Open AccessEmergency Department Observation of Heart Failure: Preliminary Analysis of Safety and Cost
Author(s) -
Storrow Alan B.,
Collins Sean P.,
Lyons Michael S.,
Wagoner Lynne E.,
Gibler W. Brian,
Lindsell Christopher J.
Publication year - 2005
Publication title -
congestive heart failure
Language(s) - English
Resource type - Journals
eISSN - 1751-7133
pISSN - 1527-5299
DOI - 10.1111/j.1527-5299.2005.03844.x
Subject(s) - medicine , emergency department , triage , heart failure , emergency medicine , randomized controlled trial , acute decompensated heart failure , clinical trial , medical emergency , surgery , psychiatry
Emergency‐department (ED)‐based observation‐unit treatment has been shown to reduce inpatient admissions, hospital bed‐hours, and costs without adversely affecting outcomes for several conditions. A sequential group design study compared risk‐matched, acute decompensated heart failure patients admitted directly to the inpatient setting with those admitted to an ED observation unit for up to 23 hours before ED disposition. Outcomes were 30‐day readmissions or repeat ED visits for heart failure or 30‐day mortality. Estimates of bed‐hours and charges between the groups were compared. Sixty‐four patients were enrolled with 36 inpatient admissions and 28 observation unit patients. No patients died within 30 days. Observation unit patients had no significant difference in outcomes, a decrease in time from ED triage to discharge, a saving in mean bed‐hours, and less total charges. This pilot trial provides preliminary data that suggest admitted, low‐risk heart failure patients may be safely and cost‐effectively managed in an ED‐based observation unit. These findings need to be further evaluated in a randomized clinical trial.