Publications by authors named "Alquezar-Arbe A"
Background And Importance: Elderly patients often have atypical clinical presentations. Lactate measurement on arrival at the Emergency Department (ED) could be useful to identify elderly patients with a bad prognosis.
Objective: The study aimed to investigate the relationship between serum lactate determined at ED arrival and the probability of inhospital mortality and intensive care (ICU) admission in elderly patients.
Article Synopsis
- The study aimed to assess the incidence of urinary tract infections (UTIs) in elderly patients visiting emergency departments in Spain, including factors like hospitalization and outcomes.
- Out of 25,375 patients, 1,058 were diagnosed with UTIs, showing an annual incidence of 24.7 per 1,000 seniors, with 36.5% requiring hospitalization; 30-day mortality was recorded at 5.4%.
- The findings highlighted that functional dependence was strongly linked to negative health outcomes, while the biomarkers tested did not effectively predict these adverse events.
Article Synopsis
- - The study analyzes the prevalence of benzodiazepine prescriptions among elderly patients visiting emergency departments in Spain and their impact on short-term health outcomes.
- - Out of 25,557 patients studied, 30.8% were prescribed benzodiazepines, which were linked to an increased chance of returning to the emergency department but not to higher rates of hospitalization or mortality within 30 days.
- - The findings suggest that while benzodiazepine use may lead to more frequent ED visits, it does not significantly affect hospitalization rates or mortality in the short term.
To investigate if worsening renal function (WRF) appearing in some patients with acute heart failure (AHF) after intravenous furosemide initiation is influenced by severity of congestion. We conducted a retrospective secondary analysis of consecutive patients diagnosed with AHF and prospectively included in 10 Spanish emergency departments (EDs) for whom serum creatinine at ED arrival and after 2-7 days of intravenous furosemide initiation were available. Congestion was clinically evaluated by identification of 7 signs/symptoms and by chest X-ray.
View Article and Find Full Text PDFObjectives: The aim of the present study was to evaluate the impact of chronic treatment with angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) on short-term clinical outcomes after an episode of AHF.
Methods: A secondary analysis of patients included in the EAHFE (Epidemiology of Acute Heart Failure in Emergency Departments) cohort, which includes patients diagnosed with AHF in 45 Spanish Emergency Departments (EDs). The primary outcome was all-cause in-hospital mortality.
Tachypnea in response to hypoxemia decreases with age in older patients.
Geriatr Gerontol Int
November 2024
Article Synopsis
- The study aimed to investigate whether older patients (≥65 years) have a diminished tachypneic response to hypoxia, meaning they may not breathe faster in response to low oxygen levels as much as younger patients do.
- Researchers analyzed data from 7126 patients in Spanish emergency departments, measuring peripheral arterial oxygen saturation (SatO2) and respiratory rate (RR) upon arrival, finding significant correlations across all age groups studied.
- Results indicated that as patient age increased, the respiratory rate response to decreasing oxygen levels slowed down, with younger individuals showing a faster increase in breathing rate in response to hypoxia compared to older individuals, particularly those aged ≥90 years.
Aims: To investigate whether seasonal influenza and COVID-19 vaccinations influence the severity of decompensations and long-term outcomes of patients with acute heart failure (AHF).
Methods And Results: We included consecutive AHF patients attended at 40 Spanish emergency departments during November and December 2022. They were grouped according to whether they had received seasonal influenza and COVID-19 vaccination.
Objective: To study factors associated with hospitalization in an unselected population of patients aged 65 years or older treated for syncope in Spanish hospital emergency departments (EDs). To determine the prevalence of adverse events at 30 days in patients discharged home and the factors associated with such events.
Methods: We included all patients aged 65 years or older who were diagnosed with syncope during a single week in 52 Spanish EDs, recording patient clinical and ED case management data.
Digoxin is commonly used to treat acute heart failure (AHF), especially in patients with concurrent atrial fibrillation (AF). Nonetheless, there is little consensus about in which patients digoxin should be given, the proper time for digoxin initiation, and whether digoxin initiation is associated with improved outcomes. We investigated factors related to digoxin initiation after an episode of AHF and whether patients receiving digoxin presented better short-term outcomes.
View Article and Find Full Text PDFArticle Synopsis
- The study examines factors influencing whether older patients (≥65 years) are discharged home or admitted to the hospital after being treated in an emergency department observation unit (EDOU).
- Data from 5,457 patients were analyzed, identifying five key indicators linked to a higher likelihood of discharge home, including the absence of fever and a Glasgow Coma Scale score of 15.
- Although a prediction model was developed to assess discharge likelihood, it showed limited accuracy and highlighted the ongoing challenge of individual-level predictions for older patients.
Article Synopsis
- Intravenous digoxin is commonly used in emergency departments to treat acute heart failure, particularly in patients experiencing rapid atrial fibrillation, but concerns about its risks in older patients and those with kidney issues exist.
- The study aimed to determine if digoxin influences 30-day mortality rates in patients with acute heart failure, taking into account factors like age, kidney function, and potassium levels.
- The analysis revealed no significant difference in mortality rates between patients treated with digoxin and those who were not, despite a high median age and serious health conditions among participants.
Objective: Analyse the association between the use of diagnostic tests and the characteristics of older patients 65 years of age or more who consult the emergency department (ED).
Methods: We performed an analysis of the EDEN cohort that includes patients who consulted 52 Spanish EDs. The association of age, sex, and ageing characteristics with the use of diagnostic tests (blood tests, electrocardiogram (ECG), microbiological cultures, X-ray, computed tomography, ultrasound, invasive techniques) was studied.
Article Synopsis
- A study evaluated the impact of older adults (aged 75+) spending a night in emergency departments (ED) on their risk of in-hospital mortality, comparing those who were admitted to wards before midnight versus those who stayed in the ED until morning.
- Despite slightly higher in-hospital mortality rates for those in the ED (10.7%) compared to the ward group (9.5%), the differences were not statistically significant, indicating that staying overnight in the ED did not conclusively increase mortality risk.
- The findings suggest that while older patients may face potential risks when waiting in an ED overnight, especially in non-academic hospitals, overall, there was no evidence of longer hospital stays or higher mortality rates tied to this practice
The elderly population frequently consults the emergency department (ED). This population could have greater use of EDs and hospital health resources. The EDEN cohort of patients aged 65 years or older visiting the ED allowed this association to be investigated.
View Article and Find Full Text PDFBackground: While the indication for noninvasive ventilation (NIV) in severely hypoxemic patients with acute heart failure (AHF) is often indicated and may improve clinical course, the benefit of early initiation before patient arrival to the emergency department (ED) remains unknown.
Objective: This study aimed to assess the impact of early initiation of NIV during emergency medical service (EMS) transportation on outcomes in patients with AHF.
Design: A secondary retrospective analysis of the EAHFE (Epidemiology of AHF in EDs) registry.
Objective: To investigate the association of the addition of thiazide diuretic on top of loop diuretic and standard of care with short-term outcomes of patients discharged after surviving an acute heart failure (AHF) episode.
Methods: This is a secondary analysis of 14,403 patients from three independent cohorts representing the main departments involved in AHF treatment for whom treatment at discharge was recorded and included loop diuretics. Patients were divided according to whether treatment included or not thiazide diuretics.
Impact of dementia on 30-, 180-, and 365-day mortality during the first pandemic wave in older adults seen in spanish emergency departments diagnosed with or without COVID-19.
Aging Ment Health
August 2024
Article Synopsis
- The study aimed to evaluate if dementia predicts mortality independently after older adults visit emergency departments during the first wave of COVID-19.
- Data was collected from nearly 10,000 patients aged 65 and older, with 15.5% having a prior history of dementia and 31.3% diagnosed with COVID-19.
- The findings revealed that dementia significantly increased the risk of death at 30, 180, and 365 days, particularly among those with a COVID-19 diagnosis.
To investigate whether the timing of a previous hospital admission for acute heart failure (AHF) is a prognostic factor for AHF patients revisiting the emergency department (ED) in the subsequent 12-month follow-up. All ED AHF patients enrolled in the previously described EAHFE registry were stratified by the presence or absence of an AHF hospitalization admission in the prior 12 months. The primary outcome was 12-month all-cause mortality post ED visit.
View Article and Find Full Text PDFST-segment elevation acute myocardial infarction & stoned: a bad trip.
Eur Heart J Acute Cardiovasc Care
May 2024
Objective: To estimate the incidence of acute heart failure (AHF) diagnosis in elderly patients in emergency departments (ED), diagnostic confirmation in hospitalized patients, and short-term adverse events.
Methods: All patients aged ≥65 years attended in 52 Spanish EDs during 1 week were included and those diagnosed with AHF were selected. In hospitalized patients, those diagnosed with AHF at discharge were collected.
Epidemiological and clinical management aspects of pneumonias diagnosed in the emergency department in elderly patients in Spain: Results of the EDEN-29 study.
Enferm Infecc Microbiol Clin (Engl Ed)
October 2024
Article Synopsis
- The study estimates pneumonia incidence in elderly patients in Spanish emergency departments, finding an annual rate of 18.4 cases per 1000 inhabitants.
- A significant 78% of these patients required hospitalization, with 30-day mortality at 14.2% and in-hospital mortality at 12.9%.
- Factors like functional dependency and severe comorbidity were closely linked to adverse events, while common biomarkers showed only moderate predictive ability for outcomes.
Background: Polypharmacy is a growing phenomenon among elderly individuals. However, there is little information about the frequency of polypharmacy among the elderly population treated in emergency departments (EDs) and its prognostic effect. This study aims to determine the prevalence and short-term prognostic effect of polypharmacy in elderly patients treated in EDs.
View Article and Find Full Text PDFPredictive usefulness of qSOFA, NEWS and GYM scores in the elderly patient: EDEN-5 study.
Enferm Infecc Microbiol Clin (Engl Ed)
November 2024
Objective: To analyze the prognostic accuracy of the scores NEWS, qSOFA, GYM used in hospital emergency department (ED) in the assessment of elderly patients who consult for an infectious disease.
Methods: Data from the EDEN (Emergency Department and Elderly Need) cohort were used. This retrospective cohort included all patients aged ≥65 years seen in 52 Spanish EDs during two weeks (from 1-4-2019 to 7-4-2019 and 30/3/2020 to 5/4/2020) with an infectious disease diagnosis in the emergency department.
Introduction: Mortality in emergency departments (EDs) is not well known. This study aimed to assess the impact of the first-wave pandemic on deaths accounted in the ED of older patients with COVID and non-COVID diseases.
Methods: We used data from the Emergency Department and Elderly Needs (EDEN) cohort (pre-COVID period) and from the EDEN-COVID cohort (COVID period) that included all patients ≥65 years seen in 52 Spanish EDs from April 1 to 7, 2019, and March 30 to April 5, 2020, respectively.
Objectives: To analyze factors related to the use of digoxin to treat patients with acute heart failure (AHF) in emergency departments (EDs) and the impact of digoxin treatment on short-term outcomes.
Material And Methods: We included patients diagnosed with AHF in 45 Spanish EDs. The patients, who were not undergoing long-term treatment for heart failure, were classified according to whether or not they were given intravenous digoxin in the ED.