Lemachatti Najla, Philippon Anne-Laure, Bloom Benjamin, Hausfater Pierre, Riou Bruno, Ray Patrick, Freund Yonathan
Emergency Department, Hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France.
Emergency Department, Hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France; Paris Sorbonne Université, UPMC Université Paris 6, UMRS Inserm 1166, IHU ICAN, 75013 Paris, France.
Arch Cardiovasc Dis. 2016 Aug-Sep;109(8-9):449-56. doi: 10.1016/j.acvd.2016.01.014. Epub 2016 Jun 21.
We previously conducted a pilot study that reported the safety of isosorbide dinitrate boluses for elderly emergency patients with acute heart failure syndrome.
To assess the temporal trend in the rate of elderly patients treated with isosorbide dinitrate, and to evaluate subsequent outcome differences.
This was a single-centre study. We compared patients aged>75 years who attended the emergency department with a primary diagnosis of acute pulmonary oedema in the years 2007 and 2014. The primary endpoint was the rate of patients who received isosorbide dinitrate boluses in the emergency department. Secondary endpoints included in-hospital mortality, need for intensive care and length of stay.
We analysed 368 charts, 232 from patients included in 2014 (63%) and 136 in 2007 (37%). The mean age was 85±6 years in both groups. There was a significant rise in the rate of patients treated with isosorbide dinitrate between 2007 and 2014: 97 patients (42%) in 2014 vs. 24 patients (18%) in 2007 (P<0.01). Comparing the two periods, we report similar in-hospital mortality rates (8% vs. 11%; P=0.5), rates of admission to the intensive care unit (13% vs. 17%; P=0.3) and lengths of stay (10 days in both groups).
We observed a significant rise in the rate of elderly patients treated with isosorbide dinitrate boluses for acute heart failure. However, we did not observe any significant improvement in outcomes.
我们之前进行了一项初步研究，报告了硝酸异山梨酯大剂量注射对老年急性心力衰竭综合征急诊患者的安全性。
评估接受硝酸异山梨酯治疗的老年患者比例的时间趋势，并评估随后的结局差异。
这是一项单中心研究。我们比较了2007年和2014年因急性肺水肿而到急诊科就诊且年龄>75岁的患者。主要终点是在急诊科接受硝酸异山梨酯大剂量注射的患者比例。次要终点包括住院死亡率、重症监护需求和住院时间。
我们分析了368份病历，2014年纳入的患者有232份（63%），2007年有136份（37%）。两组的平均年龄均为85±6岁。2007年至2014年期间，接受硝酸异山梨酯治疗的患者比例显著上升：2014年为97例（42%），2007年为24例（18%）（P<0.01）。比较两个时期，我们发现住院死亡率相似（8%对11%；P=0.5），重症监护病房入住率相似（13%对17%；P=0.3），住院时间也相似（两组均为10天）。
我们观察到使用硝酸异山梨酯大剂量注射治疗急性心力衰竭的老年患者比例显著上升。然而，我们未观察到结局有任何显著改善。
Zotero 插件