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March 25, 2021Journal of Contemporary Medicine5 citationsOpen Access

Predictors of in-hospital mortality in patients admitted to the emergency department with cardiogenic pulmonary edema

ESEkrem Taha SertKKKâmil KokuluMGMurat Gül

Key Result

Positive troponin (OR 5.47), acute myocardial infarction (OR 4.17), and inotropic drug usage (OR 5.61) significantly increased in-hospital mortality in patients with acute cardiogenic pulmonary edema.

Study Design

Type

Observational (n=305)

Multicenter

No

Structured PICO

P
Population
305 adult patients (mean age 67 years, 42.6% female) hospitalized with acute cardiogenic pulmonary edema at a single tertiary emergency department.
O
Outcome
In-hospital mortalityhard clinical

In patients with acute cardiogenic pulmonary edema, factors such as advanced age, acute myocardial infarction, positive troponin, atrial fibrillation, and the need for inotropes are strong predictors of in-hospital mortality.

Main Result

Odds Ratio: 5.47 (95% CI 1.07–7.46)

p-value: p=0.011

Limitations

  • Limited number of subjects fulfilling the inclusion criteria
  • Retrospective design restricting data to those routinely collected, carrying a risk of selection bias
  • Single-center study design carrying inherent risks of bias
  • limited number of subjects
  • retrospective nature
  • single-centered

Abstract

Background: Despite significant advances in the treatment of heart failure, the prognosis of acute cardiogenic pulmonary edema (ACPE) continues to be a serious problem. The objective of this study is to determine the risk factors affecting in-hospital mortality in patients with ACPE. Methods: We enrolled 305 patients who were hospitalized with cardiogenic pulmonary edema as a diagnosis. Clinical, biochemical and echocardiographic variables were collected and analysed. The patients were divided into two groups according to the presence of mortality. Both groups were evaluated in terms of clinical features during admission to the emergency department (ED) and factors affecting in-hospital mortality. Results: Forty-two patients died and the mortality rate was 13.8%. To determine the factors affecting mortality, multiple logistic regression analysis was performed. In the regression analysis, it was seen that age at admission to the ED (OR:1.75, 95% CI 1.18-3.05, p:0.014), systolic blood pressure (OR:0.95, 95% CI 0.31-0.98, p:0.040), presence of acute myocardial infarction (OR:4.17, 95% CI 1.85-7.13, p:0.001), positive troponin (OR:5.47, 95% Cl 1.07-7.46, p:0.011), atrial fibrillation rhythm (OR;3.16, 95% CI 1.81-8.02, p:0.010), inotropic drug usage (OR;5.61, 95% CI 1.87-9.24, p:0.013) increased in-hospital mortality. Conclusion: Our findings could help clinicians in identifying patients with poor prognosis early in the presence of identified risk factors.

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Cite This Study

Sert et al. (2021) conducted an observational in Acute cardiogenic pulmonary edema (n=305). Positive troponin vs. Negative troponin was evaluated on In-hospital mortality (OR 5.47, 95% CI 1.07-7.46, p=0.011). Positive troponin (OR 5.47), acute myocardial infarction (OR 4.17), and inotropic drug usage (OR 5.61) significantly increased in-hospital mortality in patients with acute cardiogenic pulmonary edema.

synapsesocial.com/papers/6a7761e5576efb0ddaf74d46https://doi.org/10.16899/jcm.853237
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