{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T17:32:21Z","timestamp":1773423141869,"version":"3.50.1"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n            <jats:title>Introduction:<\/jats:title>\n            <jats:p>Acute heart failure (AHF) is a leading cause of unplanned hospitalization, often associated with poor outcomes. Decongestion with intravenous loop diuretics is the mainstay of treatment. Metrics such as door-to-diuretic time, the time between presentation of AHF to the hospital, and administration of intravenous diuretics, may play an important role in faster decongestion and thereby reduce mortality. We sought to investigate whether early diuretic administration [door-to-diuretic (D2D) time 60 \u2264mins] was associated with improved outcomes among hospitalized heart failure patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>A systematic search of PubMed and Scopus databases was performed from inception until June 2023. The primary endpoints were all-cause in-hospital and 30-day mortality. Secondary endpoints were the length of hospital stay and heart failure readmission. We used a random-effects model to calculate odds ratios (OR) for binary outcomes and mean differences for continuous data.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Our meta-analysis included 6 observational studies involving 19,916 patients. No significant differences (<jats:italic toggle=\"yes\">P<\/jats:italic> &gt; 0.05) were observed between shorter D2D and delayed D2D time with respect to in-hospital mortality (OR, 0.62; 95% CI, 0.35-1.09), 30-day mortality (OR, 0.83; 95% CI, 0.51-1.33; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.44), length of hospital stay (MD, \u22120.02; 95% CI, \u22120.26 to 0.22) and heart failure readmission (OR, 1.00; 95% CI, 0.86-1.20).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Evidence from existing literature, which is largely limited to observational comparisons, highlights comparable outcomes between the 2 treatment strategies. Early diuretic administration, particularly within 60 minutes of hospital presentation, does not demonstrate any prognostic benefits.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/hpc.0000000000000362","type":"journal-article","created":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T21:01:23Z","timestamp":1732309283000},"page":"175-182","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Door-to-Diuretic Time and Short-term Outcomes in Acute Heart Failure: A Systematic Review and Meta-analysis"],"prefix":"10.1097","volume":"23","author":[{"given":"Muhammad Ali","family":"Tariq","sequence":"first","affiliation":[{"name":"From the Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minhail Khalid","family":"Malik","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zoha","family":"Khalid","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aeman","family":"Asrar","sequence":"additional","affiliation":[{"name":"Arnot Ogden Medical Center, Arnot Health, New York, NY."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2024,4,9]]},"reference":[{"key":"R1-20250506","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/j.jchf.2016.12.014","article-title":"Acute heart failure: alternatives to hospitalization.","volume":"5","author":"Zsilinszka","year":"2017","journal-title":"JACC Heart Fail"},{"key":"R2-20250506","doi-asserted-by":"crossref","first-page":"1353","DOI":"10.1002\/ejhf.1502","article-title":"Clinical phenotypes of acute heart failure based on signs and symptoms of perfusion and congestion at emergency department presentation and their relationship with patient management and outcomes.","volume":"21","author":"Javaloyes","year":"2019","journal-title":"Eur J Heart Fail"},{"key":"R3-20250506","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1002\/ejhf.1369","article-title":"The use of diuretics in heart failure with congestion - a position statement from the Heart Failure Association of the European Society of Cardiology.","volume":"21","author":"Mullens","year":"2019","journal-title":"Eur J Heart Fail"},{"key":"R4-20250506","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1161\/CIRCULATIONAHA.106.176040","article-title":"Reducing delay in seeking treatment by patients with acute coronary syndrome and stroke: a scientific statement from the American Heart Association Council on cardiovascular nursing and stroke council.","volume":"114","author":"Moser","year":"2006","journal-title":"Circulation"},{"key":"R5-20250506","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1161\/CIRCULATIONAHA.111.044107","article-title":"Improvements in door-to-balloon time in the United States, 2005 to 2010.","volume":"124","author":"Krumholz","year":"2011","journal-title":"Circulation"},{"key":"R6-20250506","doi-asserted-by":"crossref","first-page":"3042","DOI":"10.1016\/j.jacc.2017.04.042","article-title":"Time-to-furosemide treatment and mortality in patients hospitalized with acute heart failure.","volume":"69","author":"Matsue","year":"2017","journal-title":"J Am Coll Cardiol"},{"key":"R7-20250506","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1016\/j.jchf.2017.12.017","article-title":"The effect of door-to-diuretic time on clinical outcomes in patients with acute heart failure.","volume":"6","author":"Park","year":"2018","journal-title":"JACC Heart Fail"},{"key":"R8-20250506","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1002\/ejhf.592","article-title":"2016 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). 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