Publications by authors named "Hector Alonso"

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.

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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.
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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.

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This work constitutes the first survey that allows the establishment of baseline levels of environmental radioactivity in beach sands from the volcanic oceanic islands of La Graciosa, Lanzarote, Fuerteventura and Gran Canaria. Activity concentration values of Ra, Th and K were measured by gamma spectroscopy in 108 samples, collected from 39 beaches across the whole study region. The radiological hazard risks associated with these sands were studied.

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Objectives: To analyze the consistency between decisions to discharge or admit patients with acute heart failure (AHF) treated in emergency departments (EDs) and the level of risk of adverse events, and to analyze the impact of decisions to discharge patients.

Material And Methods: Prospective study of baseline clinical data collected from patients diagnosed with AHF in 16 Spanish emergency departments. Patients were stratified by severity of decompensated AHF based on MEESSI assessment (Multiple Estimation of Risk Based on the Spanish Emergency Department Score).

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Objective: Both hyperkalemia (HK) and Acute Heart Failure (AHF) are associated with increased short-term mortality, and the management of either may exacerbate the other. As the relationship between HK and AHF is poorly described, our purpose was to determine the relationship between HK and short-term outcomes in Emergency Department (ED) AHF.

Methods: The EAHFE Registry enrolls all ED AHF patients from 45 Spanish ED and records in-hospital and post-discharge outcomes.

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There is a widely recognized need to reduce human activity's impact on the environment. Many industries of the leather and textile sector (LTI), being aware of producing a significant amount of residues (Keßler et al. 2021; Liu et al.

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Introduction: Social vulnerability is a known determinant of health in respiratory diseases. Our aim was to identify whether there are socio-demographic factors among COVID-19 patients hospitalized in Spain and their potential impact on health outcomes during the hospitalization.

Methods: A multicentric retrospective case series study based on administrative databases that included all COVID-19 cases admitted in 19 Spanish hospitals from 1 March to 15 April 2020.

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Objective: Experts recommended that direct discharge without hospitalization (DDWH) for emergency departments (EDs) able to observe acute heart failure (AHF) patients should be >40%, and these discharged patients should fulfil the following outcome standards: 30-day all-cause mortality <2% (outcome A); 7-day ED revisit due to AHF < 10% (outcome B); and 30-day ED revisit/hospitalization due to AHF < 20% (outcome C). We investigated these outcomes in a nationwide cohort and their relationship with the ED DDWH percentage.

Methods: We analyzed the EAHFE registry (includes about 15% of Spanish EDs), calculated DDWH percentage of each ED, and A/B/C outcomes of DDWH patients, overall and in each individual ED.

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Background: The coexistence of other comorbidities confers poor outcomes in patients with acute heart failure. Our aim was to determine the characteristics of patients with acute heart failure and cardiorenal anaemia syndrome and the relationship between renal dysfunction and anaemia, alone or combined as cardiorenal anaemia syndrome, on short-term outcomes.

Methods: We analysed the Epidemiology of Acute Heart Failure in Emergency Departments registry (cohort of patients with acute heart failure in Spanish emergency departments).

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Objectives: This study investigated whether systemic corticosteroids (new onset) administered to patients with acute heart failure (AHF) have any association with outcomes, with differentiated analyses for patients with and without chronic obstructive pulmonary disease (COPD) as a comorbidity.

Background: Patients with undiagnosed dyspnea frequently receive corticosteroids in emergency departments while determining a final diagnosis, but their effect on the outcomes of patients with AHF without overt COPD exacerbation is unknown.

Methods: We selected patients with AHF from the EAHFE (Epidemiology of Acute Heart Failure in the Emergency Departments) registry, recording key data (new-onset corticosteroid therapy, COPD condition).

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Article Synopsis
  • The study focused on how the length of hospitalisation (LOH) affects the outcomes of patients with acute heart failure (AHF) after they are discharged, comparing results across different hospital departments.
  • Out of 8,563 patients analyzed, 90-day outcomes showed that longer hospital stays led to higher post-discharge mortality rates, particularly for those staying over 15 days, but readmission rates remained constant regardless of LOH.
  • The research concluded that shorter hospital stays do not lead to worse outcomes, and higher mortality risks associated with longer stays were consistent across various hospital departments.
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Objectives: To analyse time trends in patient characteristics, clinical course, hospitalisation rate, and outcomes in acute heart failure along a 10-year period (2007-2016).

Methods: The EAHFE registry has prospectively collected 13,971 consecutive AHF patients diagnosed in 41 Spanish emergency departments (EDs) at five different time points (2007/2009/2011/2014/2016). Eighty patient-related variables and outcomes were described and statistically significant changes along time were evaluated.

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Background And Objective: To compare the outcome of patients with acute heart failure (AHF) with a mid-range left ventricular ejection fraction (HFmrEF) with patients with a reduced (HFrEF) or preserved (HFpEF) left ventricular ejection fraction.

Patients And Method: A prospective observational study included patients diagnosed with AHF in 41 emergency departments. Patients were divided into 3 groups: HFrEF<40%, HFmrEF 40-49% and HFpEF≥50%.

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Objectives: To identify factors associated with short hospital stays for patients admitted with acute heart failure (AHF) admitted to hospitals with short-stay units (SSU).

Material And Methods: Multicenter nonintervention study in a multipurpose cohort of patients with AHF to 10 Spanish hospitals with short-stay units; patients were followed prospectively. We recorded demographic data, medical histories, baseline cardiorespiratory and function variables on arrival in the emergency department, on admission, and at 30 days.

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Article Synopsis
  • The study analyzes data from the EAHFE registry, which focuses on clinical characteristics and treatment of acute heart failure (AHF) patients in 29 Spanish emergency departments over the years 2007, 2009, and 2011.
  • It includes data from 5,845 patients, averaging 79 years old, with high rates of comorbidities like hypertension, diabetes, and atrial fibrillation, and highlights their treatment approaches, such as the widespread use of diuretics.
  • The findings show trends in management changes over time, with insights into patient demographics, treatment outcomes, and the effectiveness of various therapies compared to other AHF registries.
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Background And Objective: To study the factors associated with prolonged hospitalization in patients admitted for acute heart failure (AHF) in Spanish short-stay units (SSUs).

Patients And Methods: This was a multicentre, multipurpose cohort study with prospective follow-up including all patients admitted for AHF in the 11 SSUs of the EAHFE registry. Demographic data, previous illness, baseline cardiorespiratory and functional status, acute episode and admission and follow up variables at 60 days were recorded.

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Background: The mainstay of treatment for acutely decompensated heart failure (ADHF) is intravenous diuretic therapy either as a bolus or via continuous infusion.

Objectives: We evaluated the clinical effects and safety of three strategies of intravenous furosemide administration used in emergency departments (EDs) for ADHF.

Methods: We performed a multicentre, randomised, parallel-group study.

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Background: Patients with acute heart failure (AHF) are frequently evaluated in the Emergency Departments (ED) and discharged from their observation units (OU) without hospital admission. We examined direct discharge rates from the ED OU, risk factors for returning to the ED, and returning and mortality rates.

Patients And Methods: This prospective, longitudinal, noninterventional, population-based cohort study included all the patients with AHF consecutively attended in seven Spanish EDs who were directly discharged without hospital admission.

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