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Long‐term prognosis of acute pulmonary oedema — an ominous outcome
Author(s) -
Roguin Ariel,
Behar Doron M.,
Ami Haim Ben,
Reisner Shimon A.,
Edelstein Shimon,
Linn Shai,
Edoute Yeouda
Publication year - 2000
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/s1388-9842(00)00069-6
Subject(s) - medicine , diabetes mellitus , myocardial infarction , heart failure , atrial fibrillation , cardiology , population , angina , blood pressure , environmental health , endocrinology
Background: Acute pulmonary oedema (APOE) is a major health problem, leading to poor hospital and long‐term outcomes. There is a relative paucity of studies describing prognosis of consecutive unsolicited patients diagnosed with APOE and hospitalized in internal medicine departments. Aims: To describe the clinical profile and outcome (in hospital and 1‐year prognosis) of successive unselected patients with APOE, in a prospective observational study. Methods and results: The study population included 150 consecutive unsolicited patients (90 men, 60 women; median age 75 years) with APOE all hospitalized in an internal medicine department, in a 900‐bed care centre. Ischaemic heart disease (IHD), hypertension and diabetes were present in 85%, 70% and 52% of patients, respectively. The most common precipitating factors for APOE included high blood pressure (29%), rapid atrial fibrillation (29%), unstable angina pectoris (25%), infection (18%) and acute myocardial infarction (MI; 15%). Eighteen patients (12%) died in hospital, with 82% of these deaths attributed to cardiac pump failure. Predictors for an increased in‐hospital mortality included: diabetes ( P < 0.05), orthopnoea ( P < 0.05), echocardiographic finding of depressed global left ventricular systolic function ( P < 0.001), acute MI during hospital stay ( P < 0.001), hypotension/shock ( P < 0.05), and the need for mechanical ventilation ( P < 0.001). After a median hospital stay of 10 days, 132 patients were discharged home. The 1‐year mortality was 40%. Only the presence of pleural effusion was found as a predictor for 1‐year mortality. Conclusion: Most patients with APOE in this study are elderly, and have IHD, hypertension, diabetes and a previous history of APOE. The overall mortality is high (in‐hospital, 12%: 1‐year, 40%). Left ventricular dysfunction was associated with high in‐hospital mortality, but not with long‐term prognosis.