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Raoul F, Sanchez S, Dacunka M, Nazeyrollas P, Al Amoura A, Girodet B, Mailler B, Chapoutot L, Marchais A. [Complications of coronary invasive procedures in nonagenarians: A case-control study]. Ann Cardiol Angeiol (Paris) 2020; 69:219-226. [PMID: 32800321 DOI: 10.1016/j.ancard.2020.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/21/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Coronary heart disease is the leading cause of morbidity and mortality in nonagenarians, whose numbers have doubled in twenty years. In the absence of recommendations, the place of coronary invasive strategy in this population remains a therapeutic challenge and its interest as well as its risks are poorly established. The aim of our study was to evaluate the safety of coronary invasive practice in the nonagenarian population for all indications. POPULATION AND METHODS This was a monocentric case-control study conducted from January 1, 2010 to May 30, 2019. The patients included were all nonagenarians who had undergone coronary angiography at the centre hospitalier de Troyes during this period. For each patient included, two controls matched on sex, date of procedure and procedure were drawn at random. The main judgment criterion was the occurrence of immediate per- or post-procedure complications during the stay in which the procedure was performed. The main secondary outcome measures were average length of stay, occurrence of intercurrent events during the stay (nosocomial infections, confusional syndrome), and loss of autonomy. RESULTS In all, 59 nonagenarians and 118 controls were included in our study. We identified 30.5% major complications in the nonagenarians versus 10.2% in the controls (P=0.001; OR=0.26 [0.1-0.6]), with a significant difference in the occurrence of cardiogenic shock (P=0.04), heart failure (P=0.02) and ventricular rhythm disorders (P=0.04). Post-procedure acute renal failure was greater in the nonagenarians (P=0.02; OR=0.20 [0.05-1.57]). The mean length of stay was on average twice as long in the nonagenarians. CONCLUSION Nonagenarian patients are subject to more complications when undergoing coronary invasive procedures compared to patients under 75.
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Affiliation(s)
- F Raoul
- Pôle vasculaire, service de cardiologie, centre hospitalier de Troyes, 101, avenue Anatole-France, 10000 Troyes, France.
| | - S Sanchez
- Pôle territorial santé publique et performance, centre hospitalier de Troyes, 101, avenue Anatole-France, 10000 Troyes, France.
| | - M Dacunka
- Pôle vasculaire, service de cardiologie, centre hospitalier de Troyes, 101, avenue Anatole-France, 10000 Troyes, France.
| | - P Nazeyrollas
- Pôle vasculaire, service de cardiologie, centre hospitalo-universitaire de Reims, 52, avenue Cognacq-Jay, 51100 Reims, France.
| | - A Al Amoura
- Pôle vasculaire, service de cardiologie, centre hospitalier de Troyes, 101, avenue Anatole-France, 10000 Troyes, France.
| | - B Girodet
- Pôle vasculaire, service de cardiologie, centre hospitalier de Troyes, 101, avenue Anatole-France, 10000 Troyes, France.
| | - B Mailler
- Pôle vasculaire, service de cardiologie, centre hospitalier de Troyes, 101, avenue Anatole-France, 10000 Troyes, France.
| | - L Chapoutot
- Pôle vasculaire, service de cardiologie, centre hospitalier de Troyes, 101, avenue Anatole-France, 10000 Troyes, France.
| | - A Marchais
- Pôle vasculaire, service de cardiologie, centre hospitalier de Troyes, 101, avenue Anatole-France, 10000 Troyes, France.
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Dacunka M, Sanchez S, Chapoutot L, Marchais A. [Impact of a Home Return Assistance Service (PRADO-IC) on the re-hospitalisation rate for heart failure patients]. Ann Cardiol Angeiol (Paris) 2019; 68:310-315. [PMID: 31471045 DOI: 10.1016/j.ancard.2019.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 07/19/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Heart failure is a public health problem. Since 2013, the National Insurance has been offering the PRADO-IC service for the return home of patients hospitalised for cardiac decompensation. The aim of this study was to assess the impact of PRADO on the rate of re-hospitalisation of patients with heart failure at the centre hospitalier de Troyes (CHT). MATERIAL AND METHODS This was a 26-month monocentric retrospective study. Patients who were hospitalised for congestive heart failure in the cardiology department of the Troyes Hospital Centre from January 1, 2017 to August 31, 2018, and discharged home with the PRADO-IC service were included in the study. The primary outcome was the assessment of the number of readmissions for heart failure, 6 months before and 6 months after inclusion in the program. Secondary outcomes were the evaluation of the number of all-cause readmissions, the average length of stay and the time to readmission. RESULTS The average number of hospitalisations for cardiac decompensation before inclusion in the PRADO decreased from 0.34 to 0.25 (P=0.53) at 6 months. The average number of all-cause hospitalisations before inclusion increased from 0.57 to 0.58 (P=0.50) at 6 months. There was no significant difference in average length of stay and time to re-admission. CONCLUSION We did not highlight the impact of PRADO on the rate of re-hospitalisation of heart failure patients.
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Affiliation(s)
- M Dacunka
- Pôle vasculaire, service de cardiologie, centre hospitalier de Troyes, 101, avenue Anatole-France, 10000 Troyes, France.
| | - S Sanchez
- Pôle information médicale évaluation performance (IMEP), centre hospitalier de Troyes, hôpitaux Champagne Sud, 101, avenue Anatole CS 10178, 10003 Troyes cedex, France.
| | - L Chapoutot
- Pôle vasculaire, service de cardiologie, centre hospitalier de Troyes, 101, avenue Anatole-France, 10000 Troyes, France.
| | - A Marchais
- Pôle vasculaire, service de cardiologie, centre hospitalier de Troyes, 101, avenue Anatole-France, 10000 Troyes, France.
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