Predictors of long-term survival in patients with a first episode of acute heart failure.

Introduction: Acute heart failure (AHF) represents a critical event in heart failure progression, yet data on long-term outcomes after first hospitalization, remain scarce. The aim is to describe long-term survival and evaluate its predictors after the first episode of AHF.

Material And Methods: Patients from five Spanish hospitals with a confirmed first diagnosis of AHF were categorized based on survival (≥5 or RESULTS: A total of 1986 patients were included, median age 76 years (range: 68-82), 50% women, and 57% with preserved LVEF.

Clinical-epidemiological aspects, hospitalization, and reconsultations in older patients with atrial fibrillation in emergency departments in Spain (EDEN-35 study): sex-disaggregated analysis.

Objective: To assess, from a sex/gender perspective, the incidence bof atrial fibrillation (AF) in older patients in Spanish hospital emergency departments (EDs), their clinical characteristics, need for hospitalization, short-term follow-up consultations, long-term readmissions and mortality, and associated factors.

Methods: We included all patients aged $ 65 years diagnosed with AF in 52 Spanish EDs over a 1-week period. The outcome variables were the need for hospitalization, all-cause follow-up consultations within 30 days following discharge, and long-term readmissions and mortality.

Carbohydrate antigen 125 determined on arrival at the emergency department correlates with severity of decompensation and adverse outcomes in patients with acute heart failure.

To investigate the capacity of carbohydrate antigen 125 (CA125) to detect severe decompensation in patients diagnosed with acute heart failure (AHF) in the emergency department (ED) and to predict 1-year mortality. We assessed CA125 at ED arrival in unselected patients diagnosed with AHF in five Spanish hospitals during November-December 2022. CA125 was categorized as tertiles.

Identification of phenotypes in heart failure with preserved ejection fraction among 8161 patients from 3 Spanish cohorts.

Introduction And Objectives: To identify phenotypes in heart failure with preserved ejection fraction (HFpEF), compare mortality, and investigate whether treatments have different effects according to phenotype.

Methods: We performed a secondary analysis of 8161 patients with HFpEF included in Spanish cardiology (INCLIVA), internal medicine (RICA), and emergency (EAHFE) registries. Phenotypic clusters based on 16 baseline characteristics were identified using latent class analysis.

Non-specific abdominal pain in elderly patients discharged from the emergency department: Frequency, outcomes and risk-factors for adverse events (EDEN-43 study).

Objective: To determine the frequency of the diagnosis of NSAP among elderly patients discharged from EDs, investigate short-term outcomes and look for factors related to adverse outcomes.

Outcome Measures And Analysis: We included all patients 65 years or older diagnosed with NSAP and discharged home after ED care in 52 Spanish EDs during a one-week period. Outcomes consisted of 7-day and 30-day all-cause death, 30-day ED reconsultation and hospitalization, and 30-day combined adverse events (AEs) (ED reconsultation, hospitalization or death).

Alkalosis during emergency department evaluation of acute heart failure: Is there an association with mortality?

Objective: To analyze the possible association between a finding of plasma alkalosis in patients diagnosed with acute heart failure (AHF) in the emergency department (ED) and in-hospital mortality.

Methods: Cases of AHF were identified in the registry for Epidemiology of Acute Heart Failure in Emergency Departments (EAHFE), which comprises entries for 24 248 episodes diagnosed in 53 Spanish EDs. Studied cases were those with registered plasma pH levels determined by analysis of acid-base equilibrium in the ED.

Association between lactate determined at emergency department arrival and the probability of inhospital mortality and intensive care admission in elderly patients.

Background And Importance: Elderly patients often have atypical clinical presentations. Lactate measurement on arrival at the Emergency Department (ED) could be useful to identify elderly patients with a bad prognosis.

Objective: The study aimed to investigate the relationship between serum lactate determined at ED arrival and the probability of inhospital mortality and intensive care (ICU) admission in elderly patients.

Relationship between clinical congestion and worsening renal function after intravenous initiation of furosemide in patients with acute heart failure.

To investigate if worsening renal function (WRF) appearing in some patients with acute heart failure (AHF) after intravenous furosemide initiation is influenced by severity of congestion. We conducted a retrospective secondary analysis of consecutive patients diagnosed with AHF and prospectively included in 10 Spanish emergency departments (EDs) for whom serum creatinine at ED arrival and after 2-7 days of intravenous furosemide initiation were available. Congestion was clinically evaluated by identification of 7 signs/symptoms and by chest X-ray.

Impact of chronic renin-angiotensin-aldosterone inhibitors on short-term outcomes in patients with acute heart failure presenting to the emergency department. A propensity-matched analysis EAHFE cohort.

Objectives: The aim of the present study was to evaluate the impact of chronic treatment with angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) on short-term clinical outcomes after an episode of AHF.

Methods: A secondary analysis of patients included in the EAHFE (Epidemiology of Acute Heart Failure in Emergency Departments) cohort, which includes patients diagnosed with AHF in 45 Spanish Emergency Departments (EDs). The primary outcome was all-cause in-hospital mortality.

Effect of seasonal influenza and COVID-19 vaccination on severity and long-term outcomes of patients with heart failure decompensations.

Aims: To investigate whether seasonal influenza and COVID-19 vaccinations influence the severity of decompensations and long-term outcomes of patients with acute heart failure (AHF).

Methods And Results: We included consecutive AHF patients attended at 40 Spanish emergency departments during November and December 2022. They were grouped according to whether they had received seasonal influenza and COVID-19 vaccination.

Clinical course in older patients diagnosed with syncope treated in Spanish emergency departments: results from the Emergency Department and Elder Needs-17 study.

Objective: To study factors associated with hospitalization in an unselected population of patients aged 65 years or older treated for syncope in Spanish hospital emergency departments (EDs). To determine the prevalence of adverse events at 30 days in patients discharged home and the factors associated with such events.

Methods: We included all patients aged 65 years or older who were diagnosed with syncope during a single week in 52 Spanish EDs, recording patient clinical and ED case management data.

Digoxin initiation after an acute heart failure episode and its association with post-discharge outcomes: an international multicenter analysis.

Digoxin is commonly used to treat acute heart failure (AHF), especially in patients with concurrent atrial fibrillation (AF). Nonetheless, there is little consensus about in which patients digoxin should be given, the proper time for digoxin initiation, and whether digoxin initiation is associated with improved outcomes. We investigated factors related to digoxin initiation after an episode of AHF and whether patients receiving digoxin presented better short-term outcomes.

Use of diagnostic tests in elderly patients consulting the emergency department. Analysis of the emergency department and elder needs cohort (EDEN-8).

Objective: Analyse the association between the use of diagnostic tests and the characteristics of older patients 65 years of age or more who consult the emergency department (ED).

Methods: We performed an analysis of the EDEN cohort that includes patients who consulted 52 Spanish EDs. The association of age, sex, and ageing characteristics with the use of diagnostic tests (blood tests, electrocardiogram (ECG), microbiological cultures, X-ray, computed tomography, ultrasound, invasive techniques) was studied.

Use of resources in elderly patients consulting the emergency department: analysis of the Emergency Department and Elder Needs Cohort (EDEN-21).

The elderly population frequently consults the emergency department (ED). This population could have greater use of EDs and hospital health resources. The EDEN cohort of patients aged 65 years or older visiting the ED allowed this association to be investigated.

Effect of early initiation of noninvasive ventilation in patients transported by emergency medical service for acute heart failure.

Background: While the indication for noninvasive ventilation (NIV) in severely hypoxemic patients with acute heart failure (AHF) is often indicated and may improve clinical course, the benefit of early initiation before patient arrival to the emergency department (ED) remains unknown.

Objective: This study aimed to assess the impact of early initiation of NIV during emergency medical service (EMS) transportation on outcomes in patients with AHF.

Design: A secondary retrospective analysis of the EAHFE (Epidemiology of AHF in EDs) registry.

Combining loop with thiazide diuretics in patients discharged home after a heart failure decompensation: Association with 30-day outcomes.

Objective: To investigate the association of the addition of thiazide diuretic on top of loop diuretic and standard of care with short-term outcomes of patients discharged after surviving an acute heart failure (AHF) episode.

Methods: This is a secondary analysis of 14,403 patients from three independent cohorts representing the main departments involved in AHF treatment for whom treatment at discharge was recorded and included loop diuretics. Patients were divided according to whether treatment included or not thiazide diuretics.

Short-term prognosis of polypharmacy in elderly patients treated in emergency departments: results from the EDEN project.

Background: Polypharmacy is a growing phenomenon among elderly individuals. However, there is little information about the frequency of polypharmacy among the elderly population treated in emergency departments (EDs) and its prognostic effect. This study aims to determine the prevalence and short-term prognostic effect of polypharmacy in elderly patients treated in EDs.