Influence of the length of hospitalisation in post-discharge outcomes in patients with acute heart failure: Results of the LOHRCA study

Miró, Òscar; Padrosa, Joan; Takagi, Koji; Gayat, Étienne; Gil, Víctor; Llorens, Pere; Martín‐Sánchez, Francisco Javier; Herrero‐Puente, Pablo; Jacob, Javier; Montero, María Mir; Díez, María Pilar López; Travería, Lissete; Torres-Gárate, R.; Alonso, María Isabel; Agüera, Carmen; Valero, Amparo; Javaloyes, Patricia; Peacock, W. Frank; Bueno, Héctor; Mebazaa, Alexandre; Fuentes, Marta; Gil, Cristina; Alonso, Héctor; Garmila, Pablo; García, Guillermo; Yañez-Palma, M.C.; López, Sergio Iglesias; Escoda, Rosa; Xipell, Carolina; Sánchez, Carolina; Gaytán, Josep María; Pérez‐Durá, María José; Salvo, Eva; Pavón, José; Noval, Antonio; Torres, José Manuel; López‐Grima, María Luisa; Juan, Marian Ángeles; Aguirre, Alfons; Morales, Julián Errasti; Masó, Silvia Mínguez; Ruiz, Francisco; Franco, José Miguel; Mecina, Ana Belén; Sánchez, Susana; Carbajosa, Virginia; Piñera, Pascual; Nicolás, José Andrés Sánchez; Garate, Raquel Torres; Alquézar, Aitor; Rizzi, Miguel Alberto; Herrera, Sergio; Roset, Álex; Cabello, Irene; Richard, Fernando; Pérez, José María Álvarez; Álvarez, Joaquín Vázquez; García, Belén Prieto; González, María García García yMarta Sánchez; Marquina, Víctor; Jiménez, Inmaculada; Hernández, Néstor; Brouzet, Benjamín; Ramos, Sergio; López, Ana; Andueza, Juan Antonio; Romero, Rodolfo; Ruíz, Martín; Calvache, Roberto; Lorca, María Teresa; Calderón, Luis; Arriaga, Beatriz Amores; Sierra, Beatríz; Mojarro, Enrique Martín; Bécquer, Lisette Travería; Burillo, Guillermo; García, Lluís Llauger; LaSalle, Gerard Corominas; Urbano, Carmen Agüera; Soto, Ana Belén García; Padial, Elisa Delgado; Ferrer, Ester Soy; Garrido, Manuel; Lucas, Francisco Javier; Gaya, Rut; Bibiano, Carlos; Mir, María; Rodríguez, Beatriz; Sánchez, Natalia; Carballo, José Luís; Rodríguez‐Adrada, Esther; Rodríguez, Belén

doi:10.1016/j.ejim.2019.08.007

Cited by 7 publications

(4 citation statements)

References 26 publications

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“…Among the 761 screened citations, 28 studies published over the last 10 years 8,20,24,35–59 met the inclusion criteria after full-text review (Figure 1). These 28 studies included 19 different risk models that had been used in AHF patients in the ED setting to predict clinical outcomes (Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…20,35,39,54–59,62 In addition, nine studies used at least one risk score to define the severity of AHF decompensation, to produce subgroups of patients based on their risk or to adjust in multivariate regressions (to reduce the impact of confounding factors). 8,24,36,45–50 In one of them, the comparison between discharged and hospitalised patients at similar predicted risk (using the risk model developed by Lee et al.) 24 demonstrated a higher 90-day mortality for patients discharged home from the ED.…”

Section: Resultsmentioning

confidence: 99%

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Risk stratification scores for patients with acute heart failure in the Emergency Department: A systematic review

Miró

Rosselló

Platz

et al. 2020

European Heart Journal. Acute Cardiovascular Care

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Aims This study aimed to systematically identify and summarise all risk scores evaluated in the emergency department setting to stratify acute heart failure patients. Methods and results A systematic review of PubMed and Web of Science was conducted including all multicentre studies reporting the use of risk predictive models in emergency department acute heart failure patients. Exclusion criteria were: (a) non-original articles; (b) prognostic models without predictive purposes; and (c) risk models without consecutive patient inclusion or exclusively tested in patients admitted to a hospital ward. We identified 28 studies reporting findings on 19 scores: 13 were originally derived in the emergency department (eight exclusively using acute heart failure patients), and six in emergency department and hospitalised patients. The outcome most frequently predicted was 30-day mortality. The performance of the scores tended to be higher for outcomes occurring closer to the index acute heart failure event. The eight scores developed using acute heart failure patients only in the emergency department contained between 4–13 predictors (age, oxygen saturation and creatinine/urea included in six scores). Five scores (Emergency Heart Failure Mortality Risk Grade, Emergency Heart Failure Mortality Risk Grade 30 Day mortality ST depression, Epidemiology of Acute Heart Failure in Emergency department 3 Day, Acute Heart Failure Risk Score, and Multiple Estimation of risk based on Emergency department Spanish Score In patients with Acute Heart Failure) have been externally validated in the same country, and two (Emergency Heart Failure Mortality Risk Grade and Multiple Estimation of risk based on Emergency department Spanish Score In patients with Acute Heart Failure) further internationally validated. The c-statistic for Emergency Heart Failure Mortality Risk Grade to predict seven-day mortality was between 0.74–0.81 and for Multiple Estimation of risk based on Emergency department Spanish Score In patients with Acute Heart Failure to predict 30-day mortality was 0.80–0.84. Conclusions There are several scales for risk stratification of emergency department acute heart failure patients. Two of them are accurate, have been adequately validated and may be useful in clinical decision-making in the emergency department i.e. about whether to admit or discharge.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Risk stratification scores for patients with acute heart failure in the Emergency Department: A systematic review

Miró

Rosselló

Platz

et al. 2020

European Heart Journal. Acute Cardiovascular Care

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“…Finalmente, la estancia hospitalaria ha sido significativamente más corta en los pacientes con IC-FEp, siendo este un aspecto menos investigado, pero de forma general no se ha descrito que existan diferencias significativas en la estancia media según la FEVI 30 .…”

Section: Discussionunclassified

Epidemiology of heart failure with preserved ejection fraction: Results from the RICA Registry

Pérez-Calvo

Iborra

Pedreira

et al. 2021

Medicina Clínica (English Edition)

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“…In a Swedish registry, 30 the death rates for HF with preserved ejection fraction, HF with midrange ejection fraction, and HF with reduced ejection fraction 30 days after an AHF admission were 2.9%, 2.1%, and 2.8%, respectively, and 1‐year mortality rates were 17.4%, 14.2%, and 15.4%, respectively. In a Spanish registry 31 during the 90‐day postdischarge period, 11% of patients died and 32.2% were readmitted; the combined end point of readmission or death occurred in 37.4% of patients. Similar numbers have been reported across Asia.…”

Section: Epidemiology and Causementioning

confidence: 99%

Acute Heart Failure Is a Malignant Process: But We Can Induce Remission

Cotter,

Davison,

Lam

et al. 2023

JAHA

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Acute heart failure is a common and increasingly prevalent condition, affecting >10 million people annually. For those patients who survive to discharge, early readmissions and death rates are >30% everywhere on the planet, making it a malignant condition. Beyond these adverse outcomes, it represents one of the largest drivers of health care costs globally. Studies in the past 2 years have demonstrated that we can induce remissions in this malignant process if therapy is instituted rapidly, at the first acute heart failure episode, using full doses of all available effective medications. Multiple studies have demonstrated that this goal can be achieved safely and effectively. Now the urgent call is for all stakeholders, patients, physicians, payers, politicians, and the public at large to come together to address the gaps in implementation and enable health care providers to induce durable remissions in patients with acute heart failure.

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Influence of the length of hospitalisation in post-discharge outcomes in patients with acute heart failure: Results of the LOHRCA study

Cited by 7 publications

References 26 publications

Risk stratification scores for patients with acute heart failure in the Emergency Department: A systematic review

Risk stratification scores for patients with acute heart failure in the Emergency Department: A systematic review

Epidemiology of heart failure with preserved ejection fraction: Results from the RICA Registry

Acute Heart Failure Is a Malignant Process: But We Can Induce Remission

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