European Society of Cardiology - Acute Cardiovascular Care Association position paper on safe discharge of acute heart failure patients from the emergency department.
Identifieur interne : 000C82 ( Main/Exploration ); précédent : 000C81; suivant : 000C83European Society of Cardiology - Acute Cardiovascular Care Association position paper on safe discharge of acute heart failure patients from the emergency department.
Auteurs : Scar Mir [Espagne] ; Frank W. Peacock [États-Unis] ; John J. Mcmurray [Royaume-Uni] ; Héctor Bueno [Espagne] ; Michael Christ [Allemagne] ; Alan S. Maisel [États-Unis] ; Louise Cullen [Australie] ; Martin R. Cowie [Royaume-Uni] ; Salvatore Di Somma [Italie] ; Francisco J. Martín Sánchez [Espagne] ; Elke Platz [États-Unis] ; Josep Masip [Espagne] ; Uwe Zeymer [Allemagne] ; Christiaan Vrints [Belgique] ; Susanna Price [Royaume-Uni] ; Alexander Mebazaa [France] ; Christian Mueller [Suisse]Source :
- European heart journal. Acute cardiovascular care [ 2048-8734 ] ; 2017.
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.
DOI: 10.1177/2048872616633853
PubMed: 26900163
Affiliations:
- Allemagne, Australie, Belgique, Espagne, France, Italie, Royaume-Uni, Suisse, États-Unis
- Angleterre, Catalogne, Communauté de Madrid, Grand Londres, Latium, Massachusetts, Texas, Écosse
- Barcelone, Boston, Glasgow, Houston, Londres, Madrid, Rome
- Université complutense de Madrid, Université de Glasgow
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Institut de Recerca Biomàdica August Pi i Sunyer (IDIBAPS), ICA-SEMES Research Group, Barcelona, Catalonia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>1 Emergency Department, Hospital Clínic; Institut de Recerca Biomàdica August Pi i Sunyer (IDIBAPS), ICA-SEMES Research Group, Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author><author><name sortKey="Peacock, Frank W" sort="Peacock, Frank W" uniqKey="Peacock F" first="Frank W" last="Peacock">Frank W. Peacock</name><affiliation wicri:level="3"><nlm:affiliation>2 Emergency Medicine, Baylor College of Medicine, Houston, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>2 Emergency Medicine, Baylor College of Medicine, Houston</wicri:regionArea><placeName><settlement type="city">Houston</settlement><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Mcmurray, John J" sort="Mcmurray, John J" uniqKey="Mcmurray J" first="John J" last="Mcmurray">John J. Mcmurray</name><affiliation wicri:level="4"><nlm:affiliation>3 British Heart Foundation Cardiovascular Research Centre, University of Glasgow, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>3 British Heart Foundation Cardiovascular Research Centre, University of Glasgow</wicri:regionArea><placeName><settlement type="city">Glasgow</settlement><region type="country">Écosse</region></placeName><orgName type="university">Université de Glasgow</orgName></affiliation></author><author><name sortKey="Bueno, Hector" sort="Bueno, Hector" uniqKey="Bueno H" first="Héctor" last="Bueno">Héctor Bueno</name><affiliation wicri:level="4"><nlm:affiliation>4 Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid; Instituto de Investigación i+12 y Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid; Universidad Complutense de Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>4 Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid; Instituto de Investigación i+12 y Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid; Universidad Complutense de Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName><orgName type="university">Université complutense de Madrid</orgName></affiliation></author><author><name sortKey="Christ, Michael" sort="Christ, Michael" uniqKey="Christ M" first="Michael" last="Christ">Michael Christ</name><affiliation wicri:level="1"><nlm:affiliation>5 Department of Emergency and Critical Care Medicine, Klinikum Nürnberg, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>5 Department of Emergency and Critical Care Medicine, Klinikum Nürnberg</wicri:regionArea><wicri:noRegion>Klinikum Nürnberg</wicri:noRegion><wicri:noRegion>Klinikum Nürnberg</wicri:noRegion><wicri:noRegion>Klinikum Nürnberg</wicri:noRegion></affiliation></author><author><name sortKey="Maisel, Alan S" sort="Maisel, Alan S" uniqKey="Maisel A" first="Alan S" last="Maisel">Alan S. Maisel</name><affiliation wicri:level="1"><nlm:affiliation>6 Coronary Care Unit and Heart Failure Program, Veteran Affairs (VA) San Diego, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>6 Coronary Care Unit and Heart Failure Program, Veteran Affairs (VA) San Diego</wicri:regionArea><wicri:noRegion>Veteran Affairs (VA) San Diego</wicri:noRegion></affiliation></author><author><name sortKey="Cullen, Louise" sort="Cullen, Louise" uniqKey="Cullen L" first="Louise" last="Cullen">Louise Cullen</name><affiliation wicri:level="1"><nlm:affiliation>7 Department of Emergency Medicine, Royal Brisbane and Women's Hospital, School of Public Health, Queensland University of Technology; School of Medicine, The University of Queensland, Brisbane, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>7 Department of Emergency Medicine, Royal Brisbane and Women's Hospital, School of Public Health, Queensland University of Technology; School of Medicine, The University of Queensland, Brisbane</wicri:regionArea><wicri:noRegion>Brisbane</wicri:noRegion></affiliation></author><author><name sortKey="Cowie, Martin R" sort="Cowie, Martin R" uniqKey="Cowie M" first="Martin R" last="Cowie">Martin R. Cowie</name><affiliation wicri:level="1"><nlm:affiliation>8 Cardiology Department, Imperial College London (Royal Brompton Hospital), UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>8 Cardiology Department, Imperial College London (Royal Brompton Hospital)</wicri:regionArea><wicri:noRegion>Imperial College London (Royal Brompton Hospital)</wicri:noRegion></affiliation></author><author><name sortKey="Di Somma, Salvatore" sort="Di Somma, Salvatore" uniqKey="Di Somma S" first="Salvatore" last="Di Somma">Salvatore Di Somma</name><affiliation wicri:level="3"><nlm:affiliation>9 Emergency Medicine, Department of Medical-Surgery Sciences and Translational Medicine, Sant'Andrea Hospital, University La Sapienza, Rome, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>9 Emergency Medicine, Department of Medical-Surgery Sciences and Translational Medicine, Sant'Andrea Hospital, University La Sapienza, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Martin Sanchez, Francisco J" sort="Martin Sanchez, Francisco J" uniqKey="Martin Sanchez F" first="Francisco J" last="Martín Sánchez">Francisco J. Martín Sánchez</name><affiliation wicri:level="4"><nlm:affiliation>10 Emergency Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Universidad Complutense de Madrid, ICA-SEMES Research Group, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>10 Emergency Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Universidad Complutense de Madrid, ICA-SEMES Research Group</wicri:regionArea><orgName type="university">Université complutense de Madrid</orgName><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Platz, Elke" sort="Platz, Elke" uniqKey="Platz E" first="Elke" last="Platz">Elke Platz</name><affiliation wicri:level="3"><nlm:affiliation>11 Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>11 Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston</wicri:regionArea><placeName><settlement type="city">Boston</settlement><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Masip, Josep" sort="Masip, Josep" uniqKey="Masip J" first="Josep" last="Masip">Josep Masip</name><affiliation wicri:level="3"><nlm:affiliation>12 ICU Department, Consorci Sanitari Integral, University of Barcelona; Cardiology Department Hospital Sanitas CIMA, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>12 ICU Department, Consorci Sanitari Integral, University of Barcelona; Cardiology Department Hospital Sanitas CIMA, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Zeymer, Uwe" sort="Zeymer, Uwe" uniqKey="Zeymer U" first="Uwe" last="Zeymer">Uwe Zeymer</name><affiliation wicri:level="1"><nlm:affiliation>13 FEESC, Klinikum Ludwigshafen und Institut für Herzinfarktforschung Ludwigshafen, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>13 FEESC, Klinikum Ludwigshafen und Institut für Herzinfarktforschung Ludwigshafen</wicri:regionArea><wicri:noRegion>Klinikum Ludwigshafen und Institut für Herzinfarktforschung Ludwigshafen</wicri:noRegion><wicri:noRegion>Klinikum Ludwigshafen und Institut für Herzinfarktforschung Ludwigshafen</wicri:noRegion><wicri:noRegion>Klinikum Ludwigshafen und Institut für Herzinfarktforschung Ludwigshafen</wicri:noRegion></affiliation></author><author><name sortKey="Vrints, Christiaan" sort="Vrints, Christiaan" uniqKey="Vrints C" first="Christiaan" last="Vrints">Christiaan Vrints</name><affiliation wicri:level="1"><nlm:affiliation>14 Faculty of Medicine and Health Sciences at University of Antwerp, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>14 Faculty of Medicine and Health Sciences at University of Antwerp</wicri:regionArea></affiliation></author><author><name sortKey="Price, Susanna" sort="Price, Susanna" uniqKey="Price S" first="Susanna" last="Price">Susanna Price</name><affiliation wicri:level="3"><nlm:affiliation>15 Royal Brompton and Harefield National Health Service Foundation Trust, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>15 Royal Brompton and Harefield National Health Service Foundation Trust, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Mebazaa, Alexander" sort="Mebazaa, Alexander" uniqKey="Mebazaa A" first="Alexander" last="Mebazaa">Alexander Mebazaa</name><affiliation wicri:level="1"><nlm:affiliation>16 Hospital Lariboisière, Université Paris Diderot, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>16 Hospital Lariboisière, Université Paris Diderot</wicri:regionArea><wicri:noRegion>Université Paris Diderot</wicri:noRegion><wicri:noRegion>Université Paris Diderot</wicri:noRegion></affiliation></author><author><name sortKey="Mueller, Christian" sort="Mueller, Christian" uniqKey="Mueller C" first="Christian" last="Mueller">Christian Mueller</name><affiliation wicri:level="1"><nlm:affiliation>17 Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>17 Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel</wicri:regionArea><wicri:noRegion>University Hospital Basel</wicri:noRegion></affiliation></author></analytic><series><title level="j">European heart journal. Acute cardiovascular care</title><idno type="eISSN">2048-8734</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>Belgique</li><li>Espagne</li><li>France</li><li>Italie</li><li>Royaume-Uni</li><li>Suisse</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Catalogne</li><li>Communauté de Madrid</li><li>Grand Londres</li><li>Latium</li><li>Massachusetts</li><li>Texas</li><li>Écosse</li></region><settlement><li>Barcelone</li><li>Boston</li><li>Glasgow</li><li>Houston</li><li>Londres</li><li>Madrid</li><li>Rome</li></settlement><orgName><li>Université complutense de Madrid</li><li>Université de Glasgow</li></orgName></list><tree><country name="Espagne"><noRegion><name sortKey="Mir, Scar" sort="Mir, Scar" uniqKey="Mir " first=" Scar" last="Mir"> Scar Mir</name></noRegion><name sortKey="Bueno, Hector" sort="Bueno, Hector" uniqKey="Bueno H" first="Héctor" last="Bueno">Héctor Bueno</name><name sortKey="Martin Sanchez, Francisco J" sort="Martin Sanchez, Francisco J" uniqKey="Martin Sanchez F" first="Francisco J" last="Martín Sánchez">Francisco J. Martín Sánchez</name><name sortKey="Masip, Josep" sort="Masip, Josep" uniqKey="Masip J" first="Josep" last="Masip">Josep Masip</name></country><country name="États-Unis"><region name="Texas"><name sortKey="Peacock, Frank W" sort="Peacock, Frank W" uniqKey="Peacock F" first="Frank W" last="Peacock">Frank W. Peacock</name></region><name sortKey="Maisel, Alan S" sort="Maisel, Alan S" uniqKey="Maisel A" first="Alan S" last="Maisel">Alan S. Maisel</name><name sortKey="Platz, Elke" sort="Platz, Elke" uniqKey="Platz E" first="Elke" last="Platz">Elke Platz</name></country><country name="Royaume-Uni"><region name="Écosse"><name sortKey="Mcmurray, John J" sort="Mcmurray, John J" uniqKey="Mcmurray J" first="John J" last="Mcmurray">John J. Mcmurray</name></region><name sortKey="Cowie, Martin R" sort="Cowie, Martin R" uniqKey="Cowie M" first="Martin R" last="Cowie">Martin R. Cowie</name><name sortKey="Price, Susanna" sort="Price, Susanna" uniqKey="Price S" first="Susanna" last="Price">Susanna Price</name></country><country name="Allemagne"><noRegion><name sortKey="Christ, Michael" sort="Christ, Michael" uniqKey="Christ M" first="Michael" last="Christ">Michael Christ</name></noRegion><name sortKey="Zeymer, Uwe" sort="Zeymer, Uwe" uniqKey="Zeymer U" first="Uwe" last="Zeymer">Uwe Zeymer</name></country><country name="Australie"><noRegion><name sortKey="Cullen, Louise" sort="Cullen, Louise" uniqKey="Cullen L" first="Louise" last="Cullen">Louise Cullen</name></noRegion></country><country name="Italie"><region name="Latium"><name sortKey="Di Somma, Salvatore" sort="Di Somma, Salvatore" uniqKey="Di Somma S" first="Salvatore" last="Di Somma">Salvatore Di Somma</name></region></country><country name="Belgique"><noRegion><name sortKey="Vrints, Christiaan" sort="Vrints, Christiaan" uniqKey="Vrints C" first="Christiaan" last="Vrints">Christiaan Vrints</name></noRegion></country><country name="France"><noRegion><name sortKey="Mebazaa, Alexander" sort="Mebazaa, Alexander" uniqKey="Mebazaa A" first="Alexander" last="Mebazaa">Alexander Mebazaa</name></noRegion></country><country name="Suisse"><noRegion><name sortKey="Mueller, Christian" sort="Mueller, Christian" uniqKey="Mueller C" first="Christian" last="Mueller">Christian Mueller</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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