Predicting the risk of reattendance for acute heart failure patients discharged from Spanish Emergency Department observation units

• DOI: 10.1097/mej.0b013e32832f7666
• Publication Date: 2010-03-18T09:34:33Z
• Authors: Òscar Miró; Pere Llorens; Francisco Javier ...; Pablo Herrero; Javier Jacob; María José Pérez-...; Cesar González; Héctor Alonso; Victor Gil; Ana Bella Álvarez; Rafel Perelló; Juan Jorge Gonzál...
• Keywords: Aged, 80 and over; Heart Failure; Male; Patient Readmission; 3. Good health; Cohort Studies; 03 medical and health sciences; Outcome and Process Assessment, Health Care; 0302 clinical medicine; Risk Factors; Acute Disease; Humans; Female; Prospective Studies; Emergency Service, Hospital; Aged

Patients with acute heart failure (AHF) are frequently evaluated in the Emergency Departments (ED) and discharged from their observation units (OU) without hospital admission. We examined direct discharge rates ED OU, risk factors for returning to ED, mortality rates.This prospective, longitudinal, noninterventional, population-based cohort study included all patients AHF consecutively attended seven Spanish EDs who were directly Reattendance (dependent variable) was accepted if occurred during next 30 days after discharge. Twenty-nine independent variables recorded, covering epidemiological, clinical, functional data.Two hundred fifty-nine of 740 (35%) diagnosed entirely managed OU home (mean stay: 18.8 h); 26.7% them reattended. Only three independently associated chance reattendance: impairment predicted adverse outcomes [odds ratio (OR): 4.0, 95% confidence interval (95% CI): 1.7-9.1], while past history hypertension a systolic blood pressure greater than 160 mmHg at arrival decreased return (OR: 0.4, CI: 0.2-0.9; OR: 0.3; 0.1-0.9; respectively). An overall 4.7% recorded days.One-third consulting an episode can be relatively low reattendance (26.7%) (4.7%). physicians should especially cautious discharging dependence because they increased returning.