Document Detail

Frequency of low-risk hospital admissions for heart failure.
MedLine Citation:
PMID:  9462604     Owner:  NLM     Status:  MEDLINE    
Heart failure is one of the most common reasons for admission to acute care hospitals. A proportion of these admissions are probably low risk and could be managed in subacute care facilities, resulting in substantial cost savings. To investigate the proportion of low-risk hospital admissions for heart failure, all admissions for heart failure to Vanderbilt University Medical Center between July 1993 and June 1995 were identified (n = 743). One hundred twenty of these admissions were randomly selected, reviewed, and classified into a high-risk versus low-risk group on admission based on the severity of heart failure and the presence of life-threatening complications. Of the 120 admissions, 57 (48%) were classified as high risk based on the presence of moderate to severe heart failure for the first time or recurrent heart failure with a major complicating factor. Sixteen admissions (28%) were associated with adverse outcomes, including myocardial infarction in 5 (9%), intubation in 6 (11%), and death in 4 (7%). Sixty-three admissions (52%) were classified as low risk based on the presence of new-onset mild heart failure or mild to moderate recurrent heart failure with no complicating factors. Most of these admissions were for dyspnea without any life-threatening complication; 57 (91%) had no evidence of interstitial or alveolar pulmonary edema, and arterial oxygen saturation averaged 95 +/- 3%. Only 3 of these low risk admissions (5%) were associated with an adverse cardiovascular event. None of the patients died. These data suggest that over half of the patients admitted for heart failure to an acute care facility are low risk and probably could be managed in a subacute care setting, resulting in large cost savings.
J Butler; S Hanumanthu; D Chomsky; J R Wilson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  81     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1998 Jan 
Date Detail:
Created Date:  1998-02-19     Completed Date:  1998-02-19     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  41-4     Citation Subset:  AIM; IM    
Division of Cardiology, Vanderbilt University Medical Center, Nashville, TN 37232-0883, USA.
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MeSH Terms
Blood Gas Analysis
Health Services Misuse
Heart Failure / classification*,  complications
Hospitals, University / utilization*
Middle Aged
Outcome Assessment (Health Care)
Patient Admission / statistics & numerical data*,  trends
Patient Selection
Risk Factors
Severity of Illness Index*
Subacute Care
Tennessee / epidemiology
Utilization Review

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