Ashok Tahilyani
Tan Tock Seng Hospital, Singapore
Title: Clinical outcome and prognosis of patients with acute pulmonary oedema in Singapore
Biography
Biography: Ashok Tahilyani
Abstract
Introduction: Acute pulmonary oedema (APO) is associated with significant morbidity and mortality. Many published series of patients with APO are small and historical and offer only descriptive data on selected patients following acute myocardial infarction (AMI).
Objective: To provide a description of clinical factors and outcomes in an unselected consecutive series of patients with APO.
Methods: Case records were reviewed for all patients admitted to our institution with a primary diagnosis of APO in 2015. National databases were interrogated for readmission and mortality.
Results: 921 patients (mean age 70.99 and 70.90 years for male and female respectively with SD of 11.92 years for former and 11.95 years for latter, n=526 (63%) male, n 335 (36.3%) females) were identified. 165 patients (17%) had ejection fraction (EF>40%). Established ischemic heart disease (IHD), hypertension and diabetes were present in 61%, 83% and 55% respectively. Precipitating factors for APO included fluid indiscretion (21%) atrial fibrillation (8%), IHD (7%), infection (5%) and hypertension (4.8%). We followed these patients for 14 months +/- 8 months. The total mortality was 194 patients (21.06%) during the study period. Predictors for mortality were low EF (<35%) with high pulmonary artery systolic pressure (> 40mmHg) in the setting of AMI, sepsis and out of hospital collapse.
Conclusion: The outlook of APO in the present era remains substantial but may have improved from historical series.