The Effect of Early Diuretic Treatment on Clinical Outcomes in Patients with Acute Heart Failure: Door to Diuretic

Abstract

Objective:It was aimed to investigate the effect of early diuretic treatment on hospitalization and short-term mortality in patients with acute heart failure.Method:Our study was carried out as a retrospective, single-centered, observational study in the department of emergency a tertiary training and research hospital. The study population was the patients presenting with signs and symptoms of acute heart failure. The primary outcome was all-cause 30-day mortality and hospitalization. Univariant tests and ROC analysis were used for analysis.Results:A total of 325 patients were included. The median age of the patients was 76.0 years (interquartile range 69.0-83.0). The mortality rate of our study population was %14.4 (47). Systolic blood pressure and diastolic blood pressure were significantly higher in the survivor group (p=0.018, 0.033, respectively). Age, troponin-I, and pro-brain natriuretic peptide were significantly higher in the non-survivor group (p<0.001, <0.001, <0.001, respectively). For hospitalization, the area under the curve for the high door to diuretic time was 0.570, the cut-off value was 99 minutes, and the odds ratio was 1.75 (95% confidence interval: 1.09-2.82).Conclusion:Early initiation of diuretic treatment has no effect on short-term mortality. However, delayed initiation of diuretic treatment may affect hospitalization rates. According to our results, early initiation of diuretic treatment may reduce hospitalization rates.

Keywords

• acute disease
• diuretics
• emergency service
• heart failure
• time-to-treatment