Profile of patients hospitalized in intensive cardiac care units in France: ADDICT-ICCU registry - 21/03/24
on behalf of the ADDICT-ICCU Investigators1
Graphical abstract |
Highlights |
• | Typology of patients hospitalized in ICCU in France is poorly known. |
• | Acute coronary syndromes represent more than half of admission to ICCU. |
• | A broad array of other cardiovascular disease with comorbidities is seen. |
• | Acute heart failure represents a burden for resource use and mortality. |
• | Large proportion of patients has a good hospital prognosis and low resource use. |
Abstract |
Background |
Intensive cardiac care units (ICCU) were initially developed to monitor ventricular arrhythmias after myocardial infarction. In recent decades, ICCU have diversified their activities.
Aim |
To determine the type of patients hospitalized in ICCU in France.
Methods |
We analysed the characteristics of patients enrolled in the ADDICT-ICCU registry (NCT05063097), a prospective study of consecutive patients admitted to ICCU in 39 centres throughout France from 7th–22nd April 2021. In-hospital major adverse events (MAE) (death, resuscitated cardiac arrest and cardiogenic shock) were recorded.
Results |
Among 1499 patients (median age 65 [interquartile range 54–74] years, 69.6% male, 21.7% diabetes mellitus, 64.7% current or previous smokers), 34.9% had a history of coronary artery disease, 11.7% atrial fibrillation and 5.2% cardiomyopathy. The most frequent reason for admission to ICCU was acute coronary syndromes (ACS; 51.5%), acute heart failure (AHF; 14.1%) and unexplained chest pain (6.8%). An invasive procedure was performed in 36.2%. “Advanced” ICCU therapies were required for 19.9% of patients (intravenous diuretics 18.4%, non-invasive ventilation 6.1%, inotropic drugs 2.3%). No invasive procedures or advanced therapies were required in 44.1%. Cardiac computed tomography or magnetic resonance imaging was carried out in 12.3% of patients. The median length of ICCU hospitalization was 2.0 (interquartile range 1.0–4.0) days. The mean rate of MAE was 4.5%, and was highest in patients with AHF (10.4%).
Conclusions |
ACS remains the main cause of admissions to ICCU, with most having a low rate of in-hospital MAE. Most patients experience a brief stay in ICCU before being discharged home. AHF is associated with highest death rate and with higher resource consumption.
Le texte complet de cet article est disponible en PDF.Keywords : Intensive cardiac care unit, Cardiovascular disease, Epidemiology, In-hospital major adverse outcomes, Management
Plan
Vol 117 - N° 3
P. 195-203 - mars 2024 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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