European Society of Cardiology - Acute Cardiovascular Care Association position paper on safe discharge of acute heart failure patients from the emergency department

Miro, Ò. et al. (2017) European Society of Cardiology - Acute Cardiovascular Care Association position paper on safe discharge of acute heart failure patients from the emergency department. European Heart Journal: Acute Cardiovascular Care, 6(4), pp. 311-320. (doi:10.1177/2048872616633853) (PMID:26900163)

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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.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:McMurray, Professor John
Authors: Miro, Ò., Peacock, F. W., McMurray, J. J., Bueno, H., Christ, M., Maisel, A. S., Cullen, L., Cowie, M. R., Di Somma, S., Martin Sanchez, F. J., Platz, E., Masip, J., Zeymer, U., Vrints, C., Price, S., Mebazaa, A., and Mueller, C.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:European Heart Journal: Acute Cardiovascular Care
Publisher:SAGE
ISSN:2048-8726
ISSN (Online):2048-8734
Published Online:21 February 2016

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