Association between prehospital delay and subsequent clinical course in patients with/hospitalized for heart failure

J Card Fail. 2012 Mar;18(3):202-7. doi: 10.1016/j.cardfail.2011.12.007. Epub 2012 Jan 27.

Abstract

Background: The clinical consequences of prehospital delay in heart failure (HF) patients are unknown. This study explores the relationship between prehospital delay of HF patients and length of hospital stay, plasma values of brain natriuretic peptides (BNP) as well as the association of delay with all-cause mortality, readmission for HF, or all-cause readmissions during short- (60 days) and long-term (18 months) follow-up.

Methods: Data from 1023 hospitalized HF patients mean aged 71 years from the Coordinating study evaluating Outcomes of Advising and Counselling in HF study were analyzed.

Results: Patients who delayed less than 1 day had significantly shorter stay in hospital (10 days vs. 11 days, P = 0.033). They also had significantly (P = 0.004) lower median plasma values of BNP (377 pg/mL) at discharge compared to patients who delayed >24 hours (492 pg/mL). Delay was not related to all-cause mortality and/or readmissions for HF.

Conclusion: Although patients with a prehospital delay less than 1 day were more symptomatic on admission, they had a shorter hospital stay as well as lower plasma values of BNP at discharge. Delay was not associated hospital readmissions or mortality after discharge.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Emergency Medical Services / methods*
  • Female
  • Follow-Up Studies
  • Heart Failure / diagnosis*
  • Heart Failure / therapy*
  • Hospitalization*
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Retrospective Studies
  • Time Factors