ED patients with heart failure

identification of an observational unit-appropriate cohort

Deborah B. Diercks, W. Franklin Peacock, James D Kirk, Jim E. Weber

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Objective: To identify factors that define a low-risk cohort of patients with acute decompensated heart failure who are suitable for management in an observation unit. Methods: Prospective convenience sample of 538 patients who presented to an ED with a diagnosis of congestive heart failure. Observation unit appropriate was defined as a length of stay less than 24 hours and no adverse events (myocardial infarction, death, arrhythmia, or rehospitalization) during the 30-day follow-up period. Results: Study criteria were met by 499 patients (mean age, 61 ± 15 years), and 234 (47%) were women. Of these, 133 (27%) met the criteria for observation unit appropriateness. Independent predictors were systolic blood pressure of greater than 160 (odds ratio, 1.8; 95% confidence interval, 1.15-2.7) and normal troponin I (odds ratio, 14.7; 95% confidence interval, 1.9-105). Conclusion: Initial blood pressure and troponin I can help identify patients with congestive heart failure at low risk for prolonged hospitalization and adverse events and who are reasonable candidates for observation unit management.

Original languageEnglish (US)
Pages (from-to)319-324
Number of pages6
JournalAmerican Journal of Emergency Medicine
Volume24
Issue number3
DOIs
StatePublished - May 2006

Fingerprint

Heart Failure
Observation
Troponin I
Blood Pressure
Odds Ratio
Confidence Intervals
Cardiac Arrhythmias
Length of Stay
Hospitalization
Myocardial Infarction

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

ED patients with heart failure : identification of an observational unit-appropriate cohort. / Diercks, Deborah B.; Peacock, W. Franklin; Kirk, James D; Weber, Jim E.

In: American Journal of Emergency Medicine, Vol. 24, No. 3, 05.2006, p. 319-324.

Research output: Contribution to journalArticle

Diercks, Deborah B. ; Peacock, W. Franklin ; Kirk, James D ; Weber, Jim E. / ED patients with heart failure : identification of an observational unit-appropriate cohort. In: American Journal of Emergency Medicine. 2006 ; Vol. 24, No. 3. pp. 319-324.
@article{b5177d82352a45659b106486d6ce3ae5,
title = "ED patients with heart failure: identification of an observational unit-appropriate cohort",
abstract = "Objective: To identify factors that define a low-risk cohort of patients with acute decompensated heart failure who are suitable for management in an observation unit. Methods: Prospective convenience sample of 538 patients who presented to an ED with a diagnosis of congestive heart failure. Observation unit appropriate was defined as a length of stay less than 24 hours and no adverse events (myocardial infarction, death, arrhythmia, or rehospitalization) during the 30-day follow-up period. Results: Study criteria were met by 499 patients (mean age, 61 ± 15 years), and 234 (47{\%}) were women. Of these, 133 (27{\%}) met the criteria for observation unit appropriateness. Independent predictors were systolic blood pressure of greater than 160 (odds ratio, 1.8; 95{\%} confidence interval, 1.15-2.7) and normal troponin I (odds ratio, 14.7; 95{\%} confidence interval, 1.9-105). Conclusion: Initial blood pressure and troponin I can help identify patients with congestive heart failure at low risk for prolonged hospitalization and adverse events and who are reasonable candidates for observation unit management.",
author = "Diercks, {Deborah B.} and Peacock, {W. Franklin} and Kirk, {James D} and Weber, {Jim E.}",
year = "2006",
month = "5",
doi = "10.1016/j.ajem.2005.11.014",
language = "English (US)",
volume = "24",
pages = "319--324",
journal = "American Journal of Emergency Medicine",
issn = "0735-6757",
publisher = "W.B. Saunders Ltd",
number = "3",

}

TY - JOUR

T1 - ED patients with heart failure

T2 - identification of an observational unit-appropriate cohort

AU - Diercks, Deborah B.

AU - Peacock, W. Franklin

AU - Kirk, James D

AU - Weber, Jim E.

PY - 2006/5

Y1 - 2006/5

N2 - Objective: To identify factors that define a low-risk cohort of patients with acute decompensated heart failure who are suitable for management in an observation unit. Methods: Prospective convenience sample of 538 patients who presented to an ED with a diagnosis of congestive heart failure. Observation unit appropriate was defined as a length of stay less than 24 hours and no adverse events (myocardial infarction, death, arrhythmia, or rehospitalization) during the 30-day follow-up period. Results: Study criteria were met by 499 patients (mean age, 61 ± 15 years), and 234 (47%) were women. Of these, 133 (27%) met the criteria for observation unit appropriateness. Independent predictors were systolic blood pressure of greater than 160 (odds ratio, 1.8; 95% confidence interval, 1.15-2.7) and normal troponin I (odds ratio, 14.7; 95% confidence interval, 1.9-105). Conclusion: Initial blood pressure and troponin I can help identify patients with congestive heart failure at low risk for prolonged hospitalization and adverse events and who are reasonable candidates for observation unit management.

AB - Objective: To identify factors that define a low-risk cohort of patients with acute decompensated heart failure who are suitable for management in an observation unit. Methods: Prospective convenience sample of 538 patients who presented to an ED with a diagnosis of congestive heart failure. Observation unit appropriate was defined as a length of stay less than 24 hours and no adverse events (myocardial infarction, death, arrhythmia, or rehospitalization) during the 30-day follow-up period. Results: Study criteria were met by 499 patients (mean age, 61 ± 15 years), and 234 (47%) were women. Of these, 133 (27%) met the criteria for observation unit appropriateness. Independent predictors were systolic blood pressure of greater than 160 (odds ratio, 1.8; 95% confidence interval, 1.15-2.7) and normal troponin I (odds ratio, 14.7; 95% confidence interval, 1.9-105). Conclusion: Initial blood pressure and troponin I can help identify patients with congestive heart failure at low risk for prolonged hospitalization and adverse events and who are reasonable candidates for observation unit management.

UR - http://www.scopus.com/inward/record.url?scp=33646073410&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33646073410&partnerID=8YFLogxK

U2 - 10.1016/j.ajem.2005.11.014

DO - 10.1016/j.ajem.2005.11.014

M3 - Article

VL - 24

SP - 319

EP - 324

JO - American Journal of Emergency Medicine

JF - American Journal of Emergency Medicine

SN - 0735-6757

IS - 3

ER -