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Article: Treatment and outcome of acute cardiogenic pulmonary oedema presenting to an emergency department in Hong Kong: Retrospective cohort study
Title | Treatment and outcome of acute cardiogenic pulmonary oedema presenting to an emergency department in Hong Kong: Retrospective cohort study |
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Authors | |
Keywords | Mortality Epidemiology Heart diseases Hospital emergency service Drug therapy |
Issue Date | 2006 |
Citation | Hong Kong Journal of Emergency Medicine, 2006, v. 13, n. 3, p. 148-154 How to Cite? |
Abstract | Objectives: To explore the epidemiology, treatment and outcome of acute cardiogenic pulmonary oedema (ACPO) in a Hong Kong emergency department (ED). Methods: This was a retrospective cohort study in a university hospital ED. Cases were identified from ED records and resuscitation room logbooks. The study extended from 1 September 2004 to 30 April 2005. Parametric tests and logistic regression were used to identify predictors of survival. Results: A total of 140 patients were identified, with a mean age of 75 years and male:female ratio of 1:1.4. Mean values (range) on presentation were as follows: pulse rate 103 beats/minute (36-108); blood pressure (BP) 169/88 mmHg (77-274/20-162) and respiratory rate 31 breaths/minute (12-88). Past medical history included previous ACPO (12.1%), diabetes (45.7%), chronic obstructive pulmonary disease (9.3%), ischaemic heart disease (45.0%), hypertension (72.1%) and congestive heart failure (40.7%). On admission, 47.1% had pH<7.35 and 40.7% had PaCO2>5.5kPa. ED treatments included: sublingual nitrates (n=2), intravenous (IV) nitrates (n=89, median 10 mg/hr), IV frusemide (n=85, median 40 mg), IV morphine (n=25, median 3 mg). There were 21 patients on non-invasive ventilation; 27 intubations and 41 patients were admitted to the intensive care unit. Survival to discharge was 95.7%; and median length of hospital stay was 8 days. The 90-day all-cause hospital readmission rate was 30.0%. The 30-day mortality was 12.9% (n=18) and 90-day mortality was 29.3% (n=41). Logistic regression showed that past history of hypertension (p=0.0061), higher systolic BP on ED discharge (p=0.0102) and lower creatinine following treatment (p=0.035) were predictors of improved survival at 90 days. Conclusion: ACPO commonly presents to the ED in Hong Kong and has a high 90-day mortality. Previous hypertension, higher systolic blood pressure on leaving the ED and lower creatinine following treatment predict improved survival at 90 days. |
Persistent Identifier | http://hdl.handle.net/10722/292581 |
ISSN | 2021 Impact Factor: 0.529 2020 SCImago Journal Rankings: 0.145 |
DC Field | Value | Language |
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dc.contributor.author | Kwok, Tony Yip Tung | - |
dc.contributor.author | Mak, Paulina Siu Kuen | - |
dc.contributor.author | Rainer, Timothy Hudson | - |
dc.contributor.author | Graham, Colin A. | - |
dc.date.accessioned | 2020-11-17T14:56:47Z | - |
dc.date.available | 2020-11-17T14:56:47Z | - |
dc.date.issued | 2006 | - |
dc.identifier.citation | Hong Kong Journal of Emergency Medicine, 2006, v. 13, n. 3, p. 148-154 | - |
dc.identifier.issn | 1024-9079 | - |
dc.identifier.uri | http://hdl.handle.net/10722/292581 | - |
dc.description.abstract | Objectives: To explore the epidemiology, treatment and outcome of acute cardiogenic pulmonary oedema (ACPO) in a Hong Kong emergency department (ED). Methods: This was a retrospective cohort study in a university hospital ED. Cases were identified from ED records and resuscitation room logbooks. The study extended from 1 September 2004 to 30 April 2005. Parametric tests and logistic regression were used to identify predictors of survival. Results: A total of 140 patients were identified, with a mean age of 75 years and male:female ratio of 1:1.4. Mean values (range) on presentation were as follows: pulse rate 103 beats/minute (36-108); blood pressure (BP) 169/88 mmHg (77-274/20-162) and respiratory rate 31 breaths/minute (12-88). Past medical history included previous ACPO (12.1%), diabetes (45.7%), chronic obstructive pulmonary disease (9.3%), ischaemic heart disease (45.0%), hypertension (72.1%) and congestive heart failure (40.7%). On admission, 47.1% had pH<7.35 and 40.7% had PaCO2>5.5kPa. ED treatments included: sublingual nitrates (n=2), intravenous (IV) nitrates (n=89, median 10 mg/hr), IV frusemide (n=85, median 40 mg), IV morphine (n=25, median 3 mg). There were 21 patients on non-invasive ventilation; 27 intubations and 41 patients were admitted to the intensive care unit. Survival to discharge was 95.7%; and median length of hospital stay was 8 days. The 90-day all-cause hospital readmission rate was 30.0%. The 30-day mortality was 12.9% (n=18) and 90-day mortality was 29.3% (n=41). Logistic regression showed that past history of hypertension (p=0.0061), higher systolic BP on ED discharge (p=0.0102) and lower creatinine following treatment (p=0.035) were predictors of improved survival at 90 days. Conclusion: ACPO commonly presents to the ED in Hong Kong and has a high 90-day mortality. Previous hypertension, higher systolic blood pressure on leaving the ED and lower creatinine following treatment predict improved survival at 90 days. | - |
dc.language | eng | - |
dc.relation.ispartof | Hong Kong Journal of Emergency Medicine | - |
dc.subject | Mortality | - |
dc.subject | Epidemiology | - |
dc.subject | Heart diseases | - |
dc.subject | Hospital emergency service | - |
dc.subject | Drug therapy | - |
dc.title | Treatment and outcome of acute cardiogenic pulmonary oedema presenting to an emergency department in Hong Kong: Retrospective cohort study | - |
dc.type | Article | - |
dc.description.nature | link_to_OA_fulltext | - |
dc.identifier.doi | 10.1177/102490790601300304 | - |
dc.identifier.scopus | eid_2-s2.0-33746803697 | - |
dc.identifier.volume | 13 | - |
dc.identifier.issue | 3 | - |
dc.identifier.spage | 148 | - |
dc.identifier.epage | 154 | - |
dc.identifier.issnl | 1024-9079 | - |