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An electronic strategy to identify hospitalized heart failure patients
Author(s) -
Halasyamani Lakshmi K.,
Czerwinski Jennifer,
Clinard Rosemary,
Cowen Mark E.
Publication year - 2007
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.1002/jhm.284
Subject(s) - medicine , heart failure , spironolactone , pharmacy , intensive care medicine , hospital medicine , diuretic , specialty , emergency medicine , hydrochlorothiazide , medical prescription , hospital discharge , family medicine , blood pressure , pharmacology
BACKGROUND A common challenge in improving performance measures regarding heart failure (HF) is identifying patients early in the course of their hospitalization so that multidisciplinary education and clinical interventions can be implemented. We describe the accuracy of using an electronic pharmacy‐based strategy to identify hospitalized patients likely to have a principal diagnosis of HF at discharge. METHODS We evaluated 2 strategies. The first used the receipt of an intravenous loop diuretic as a single predictor; the second incorporated additional lab, pharmacy, and demographic information in a multivariable general estimating equation. RESULTS Receipt of an intravenous diuretic predicted a discharge diagnosis of heart failure with a sensitivity of 0.89 and a specificity of 0.87. Adding age, B‐type natriuretic peptide level, previous hospitalizations, attending physician specialty, and receipt of spironolactone into the predictor improved the sensitivity to 0.91 and the specificity to 0.89. CONCLUSIONS The receipt of intravenous loop diuretics is a reasonable and easily implemented screening test to identify patients likely to have a principal diagnosis of heart failure at discharge. The accuracy is improved by incorporating other electronically available variables. Journal of Hospital Medicine 2007;2:409–414. © 2007 Society of Hospital Medicine.