Ambient temperature and atmospheric pressure at discharge as precipitating factors in immediate adverse events in patients treated for decompensated heart failure.
Por:
Benito-Lozano M, López-Ayala P, Rodríguez S, Gil V, Llorens P, Yufera A, Jacob J, Travería-Becker L, Strebel I, Lucas-Imbernon FJ, Tost J, López-Hernández Á, Rodríguez B, Fuentes M, Sánchez-Ramón S, Herrera-Mateo S, Aguirre A, Alonso MI, Pavón J, López-Grima ML, Espinosa B, Mueller C, Burillo-Putze G and Miró Ò
Publicada:
1 oct 2022
Ahead of Print:
1 sep 2022
Resumen:
To investigate the relationship of ambient temperature and atmospheric pressure (AP) at patient discharge after an episode of acute heart failure (AHF) with very early post-discharge adverse outcomes. We analyzed 14,656 patients discharged after an AHF episode from 26 hospitals in 16 Spanish cities. The primary outcome was the 7-day post-discharge combined adverse event (emergency department -ED- revisit or hospitalization due to AHF, or all-cause death), and secondary outcomes were these three adverse events considered individually. Associations (adjusted for patient and demographic conditions, and length of stay -LOS- during the AHF index episode) of temperature and AP with the primary and secondary outcomes were investigated. We used restricted cubic splines to model the continuous non-linear association of temperature and AP with each endpoint. Some sensitivity analyses were performed. Patients were discharged after a median LOS of 5 days (IQR = 1-10). The highest temperature at discharge ranged from - 2 to 41.6 °C, and AP was from 892 to 1037 hPa. The 7-day post-discharge combined event occurred in 1242 patients (8.4%), with percentages of 7-day ED-revisit, hospitalization and death of 7.8%, 5.1% and 0.9%, respectively. We found no association between the maximal temperature and AP on the day of discharge and the primary or secondary outcomes. Similarly, there were no significant associations when the analyses were restricted to hospitalized patients (median LOS = 7 days, IQR = 4-11) during the index event, or when lag-1, lag-2 or the mean of the 3 post-discharge days (instead of point estimation) of ambient temperature and AP were considered. Temperature and AP on the day of patient discharge are not independently associated with the risk of very early adverse events during the vulnerable post-discharge period in patients discharged after an AHF episode.
Filiaciones:
Benito-Lozano M:
Emergency Department, Hospital Universitario de Canarias, Tenerife, Spain
López-Ayala P:
Cardiology Department, Cardiovascular Research Institute Basel, University Hospital of Basel, Basel, Switzerland
Rodríguez S:
Estación Experimental de Zonas Áridas (EEZA), Centro Superior de Investigaciones Científicas, Almería, Spain
Centro Superior de Investigaciones Científicas, Institute of Natural Products and Agrobiology, IPNA, Tenerife, Spain
Gil V:
Emergency Department, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, c/ Villarroel 170, 08036, Barcelona, Catalonia, Spain
:
Emergency Department, Short Stay Unit and Hospitalization at Home Unit, Hospital General de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Universidad Miguel Hernández, Alicante, Spain
Yufera A:
Cardiology Department, Cardiovascular Research Institute Basel, University Hospital of Basel, Basel, Switzerland
Jacob J:
Emergency Department, Hospital Universitari de Bellvitge, l'Hospitalet de Llobregat, Barcelona, Catalonia, Spain
Travería-Becker L:
Emergency Department, Hospital Universitario de Canarias, Tenerife, Spain
Strebel I:
Cardiology Department, Cardiovascular Research Institute Basel, University Hospital of Basel, Basel, Switzerland
Lucas-Imbernon FJ:
Emergency Department, Hospital General de Albacete, Albacete, Spain
Tost J:
Emergency Department, Hospital de Terrassa, Barcelona, Catalonia, Spain
López-Hernández Á:
Emergency Department, Hospital Universitario de Canarias, Tenerife, Spain
Rodríguez B:
Emergency Department, Hospital Universitario Infanta Leonor, Madrid, Spain
Fuentes M:
Emergency Department, Hospital Universitario de Salamanca, Salamanca, Spain
Sánchez-Ramón S:
Emergency Department, Hospital Rio Hortega, Valladolid, Spain
Herrera-Mateo S:
Emergency Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
Aguirre A:
Emergency Department, Hospital del Mar, Barcelona, Catalonia, Spain
Alonso MI:
Emergency Department, Hospital Virgen de Valme, Seville, Spain
Pavón J:
Emergency Department, Hospital Doctor Negrín, Las Palmas, Spain
López-Grima ML:
Emergency Department, Hospital Doctor Peset, Valencia, Spain
:
Emergency Department, Short Stay Unit and Hospitalization at Home Unit, Hospital General de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Universidad Miguel Hernández, Alicante, Spain
Mueller C:
Cardiology Department, Cardiovascular Research Institute Basel, University Hospital of Basel, Basel, Switzerland
The GREAT network, Rome, Italy
Burillo-Putze G:
Emergency Department, Hospital Universitario de Canarias, Tenerife, Spain
Miró Ò:
Emergency Department, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, c/ Villarroel 170, 08036, Barcelona, Catalonia, Spain.
The GREAT Network, Rome, Italy.
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