Assessing Risk and Preventing 30-Day Readmissions in Decompensated Heart Failure: Opportunity to Intervene?
Assessing Risk and Preventing 30-Day Readmissions in Decompensated Heart Failure: Opportunity to Intervene?
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DOI：
10.1007/s11897-015-0266-4
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发表时间：
2015-10
影响因子：
--
通讯作者：
Lee DS
中科院分区：
文献类型：
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作者：
Dunbar-Yaffe R;Stitt A;Lee JJ;Mohamed S;Lee DS
心力衰竭（HF）患者再次住院的风险很高，这导致了大量的医疗费用。人们对减少心衰再住院的策略非常感兴趣。然而，许多再入院发生在初次出院后30天内，这对在短时间内制定干预措施提出了挑战。减少心衰再入院的潜在策略可分为三种不同的形式。首先，再入院高风险的患者甚至可以在他们最初的指标出院之前就被识别出来。其次，可以制定动态远程监测策略，在心衰急性失代偿发生之前识别早期预警信号。最后，可以在急诊科采用策略来识别可能不需要再入院的低风险患者。如果初步治疗后症状有所改善，低危患者可转到专门的快速门诊随访治疗，在门诊环境中进行调查和治疗。
Heart failure (HF) patients are at high risk of hospital readmission, which contributes to substantial health care costs. There is great interest in strategies to reduce rehospitalization for HF. However, many readmissions occur within 30 days of initial hospital discharge, presenting a challenge for interventions to be instituted in a short time frame. Potential strategies to reduce readmissions for HF can be classified into three different forms. First, patients who are at high risk of readmission can be identified even before their initial index hospital discharge. Second, ambulatory remote monitoring strategies may be instituted to identify early warning signs before acute decompensation of HF occurs. Finally, strategies may be employed in the emergency department to identify low-risk patients who may not need hospital readmission. If symptoms improve with initial therapy, low-risk patients could be referred to specialized, rapid outpatient follow-up care where investigations and therapy can occur in an outpatient setting.