Clinical Characteristics of Patients Hospitalized for Acute Heart Failure According to Hospital Arrival Timing

Background: Whether clinical characteristics and outcomes in patients suffering acute heart failure (AHF) vary according to the timing of hospital arrival is unclear. We aimed to evaluate differences between subjects presenting in the daytime and nighttime.Methods: A total of 679 patients with AHF were examined, classified into the two groups from the viewpoint of hospital arrival period into daytime (n = 370; 8 am-6 pm) and nighttime (n = 309; 6 pm-8 am).Results: The prevalence of malnutrition and longer pre-hospital delay (>= 48 h) were greater, whereas a previous history of myocardial infarction, proportion of arrival by ambulance, and the frequency of New York Heart Association class IV symptoms, as well as systolic and diastolic blood pressure, and heart rate were lower in subjects presenting in the daytime. Patients with malnutrition defined as 5 >= of the Controlling Nutrition Status scores demonstrate a longer pre-hospital delay compared to those without (34.2% vs. 19.9%, p < 0.05). There was no significant difference in the 30-day outcomes but length of stay was significantly longer in subjects presenting in the daytime than in the nighttime. Multivariable logistic regression analysis revealed that systolic blood pressure, malnutrition, and chronic kidney disease were significantly related to prolonged length of stay.Conclusions: Our present results suggest that patients with AHF who present in the daytime may have higher rate of malnutrition status and lower systolic blood pressure compared to those presenting in the nighttime. (C) 2016 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.