TY - JOUR
T1 - Acute cardiogenic pulmonary edema in the elderly
T2 - Factors predicting in-hospital and one-year mortality
AU - Plotnick, Gary D.
AU - Kelemen, Michael H.
AU - Garrett, Robert B.
AU - Randall, William
AU - Fisher, Michael L.
PY - 1982/5
Y1 - 1982/5
N2 - This prospective evaluation of 55 consecutive patients, aged 60 years or older, admitted in 1977-1978 to a community hospital coronary care unit for treatment of cardiogenic pulmonary edema, examines mortality during hospitalization and during the subsequent one-year follow-up. Their treatment was based on clinical criteria, without the “advantage” of Swan-Ganz catheters and before widespread use of vasodilators for severe congestive heart failure. Multiple clinical and laboratory features were reviewed to determine possible prognostic clues. The nine patients who died during the initial hospitalization provided several clues to immediate mortality, including admission systolic blood pressure of less than 150 mm Hg, dyspnea for more than four hours, and peak creatine kinase values greater than 1,000 IU/L. The study identified high-risk patients who may benefit from more aggressive in-hospital therapy. The one-year mortality among the 46 patients discharged from the hospital was high (43%). Most noninvasive methods were not useful in attempting to predict one-year survival. The important question of whether newer therapeutic methods including vasodilators will favorably alter the relatively poor long-term prognosis in the elderly needs further study.
AB - This prospective evaluation of 55 consecutive patients, aged 60 years or older, admitted in 1977-1978 to a community hospital coronary care unit for treatment of cardiogenic pulmonary edema, examines mortality during hospitalization and during the subsequent one-year follow-up. Their treatment was based on clinical criteria, without the “advantage” of Swan-Ganz catheters and before widespread use of vasodilators for severe congestive heart failure. Multiple clinical and laboratory features were reviewed to determine possible prognostic clues. The nine patients who died during the initial hospitalization provided several clues to immediate mortality, including admission systolic blood pressure of less than 150 mm Hg, dyspnea for more than four hours, and peak creatine kinase values greater than 1,000 IU/L. The study identified high-risk patients who may benefit from more aggressive in-hospital therapy. The one-year mortality among the 46 patients discharged from the hospital was high (43%). Most noninvasive methods were not useful in attempting to predict one-year survival. The important question of whether newer therapeutic methods including vasodilators will favorably alter the relatively poor long-term prognosis in the elderly needs further study.
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U2 - 10.1097/00007611-198205000-00015
DO - 10.1097/00007611-198205000-00015
M3 - Article
C2 - 7079813
AN - SCOPUS:0020320989
SN - 0038-4348
VL - 75
SP - 565
EP - 569
JO - Southern medical journal
JF - Southern medical journal
IS - 5
ER -