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European Society of Cardiology - Acute cardiovascular care association position paper on safe discharge of acute heart failure patients from the emergency department
Miró, Òscar Peacock, F. McMurray, John J. Bueno, Héctor Christ, Michael Maisel, Alan S. Cullen, Louise Cowie, Martin R. Di Somma, Salvatore Martín-Sánchez, Francisco J.
Miró, Òscar
Peacock, F.
McMurray, John J.
Bueno, Héctor
Christ, Michael
Maisel, Alan S.
Cullen, Louise
Cowie, Martin R.
Di Somma, Salvatore
Martín-Sánchez, Francisco J.
Abstract
Heart failure is a global public health challenge frequently presenting to the emergency department. After initial stabilization and management, one of the most important decisions is to determine which patients can be safely discharged and which require hospitalization. This is a complex decision that depends on numerous subjective factors, including both the severity of the patient’s underlying condition and an estimate of the acuity of the presentation. An emergency department observation period may help select the correct option. Ideally, during an observation period, risk stratification should be carried out using parameters specifically designed for use in the emergency department. Unfortunately, there is little objective literature to guide this disposition decision. An objective and reliable definition of low-risk characteristics to identify early discharge candidates is needed. Benchmarking outcomes in patients discharged from the emergency department without hospitalization could aid this process. Biomarker determinations, although undoubtedly useful in establishing diagnosis and predicting longer-term prognosis, require prospective validation for emergency department disposition guidance. The challenge of identifying emergency department acute heart failure discharge candidates will only be overcome by future multidisciplinary research defining the current knowledge gaps and identifying potential solutions.
Keywords
acute heart failure, emergency department, discharge, risk stratification, prognosis
Date
2017
Type
Journal article
Journal
European Heart Journal: Acute Cardiovascular Care
Book
Volume
6
Issue
4
Page Range
311-320
Article Number
ACU Department
Collections
Relation URI
Source URL
Event URL
Open Access Status
Published as green open access
License
File Access
Controlled
Open
Open