Publication Information: Linköpings universitet, Avdelningen för diagnostik och specialistmedicin
Linköpings universitet, Medicinska fakulteten
Region Östergötland, Kardiologiska kliniken US
Natl & Kapodistrian Univ Athens, Greece
Natl Heart Ctr, Singapore; Univ Amsterdam, Netherlands
Natl & Kapodistrian Univ Athens, Greece; Univ Cyprus, Cyprus
Vanderbilt Univ, TN USA; Geriatr Res & Educ Ctr, TN USA
Comprehens Heart Failure Ctr Univ, Germany; Univ Hosp Wurzburg, Germany
Univ Bergen, Norway
Natl Univ Singapore, Singapore; Natl Univ Hlth Syst, Singapore; Duke NUS Med Sch, Singapore; Yong Loo Lin Sch Med, Singapore
Univ Glasgow, Scotland; Imperial Coll, England
Novartis Pharm AG, Switzerland
M Ghadanfar Consulting Life Sci, Switzerland
Cruce Hosp Florencio Varela, Argentina
Alexandria Univ, Egypt
Natl Heart Ctr, Singapore; Duke NUS Med Sch, Singapore
WILEY PERIODICALS, INC
Abstract: Aims Hospital admission during nighttime and off hours may affect the outcome of patients with various cardiovascular conditions due to suboptimal resources and personnel availability, but data for acute heart failure remain controversial. Therefore, we studied outcomes of acute heart failure patients according to their time of admission from the global International Registry to assess medical practice with lOngitudinal obseRvation for Treatment of Heart Failure.Methods and results Overall, 18 553 acute heart failure patients were divided according to time of admission into morning (7:00-14:59), evening (15:00-22:59), and night (23:00-06:59) shift groups. Patients were also dichotomized to admission during working hours (9:00-16:59 during standard working days) and non-working hours (any other time). Clinical characteristics, treatments, and outcomes were compared across groups. The hospital length of stay was longer for morning (odds ratio: 1.08; 95% confidence interval: 1.06-1.10, P < 0.001) and evening shift (odds ratio: 1.10; 95% confidence interval: 1.07-1.12, P < 0.001) as compared with night shift. The length of stay was also longer for working vs. non-working hours (odds ratio: 1.03; 95% confidence interval: 1.02-1.05, P < 0.001). There were no significant differences in in-hospital mortality among the groups. Admission during working hours, compared with non-working hours, was associated with significantly lower mortality at 1 year (hazard ratio: 0.88; 95% confidence interval: 0.80-0.96, P = 0.003).Conclusions Acute heart failure patients admitted during the night shift and non-working hours had shorter length of stay but similar in-hospital mortality. However, patients admitted during non-working hours were at a higher risk for 1 year mortality. These findings may have implications for the health policies and heart failure trials. ; Funding Agencies|Novartis
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