Effect of an Emergency Department Care Bundle on 30-Day Hospital Discharge and Survival Among Elderly Patients With Acute Heart Failure: The ELISABETH Randomized Clinical Trial.

JAMA : the Journal of the American Medical Association
Yonathan FreundAlexandre Mebazaa

Abstract

Clinical guidelines for the early management of acute heart failure in the emergency department (ED) setting are based on only moderate levels of evidence, with subsequent low adherence to these guidelines. To test the effect of an early guideline-recommended care bundle on short-term prognosis in older patients with acute heart failure in the ED. Stepped-wedge cluster randomized trial in 15 EDs in France of 503 patients 75 years and older with a diagnosis of acute heart failure in the ED from December 2018 to September 2019 and followed up for 30 days until October 2019. A care bundle that included early intravenous nitrate boluses; management of precipitating factors, such as acute coronary syndrome, infection, or atrial fibrillation; and moderate dose of intravenous diuretics (n = 200). In the control group, patient care was left to the discretion of the treating emergency physician (n = 303). Each center was randomized to the order in which they switched to the "intervention period." After the initial 4-week control period for all centers, 1 center entered in the intervention period every 2 weeks. The primary end point was the number of days alive and out of hospital at 30 days. Secondary outcomes included 30-day all-cause ...Continue Reading

References

Jul 11, 2006·Contemporary Clinical Trials·Michael A Hussey, James P Hughes
Feb 19, 2008·European Journal of Heart Failure·Justin A EzekowitzPaul W Armstrong
Oct 31, 2008·Australian and New Zealand Journal of Public Health·Adrian G BarnettJohn F Fraser
Mar 4, 2011·The New England Journal of Medicine·G Michael FelkerUNKNOWN NHLBI Heart Failure Clinical Research Network
Nov 27, 2014·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Sean P CollinsDaniel J Lenihan
Oct 1, 2015·European Journal of Heart Failure·Antonio TeixeiraUNKNOWN GREAT (Global Research on Acute Conditions Team) Network
May 18, 2016·Archives of Cardiovascular Diseases·Antonio TeixeiraAlexandre Mebazaa
Apr 14, 2017·The New England Journal of Medicine·Milton PackerUNKNOWN TRUE-AHF Investigators
Jun 24, 2017·Journal of the American College of Cardiology·Yuya MatsueTakeshi Kitai
Aug 29, 2019·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Judith GorlickiYonathan Freund

❮ Previous
Next ❯

Citations

Mar 10, 2021·JAMA : the Journal of the American Medical Association·Yonathan Freund, Judith Gorlicki
Mar 10, 2021·JAMA : the Journal of the American Medical Association·Kan Liu
Jun 5, 2021·The European Respiratory Journal·Pradeesh SivapalanUNKNOWN ProPAC-COVID study group
Aug 28, 2021·European Heart Journal·Theresa A McDonaghUNKNOWN ESC Scientific Document Group
Sep 1, 2021·Soins. Gérontologie·Adrien GoldsteinPatrick Ray

❮ Previous
Next ❯

Related Concepts

Related Feeds

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.