Abstract 4367530: Impact Of Admission Timing On Management And In-Hospital Outcomes In Acute Heart Failure: Insight From The CAN-HF Registry
Notice bibliographique
Résumé
Background: The impact of hospital admission timing on outcomes in acute heart failure (AHF) remain unclear. Prior studies suggest that timing of hospital presentation may affect early management. This study aimed to determine whether admission timing was associated with differences in patient characteristics, acute management, and in-hospital outcomes for AHF. Methods: We conducted a retrospective analysis of the Canadian Heart Failure (CAN-HF) registry of hospitalized patients with AHF across multiple Canadian centers. We categorized patient presentation by admission timing: weekday vs weekend, and daytime (8am to 8pm) vs nighttime (8pm to 8am). Baseline patient characteristics and clinical presentation details were compared between timing groups. Emergency department (ED) treatment patterns and key in-hospital outcomes were assessed for differences based on admission timing. Results: Of 943 patients hospitalized with AHF, 21.6% were admitted on weekends and 28.6% during nighttime hours. Patients with weekend admissions were older (77.8 vs. 75.5 years, p = 0.03), had more chronic kidney disease (12.7% vs. 6.9%, p = 0.01), and presented more frequently with pulmonary congestion on imaging (72.1% vs. 64.8%, p = 0.05). ED treatment was more intensive during off-hours: weekend admissions received more IV diuretics (71.6% vs. 61.7%, p = 0.01) and non-invasive ventilation (9.3% vs. 4.6%, p = 0.01); nighttime admissions had higher use of IV nitrates (5.6% vs. 1.5%, p < 0.01) and non-invasive ventilation (9.3% vs. 4.2%, p < 0.01). There were no delays (> 6 hours) in cardiology consultation based on timing of presentation (p = 0.50 weekday vs weekend, p = 0.56 daytime vs nighttime). Median time to diuretics was shorter at night (185 vs. 224.5 minutes, p = 0.02), and trended towards significance after adjustment ( Table 1) ; ED length of stay (LOS) was modestly shorter at night (10.5 vs. 11.0 hours, p = 0.04). Nighttime admission remained independently associated with shorter hospital stay while weekend admission did not impact LOS. Admission timing did not affect adjusted in-hospital mortality (Table 1). Conclusion: Patients presenting during off-hours were more acute and required more intensive, expeditious therapies in the ED. However, key in-hospital outcomes did not differ by admission timing. These findings suggest that prompt delivery of HF therapy rather than timing of presentation may drive outcomes.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».