Association between prehospital arterial hypercapnia and mortality in acute heart failure: a retrospective cohort study
Dublin Core
Title
Association between prehospital arterial hypercapnia and mortality in acute heart failure: a retrospective cohort study
Subject
Prehospital hypercapnia is associated with an increase in in-hospital and 7-day mortality in patient
with AHF.
with AHF.
Description
Background: Acute Heart Failure (AHF) is a potentially lethal pathology and is often encountered in the prehospital
setting. Although an association between prehospital arterial hypercapnia in AHF patients and admission in highdependency and intensive care units has been previously described, there is little data to support an association
between prehospital arterial hypercapnia and mortality in this population.
Methods: This was a retrospective study based on electronically recorded prehospital medical files. All adult
patients with AHF were included. Records lacking arterial blood gas data were excluded. Other exclusion criteria
included the presence of a potentially confounding diagnosis, prehospital cardiac arrest, and inter-hospital transfers.
Hypercapnia was defined as a PaCO2 higher than 6.0 kPa. The primary outcome was in-hospital mortality, and
secondary outcomes were 7-day mortality and emergency room length of stay (ER LOS). Univariable and
multivariable logistic regression models were used.
Results: We included 225 patients in the analysis. Prehospital hypercapnia was found in 132 (58.7%) patients. Inhospital mortality was higher in patients with hypercapnia (17.4% [23/132] versus 6.5% [6/93], p = 0.016), with a
crude odds-ratio of 3.06 (95%CI 1.19–7.85). After adjustment for pre-specified covariates, the adjusted OR was 3.18
(95%CI 1.22–8.26). The overall 7-day mortality was also higher in hypercapnic patients (13.6% versus 5.5%, p = 0.044),
and ER LOS was shorter in this population (5.6 h versus 7.1 h, p = 0.018).
setting. Although an association between prehospital arterial hypercapnia in AHF patients and admission in highdependency and intensive care units has been previously described, there is little data to support an association
between prehospital arterial hypercapnia and mortality in this population.
Methods: This was a retrospective study based on electronically recorded prehospital medical files. All adult
patients with AHF were included. Records lacking arterial blood gas data were excluded. Other exclusion criteria
included the presence of a potentially confounding diagnosis, prehospital cardiac arrest, and inter-hospital transfers.
Hypercapnia was defined as a PaCO2 higher than 6.0 kPa. The primary outcome was in-hospital mortality, and
secondary outcomes were 7-day mortality and emergency room length of stay (ER LOS). Univariable and
multivariable logistic regression models were used.
Results: We included 225 patients in the analysis. Prehospital hypercapnia was found in 132 (58.7%) patients. Inhospital mortality was higher in patients with hypercapnia (17.4% [23/132] versus 6.5% [6/93], p = 0.016), with a
crude odds-ratio of 3.06 (95%CI 1.19–7.85). After adjustment for pre-specified covariates, the adjusted OR was 3.18
(95%CI 1.22–8.26). The overall 7-day mortality was also higher in hypercapnic patients (13.6% versus 5.5%, p = 0.044),
and ER LOS was shorter in this population (5.6 h versus 7.1 h, p = 0.018).
Creator
Mathias Fabre, Christophe A. Fehlmann, Kevin E. Boczar, Birgit Gartner, Catherine G. Zimmermann-Ivol , François Sarasin and Laurent Suppan
Publisher
BMC Emergency Medicine
Date
(2021) 21:130
Contributor
Fajar bagus W
Format
PDF
Language
Indonesia
Type
Text
Files
Collection
Citation
Mathias Fabre, Christophe A. Fehlmann, Kevin E. Boczar, Birgit Gartner, Catherine G. Zimmermann-Ivol , François Sarasin and Laurent Suppan , “Association between prehospital arterial hypercapnia and mortality in acute heart failure: a retrospective cohort study,” Repository Horizon University Indonesia, accessed November 21, 2024, https://repository.horizon.ac.id/items/show/3883.