Acute Heart Failure in the Emergency Department: What Is the Prognosis?
Authors: Peter S. Rahko
Journal: Annals of Internal Medicine (2017)

Editorials21 November 2017Acute Heart Failure in the Emergency Department: What Is the Prognosis?Peter S. Rahko, MDPeter S. Rahko, MDFrom University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-2389 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Heart failure (HF) is and will continue to be a major clinical problem in the United States, with an estimated prevalence of 6.5 million that is projected to increase to 8 million by 2030. Persons with HF account for about 1 million acute care hospitalizations, 2 million outpatient visits, and at least 500 000 emergency department (ED) evaluations annually (1). Patients with HF typically are older than 55 years and fragile and have multiple comorbid conditions, such as hypertension, coronary artery disease, atrial fibrillation, diabetes, and chronic renal insufficiency. Only about half have systolic dysfunction (ejection fraction <0.40), for which treatment ...References1. Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, et al; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics-2017 update: a report from the American Heart Association. Circulation. 2017;135:e146-e603. [PMID: 28122885] doi:10.1161/CIR.0000000000000485 CrossrefMedlineGoogle Scholar2. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH, et al; American College of Cardiology Foundation. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. 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Clinical assessment identifies hemodynamic profiles that predict outcomes in patients admitted with heart failure. J Am Coll Cardiol. 2003;41:1797-804. [PMID: 12767667] CrossrefMedlineGoogle Scholar6. Stiell IG, Perry JJ, Clement CM, Brison RJ, Rowe BH, Aaron SD, et al. Prospective and explicit clinical validation of the Ottawa Heart Failure Risk Scale, with and without use of quantitative NT-proBNP. Acad Emerg Med. 2017;24:316-327. [PMID: 27976497] doi:10.1111/acem.13141 CrossrefMedlineGoogle Scholar7. Miró Ò, Rossello X, Gil V, Martín-Sánchez FJ, Llorens P, Herrero-Puente P, et al. Predicting 30-day mortality for patients with acute heart failure in the emergency department. A cohort study. Ann Intern Med. 2017;167:698-705. doi:10.7326/M16-2726 LinkGoogle Scholar8. 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, W-261, W-262. [PMID: 22665814]. doi:10.7326/0003-4819-156-11-201206050-00003 LinkGoogle Scholar9. Collins SP, Jenkins CA, Harrell FE, Liu D, Miller KF, Lindsell CJ, et al. Identification of emergency department patients with acute heart failure at low risk for 30-day adverse events: the STRATIFY decision tool. JACC Heart Fail. 2015;3:737-47. [PMID: 26449993] doi:10.1016/j.jchf.2015.05.007 CrossrefMedlineGoogle Scholar10. Stiell IG, Clement CM, Brison RJ, Rowe BH, Borgundvaag B, Aaron SD, et al. A risk scoring system to identify emergency department patients with heart failure at high risk for serious adverse events. Acad Emerg Med. 2013;20:17-26. [PMID: 23570474] doi:10.1111/acem.12056 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.Disclosures: The author has disclosed no conflicts of interest. His form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-2389.Corresponding Author: Peter S. Rahko, MD, Division of Cardiovascular Medicine, Mail Stop 3248, University of Wisconsin Hospital, 600 Highland Avenue, Madison, WI 53792-3248; e-mail, [email protected]wisc.edu.This article was published at Annals.org on 3 October 2017. 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 Metrics 21 November 2017Volume 167, Issue 10Page: 744-745KeywordsEmergency departmentHeart failureHospitalizationsLong-term careMortalityOutpatientsPopulation statisticsTreatment guidelinesTriageTroponin ePublished: 3 October 2017 Issue Published: 21 November 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...