appeared in the use of ventilatory support: 78.3% of EMS patients vs. 67.5% of non- EMS patients received supplementary oxygen (p = 0.007), and non-invasive ventilation was administered to 12.5% of EMS patients vs. 4.2% non- EMS patients (p = 0.002). EMS patients were more often hospitalized (82.4% vs. 65.9%, p < 0.001), had higher in-hospital mortality (8.7% vs. 3.1%, p = 0.014) and 30-day mortality (14.3% vs. 4.9%, p < 0.001). The use of EMS was an independent predictor of 30-day mortality (OR = 2.54, 95% CI 1.11–5.81, p = 0.027). Conclusion: Most acute heart failure patients arrive at ED by EMS. These patients suffer from more severe respiratory distress and receive more often ventilatory support. EMS use is an independent predictor of 30-day mortality.",

author = "Pia Harjola and Tuukka Tarvasm{\"a}ki and {On Behalf of the EURODEM Study Group} and Cinzia Barletta and Richard Body and Jean Capsec and Michael Christ and Luis Garcia-Castrillo and Adela Golea and Karamercan, {Mehmet A.} and Martin, {Paul Louis} and {\`O}scar Mir{\'o} and Jukka Tolonen and {van Meer}, Oene and Ari Palom{\"a}ki and Franck Verschuren and Harjola, {Veli Pekka} and Said Laribi and Patrick Plaisance and Dandachi, {Ghanima Al} and Maxime Maignan and Dominique Pateron and Christelle Hermand and Cindy Tessier and Roy, {Pierre Marie} and Lucie Bucco and Nicolas Duytsche and Pablo Garmilla and Giorgio Carbone and Roberto Cosentini and Sorana Truț{\u a} and Natalia Hrihorișan and Diana Cimpoeșu and Luciana Rotaru and Alina Petrica and Mariana Cojocaru and Silvia Nica and Rodica Tudoran and Cristina Vecerdi and Monica Puticiu and Titus Sch{\"o}nberger and Constant Coolsma and Maarten Baggelaar and Noortje Fransen and {van den Brand}, Crispijn and Doutsje Idzenga and Maaike Maas and Myriam Franssen and Staal, {Charlotte Mackaij} and Joyce Jansen and Marna Bouwhuis",

note = "Funding Information: PH has received funding from Department of Emergency Medicine and Services, Helsinki University Hospital for the analysis of the data and the writing of the manuscript. For the remaining authors none were declared. Open access is funded by Helsinki University Library. Publisher Copyright: {\textcopyright} 2022, The Author(s).",

year = "2022",

month = feb,

day = "14",

doi = "10.1186/s12873-022-00574-z",

language = "English",

volume = "22",

journal = "BMC Emergency Medicine",

issn = "1471-227X",

publisher = "BioMed Central Ltd.",

number = "1",

}

Harjola, P, Tarvasmäki, T, On Behalf of the EURODEM Study Group, Barletta, C, Body, R, Capsec, J, Christ, M, Garcia-Castrillo, L, Golea, A, Karamercan, MA, Martin, PL, Miró, Ò, Tolonen, J, van Meer, O, Palomäki, A, Verschuren, F, Harjola, VP, Laribi, S, Plaisance, P, Dandachi, GA, Maignan, M, Pateron, D, Hermand, C, Tessier, C, Roy, PM, Bucco, L, Duytsche, N, Garmilla, P, Carbone, G, Cosentini, R, Truță, S, Hrihorișan, N, Cimpoeșu, D, Rotaru, L, Petrica, A, Cojocaru, M, Nica, S, Tudoran, R, Vecerdi, C, Puticiu, M, Schönberger, T, Coolsma, C, Baggelaar, M, Fransen, N, van den Brand, C, Idzenga, D, Maas, M, Franssen, M, Staal, CM, Jansen, J & Bouwhuis, M 2022, 'The emergency department arrival mode and its relations to ED management and 30-day mortality in acute heart failure: an ancillary analysis from the EURODEM study', BMC Emergency Medicine, vol. 22, no. 1, 27. https://doi.org/10.1186/s12873-022-00574-z

The emergency department arrival mode and its relations to ED management and 30-day mortality in acute heart failure: an ancillary analysis from the EURODEM study. / Harjola, Pia; Tarvasmäki, Tuukka; On Behalf of the EURODEM Study Group et al.
In: BMC Emergency Medicine, Vol. 22, No. 1, 27, 14.02.2022.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - The emergency department arrival mode and its relations to ED management and 30-day mortality in acute heart failure

T2 - an ancillary analysis from the EURODEM study

AU - Harjola, Pia

AU - Tarvasmäki, Tuukka

AU - On Behalf of the EURODEM Study Group

AU - Barletta, Cinzia

AU - Body, Richard

AU - Capsec, Jean

AU - Christ, Michael

AU - Garcia-Castrillo, Luis

AU - Golea, Adela

AU - Karamercan, Mehmet A.

AU - Martin, Paul Louis

AU - Miró, Òscar

AU - Tolonen, Jukka

AU - van Meer, Oene

AU - Palomäki, Ari

AU - Verschuren, Franck

AU - Harjola, Veli Pekka

AU - Laribi, Said

AU - Plaisance, Patrick

AU - Dandachi, Ghanima Al

AU - Maignan, Maxime

AU - Pateron, Dominique

AU - Hermand, Christelle

AU - Tessier, Cindy

AU - Roy, Pierre Marie

AU - Bucco, Lucie

AU - Duytsche, Nicolas

AU - Garmilla, Pablo

AU - Carbone, Giorgio

AU - Cosentini, Roberto

AU - Truță, Sorana

AU - Hrihorișan, Natalia

AU - Cimpoeșu, Diana

AU - Rotaru, Luciana

AU - Petrica, Alina

AU - Cojocaru, Mariana

AU - Nica, Silvia

AU - Tudoran, Rodica

AU - Vecerdi, Cristina

AU - Puticiu, Monica

AU - Schönberger, Titus

AU - Coolsma, Constant

AU - Baggelaar, Maarten

AU - Fransen, Noortje

AU - van den Brand, Crispijn

AU - Idzenga, Doutsje

AU - Maas, Maaike

AU - Franssen, Myriam

AU - Staal, Charlotte Mackaij

AU - Jansen, Joyce

AU - Bouwhuis, Marna

N1 - Funding Information: PH has received funding from Department of Emergency Medicine and Services, Helsinki University Hospital for the analysis of the data and the writing of the manuscript. For the remaining authors none were declared. Open access is funded by Helsinki University Library. Publisher Copyright: © 2022, The Author(s).

PY - 2022/2/14

Y1 - 2022/2/14

N2 - Background: Acute heart failure patients are often encountered in emergency departments (ED) from 11% to 57% using emergency medical services (EMS). Our aim was to evaluate the association of EMS use with acute heart failure patients’ ED management and short-term outcomes. Methods: This was a sub-analysis of a European EURODEM study. Data on patients presenting with dyspnoea were collected prospectively from European EDs. Patients with ED diagnosis of acute heart failure were categorized into two groups: those using EMS and those self-presenting (non- EMS). The independent association between EMS use and 30-day mortality was evaluated with logistic regression. Results: Of the 500 acute heart failure patients, with information about the arrival mode to the ED, 309 (61.8%) arrived by EMS. These patients were older (median age 80 vs. 75 years, p < 0.001), more often female (56.4% vs. 42.1%, p = 0.002) and had more dementia (18.7% vs. 7.2%, p < 0.001). On admission, EMS patients had more often confusion (14.2% vs. 2.1%, p < 0.001) and higher respiratory rate (24/min vs. 21/min, p = 0.014; respiratory rate > 30/min in 17.1% patients vs. 7.5%, p = 0.005). The only difference in ED management appeared in the use of ventilatory support: 78.3% of EMS patients vs. 67.5% of non- EMS patients received supplementary oxygen (p = 0.007), and non-invasive ventilation was administered to 12.5% of EMS patients vs. 4.2% non- EMS patients (p = 0.002). EMS patients were more often hospitalized (82.4% vs. 65.9%, p < 0.001), had higher in-hospital mortality (8.7% vs. 3.1%, p = 0.014) and 30-day mortality (14.3% vs. 4.9%, p < 0.001). The use of EMS was an independent predictor of 30-day mortality (OR = 2.54, 95% CI 1.11–5.81, p = 0.027). Conclusion: Most acute heart failure patients arrive at ED by EMS. These patients suffer from more severe respiratory distress and receive more often ventilatory support. EMS use is an independent predictor of 30-day mortality.

AB - Background: Acute heart failure patients are often encountered in emergency departments (ED) from 11% to 57% using emergency medical services (EMS). Our aim was to evaluate the association of EMS use with acute heart failure patients’ ED management and short-term outcomes. Methods: This was a sub-analysis of a European EURODEM study. Data on patients presenting with dyspnoea were collected prospectively from European EDs. Patients with ED diagnosis of acute heart failure were categorized into two groups: those using EMS and those self-presenting (non- EMS). The independent association between EMS use and 30-day mortality was evaluated with logistic regression. Results: Of the 500 acute heart failure patients, with information about the arrival mode to the ED, 309 (61.8%) arrived by EMS. These patients were older (median age 80 vs. 75 years, p < 0.001), more often female (56.4% vs. 42.1%, p = 0.002) and had more dementia (18.7% vs. 7.2%, p < 0.001). On admission, EMS patients had more often confusion (14.2% vs. 2.1%, p < 0.001) and higher respiratory rate (24/min vs. 21/min, p = 0.014; respiratory rate > 30/min in 17.1% patients vs. 7.5%, p = 0.005). The only difference in ED management appeared in the use of ventilatory support: 78.3% of EMS patients vs. 67.5% of non- EMS patients received supplementary oxygen (p = 0.007), and non-invasive ventilation was administered to 12.5% of EMS patients vs. 4.2% non- EMS patients (p = 0.002). EMS patients were more often hospitalized (82.4% vs. 65.9%, p < 0.001), had higher in-hospital mortality (8.7% vs. 3.1%, p = 0.014) and 30-day mortality (14.3% vs. 4.9%, p < 0.001). The use of EMS was an independent predictor of 30-day mortality (OR = 2.54, 95% CI 1.11–5.81, p = 0.027). Conclusion: Most acute heart failure patients arrive at ED by EMS. These patients suffer from more severe respiratory distress and receive more often ventilatory support. EMS use is an independent predictor of 30-day mortality.

UR - http://www.scopus.com/inward/record.url?scp=85124679540&partnerID=8YFLogxK

U2 - 10.1186/s12873-022-00574-z

DO - 10.1186/s12873-022-00574-z

M3 - Article

C2 - 35164693

AN - SCOPUS:85124679540

SN - 1471-227X

VL - 22

JO - BMC Emergency Medicine

JF - BMC Emergency Medicine

IS - 1

M1 - 27

ER -

The emergency department arrival mode and its relations to ED management and 30-day mortality in acute heart failure: an ancillary analysis from the EURODEM study

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