Patients suffering from acute heart failure incur a higher mortality risk than those who experience heart attacks, yet research on improving care for such patients lags 30 years behind, according to the European Society of Cardiology. One determining factor for acute heart failure outcomes is time of discharge, and new advice published in the European Heart Journal: Acute Cardiovascular Care aims to address that important element.
"Only half of patients discharged from hospital with acute heart failure are alive in three years, even though they felt fine," Christian Mueller, MD, chair of the European Society of Cardiology's Acute Heart Failure Study Group, said in a statement accompanying the publication of the research. "Despite the severity of the condition there are no standard treatment pathways, whereas these were agreed across Europe for heart attack 30 years ago. The paper published today is the first step towards catching up with heart attack care and establishing similar standards for acute heart failure."
A lack of guidance on best practices for either admitting or discharging acute heart failure patients often results in emergency physicians admitting patients out of an abundance of caution, which might not be best for them, according to the authors.
Patients with acute heart failure, which is incurable and often treated as symptoms flare up, are at a greater risk of infection and experiencing disrupted sleep, which can make the condition worse. The paper includes an algorithm physicians can use to decide which patients with acute heart failure should be discharged from the emergency department.
"It's never ever possible to treat acute heart failure sufficiently in 24 hours in the emergency department," Dr. Mueller said in a statement. "Intense follow up will always be needed. It's the task of the emergency department physician to either make the first follow up appointment or to ensure that this will occur…Ultimately we hope this guidance will improve the management of patients with acute heart failure and make some inroads towards giving them a better outlook."
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