PMID- 32867269
OWN - NLM
STAT- MEDLINE
DCOM- 20210329
LR  - 20210329
IS  - 1648-9144 (Electronic)
IS  - 1010-660X (Print)
IS  - 1010-660X (Linking)
VI  - 56
IP  - 9
DP  - 2020 Aug 27
TI  - Clinical Predictors Influencing the Length of Stay in Emergency Department 
      Patients Presenting with Acute Heart Failure.
LID - 10.3390/medicina56090434 [doi]
LID - 434
AB  - Background and objectives: Acute heart failure is a common problem encountered in 
      the emergency department (ED). More than 80% of the patients with the condition 
      subsequently require lengthy and repeated hospitalization. In a setting with 
      limited in-patient capacity, the patient flow is often obstructed. Appropriate 
      disposition decisions must be made by emergency physicians to deliver effective 
      care and alleviate ED overcrowding. This study aimed to explore clinical 
      predictors influencing the length of stay (LOS) in patients with acute heart 
      failure who present to the ED. Materials and Methods: We conducted prognostic 
      factor research with a retrospective cohort design. Medical records of patients 
      with acute heart failure who presented to the ED of Ramathibodi Hospital from 
      January to December 2015 were assessed for eligibility. Thirteen potential 
      clinical predictors were selected as candidates for statistical modeling based on 
      previous reports. Multivariable Poisson regression was used to estimate the 
      difference in LOS between patients with and without potential predictors. 
      Results: A total of 207 patients were included in the analysis. Most patients 
      were male with a mean age of 74.2 +/- 12.5 years. The median LOS was 54.6 h 
      (Interquartile range 17.5, 149.3 h). From the multivariable analysis, four 
      clinical characteristics were identified as independent predictors with an 
      increase in LOS. These were patients with New York Heart Association (NYHA) 
      functional class III/IV (+72.9 h, 95%Confidence interval (CI) 23.9, 121.8, p = 
      0.004), respiratory rate >24 per minute (+80.7 h, 95%CI 28.0, 133.3, p = 0.003), 
      hemoglobin level <10 mg/dL (+60.4 h, 95%CI 8.6, 112.3, p = 0.022), and serum 
      albumin <3.5 g/dL (+52.8 h, 95%CI 3.6, 102.0, p = 0.035). Conclusions: Poor NYHA 
      functional class, tachypnea, anemia, and hypoalbuminemia are significant clinical 
      predictors of patients with acute heart failure who required longer LOS.
FAU - Sricharoen, Pungkava
AU  - Sricharoen P
AUID- ORCID: 0000-0002-6421-0280
AD  - Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, 
      Mahidol University, Bangkok 10400, Thailand.
FAU - Phinyo, Phichayut
AU  - Phinyo P
AUID- ORCID: 0000-0002-8543-6254
AD  - Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang 
      Mai 50200, Thailand.
AD  - Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, 
      Chiang Mai University, Chiang Mai 50200, Thailand.
FAU - Patumanond, Jayanton
AU  - Patumanond J
AD  - Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, 
      Chiang Mai University, Chiang Mai 50200, Thailand.
FAU - Piyayotai, Dilok
AU  - Piyayotai D
AD  - Department of Medicine, Faculty of Medicine, Thammasat University, Pathum Thani 
      12121, Thailand.
FAU - Sittichanbuncha, Yuwares
AU  - Sittichanbuncha Y
AD  - Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, 
      Mahidol University, Bangkok 10400, Thailand.
FAU - Yuksen, Chaiyaporn
AU  - Yuksen C
AD  - Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, 
      Mahidol University, Bangkok 10400, Thailand.
FAU - Likittanasombat, Khanchit
AU  - Likittanasombat K
AD  - Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, 
      Mahidol University, Bangkok 10400, Thailand.
FAU - Cheuathonghua, Ekpaiboon
AU  - Cheuathonghua E
AD  - Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, 
      Mahidol University, Bangkok 10400, Thailand.
LA  - eng
PT  - Journal Article
DEP - 20200827
PL  - Switzerland
TA  - Medicina (Kaunas)
JT  - Medicina (Kaunas, Lithuania)
JID - 9425208
SB  - IM
MH  - Acute Disease
MH  - Aged
MH  - Anemia/complications
MH  - Emergency Service, Hospital
MH  - Female
MH  - Heart Failure/*complications/*diagnosis/therapy
MH  - Humans
MH  - Hypoalbuminemia/complications
MH  - *Length of Stay
MH  - Male
MH  - Patient Readmission
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Tachypnea/complications
MH  - Thailand
MH  - Triage
PMC - PMC7558979
OTO - NOTNLM
OT  - emergency department
OT  - heart failure
OT  - length of stay
OT  - predictors
OT  - risk stratification
COIS- The authors declare no conflict of interest.
EDAT- 2020/09/02 06:00
MHDA- 2021/03/30 06:00
PMCR- 2020/08/27
CRDT- 2020/09/02 06:00
PHST- 2020/07/15 00:00 [received]
PHST- 2020/08/24 00:00 [revised]
PHST- 2020/08/26 00:00 [accepted]
PHST- 2020/09/02 06:00 [entrez]
PHST- 2020/09/02 06:00 [pubmed]
PHST- 2021/03/30 06:00 [medline]
PHST- 2020/08/27 00:00 [pmc-release]
AID - medicina56090434 [pii]
AID - medicina-56-00434 [pii]
AID - 10.3390/medicina56090434 [doi]
PST - epublish
SO  - Medicina (Kaunas). 2020 Aug 27;56(9):434. doi: 10.3390/medicina56090434.