Validation of the ADHERE model for risk stratification in patients with acute heart failure admitted to the critical care unit

Rey, Hcv; Rangel, Fod; Bittencourt, MI; Rocha, RM; Marins, Alc; Almeida, Guilherme C.; Bernardo, EP; Salgado, CG; Esporcatte, Roberto

doi:10.1186/cc3579

Cited by 2 publications

(2 citation statements)

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“…Statistically significant variables are then frequently prospectively studied to validate. For example, the Acute Decompensated Heart Failure National Registry (ADHERE) uses blood urea nitrogen (BUN), systolic blood pressure, and age to evaluate mortality risk for those with decompensated heart failure (Fonarow et al, 2005; Rey HCV et al, 2005). Similarly, a cohort of 88,074 patients with chronic obstructive pulmonary disorder (COPD) was studied to formulate the BAP-65 to predict mortality in COPD (Tabak et al, 2009).…”

Section: Modelsmentioning

confidence: 99%

Hospital at home: A change in the course of care

Gaillard¹,

Russinoff²

2022

J Am Assoc Nurse Pract

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Acute care services in the United States are largely delivered in the hospital setting. Since the recent pandemic, acute care services in the hospital have become overwhelmed. An elderly population with comorbidities and lack of hospital capacity is leading to a "hospital without walls" approach to acute care. Hospital at Home (HaH) is a paradigm shift in the standard way to administer acute care. Model development coupled with innovations in telehealth and remote patient monitoring has led to HaH being considered a viable alternative to admitting patients to the hospital. Robust evidence suggests that HaH interventions are a new option for providers to assess, treat, and monitor patients. Outcomes equivalent to in-patient stays with no mortality difference makes this model a viable option for patient care outside of the hospital. An overall reduction in cost compared with an in-patient stay may be an economically viable option for overwhelmed hospital systems looking to care for their surrounding population. In this brief, we review some of the existing evidence and the growth of the HaH concept, and what it means for members of the interdisciplinary care team.

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Section: Modelsmentioning

confidence: 99%

Hospital at home: A change in the course of care

Gaillard¹,

Russinoff²

2022

J Am Assoc Nurse Pract

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“…Currently, there are many clinical scores to stratify AHF prognosis, but most of them have been validated only in specific settings, and their generalization should be cautious especially in Emergency Departments, Intensive Care Units (ICU), and Internal Medicine departments. In fact, several robust and validated scores shown low accuracy in predicting short-term mortality in specific settings, as in the ICU [ 8 ] or ED [ 9 ]. Moreover, regional variations of risk factors and comorbidities, mainly due to different standards of living, life expectancy, quality of care, and efficacy of sanitary systems, can account for a substantial variation of accuracy of predictive scores in different populations [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Improving the EHMRG Prognostic Evaluation of Acute Heart Failure with TAPSE/PASp: A Sequential Approach

et al. 2022

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The Emergency Heart Failure Mortality Risk Grade (EHMRG) can predict short-term mortality in patients admitted for acute heart failure (AHF) in the emergency department (ED). This paper aimed to evaluate if TAPSE/PASp, an echocardiographic marker of ventricular desynchronization, can improve in-hospital death prediction in patients at moderate-to-high risk, according to EHMRG score classification. From 1 January 2018 to 30 December 2019, we retrospectively enrolled all the consecutive subjects admitted to our Internal Medicine Department for AHF from the ED. We performed bedside echocardiography within the first 24 h of admission. We evaluated EHMRG and NYHA in the ED, days of admission in Internal Medicine, and in-hospital mortality. We assessed cutoffs with ROC curve analysis and survival with Kaplan–Meier and Cox regression. We obtained a cohort of 439 subjects; 10.3% underwent in-hospital death. Patients with normal TAPSE/PASp in EHMRG Classes 4, 5a, and 5b had higher survival rates (100%, 100%, and 94.3%, respectively), while subjects with pathologic TAPSE/PASp had lower survival rates (81.8%, 78.3%, and 43.4%, respectively) (p < 0.0001, log-rank test). TAPSE/PASp, an echocardiographic marker of ventricular desynchronization, can further stratify the risk of in-hospital death evaluated by EHMRG.

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Validation of the ADHERE model for risk stratification in patients with acute heart failure admitted to the critical care unit

Cited by 2 publications

References 0 publications

Hospital at home: A change in the course of care

Hospital at home: A change in the course of care

Improving the EHMRG Prognostic Evaluation of Acute Heart Failure with TAPSE/PASp: A Sequential Approach

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