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A. .. , 69 <0,01* <0,01* <0,01* Cardiologie 18 (1,4) 16 (1,8) 2 (0,5) 11 (1,3) 7 (1,4) 10 (1,0) 8 (2,8) Pneumologie 371 (28,0) 240 (26,3) 131 (31,6) 241 (29,0) 130 (26,2) 297 (28,6) 74 (25,8) Gériatrie 50 (3,8) 40 (4,4) 10 (2,4) 30 (3,6) 20 (4,0) 34 (3,3) 16 (5,6) Médecine interne 44 (3,3) 27 (3,0) 17 (4,1) 30 (3,6) 14 (2,8) 33 (3,2) 11 (3,8), vol.22, p.68

S. Price, E. Platz, L. Cullen, G. Tavazzi, M. Christ et al., Acute Heart Failure Study Group of the European Society of Cardiology Acute Cardiovascular Care Association

, Expert consensus document: Echocardiography and lung ultrasonography for the assessment and management of acute heart failure, Nat Rev Cardiol, vol.14, issue.7, pp.427-440, 2017.

A. M. Kelly, A. Holdgate, G. Keijzers, S. Klim, C. A. Graham et al., Epidemiology, prehospital care and outcomes of patients arriving by ambulance with dyspnea: an observational study, Scand J Trauma Resusc Emerg Med, vol.24, issue.1, p.113, 2016.

A. M. Kelly, G. Keijzers, S. Klim, C. A. Graham, S. Craig et al., Australia and New Zealand Dyspnea in Emergency Departments (AANZDEM) study: Rationale, design and analysis, vol.27, pp.187-91, 2015.

C. Ara-somohano, A. Bonadona, F. Carpentier, P. Pavese, A. Vesin et al., Evaluation of eight biomarkers to predict short term mortality in patients with acute severe dyspnea, Minerva Anestesiol, vol.83, issue.8, pp.824-835, 2017.

P. Ponikowski, A. A. Voors, S. D. Anker, H. Bueno, J. Cleland et al., ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC, European Heart Journal, vol.37, issue.27, pp.2129-200, 2016.

T. Chouihed, S. Manzo-silberman, N. Peschanski, S. Charpentier, M. Elbaz et al., Management of suspected acute heart failure dyspnea in the emergency department: results from the French prospective multicenter DeFSSICA survey, Scand J Trauma Resusc Emerg Med, vol.24, issue.1, p.112, 2016.

S. P. Collins, A. B. Storrow, and P. D. Levy, Early management of patients with acute heart failure: state of the art and future directions-a consensus document from the SAEM/HFSA acute heart failure working group, Acad Emerg Med, vol.22, pp.94-112, 2015.

D. Logeart, R. Isnard, and M. Resche-rigon, Current aspects of the spectrum of acute heart failure syndromes in a real-life setting: the OFICA study, Eur J Heart Fail, vol.15, pp.465-76, 2013.
URL : https://hal.archives-ouvertes.fr/hal-00880093

G. Filippatos and F. Zannad, An introduction to acute heart failure syndromes: definition and classification, Heart Fail Rev, vol.12, pp.87-90, 2007.

M. Metra, G. M. Felker, V. Zacà, S. Bugatti, C. Lombardi et al., Acute heart failure: multiple clinical profiles and mechanisms require tailored therapy, Int J Cardiol, vol.144, pp.175-179, 2010.

G. J. Gibson, R. Loddenkemper, B. Lundbäck, and Y. Sibille, Respiratory health and disease in Europe: the new-uropean Lung White Book.-ur, Respir J. sept, vol.42, issue.3, p.55963, 2013.

B. R. Celli, W. Macnee, A. Agusti, A. Anzueto, B. Berg et al., Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper, Eur Respir J, vol.23, issue.6, p.93246, 2004.

J. Wedzicha, . Co-chair, M. Miravitlles, J. R. Hurst, P. M. Calverley et al., Management of COPD exacerbations, vol.49, issue.3, 2017.

K. H. Groenewegen, A. Schols, and E. Wouters, Mortality and mortality-related factors after hospitalization for acute exacerbation of COPD, Chest, vol.124, issue.2, pp.459-67, 2003.
DOI : 10.1378/chest.124.2.459

T. Ho, Y. Tsai, S. Ruan, C. Huang, F. Lai et al., In-hospital and one-year mortality and their predictors in patients hospitalized for first-ever chronic obstructive pulmonary disease exacerbations: a nationwide population-based study, PLoS ONE, vol.9, issue.12, 2014.

M. García-sanz, C. Senín-rial, L. Aboal-viñas, J. Barreiro-garcía, A. López-val et al., One-year and long-term mortality in patients hospitalized for chronic obstructive pulmonary disease, J Thorac Dis, vol.9, issue.3, pp.636-681, 2017.

, BTS Guidelines for the Management of Community Acquired Pneumonia in Adults, Thorax, vol.56, issue.4, pp.1-64, 2001.

T. Welte, A. Torres, and D. Nathwani, Clinical and economic burden of community-acquired pneumonia among adults in Europe, Thorax, vol.67, issue.1, pp.71-80, 2012.

J. Almirall, I. Bolibar, and J. Vidal, Epidemiology of community-acquired pneumonia in adults: a population-based study, Eur Respir J, vol.15, pp.757-63, 2000.

G. Viegi, R. Pistelli, and M. Cazzola, Epidemiological survey on incidence and treatment of community acquired pneumonia in Italy, Respir Med, vol.100, pp.46-55, 2006.

M. Schnoor, J. Hedicke, and K. Dalhoff, Approaches to estimate the population-based incidence of community acquired pneumonia, J Infect, vol.55, pp.233-242, 2007.

B. Fantin, J. P. Aubert, and P. Unger, Clinical evaluation of the management of community-acquired pneumonia by general practitioners in France, Chest, vol.120, pp.185-92, 2001.

F. Jehl, J. Bedos, and R. Poirier, Nationwide survey on community-acquired pneumococcal pneumonia necessitating hospitalization, Med Mal Infect, vol.32, pp.267-83, 2002.

O. Leroy, A five-year study of severe community-acquired pneumonia with emphasis on prognosis in patients admitted to an intensive care unit, Intensive Care Med, vol.21, pp.24-31, 1995.

A. Jobs, R. Simon, S. De-waha, K. Rogacev, A. Katalinic et al., Pneumonia and inflammation in acute decompensated heart failure: a registry-based analysis of 1939 patients. Eur Heart J Acute Cardiovasc Care, 2017.

P. Ray, S. Birolleau, Y. Lefort, M. Becquemin, C. Beigelman et al., Acute respiratory failure in the elderly: etiology, emergency diagnosis and prognosis, Crit Care Lond Engl, vol.10, issue.3, p.82, 2006.

R. A. Incalzi, L. Fuso, M. Serra, S. Basso, L. Carosella et al., Exacerbated chronic o structive pulmonary disease: a frequently unrecognized condition, J Intern Med, vol.252, issue.1, p.4855, 2002.

D. Papanagnou, M. Secko, J. Gullett, M. Stone, and S. Zehtabchi, Clinician-Performed Bedside Ultrasound in Improving Diagnostic Accuracy in Patients Presenting to the ED with Acute Dyspnea, Western Journal of Emergency Medicine, vol.18, issue.3, pp.382-389, 2017.

C. S. Wang, J. M. Fitzgerald, M. Schulzer, E. Mak, and N. T. Ayas, Does this dyspneic patient in the emergency department have congestive heart failure?, JAMA, vol.294, issue.15, p.194456, 2005.
DOI : 10.1001/jama.294.15.1944

B. D. Steinhart, P. Levy, H. Vandenberghe, G. Moe, A. T. Yan et al., A Randomized Control Trial Using a Validated Prediction Model for Diagnosing Acute Heart Failure in Undifferentiated Dyspneic Emergency Department Patients-Results of the GASP4Ar Study, J Card Fail, vol.23, issue.2, pp.145-152, 2017.

A. S. Maisel, W. F. Peacock, N. Mcmullin, J. R. Fonarow, G. C. Wynne et al., Timing of immunoreactive B-type natriuretic peptide levels and treatment delay in acute decompensated heart failure: an ADHERE (Acute Decompensated Heart Failure National Registry) analysis, J Am Coll Cardiol, vol.52, pp.534-540, 2008.

R. C. Wuerz and S. A. Meador, Effects of prehospital medications on mortality and length of stay in congestive heart failure, Ann Emerg Med, vol.21, pp.669-674, 1992.

W. F. Peacock, C. Emerman, M. R. Costanzo, D. B. Diercks, M. Lopatin et al., Early vasoactive drugs improve heart failure outcomes, Congest Heart Fail, vol.15, pp.256-264, 2009.

M. Takahashi, S. Kohsaka, H. Miyata, T. Yoshikawa, A. Takagi et al., Association between prehospital time interval and short-term outcome in acute heart failure patients, J Card Fail, vol.17, issue.9, pp.742-749, 2011.

Y. Matsue, K. Damman, A. A. Voors, N. Kagiyama, T. Yamaguchi et al., Time-to-Furosemide Treatment and Mortality in Patients Hospitalized With Acute Heart Failure, J Am Coll Cardiol, vol.69, issue.25, pp.3042-3051, 2017.

P. M. Houck, D. W. Bratzler, W. Nsa, A. Ma, and J. G. Bartlett, Timing of antibiotic administration and outcomes for Medicare patients hospitalized with community-acquired pneumonia, Arch Intern Med, vol.164, issue.6, pp.637-681, 2004.

F. Beygui, M. Castren, N. D. Brunetti, F. Rosell-ortiz, M. Christ et al., Pre-hospital management of patients with chest pain and/or dyspnoea of cardiac origin. A position paper of the Acute Cardiovascular Care Association (ACCA) of the ESC, Eur Heart J Acute Cardiovasc Care, 2015.
URL : https://hal.archives-ouvertes.fr/hal-01906327

A. Mebazaa, M. B. Yilmaz, P. Levy, P. Ponikowski, W. F. Peacock et al., Recommendations on pre-hospital and early hospital management of acute heart failure: a consensus paper from the Heart Failure Association of the European Society of Cardiology, the European Society of Emergency Medicine and the Society of Academic Emergency Medicine-short version, Eur Heart J, vol.36, issue.30, p.195866, 2015.

L. Gal, G. Righini, M. Roy, P. Aujesky, D. Bounameaux et al., Prediction of Pulmonary Embolism in the Emergency Department: The Revised Geneva Score, Ann Intern Med, vol.144, pp.165-171, 2006.
URL : https://hal.archives-ouvertes.fr/hal-00689133

A. Basset, -. Nowak, P. Castellant, G. Go-ert, C. et al., Development of a clinical prediction score for congestive heart failure diagnosis in the emergency care setting: the Brest score, Am J Emerg Med, vol.34, issue.12, pp.2277-2283, 2016.
URL : https://hal.archives-ouvertes.fr/hal-01561043

J. C. Kelder, M. R. Cowie, T. A. Mcdonagh, S. M. Hardman, D. E. Grobbee et al., Quantifying the added value of BNP in suspected heart failure in general practice: an individual patient data metaanalysis, Heart, vol.97, pp.959-963, 2011.

A. Maisel, S. X. Neath, J. Landsberg, C. Mueller, R. M. Nowak et al., Use of procalcitonin for the diagnosis of pneumonia in patients presenting with a chief complaint of dyspnoea: results from the BACH (Biomarkers in Acute Heart Failure) trial, Eur J Heart Fail, vol.14, pp.278-286, 2012.

H. Kara, A. Bayir, S. Degirmenci, S. A. Kayis, M. Akinci et al., D-dimer and D-dimer/fibrinogen ratio in predicting pulmonary embolism in patients evaluated in a hospital emergency department, Acta Clin Belg, vol.69, issue.4, pp.240-245, 2014.

S. Chakko, D. Woska, H. Martinez, E. De-marchena, L. Futterman et al., Clinical, radiographic, and hemodynamic correlations in chronic congestive heart failure: conflicting results may lead to inappropriate care, Am J Med, vol.90, pp.353-359, 1991.

D. A. Lichtenstein and G. A. Mezière, Relevance of lung ultrasound in the diagnosis of acute respiratory failure: the BLUE protocol, Chest, vol.134, issue.1, pp.117-142, 2008.

A. Pagano, F. G. Numis, G. Visone, C. Pirozzi, M. Masarone et al., Lung ultrasound for diagnosis of pneumonia in emergency department, Intern Emerg Med, vol.10, issue.7, pp.851-855, 2015.

S. Silva, C. Biendel, J. Ruiz, M. Olivier, B. Bataille et al., Usefulness of cardiothoracic chest ultrasound in the management of acute respiratory failure in critical care practice, Chest, vol.144, issue.3, pp.859-865, 2013.

C. Pirozzi, F. G. Numis, A. Pagano, R. Copetti, and F. Schiraldi, Immediate versus delayed integrated point-ofcare-ultrasonography to manage acute dyspnea in the emergency department, Crit Ultrasound J, vol.6, issue.1, p.5, 2014.

W. Lim, . Van-der-eerden, . Mm, and R. Laing, Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study, Thorax, vol.58, issue.5, pp.377-82, 2003.

M. Fine, T. Auble, and D. M. Yealy, A prediction rule to identify lowrisk patients with communityacquired pneumonia, N Engl J Med, vol.336, issue.4, pp.243-50, 1997.

C. Venetz, D. Jiménez, M. Méan, and D. Aujesky, A comparison of the original and simplified Pulmonary Embolism Severity Index, Thromb Haemost, vol.106, issue.3, pp.423-431, 2011.

W. R. Smith, R. M. Poses, D. K. Mcclish, E. C. Huber, F. L. Clemo et al., Prognostic judgments and triage decisions for patients with acute congestive heart failure, Chest, vol.121, issue.5, pp.1610-1617, 2002.

D. S. Lee, A. Stitt, P. C. Austin, T. A. Stukel, M. J. Schull et al., Prediction of heart failure mortality in emergent care: a cohort study, Ann Intern Med, vol.156, issue.11, pp.767-75, 2012.

P. N. Peterson, J. S. Rumsfeld, L. Liang, N. M. Albert, A. F. Hernandez et al.,

, American Heart Association Get With the Guidelines-Heart Failure Program. A validated risk score for in-hospital mortality in patients with heart failure from the American Heart Association get with the guidelines program, Circ Cardiovasc Qual Outcomes, vol.3, issue.1, pp.25-32, 2010.

O. Connor, C. M. , A. Ert, N. M. , C. R. et al., Predictors of mortality after discharge in patients hospitalized with heart failure: an analysis from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF), Am Heart J, vol.156, pp.662-673, 2008.

H. Okazaki, A. Shirakabe, N. Hata, M. Yamamoto, N. Kobayashi et al., New scoring system (APACHE-HF) for predicting adverse outcomes in patients with acute heart failure: evaluation of the APACHE II and Modified APACHE II scoring systems, J Cardiol, vol.64, pp.441-449, 2014.

J. Spinar, J. Jarkovsky, L. Spinarova, A. Mebazaa, E. Gayat et al., AHEAD score-Long-term risk classification in acute heart failure, Int J Cardiol, vol.202, pp.21-27, 2015.

R. H. Slenter, R. T. Sprooten, D. Kotz, G. Wesseling, E. F. Wouters et al., Predictors of 1-year mortality at hospital admission for acute exacerbations of chronic obstructive pulmonary disease, Respiration, vol.85, issue.1, pp.15-26, 2013.

G. C. Fonarow, W. F. Peacock, C. O. Phillips, M. M. Givertz, and M. Lopatin, ADHERE Scientific Advisory Committee and Investigators. Admission B-type natriuretic peptide levels and in-hospital mortality in acute decompensated heart failure, J Am Coll Cardiol, vol.49, pp.1943-50, 2007.

B. G. Demissei, D. Postmus, J. G. Cleland, C. M. O&apos;connor, M. Metra et al., Plasma biomarkers to predict or rule out early post-discharge events after hospitalization for acute heart failure, Eur J Heart Fail, vol.19, issue.6, pp.728-738, 2017.

J. P. Ferreira, N. Girerd, M. Arrigo, P. B. Medeiros, M. B. Ricardo et al., Enlarging Red Blood Cell Distribution Width During Hospitalization Identifies a Very High-Risk Subset of Acutely Decompensated Heart Failure Patients and Adds Valuable Prognostic Information on Top of Hemoconcentration, Medicine, vol.95, issue.14, p.3307, 2016.
URL : https://hal.archives-ouvertes.fr/hal-01759761

K. Duarte, J. Monnez, E. Albuisson, B. Pitt, F. Zannad et al., Prognostic Value of Estimated Plasma Volume in Heart-ailure. JACC Heart-ail, vol.3, p.88693, 2015.

L. W. Eurlings, S. Sanders-van-wijk, R. Van-kimmenade, A. Osinski, L. Van-helmond et al., Multimarker strategy for short-term risk assessment in patients with dyspnea in the emergency department: the MARKED (Multi mARKer Emergency Dyspnea)-risk score, J Am Coll Cardiol, 2012.

, Oct, vol.23, issue.17, pp.1668-77

A. P. Maggioni, U. Dahlström, G. Filippatos, O. Chioncel, C. Leiro et al., EURObservational Research Programme: regional differences and 1-year follow-up results of the Heart Failure Pilot Survey (ESC-HF Pilot), Eur J Heart Fail, vol.15, issue.7, pp.808-825, 2013.

S. V. Konstantinides, A. Torbicki, G. Agnelli, N. Danchin, D. Fitzmaurice et al., ESC guidelines on the diagnosis and management of acute pulmonary embolism, Eur Heart J. nov, vol.35, issue.43, pp.3033-3069, 2014.

A. O. Grubb, Cystatin C-properties and use as diagnostic marker, Adv Clin Chem, vol.35, pp.63-99, 2001.

M. Gheorghiade, W. T. Abraham, N. M. Albert, G. Stough, W. Greenberg et al., OPTIMIZE-HF Investigators and Coordinators. Relationship between admission serum sodium concentration and clinical outcomes in patients hospitalized for heart failure: an analysis from the OPTIMIZE-HF registry, Eur Heart J, vol.28, issue.8, pp.980-988, 2007.

J. Rossi, M. Bayram, and J. E. Udelson, Improvement in hyponatremia during hospitalization for worsening heart failure is associated with improved outcomes: insights from the Acute and Chronic Therapeutic Impact of Vasopressin Antagonist in Chronic Heart Failure (ACTIV in CHF) trial, Acute Card Care, vol.9, pp.82-86, 2007.

G. T. Jao and J. R. Chiong, Hyponatremia in acute decompensated heart failure: mechanisms, prognosis, and treatment options, Clin Cardiol, vol.33, issue.11, pp.666-71, 2010.

J. A. Winther, J. Brynildsen, A. D. Høiseth, I. Følling, and P. H. Brekke, Prevalence and Prognostic Significance of Hyponatremia in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease: Data from the Akershus Cardiac Examination (ACE) 2 Study. PLoS One, vol.11, p.161232, 2016.

D. Miguel-yanes, J. M. , G. , C. Muñoz-rivas, N. Méndez-bailón et al., First plasma glucose value after urgent admission and in-hospital mortality in acutely decompensated heart failure, Heart Lung. avr, vol.44, issue.2, pp.137-177, 2015.

A. Mebazaa, E. Gayat, J. Lassus, T. Meas, C. Mueller et al., Association Between Elevated Blood Glucose and Outcome in Acute Heart Failure, Journal of the American College of Cardiology, vol.61, issue.8, pp.820-829, 2013.

, Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO Clinical Practice Guideline for Acute Kidney Injury, Kidney inter, vol.2, pp.1-138, 2012.

G. M. Chertow, E. Burdick, M. Honour, J. V. Bonventre, and D. W. Bates, Acute kidney injury, mortality, length of stay, and costs in hospitalized patients, J Am Soc Nephrol, vol.16, pp.3365-3370, 2005.

F. Zannad, A. Mebazaa, Y. Juillière, A. Cohen-solal, L. Guize et al., Clinical profile, contemporary management and one-year mortality in patients with severe acute heart failure syndromes: The EFICA study, European Journal of Heart Failure, vol.8, pp.697-705, 2006.

J. T. Heywood, G. C. Fonarow, M. R. Costanzo, V. S. Mathur, J. R. Wigneswaran et al., High prevalence of renal dysfunction and its impact on outcome in 118,465 patients hospitalized with acute decompensated heart failure: a report from the ADHERE database, J Card Fail, vol.13, issue.6, pp.422-452, 2007.

S. P. Collins, C. J. Lindsell, A. J. Naftilan, W. F. Peacock, D. Diercks et al., Low-risk acute heart failure patients: external validation of the ociety of Chest Pain Center's recommendations, Crit Pathw Cardiol, vol.8, issue.3, pp.99-103, 2009.

, ANNEXES Annexe 1 : Profils cliniques des patients souffrant d'insuffisance cardiaque aiguë

P. Ponikowski, ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed, European Heart Journal. 14 juill, vol.37, issue.27, pp.2129-200, 2016.

, Annexe 2 : Score de sévérité des pneumopathies aiguës communautaires : score PSI de Fine et al

M. Fine, T. Auble, and D. M. Yealy, A prediction rule to identify lowrisk patients with communityacquired pneumonia, N Engl J Med, p.250

, Annexe 3 : tratification du risque et orientation des patients dans l'em olie pulmonaire basée sur le score PESI

S. V. Konstantinides, A. Torbicki, G. Agnelli, N. Danchin, D. Fitzmaurice et al., ESC guidelines on the diagnosis and management of acute pulmonary embolism, Eur Heart J, vol.35, issue.43, pp.3069-3069, 2014.

A. !jbgences-?-?-?-?-?-et-heure-du and . Prélàvtmtnt, EXAMENS 8101 OGJOllf5, pp.1-11

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