Predictors of in-hospital mortality in patients admitted to the emergency department with cardiogenic pulmonary edema

Abstract

Background: Despite significant advances in the treatment of heart failure, the prognosis of acute cardiogenic pulmonary edema (ACPE) continues to be a serious problem. The objective of this study is to determine the risk factors affecting in-hospital mortality in patients with ACPE. Methods: We enrolled 305 patients who were hospitalized with cardiogenic pulmonary edema as a diagnosis. Clinical, biochemical and echocardiographic variables were collected and analysed. The patients were divided into two groups according to the presence of mortality. Both groups were evaluated in terms of clinical features during admission to the emergency department (ED) and factors affecting in-hospital mortality. Results: Forty-two patients died and the mortality rate was 13.8%. To determine the factors affecting mortality, multiple logistic regression analysis was performed. In the regression analysis, it was seen that age at admission to the ED (OR:1.75, 95% CI 1.18-3.05, p:0.014), systolic blood pressure (OR:0.95, 95% CI 0.31-0.98, p:0.040), presence of acute myocardial infarction (OR:4.17, 95% CI 1.85-7.13, p:0.001), positive troponin (OR:5.47, 95% Cl 1.07-7.46, p:0.011), atrial fibrillation rhythm (OR;3.16, 95% CI 1.81-8.02, p:0.010), inotropic drug usage (OR;5.61, 95% CI 1.87-9.24, p:0.013) increased in-hospital mortality. Conclusion: Our findings could help clinicians in identifying patients with poor prognosis early in the presence of identified risk factors.

Keywords

• Cardiogenic pulmonary edema
• mortality
• emergency department
• clinical presentation

Acil servise kardiyojenik pulmoner ödem ile başvuran hastalarda hastane içi mortalitenin belirleyicileri

Abstract

Amaç: Kalp yetmezliği tedavisindeki önemli ilerlemelere rağmen akut kardiyojenik pulmoner ödemin (AKPÖ) prognozu ciddi bir sorun olmaya devam etmektedir. Bu çalışmanın amacı, ACPE gelişen hastalarda hastane içi mortaliteyi etkileyen risk faktörlerini belirlemektir. Yöntem: Çalışmamıza AKPÖ nedeniyle hastaneye yatırılan 305 hastayı dahil ettik. Klinik, biyokimyasal ve ekokardiyografik bulgular analiz edildi. Hastalar, mortalite varlığına göre iki gruba ayrıldı. Her iki grup acil servise (AS) başvurudaki klinik özellikler ve hastane içi mortaliteye etki eden faktörler açısından değerlendirildi. Bulgular: Hastaların %13.8’i hayatını kaybetti. Mortaliteye etki eden faktörleri belirlemek için çoklu lojistik regresyon analizi yapıldı. Yapılan regresyon analizinde, AS’ye kabulündeki yaş (OR:1.75, %95 CI 1.18-3.05, p:0.014), sistolik kan basıncı (OR: 0.95, %95 CI 0.31-0.98, p:0.040), akut miyokard infarktüsü varlığı OR:4.17, %95 CI 1.85-7.13, p:0.001), pozitif troponin (OR:5.47, %95CI 1.07-7.46, p:0.011), atriyal fibrilasyon (OR;3.16, %95 CI 1.81-8.02, p: 0.010), inotropik ilaç kullanımının (OR;5.61, %95 CI 1.87-9.24, p: 0.013) hastane içi mortaliteyi arttırdığı görüldü. Sonuç: Bulgularımız, tanımlanan risk faktörlerinin varlığında, klinisyenlerin kötü prognoza sahip olacak hastaları erken dönemde tanımlamasına yardımcı olabilir.

Keywords

• Kardiyojenik pulmoner ödem
• mortalite
• acil servis
• klinik tablo

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