• Matthieu Marchetti, Antoine Benedetti, Olivier Mimoz, Jean-Yves Lardeur, Jérémy Guenezan, and Nicolas Marjanovic.
• Emergency Department, University Hospital of Poitiers, 86000 Poitiers, France. Electronic address: matthieu.marchetti@gmail.com.
• Am J Emerg Med. 2017 Mar 1; 35 (3): 444-447.

ObjectivesAcute heart failure (AHF) is a leading cause of admission in emergency departments (ED). It is associated with significant in-hospital mortality, suggesting that there is room for improvement of care. Our aims were to investigate clinical patterns, biological characteristics and determinants of 30-day mortality.MethodsWe conducted a single site, retrospective review of adult patients (≥18years) admitted to ED for AHF over a 12-month period. Data collected included demographics, clinical, biological and outcomes data. Epidemiologic data were collected at baseline, and patients were followed up during a 30-day period.ResultsThere were a total of 322 patients. Mean age was 83.9±9.1years, and 47% of the patients were men. Among them, 59 patients (18.3%) died within 30days of admission to the ED. The following three characteristics were associated with increased mortality: age>85years (OR=1.5[95%CI:0.8-2.7], p=0.01), creatinine clearance <30mL/min (OR=2.6[95%CI:1.4-5], p<0.001) and Nt-proBNP >5000pg/mL (OR=2.2[95%CI:1.2-4], p<0.001). The best Nt-proBNP cut-off value to predict first-day mortality was 9000pg/mL (area under the curve (AUC) [95%CI] of 0.790 [0.634-0.935], p<0.001). For 7-day mortality, it was 7900pg/mL (0.698 [0.578-0.819], p<0.001) and for 30-day mortality, 5000pg/mL (0.667 [0.576-0.758], p<0.001).ConclusionsNt-proBNP level on admission, age and creatinine clearance, are predictive of 30-day mortality in adult patients admitted to ED for AHF.Copyright © 2016 Elsevier Inc. All rights reserved.

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