急诊科与心内科慢性心力衰竭急性加重患者的区别分析

doi:10.3969/j.issn.1002-1949.2019.11.006

Chinese Journal of Critical Care Medicine

2019, Vol. 39

Issue (11): 1040-1044 DOI: 10.3969/j.issn.1002-1949.2019.11.006

Analysis on the differences in patients with acute exacerbation of chronic heart failure between emergency department and cardiology department

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Abstract Objective To analyze the differences in patients with acute exacerbation of chronic heart failure between emergency department and cardiology department. Methods Patients with acute exacerbation of chronic heart failure whose left ventricular ejection fraction (LVEF) was less than 40% were enrolled from July 2014 to December 2016 in the emergency department and cardiology department of Peking University People′s Hospital. Data for basic information, past medical history, admission conditions, accessory examinations, treatments during hospitalization, nosocomial outcomes and discharge medications were collected. According to the in patient departments, they were divided into the emergency department treatment group and the cardiology department treatment group. All analyses were performed with SPSS 21.0 statistical software package. Results In total, 203 patients were enrolled and 12 patients (9.9%) died. 53 patients (26.1%) were hospitalized in the emergency department and 150 patients (73.9%) were hospitalized in the cardiology department. Compared to the cardiology department treatment group, age, proportions with coronary heart disease and diabetes history, proportion of heart function classification Ⅳ, systolic blood pressure, heart rate, white blood cell, C reactive protein, aspartate aminotransferase, blood urea nitrogen, LVEF, the first dose and the maximum daily dose of furosemide, proportions of nitrates and non-invasive mechanical ventilation and mortality were higher in the emergency department, but hemoglobin, hematocrit, serum sodium and estimated glomerular filtration rate were lower (P<0.05). Excluding the deaths, the proportions of sequential oral diuretics, inotropes, nitrates, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, β receptor blocker and mineralocorticoid receptor antagonist at discharge were lower in the emergency department (P<0.05). Conclusion Patients with acute exacerbation of chronic heart failure in the emergency department have shorter hospital duration, but they have more risk factors, worse conditions, higher mortality, and the proportions of sequential oral drugs are lower at discharge. 

Key words： Emergency department Cardiology department Chronic heart failure Acute exacerbation

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http://www.cnemergency.org.cn/EN/10.3969/j.issn.1002-1949.2019.11.006 OR http://www.cnemergency.org.cn/EN/Y2019/V39/I11/1040

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