Prehospital acute life-threatening cardiovascular disease in elderly: an observational, prospective, multicentre, ambulance-based cohort study

Article Subjects > Biomedicine Europe University of Atlantic > Research > Scientific Production
Fundación Universitaria Internacional de Colombia > Research > Scientific Production
Ibero-american International University > Research > Scientific Production
Ibero-american International University > Research > Articles and Books
Universidad Internacional do Cuanza > Research > Scientific Production
University of La Romana > Research > Scientific Production
Open English Objective The aim was to explore the association of demographic and prehospital parameters with short-term and long-term mortality in acute life-threatening cardiovascular disease by using a hazard model, focusing on elderly individuals, by comparing patients under 75 years versus patients over 75 years of age. Design Prospective, multicentre, observational study. Setting Emergency medical services (EMS) delivery study gathering data from two back-to-back studies between 1 October 2019 and 30 November 2021. Six advanced life support (ALS), 43 basic life support and five hospitals in Spain were considered. Participants Adult patients suffering from acute life-threatening cardiovascular disease attended by the EMS. Primary and secondary outcome measures The primary outcome was in-hospital mortality from any cause within the first to the 365 days following EMS attendance. The main measures included prehospital demographics, biochemical variables, prehospital ALS techniques used and syndromic suspected conditions. Results A total of 1744 patients fulfilled the inclusion criteria. The 365-day cumulative mortality in the elderly amounted to 26.1% (229 cases) versus 11.6% (11.6%) in patients under 75 years old. Elderly patients (≥75 years) presented a twofold risk of mortality compared with patients ≤74 years. Life-threatening interventions (mechanical ventilation, cardioversion and defibrillation) were also related to a twofold increased risk of mortality. Importantly, patients suffering from acute heart failure presented a more than twofold increased risk of mortality. Conclusions This study revealed the prehospital variables associated with the long-term mortality of patients suffering from acute cardiovascular disease. Our results provide important insights for the development of specific codes or scores for cardiovascular diseases to facilitate the risk of mortality characterisation. metadata del Pozo Vegas, Carlos; Zalama-Sánchez, Daniel; Sanz-Garcia, Ancor; López-Izquierdo, Raúl; Sáez-Belloso, Silvia; Mazas Pérez-Oleaga, Cristina; Dominguez Azpíroz, Irma; Elío Pascual, Iñaki and Martín-Rodríguez, Francisco mail UNSPECIFIED, UNSPECIFIED, UNSPECIFIED, UNSPECIFIED, UNSPECIFIED, cristina.mazas@uneatlantico.es, irma.dominguez@unini.edu.mx, inaki.elio@uneatlantico.es, UNSPECIFIED (2023) Prehospital acute life-threatening cardiovascular disease in elderly: an observational, prospective, multicentre, ambulance-based cohort study. BMJ Open, 13 (11). e078815. ISSN 2044-6055

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Abstract

Objective The aim was to explore the association of demographic and prehospital parameters with short-term and long-term mortality in acute life-threatening cardiovascular disease by using a hazard model, focusing on elderly individuals, by comparing patients under 75 years versus patients over 75 years of age. Design Prospective, multicentre, observational study. Setting Emergency medical services (EMS) delivery study gathering data from two back-to-back studies between 1 October 2019 and 30 November 2021. Six advanced life support (ALS), 43 basic life support and five hospitals in Spain were considered. Participants Adult patients suffering from acute life-threatening cardiovascular disease attended by the EMS. Primary and secondary outcome measures The primary outcome was in-hospital mortality from any cause within the first to the 365 days following EMS attendance. The main measures included prehospital demographics, biochemical variables, prehospital ALS techniques used and syndromic suspected conditions. Results A total of 1744 patients fulfilled the inclusion criteria. The 365-day cumulative mortality in the elderly amounted to 26.1% (229 cases) versus 11.6% (11.6%) in patients under 75 years old. Elderly patients (≥75 years) presented a twofold risk of mortality compared with patients ≤74 years. Life-threatening interventions (mechanical ventilation, cardioversion and defibrillation) were also related to a twofold increased risk of mortality. Importantly, patients suffering from acute heart failure presented a more than twofold increased risk of mortality. Conclusions This study revealed the prehospital variables associated with the long-term mortality of patients suffering from acute cardiovascular disease. Our results provide important insights for the development of specific codes or scores for cardiovascular diseases to facilitate the risk of mortality characterisation.

Document Type: Article
Subject classification: Subjects > Biomedicine
Divisions: Europe University of Atlantic > Research > Scientific Production
Fundación Universitaria Internacional de Colombia > Research > Scientific Production
Ibero-american International University > Research > Scientific Production
Ibero-american International University > Research > Articles and Books
Universidad Internacional do Cuanza > Research > Scientific Production
University of La Romana > Research > Scientific Production
Deposited: 30 Nov 2023 23:30
Last Modified: 02 Jan 2024 23:30
URI: https://repositorio.unib.org/id/eprint/9908

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