000 02604cam a2200301 4500500
005 20251012013149.0
041 _afre
042 _adc
100 1 0 _aCloppet-Fontaine, A.
_eauthor
700 1 0 _a Ray, P.
_eauthor
700 1 0 _a Pautas, E.
_eauthor
700 1 0 _a Raynaud-Simon, A.
_eauthor
700 1 0 _a Bouvard, E.
_eauthor
700 1 0 _a Casalino, E.
_eauthor
700 1 0 _a Pateron, D.
_eauthor
700 1 0 _a Thomas, C.
_eauthor
700 1 0 _a Raphael, M.
_eauthor
700 1 0 _a Verny, C.
_eauthor
700 1 0 _a Bornand, A.
_eauthor
700 1 0 _a Riou, B.
_eauthor
700 1 0 _a Boddaert, J.
_eauthor
245 0 0 _aDiagnosis and prognostic value of precipitating factors in acute heart failure in older patients admitted to the emergency department
260 _c2025.
500 _a54
520 _aObjectivesTo analyze the impact of incorrectly diagnosing precipitating factors (PFs) after an emergency department (ED) visit on outcomes in older patients admitted for acute heart failure (AHF).MethodsA retrospective multicenter cohort study was conducted in the emergency and geriatric departments of six university hospitals in the Paris region. The study population consisted of older patients who presented to the ED with AHF and were subsequently admitted to the geriatric department. Medical records were reviewed to assess the diagnosis of AHF and its PFs, as determined by ED physicians and an expert panel. A poor outcome was defined as a composite endpoint including in-hospital mortality, readmission, and/or death within 30 days of discharge.ResultsDuring the study period, of the 4,163 patients over the age of 75 admitted to the ED, 234 were transferred to the geriatric department with an AHF diagnosis. A PF was identified in 170 patients (73%), mainly infections (52%), arrhythmia (14%), anemia (9%), acute coronary syndrome (6%), and medication non-adherence (6%). An inaccurate diagnosis of the PF during the ED stay was not associated with a poor outcome (OR: 0.77 [0.36–1.63], p = 0.49), unlike elevated serum creatinine levels at admission (OR: 1.01 [1.00–1.01] per 1 μmol/L increase, p < 0.001).ConclusionMost older patients admitted for AHF have an identifiable PF, with infections being the most common. An incorrect diagnosis of the PF in the ED was not significantly associated with a poor outcome.
786 0 _nAnnales françaises de médecine d’urgence | 15 | 4 | 2025-07-08 | p. 229-236 | 2108-6524
856 4 1 _uhttps://shs.cairn.info/journal-annales-francaises-de-medecine-durgence-2025-4-page-229?lang=en&redirect-ssocas=7080
999 _c1528587
_d1528587