Low-risk acute heart failure patients

External validation of the society of chest pain center's recommendations

Sean P. Collins, Christopher J. Lindsell, Allen J. Naftilan, W. Frank Peacock, Deborah Diercks, Brian Hiestand, Alan Maisel, Alan B. Storrow

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Introduction: Risk-stratification in acute heart failure syndromes (AHFS) is problematic. A recent set of recommendations describes emergency department (ED) patients with AHFS who do not fulfill high-risk criteria and may be good candidates for observation unit (OU) management. The goal of this analysis was to report on the outcomes experienced by ED patients with AHFS who do not have any of these high-risk criteria. Methods: We performed a secondary analysis of the HEart failure and Audicor technology for Rapid Diagnosis and Initial Treatment (HEARD-IT) multinational study. HEARD-IT was a multicenter study designed to test the impact of acoustic cardiography on ED decision making in patients with possible AHFS. For the purposes of the current analysis we identified a subset of HEARD-IT patients who did not fulfill any high-risk criteria based on published data. The proportion of these patients who experienced an adverse outcome was determined. Results: The 201 subjects who fulfilled the inclusion criteria had a mean age of 64 years (SD: 13), 61% were male, 34% were Caucasian, and 55% were black. There were a total of 25 (12.4%) cardiac events, including 1 death due to AHFS. The majority of the cardiac events were 30-day readmissions related to AHFS (16/25, 64.0%). Conclusion: AHFS patients at low-risk for subsequent morbidity and mortality based on recent consensus guidelines may be good candidates for early discharge after a brief period of observation in the OU or ED. Additional prospective research is needed to determine the impact of implementation of these criteria in ED patients with AHFS.

Original languageEnglish (US)
Pages (from-to)99-103
Number of pages5
JournalCritical Pathways in Cardiology
Volume8
Issue number3
DOIs
StatePublished - Sep 2009

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Pain Clinics
Chest Pain
Heart Failure
Hospital Emergency Service
Observation
Technology
Acoustics
Multicenter Studies
Consensus
Decision Making
Therapeutics

Keywords

  • Acute heart failure
  • Low-risk
  • Society of chest pain center
  • Validation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Low-risk acute heart failure patients : External validation of the society of chest pain center's recommendations. / Collins, Sean P.; Lindsell, Christopher J.; Naftilan, Allen J.; Peacock, W. Frank; Diercks, Deborah; Hiestand, Brian; Maisel, Alan; Storrow, Alan B.

In: Critical Pathways in Cardiology, Vol. 8, No. 3, 09.2009, p. 99-103.

Research output: Contribution to journalArticle

Collins, Sean P. ; Lindsell, Christopher J. ; Naftilan, Allen J. ; Peacock, W. Frank ; Diercks, Deborah ; Hiestand, Brian ; Maisel, Alan ; Storrow, Alan B. / Low-risk acute heart failure patients : External validation of the society of chest pain center's recommendations. In: Critical Pathways in Cardiology. 2009 ; Vol. 8, No. 3. pp. 99-103.
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