IMPACT OF DOOR-TO-FUROSEMIDE TIME ON CLINICAL OUTCOMES IN PATIENTS WITH ACUTE HEART FAILURE

BACKGROUND Rapid diagnosis and initiation of therapeutic interventions is a quality measure in acute heart failure (AHF) care. However, the impact of earlier treatment is unclear. We examined the association between door-to-furosemide (D2F) time and clinical outcomes in patients presenting to hospital with AHF. METHODS AND RESULTS CAN-HF is a Canadian multi-centre, retrospective, observational study of patients hospitalized with AHF. Patients age 18 and above with AHF in seven sites between January 2017 and April 2020 who received intravenous furosemide within 58 hours of presentation were included. D2F time was defined as the time from patient arrival at the emergency department to the first intravenous furosemide injection. Patients were stratified according to tertiles of D2F time. 551 patients met the inclusion criteria. The overall median D2F time was 207 minutes (interquartile range [IQR]: 104 to 361), with shorter median D2F time in community hospitals compared to tertiary centres (182 vs 217 minutes; p CONCLUSION In this multicentre observational cohort study of patients presenting to hospital with AHF, D2F time was not associated with hospital length of stay, change in renal function, or in-hospital mortality.