Summary
Factors associated with short stays for patients admitted with acute heart failure
Carbajosa V, Martín-Sánchez FJ, Llorens P, Herrero P, Jacob J, Alquézar A, Pérez-Durá MJ, Alonso H, Garrido JM, Torres Murillo J, Torres-Murillo JM, López-Grima MI, Piñera P, Fernández C, Miró O
Affiliation of the authors
Servicio de Urgencias, Hospital Universitario Río Hortega, Valladolid, Spain. Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, Spain. Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain. Facultad de Medicina, Universidad Complutense de Madrid, Spain. Servicio de Urgencias, Unidad de Corta Estancia y Unidad de Hospitalización a Domicilio, Hospital General Universitario de Alicante. Alicante, Spain. Servicio de Urgencias, Hospital Universitario Central de Asturias, Oviedo, Spain. Servicio de Urgencias, Hospital Universitari de Bellvitge, IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain. Servicio de Urgencias, Hospital Sant Pau, Barcelona, Spain. Servicio de Urgencias, Hospital La Fe, Valencia, Spain. Servicio de Urgencias, Hospital Marqués de Valdecilla, Santander, Spain. Servicio de Urgencias, Hospital Virgen de la Macarena, Sevilla, Spain. Servicio de Urgencias, Hospital Reina Sofía, Córdoba, Spain. Servicio de Urgencias, Hospital Peset, Valencia, Spain. Servicio de Urgencias, Hospital Reina Sofía, Murcia, Spain. Servicio de Medicina Preventiva, Hospital Clínico San Carlos, Madrid, Spain. Área de Urgencias, Hospital Clínic, Barcelona, Spain. Grupo de investigación “Urgencias: procesos y patologías”, IDIBAPS. Barcelona, Spain.
DOI
Quote
Carbajosa V, Martín-Sánchez FJ, Llorens P, Herrero P, Jacob J, Alquézar A, et al. Factors associated with short stays for patients admitted with acute heart failure. Emergencias. 2016;28:366-74
Summary
Objective.
Methods.
outcome variable was a short hospital stay ( 4 days). We built receiver operating characteristic curves of simple and mixed predictive models for short stays and calculated the area under the curves.
Results.
to conventional wards. The variables associated with a short-stay according to the mixed regression model were hypertensive crisis (odds ratio [OR], 1.79; 95% CI, 1.17–2.73; P=.007) and admission to a SSU (OR, 16.6; 95% CI, 10.0–33.3; P<.001). Hypotensive AHF (OR, 0.49; 95% CI, 0.26–0.91; P=.025), hypoxemia (OR, 0.68; 95% CI, 0.53–0.88; P=.004); and admission on a Wednesday, Thursday, or Friday (OR, 0.62; 95% CI, 0.49–0.77; P<.001) were associated with a long stay. The area under the receiver operating characteristic curve was 0.827 (95% CI, 0.80–0.85; P<.001). Thirty-day mortality and readmission rates did not differ between patients with short vs long stays (mortality, 0.5% in both cases, P=.959; and readmission, 22.9% vs 27.7%, respectively; P=.059). Conclusion. Both clinical and administrative factors are independently related to whether patients with AHF have short stays in the hospitals studied, and among therapy, it is remaslcasle the existence of a SSU.