Objectives: We aimed to demonstrate the outcomes of various presentations of acute heart failure (AHF), as well as test the generalizability of previous results in routine clinical practice.
Methods: This retrospective cohort study compares two patient groups of AHF: those who self-presented compared to those who used an ambulance. The primary endpoint was the measure of 30-, 180-, and 365-day cardiovascular (CV) mortality after the index hospitalization event. Secondary endpoints included HF rehospitalization within 30 days of enrollment, index hospital stay, and death from any cause during the index hospitalization. The relationship between the two modes of presentation was calculated by multivariate analysis.
Results: A total of 14,454 patients with AHF presented to the emergency department. Patients who presented by ambulance had a higher 30-, 180-, and 365-day mortality than those who self-presented (30-day: 5.57% vs. 3.53%, OR [95% CI]: 0.65 [0.24-0.93], -value <0.001; 180-day: 11.25% vs. 8.41%, OR [95% CI]: 0.52 [0.34-0.97], -value = 0.021; and 365-day: 19.25% vs. 15.48%, OR [95% CI]: 0.67 [0.33-0.95], -value <0.001).
Conclusion: AHF patients who presented via ambulance had a higher 30-, 180-, and 365-day mortality as compared to self-presentation.
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