Predicting 30-Day Mortality for Patients With Acute Heart Failure in the Emergency Department
Authors: Óscar Miró, Stuart J. Pocock
Journal: Annals of Internal Medicine (2018)

Letters19 June 2018Predicting 30-Day Mortality for Patients With Acute Heart Failure in the Emergency DepartmentÓscar Miró, PhD and Stuart J. Pocock, PhDÓscar Miró, PhDUniversity of Barcelona, Barcelona, Spain (Ó.M.) and Stuart J. Pocock, PhDLondon School of Hygiene and Tropical Medicine, London, United Kingdom (S.J.P.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L18-0096 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate Dr. Safiri and colleagues' interest, but their points do not seem relevant.First, all-cause mortality over a short period (we chose 30 days) from the time of emergency department admission with acute heart failure is of key interest in assessing a patient's severity and prognosis. Short-term all-cause mortality has also been the primary or key secondary end point selected in many major trials and registries for assessing the prognosis of patients with acute heart failure (1–5). To call it a "combined outcome" misses the point.Second, the concept of time-varying variables is irrelevant because we need ...References1. Mebazaa A, Nieminen MS, Filippatos GS, Cleland JG, Salon JE, Thakkar R, et al. Levosimendan vs. dobutamine: outcomes for acute heart failure patients on beta-blockers in SURVIVE. Eur J Heart Fail. 2009;11:304-11. [PMID: 19158152] doi:10.1093/eurjhf/hfn045 CrossrefMedlineGoogle Scholar2. O'Connor CM, Starling RC, Hernandez AF, Armstrong PW, Dickstein K, Hasselblad V, et al. Effect of nesiritide in patients with acute decompensated heart failure. N Engl J Med. 2011;365:32-43. [PMID: 21732835] doi:10.1056/NEJMoa1100171 CrossrefMedlineGoogle Scholar3. Lee DS, Stitt A, Austin PC, Stukel TA, Schull MJ, Chong A, et al. Prediction of heart failure mortality in emergent care: a cohort study. Ann Intern Med. 2012;156:767-75. [PMID: 22665814]. doi:10.7326/0003-4819-156-11-201206050-00003 LinkGoogle Scholar4. Lee DS, Schull MJ, Alter DA, Austin PC, Laupacis A, Chong A, et al. Early deaths in patients with heart failure discharged from the emergency department: a population-based analysis. Circ Heart Fail. 2010;3:228-35. [PMID: 20107191] doi:10.1161/CIRCHEARTFAILURE.109.885285 CrossrefMedlineGoogle Scholar5. Miró Ò, Llorens P, Escalada X, Herrero P, Jacob J, Gil V, et al; Grupo de Investigación ICA-SEMES. [Prehospital emergency care of patients with acute heart failure in Spain: the SEMICA study (Emergency Medical Response Systems for Patients with Acute Heart Failure)]. Emergencias. 2017;29:223-30. [PMID: 28825276] MedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Barcelona, Barcelona, Spain (Ó.M.)London School of Hygiene and Tropical Medicine, London, United Kingdom (S.J.P.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-2726. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPredicting 30-Day Mortality for Patients With Acute Heart Failure in the Emergency Department Òscar Miró , Xavier Rossello , Víctor Gil , Francisco Javier Martín-Sánchez , Pere Llorens , Pablo Herrero-Puente , Javier Jacob , Héctor Bueno , Stuart J. Pocock , and Predicting 30-Day Mortality for Patients With Acute Heart Failure in the Emergency Department Saeid Safiri , Jamal Hallajzadeh , and Erfan Ayubi Metrics Cited byLong‐term risk stratification for hospitalized patients with acute heart failure at a single rural cardiovascular centreDeterminants of In-Hospital Mortality in Elderly Patients Aged 80 Years or above with Acute Heart Failure: A Retrospective Cohort Study at a Single Rural Hospital 19 June 2018Volume 168, Issue 12Page: 899-900KeywordsBlood pressureDisclosureEmergency departmentHeart failureMedical risk factorsMortalityNatriuretic peptidesPotassiumSystolic pressureTroponin ePublished: 19 June 2018 Issue Published: 19 June 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...