Clinical presentation, management and outcomes in the Acute Heart Failure Global Survey of Standard Treatment (ALARM-HF)

Purpose We performed a survey on acute heart failure (AHF) in nine countries in four continents. We aimed to describe characteristics and management of AHF among various countries, to compare patients with de novo AHF versus patients with a pre-existing episode of AHF, and to describe subpopulations...

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Veröffentlicht in:Intensive care medicine 2011-04, Vol.37 (4), p.619-626
Hauptverfasser: Follath, F., Yilmaz, M. B., Delgado, J. F., Parissis, J. T., Porcher, R., Gayat, E., Burrows, Nigel, Mclean, A., Vilas-Boas, F., Mebazaa, A.
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container_end_page 626
container_issue 4
container_start_page 619
container_title Intensive care medicine
container_volume 37
creator Follath, F.
Yilmaz, M. B.
Delgado, J. F.
Parissis, J. T.
Porcher, R.
Gayat, E.
Burrows, Nigel
Mclean, A.
Vilas-Boas, F.
Mebazaa, A.
description Purpose We performed a survey on acute heart failure (AHF) in nine countries in four continents. We aimed to describe characteristics and management of AHF among various countries, to compare patients with de novo AHF versus patients with a pre-existing episode of AHF, and to describe subpopulations hospitalized in intensive care unit (ICU) versus cardiac care unit (CCU) versus ward. Methods and results Data from 4,953 patients with AHF were collected via questionnaire from 666 hospitals. Clinical presentation included decompensated congestive HF (38.6%), pulmonary oedema (36.7%) and cardiogenic shock (11.7%). Patients with de novo episode of AHF (36.2%) were younger, had less comorbidities and lower blood pressure despite greater left ventricular ejection fraction (LVEF) and were more often admitted to ICU. Overall, intravenous (IV) diuretics were given in 89.7%, vasodilators in 41.1%, and inotropic agents (dobutamine, dopamine, adrenaline, noradrenaline and levosimendan) in 39% of cases. Overall hospital death rate was 12%, the majority due to cardiogenic shock (43%). More patients with de novo AHF (14.2%) than patients with a pre-existing episode of AHF (10.8%) ( p  = 0.0007) died. There was graded mortality in ICU, CCU and ward patients with mortality in ICU patients being the highest (17.8%) ( p  
doi_str_mv 10.1007/s00134-010-2113-0
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B. ; Delgado, J. F. ; Parissis, J. T. ; Porcher, R. ; Gayat, E. ; Burrows, Nigel ; Mclean, A. ; Vilas-Boas, F. ; Mebazaa, A.</creator><creatorcontrib>Follath, F. ; Yilmaz, M. B. ; Delgado, J. F. ; Parissis, J. T. ; Porcher, R. ; Gayat, E. ; Burrows, Nigel ; Mclean, A. ; Vilas-Boas, F. ; Mebazaa, A.</creatorcontrib><description>Purpose We performed a survey on acute heart failure (AHF) in nine countries in four continents. We aimed to describe characteristics and management of AHF among various countries, to compare patients with de novo AHF versus patients with a pre-existing episode of AHF, and to describe subpopulations hospitalized in intensive care unit (ICU) versus cardiac care unit (CCU) versus ward. Methods and results Data from 4,953 patients with AHF were collected via questionnaire from 666 hospitals. Clinical presentation included decompensated congestive HF (38.6%), pulmonary oedema (36.7%) and cardiogenic shock (11.7%). Patients with de novo episode of AHF (36.2%) were younger, had less comorbidities and lower blood pressure despite greater left ventricular ejection fraction (LVEF) and were more often admitted to ICU. Overall, intravenous (IV) diuretics were given in 89.7%, vasodilators in 41.1%, and inotropic agents (dobutamine, dopamine, adrenaline, noradrenaline and levosimendan) in 39% of cases. Overall hospital death rate was 12%, the majority due to cardiogenic shock (43%). More patients with de novo AHF (14.2%) than patients with a pre-existing episode of AHF (10.8%) ( p  = 0.0007) died. There was graded mortality in ICU, CCU and ward patients with mortality in ICU patients being the highest (17.8%) ( p  &lt; 0.0001). Conclusions Our data demonstrated the existence of different subgroups based on de novo or pre-existing episode(s) of AHF and the site of hospitalization. Recognition of these subgroups might improve management and outcome by defining specific therapeutic requirements.</description><identifier>ISSN: 0342-4642</identifier><identifier>EISSN: 1432-1238</identifier><identifier>DOI: 10.1007/s00134-010-2113-0</identifier><identifier>PMID: 21210078</identifier><identifier>CODEN: ICMED9</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Acute Disease ; Aged ; Aged, 80 and over ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Anesthesiology ; Biological and medical sciences ; Cardiology ; Cardiovascular disease ; Comorbidity ; Critical Care Medicine ; Diuretics ; Ejection fraction ; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care ; Emergency Medicine ; Female ; France ; Heart ; Heart failure ; Heart Failure - drug therapy ; Heart Failure - epidemiology ; Heart Failure - physiopathology ; Hospital Mortality ; Hospital patients ; Hospitalization ; Hospitals ; Humans ; Intensive ; Intensive care ; Intensive care medicine ; Intensive Care Units ; Internationality ; Male ; Medical colleges ; Medical sciences ; Medicine ; Medicine &amp; Public Health ; Middle Aged ; Missing data ; Mortality ; Original ; Outcome Assessment (Health Care) ; Pain Medicine ; Patients ; Pediatrics ; Pneumology/Respiratory System ; Prognosis ; Questionnaires ; Shock ; Surveys ; Surveys and Questionnaires ; Transplants &amp; implants ; Vasodilators</subject><ispartof>Intensive care medicine, 2011-04, Vol.37 (4), p.619-626</ispartof><rights>Copyright jointly held by Springer and ESICM 2010</rights><rights>2015 INIST-CNRS</rights><rights>COPYRIGHT 2011 Springer</rights><rights>Copyright jointly held by Springer and ESICM 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c505t-1d8f44657206c267ac9a05a49eb26b2084c0b8d2b156079ef197238466a58dd3</citedby><cites>FETCH-LOGICAL-c505t-1d8f44657206c267ac9a05a49eb26b2084c0b8d2b156079ef197238466a58dd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00134-010-2113-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00134-010-2113-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=24014794$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21210078$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Follath, F.</creatorcontrib><creatorcontrib>Yilmaz, M. B.</creatorcontrib><creatorcontrib>Delgado, J. F.</creatorcontrib><creatorcontrib>Parissis, J. T.</creatorcontrib><creatorcontrib>Porcher, R.</creatorcontrib><creatorcontrib>Gayat, E.</creatorcontrib><creatorcontrib>Burrows, Nigel</creatorcontrib><creatorcontrib>Mclean, A.</creatorcontrib><creatorcontrib>Vilas-Boas, F.</creatorcontrib><creatorcontrib>Mebazaa, A.</creatorcontrib><title>Clinical presentation, management and outcomes in the Acute Heart Failure Global Survey of Standard Treatment (ALARM-HF)</title><title>Intensive care medicine</title><addtitle>Intensive Care Med</addtitle><addtitle>Intensive Care Med</addtitle><description>Purpose We performed a survey on acute heart failure (AHF) in nine countries in four continents. We aimed to describe characteristics and management of AHF among various countries, to compare patients with de novo AHF versus patients with a pre-existing episode of AHF, and to describe subpopulations hospitalized in intensive care unit (ICU) versus cardiac care unit (CCU) versus ward. Methods and results Data from 4,953 patients with AHF were collected via questionnaire from 666 hospitals. Clinical presentation included decompensated congestive HF (38.6%), pulmonary oedema (36.7%) and cardiogenic shock (11.7%). Patients with de novo episode of AHF (36.2%) were younger, had less comorbidities and lower blood pressure despite greater left ventricular ejection fraction (LVEF) and were more often admitted to ICU. Overall, intravenous (IV) diuretics were given in 89.7%, vasodilators in 41.1%, and inotropic agents (dobutamine, dopamine, adrenaline, noradrenaline and levosimendan) in 39% of cases. Overall hospital death rate was 12%, the majority due to cardiogenic shock (43%). More patients with de novo AHF (14.2%) than patients with a pre-existing episode of AHF (10.8%) ( p  = 0.0007) died. There was graded mortality in ICU, CCU and ward patients with mortality in ICU patients being the highest (17.8%) ( p  &lt; 0.0001). Conclusions Our data demonstrated the existence of different subgroups based on de novo or pre-existing episode(s) of AHF and the site of hospitalization. Recognition of these subgroups might improve management and outcome by defining specific therapeutic requirements.</description><subject>Acute Disease</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anesthesia. Intensive care medicine. Transfusions. 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B. ; Delgado, J. F. ; Parissis, J. T. ; Porcher, R. ; Gayat, E. ; Burrows, Nigel ; Mclean, A. ; Vilas-Boas, F. ; Mebazaa, A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c505t-1d8f44657206c267ac9a05a49eb26b2084c0b8d2b156079ef197238466a58dd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Acute Disease</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Anesthesiology</topic><topic>Biological and medical sciences</topic><topic>Cardiology</topic><topic>Cardiovascular disease</topic><topic>Comorbidity</topic><topic>Critical Care Medicine</topic><topic>Diuretics</topic><topic>Ejection fraction</topic><topic>Emergency and intensive cardiocirculatory care. Cardiogenic shock. 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B.</au><au>Delgado, J. F.</au><au>Parissis, J. T.</au><au>Porcher, R.</au><au>Gayat, E.</au><au>Burrows, Nigel</au><au>Mclean, A.</au><au>Vilas-Boas, F.</au><au>Mebazaa, A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical presentation, management and outcomes in the Acute Heart Failure Global Survey of Standard Treatment (ALARM-HF)</atitle><jtitle>Intensive care medicine</jtitle><stitle>Intensive Care Med</stitle><addtitle>Intensive Care Med</addtitle><date>2011-04-01</date><risdate>2011</risdate><volume>37</volume><issue>4</issue><spage>619</spage><epage>626</epage><pages>619-626</pages><issn>0342-4642</issn><eissn>1432-1238</eissn><coden>ICMED9</coden><abstract>Purpose We performed a survey on acute heart failure (AHF) in nine countries in four continents. We aimed to describe characteristics and management of AHF among various countries, to compare patients with de novo AHF versus patients with a pre-existing episode of AHF, and to describe subpopulations hospitalized in intensive care unit (ICU) versus cardiac care unit (CCU) versus ward. Methods and results Data from 4,953 patients with AHF were collected via questionnaire from 666 hospitals. Clinical presentation included decompensated congestive HF (38.6%), pulmonary oedema (36.7%) and cardiogenic shock (11.7%). Patients with de novo episode of AHF (36.2%) were younger, had less comorbidities and lower blood pressure despite greater left ventricular ejection fraction (LVEF) and were more often admitted to ICU. Overall, intravenous (IV) diuretics were given in 89.7%, vasodilators in 41.1%, and inotropic agents (dobutamine, dopamine, adrenaline, noradrenaline and levosimendan) in 39% of cases. Overall hospital death rate was 12%, the majority due to cardiogenic shock (43%). More patients with de novo AHF (14.2%) than patients with a pre-existing episode of AHF (10.8%) ( p  = 0.0007) died. There was graded mortality in ICU, CCU and ward patients with mortality in ICU patients being the highest (17.8%) ( p  &lt; 0.0001). Conclusions Our data demonstrated the existence of different subgroups based on de novo or pre-existing episode(s) of AHF and the site of hospitalization. Recognition of these subgroups might improve management and outcome by defining specific therapeutic requirements.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>21210078</pmid><doi>10.1007/s00134-010-2113-0</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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subjects Acute Disease
Aged
Aged, 80 and over
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Anesthesiology
Biological and medical sciences
Cardiology
Cardiovascular disease
Comorbidity
Critical Care Medicine
Diuretics
Ejection fraction
Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care
Emergency Medicine
Female
France
Heart
Heart failure
Heart Failure - drug therapy
Heart Failure - epidemiology
Heart Failure - physiopathology
Hospital Mortality
Hospital patients
Hospitalization
Hospitals
Humans
Intensive
Intensive care
Intensive care medicine
Intensive Care Units
Internationality
Male
Medical colleges
Medical sciences
Medicine
Medicine & Public Health
Middle Aged
Missing data
Mortality
Original
Outcome Assessment (Health Care)
Pain Medicine
Patients
Pediatrics
Pneumology/Respiratory System
Prognosis
Questionnaires
Shock
Surveys
Surveys and Questionnaires
Transplants & implants
Vasodilators
title Clinical presentation, management and outcomes in the Acute Heart Failure Global Survey of Standard Treatment (ALARM-HF)
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