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

Identifieur interne : 000C85 ( PubMed/Checkpoint ); précédent : 000C84; suivant : 000C86

European 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 :

RBID : pubmed:26900163

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


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pubmed:26900163

Le document en format XML

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<name sortKey="Zeymer, Uwe" sort="Zeymer, Uwe" uniqKey="Zeymer U" first="Uwe" last="Zeymer">Uwe Zeymer</name>
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<name sortKey="Mebazaa, Alexander" sort="Mebazaa, Alexander" uniqKey="Mebazaa A" first="Alexander" last="Mebazaa">Alexander Mebazaa</name>
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<nlm:affiliation>16 Hospital Lariboisière, Université Paris Diderot, France.</nlm:affiliation>
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<wicri:regionArea>16 Hospital Lariboisière, Université Paris Diderot</wicri:regionArea>
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<wicri:noRegion>Université Paris Diderot</wicri:noRegion>
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<author>
<name sortKey="Mueller, Christian" sort="Mueller, Christian" uniqKey="Mueller C" first="Christian" last="Mueller">Christian Mueller</name>
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<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>
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<title level="j">European heart journal. Acute cardiovascular care</title>
<idno type="eISSN">2048-8734</idno>
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<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>
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<Day>22</Day>
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<Issue>4</Issue>
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<Year>2017</Year>
<Month>Jun</Month>
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<Title>European heart journal. Acute cardiovascular care</Title>
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<ArticleTitle>European Society of Cardiology - Acute Cardiovascular Care Association position paper on safe discharge of acute heart failure patients from the emergency department.</ArticleTitle>
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<AbstractText>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.</AbstractText>
</Abstract>
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<LastName>Miró</LastName>
<ForeName>Òscar</ForeName>
<Initials>Ò</Initials>
<AffiliationInfo>
<Affiliation>1 Emergency Department, Hospital Clínic; Institut de Recerca Biomàdica August Pi i Sunyer (IDIBAPS), ICA-SEMES Research Group, Barcelona, Catalonia, Spain.</Affiliation>
</AffiliationInfo>
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<LastName>Peacock</LastName>
<ForeName>Frank W</ForeName>
<Initials>FW</Initials>
<AffiliationInfo>
<Affiliation>2 Emergency Medicine, Baylor College of Medicine, Houston, USA.</Affiliation>
</AffiliationInfo>
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<LastName>McMurray</LastName>
<ForeName>John J</ForeName>
<Initials>JJ</Initials>
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<Affiliation>3 British Heart Foundation Cardiovascular Research Centre, University of Glasgow, UK.</Affiliation>
</AffiliationInfo>
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<LastName>Bueno</LastName>
<ForeName>Héctor</ForeName>
<Initials>H</Initials>
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<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.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Christ</LastName>
<ForeName>Michael</ForeName>
<Initials>M</Initials>
<AffiliationInfo>
<Affiliation>5 Department of Emergency and Critical Care Medicine, Klinikum Nürnberg, Germany.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Maisel</LastName>
<ForeName>Alan S</ForeName>
<Initials>AS</Initials>
<AffiliationInfo>
<Affiliation>6 Coronary Care Unit and Heart Failure Program, Veteran Affairs (VA) San Diego, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Cullen</LastName>
<ForeName>Louise</ForeName>
<Initials>L</Initials>
<AffiliationInfo>
<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.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Cowie</LastName>
<ForeName>Martin R</ForeName>
<Initials>MR</Initials>
<AffiliationInfo>
<Affiliation>8 Cardiology Department, Imperial College London (Royal Brompton Hospital), UK.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Di Somma</LastName>
<ForeName>Salvatore</ForeName>
<Initials>S</Initials>
<AffiliationInfo>
<Affiliation>9 Emergency Medicine, Department of Medical-Surgery Sciences and Translational Medicine, Sant'Andrea Hospital, University La Sapienza, Rome, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Martín Sánchez</LastName>
<ForeName>Francisco J</ForeName>
<Initials>FJ</Initials>
<AffiliationInfo>
<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.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Platz</LastName>
<ForeName>Elke</ForeName>
<Initials>E</Initials>
<AffiliationInfo>
<Affiliation>11 Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Masip</LastName>
<ForeName>Josep</ForeName>
<Initials>J</Initials>
<AffiliationInfo>
<Affiliation>12 ICU Department, Consorci Sanitari Integral, University of Barcelona; Cardiology Department Hospital Sanitas CIMA, Barcelona, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Zeymer</LastName>
<ForeName>Uwe</ForeName>
<Initials>U</Initials>
<AffiliationInfo>
<Affiliation>13 FEESC, Klinikum Ludwigshafen und Institut für Herzinfarktforschung Ludwigshafen, Germany.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Vrints</LastName>
<ForeName>Christiaan</ForeName>
<Initials>C</Initials>
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<Affiliation>14 Faculty of Medicine and Health Sciences at University of Antwerp, Belgium.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Price</LastName>
<ForeName>Susanna</ForeName>
<Initials>S</Initials>
<AffiliationInfo>
<Affiliation>15 Royal Brompton and Harefield National Health Service Foundation Trust, London, UK.</Affiliation>
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<LastName>Mebazaa</LastName>
<ForeName>Alexander</ForeName>
<Initials>A</Initials>
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<Affiliation>16 Hospital Lariboisière, Université Paris Diderot, France.</Affiliation>
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<Author ValidYN="Y">
<LastName>Mueller</LastName>
<ForeName>Christian</ForeName>
<Initials>C</Initials>
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<Affiliation>17 Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Switzerland.</Affiliation>
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</Author>
<Author ValidYN="Y">
<CollectiveName>Acute Heart Failure Study Group of the ESC Acute Cardiovascular Care Association</CollectiveName>
</Author>
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<Language>eng</Language>
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<Keyword MajorTopicYN="N">Acute heart failure</Keyword>
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