Original article Management of Acute Heart Failure in Spanish Emergency Departments Based on Age Francisco Javier Martı ´n-Sa ´ nchez, a,b, * Rocı ´o Marino-Genicio, c Esther Rodrı ´guez-Adrada, a Javier Jacob, d Pablo Herrero, c O ` scar Miro ´, e,f Pere Llorens, g and Jose ´ Manuel Ribera-Casado, h on behalf of the ICA-SEMES Group ^ a Servicio de Urgencias, Hospital Clı´nico San Carlos, Madrid, Spain b Instituto de Investigacio ´n Sanitaria, Hospital Clı´nico San Carlos (IdISSC), Madrid, Spain c Servicio de Urgencias, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain d Servicio de Urgencias, Hospital Universitari de Bellvitge IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain e A ´ rea de Urgencias, Hospital Clı´nic, Barcelona, Spain f Grupo de Investigacio ´n ‘‘Urgencias: procesos y patologı´as’’, IDIBAPS, Barcelona, Spain g Servicio de Urgencias-UCE y UHD, Hospital General Universitario de Alicante, Alicante, Spain h Departamento de Geriatrı´a, Universidad Complutense, Hospital Clı´nico San Carlos, Madrid, Spain Rev Esp Cardiol. 2013;66(9):715–720 Article history: Received 24 April 2013 Accepted 26 April 2013 Available online 20 July 2013 Keywords: Acute heart failure Elderly Emergency department A B S T R A C T Introduction and objectives: To investigate possible age-related differences in the profile, clinical symptoms, management, and short-term outcomes of patients seen for acute heart failure in Spanish emergency departments. Methods: We performed a multipurpose, multicenter study with prospective follow-up including all patients with acute heart failure attended in 29 Spanish emergency departments. The following variables were collected: demographic, personal history, geriatric syndromes, data of acute episode, discharge destination, in-hospital and 30-day mortality and 30-day revisit. The sample was divided into 4 age groups: <65, 65-74, 75-84, and 85 years. Results: We included 5819 patients: 493 (8.5%) were <65 years old, 971 (16.7%) were 65-74 years old, 2407 (41.4%) were 75-84 years old, and 1948 (33.5%) were 85 years old; 4424 patients (76.5%) were admitted from the emergency department, 251 of whom (4.5%) died during hospitalization. Statistically significant differences were observed in relation to cardiovascular risk factors, comorbidities, geriatric syndromes, clinical presentation, and diagnostic and therapeutic procedures based on an increase in the age of the groups. A statistically significant linear trend was observed between age group and the probability of hospital admission (P<.001), and hospital (P<.001) and 30-day mortality (P<.001). Conclusions: The management of acute heart failure in elderly patients requires a multidimensional approach which goes beyond merely cardiological aspects of treatment. ß 2013 Sociedad Espan ˜ola de Cardiologı ´a. Published by Elsevier Espan ˜a, S.L. All rights reserved. El manejo de la insuficiencia cardiaca aguda en los servicios de urgencias hospitalarios espan ˜ oles en funcio ´n de la edad Palabras clave: Insuficiencia cardiaca aguda Anciano Servicio de urgencias R E S U M E N Introduccio ´n y objetivos: Determinar si en funcio ´n de la edad hay diferencias en el perfil, la clı ´nica, el manejo y los resultados a corto plazo en los pacientes atendidos por insuficiencia cardiaca aguda en los servicios de urgencias espan ˜ oles. Me ´todos: Estudio de cohorte multipropo ´ sito y multice ´ ntrico, con seguimiento prospectivo, que incluyo ´a todos los pacientes con insuficiencia cardiaca aguda de 29 servicios de urgencias espan ˜ oles. Se recogieron variables demogra ´ ficas, antecedentes personales, sı ´ndromes geria ´ tricos, datos del episodio agudo, destino final, mortalidad hospitalaria y mortalidad y revisita a los 30 dı ´as. Se dividio ´ la muestra en cuatro grupos en funcio ´n de la edad (< 65, 65-74, 75-84,  85 an ˜os). * Corresponding author: Servicio de Urgencias, Hospital Clı ´nico San Carlos, Prof. Martı ´n-Lagos s/n, 28040 Madrid, Spain. E-mail address: fjjms@hotmail.com (F.J. Martı ´n-Sa ´ nchez). ^ EAHFE-Group ICA-SEMES registry researchers: He ´ ctor Alonso (Hospital Marque ´s de Valdecilla, Santander); Cristina Gil, Marta Fuentes (Hospital Universitario Salamanca); Jose ´ Valles, M. Jose ´ Pe ´ rez-Dura ´(Hospital La Fe, Valencia); Jose ´ Pavo ´ n, Ana Bella A ´ lvarez (Hospital Dr. Negrı´n, Las Palmas de Gran Canaria); Antonio Noval (Hospital Insular, Las Palmas de Gran Canaria); Jose ´ M. Torres (Hospital Reina Sofı´a, Co ´rdoba); Marı ´a Luisa Lo ´ pez-Grima (Hospital Dr. Peset, Valencia); Alfons Aguirre (Hospital del Mar, Barcelona); Helena Sancho, Francisco Ruiz (Hospital de Valme, Sevilla); Jose ´ Miguel Franco, Antonio Gime ´ nez (Hospital Miguel Servet, Zaragoza); Sergio Pardo (Hospital San Juan, San Juan de Alicante); Ana Bele ´n Mecina (Hospital de Alcorcon, Alcorco ´n); Josep Tost (Consorci Sanitari de Terrassa, Terrassa); Jordi Fabregat (Hospital Mu ´tua de Terrassa, Terrassa); Francisco Epelde (Consorci Sanitari i Universitari Parc Taulı´, Sabadell); Susana Sa ´ nchez (Hospital Rio Ortega, Valladolid); Pascual Pin ˜era (Hospital Reina Sofı´a, Murcia); Raquel Torres (Hospital Severo Ochoa, Legane ´s); Miguel Alberto Rizzi, Aitor Alquezar (Hospital de Sant Pau, Barcelona); Javier Lucas (Hospital General de Albacete, Albacete); Fernando Richard (Hospital de Burgos, Burgos); Jose ´ Garrido (Hospital Virgen de la Macarena, Sevilla). 1885-5857/$ – see front matter ß 2013 Sociedad Espan ˜ola de Cardiologı ´a. Published by Elsevier Espan ˜a, S.L. All rights reserved. http://dx.doi.org/10.1016/j.rec.2013.04.019 Document downloaded from http://www.revespcardiol.org, day 22/05/2017. This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited.