title: Association between the admission time and the clinical findings in patients with acute heart failure.
abstract: BACKGROUND
  There have been few reports about the clinical significance of the time of admission for acute heart failure (AHF).
  
  
  METHODS
  Five hundred thirty-one patients with AHF admitted to the intensive care unit (ICU) were analyzed. The patients were assigned to either the daytime HF group (n=195, visited from 08:00 to 20:00, Group D) or nighttime HF group (n=336, visited from 20:00 to 08:00, Group N). The clinical findings and outcomes were compared between these groups.
  
  
  RESULTS
  The systolic blood pressure (SBP), the number of patients with clinical scenario (CS) 1, and the heart rate (HR) were significantly higher in group N (SBP, 171.0±38.9mmHg; CS 1, 80.9%; HR, 116.9±28.0beats/min) than in group D (SBP, 154.2±37.1mmHg; CS 1, 66.2%; HR, 108.6±31.4beats/min). The patients in group N were more likely to have orthopnea (91.1%) than those in group D (70.3%). A multivariate logistic regression model identified a SBP ≥164mmHg [odds ratio (OR): 2.043; 95% confidence interval (CI): 1.383-3.109], HR ≥114beats/min (OR: 1.490; 95%CI: 1.001-2.218), and orthopnea (OR: 2.257; 95%CI: 1.377-3.701) to be independently associated with Group N. The length of ICU stay was shorter in group N (5.8±10.5 days) than in group D (7.8±11.5 days).
  
  
  CONCLUSIONS
  The nighttime HF was characterized by high SBP, high HR, and orthopnea, and the length of ICU stay was shorter in the nighttime HF group.
authors.affiliation: Division of Intensive Care Unit, Chiba Hokusoh Hospital, Nippon Medical School, Chiba, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Matsushita
authors.forename: Akihiro
authors.initials: A
authors.lastname: Shirakabe
authors.forename: Noritake
authors.initials: N
authors.lastname: Hata
authors.forename: Takuro
authors.initials: T
authors.lastname: Shinada
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Kazunori
authors.initials: K
authors.lastname: Tomita
authors.forename: Masafumi
authors.initials: M
authors.lastname: Tsurumi
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Shimura
authors.forename: Hirotake
authors.initials: H
authors.lastname: Okazaki
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Shinya
authors.initials: S
authors.lastname: Yokoyama
authors.forename: Kuniya
authors.initials: K
authors.lastname: Asai
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Mizuno
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D005260:Female; D006333:Heart Failure / Q000503:physiopathology; D006339:Heart Rate; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010343:Patient Admission / Q000706:statistics & numerical data*; D013599:Systole; D013997:Time Factors