Heart failure & cardiomyopathies
Impact of congestion and perfusion status in the emergency department on severity of decompensation and short-term prognosis in patients with acute heart failure
Authors' conclusion
The presence of congestion/hypoperfusion at ED arrival is a simple clinical marker associated with a higher risk of severity/adverse short-term outcomes.
Study context
- Population
- Patients with acute HF in the emergency department (ED) (EAHFE Registry); median age 83 years, women 55.7%analysed
- Participants
- 18,120 patients
- Exposure
- Severity of congestion/hypoperfusion at ED arrival
- Outcome
- Need for hospitalization, in-hospital all-cause mortality (hospitalized) and prolonged hospitalization (discharged alive)
Main finding
As reported in the abstract
- >2 signs/symptoms of congestion
- 72%
- ≥1 sign/symptom of hypoperfusion
- 18%
- Hospitalized
- 75%
- In-hospital death
- 9%
- Prolonged hospitalization (discharged alive)
- 47%
- More congestion signs: hospitalization
- P < 0.001
- More congestion signs: prolonged stay
- P = 0.011
- More congestion signs: mortality (not significant)
- P = 0.06
- More hypoperfusion signs: hospitalization
- P < 0.001
- More hypoperfusion signs: mortality
- P < 0.001
- More hypoperfusion signs: prolonged stay (not significant)
- P = 0.227
Observational data: associations, not effects.
Original publication
Impact of congestion and perfusion status in the emergency department on severity of decompensation and short-term prognosis in patients with acute heart failure. Eur Heart J Acute Cardiovasc Care. Published 22 September 2022. doi:10.
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