Association between prehospital arterial hypercapnia and mortality in acute heart failure: a retrospective cohort study

Abstract 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 high-dependency and intensive care units has been previously describe...

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Autores principales:	Mathias Fabre, Christophe A. Fehlmann, Kevin E. Boczar, Birgit Gartner, Catherine G. Zimmermann-Ivol, François Sarasin, Laurent Suppan
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Special situations and conditions RC952-1245 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/0e94e9c7aab6418d841a4a44f8ab4d12
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spelling	oai:doaj.org-article:0e94e9c7aab6418d841a4a44f8ab4d122021-11-08T10:45:15ZAssociation between prehospital arterial hypercapnia and mortality in acute heart failure: a retrospective cohort study10.1186/s12873-021-00527-y1471-227Xhttps://doaj.org/article/0e94e9c7aab6418d841a4a44f8ab4d122021-11-01T00:00:00Zhttps://doi.org/10.1186/s12873-021-00527-yhttps://doaj.org/toc/1471-227XAbstract 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 high-dependency 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. In-hospital 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). Conclusion Prehospital hypercapnia is associated with an increase in in-hospital and 7-day mortality in patient with AHF.Mathias FabreChristophe A. FehlmannKevin E. BoczarBirgit GartnerCatherine G. Zimmermann-IvolFrançois SarasinLaurent SuppanBMCarticleSpecial situations and conditionsRC952-1245Medical emergencies. Critical care. Intensive care. First aidRC86-88.9ENBMC Emergency Medicine, Vol 21, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Special situations and conditions RC952-1245 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	Special situations and conditions RC952-1245 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Mathias Fabre Christophe A. Fehlmann Kevin E. Boczar Birgit Gartner Catherine G. Zimmermann-Ivol François Sarasin Laurent Suppan Association between prehospital arterial hypercapnia and mortality in acute heart failure: a retrospective cohort study
description	Abstract 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 high-dependency 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. In-hospital 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). Conclusion Prehospital hypercapnia is associated with an increase in in-hospital and 7-day mortality in patient with AHF.
format	article
author	Mathias Fabre Christophe A. Fehlmann Kevin E. Boczar Birgit Gartner Catherine G. Zimmermann-Ivol François Sarasin Laurent Suppan
author_facet	Mathias Fabre Christophe A. Fehlmann Kevin E. Boczar Birgit Gartner Catherine G. Zimmermann-Ivol François Sarasin Laurent Suppan
author_sort	Mathias Fabre
title	Association between prehospital arterial hypercapnia and mortality in acute heart failure: a retrospective cohort study
title_short	Association between prehospital arterial hypercapnia and mortality in acute heart failure: a retrospective cohort study
title_full	Association between prehospital arterial hypercapnia and mortality in acute heart failure: a retrospective cohort study
title_fullStr	Association between prehospital arterial hypercapnia and mortality in acute heart failure: a retrospective cohort study
title_full_unstemmed	Association between prehospital arterial hypercapnia and mortality in acute heart failure: a retrospective cohort study
title_sort	association between prehospital arterial hypercapnia and mortality in acute heart failure: a retrospective cohort study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/0e94e9c7aab6418d841a4a44f8ab4d12
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Association between prehospital arterial hypercapnia and mortality in acute heart failure: a retrospective cohort study

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