Analysis of the effectiveness and safety of short-stay units in the hospitalization of patients with acute heart failure. Propensity Score SSU-EAHFE.

OBJECTIVES: This work aims to analyze if hospitalization in short-stay units (SSU) of patients diagnosed in the emergency department with acute heart failure (AHF) is effective in terms of the length of hospital stay and if it is associated with differences in short-term progress. METHOD: Patients from the EAHFE registry diagnosed with AHF who were admitted to the SSU (SSU group) were included and compared to those hospitalized in other departments (non-SSU group) from all hospitals (comparison A) and, separately, those from hospitals with an SSU (comparison B) and without an SSU (comparison C). For each comparison, patients in the SSU/non-SSU groups were matched by propensity score. The length of hospital stay (efficacy), 30-day mortality, and post-discharge adverse events at 30 days (safety) were compared. RESULTS: A total of 2,003 SSU patients and 12,193 non-SSU patients were identified. Of them, 674 pairs of patients were matched for comparison A, 634 for comparison B, and 588 for comparison C. The hospital stay was significantly shorter in the SSU group in all comparisons (A: median 4 days (IQR = 2-5) versus 8 (5-12) days, p < 0.001; B: 4 (2-5) versus 8 (5-12), p < 0.001; C: 4 (2-5) versus 8 (6-12), p < 0.001). Admission to the SSU was not associated with differences in mortality (A: HR = 1.027, 95%CI = 0.681-1.549; B: 0.976, 0.647-1.472; C: 0.818, 0.662-1.010) or post-discharge adverse events (A: HR = 1.002, 95%CI = 0.816-1.232; B: 0.983, 0.796-1.215; C: 1.135, 0.905-1.424). CONCLUSION: The hospitalization of patients with AHF in the SSU is associated with shorter hospital stays but there were no differences in short-term progress.

Análisis de la efectividad y seguridad de las unidades de estancia corta en la hospitalización de pacientes con insuficiencia cardíaca aguda. Propensity Score UCE-EAHFE / Analysis of the effectiveness and safety of short-stay units in the hospitalization of patients with acute heart failure. Propensity Score SSU-EAHFE

Objetivos Analizar si la hospitalización en unidades de corta estancia (UCE) de pacientes diagnosticados en urgencias de insuficiencia cardíaca aguda (ICA) resulta efectiva en términos de estancia hospitalaria y si se asocia con diferencias en la evolución a corto plazo. Método Se incluyeron los pacientes del registro EAHFE diagnosticados de ICA que ingresaron en UCE (grupo UCE) y se compararon con los hospitalizados en otros servicios (grupo No-UCE) procedentes de todos los hospitales (comparación A) y, separadamente, de hospitales con UCE (comparación B) y sin UCE (comparación C). Para cada comparación, se emparejaron pacientes de los grupos UCE/No-UCE por puntuación de propensión, y se comparó la estancia hospitalaria (eficacia) y mortalidad a 30 días y evento adverso posalta a 30 días (seguridad). Resultados Se identificaron 2.003 pacientes UCE y 12.193 No-UCE. Se emparejaron 674 pares de pacientes para la comparación A, 634 para la comparación B y 588 para la comparación C. La estancia hospitalaria fue significativamente inferior en el grupo UCE en todas las comparaciones (A: mediana 4 días [RIC = 2–5] versus 8 [5–12] días, p < 0,001; B: 4 [2–5] versus 8 [5–12], p < 0,001; C: 4 [2–5] versus 8 [6–12], p < 0,001). El ingreso en UCE no se asoció a diferencias en mortalidad (A: HR = 1,027, IC95% = 0,681−1,549; B: 0,976, 0,647−1,472; C: 0,818, 0,662−1,010) ni en eventos adversos posalta (A: 1,002, 0,816−1,232; B: 0,983, 0,796−1,215; C: 1,135, 0,905−1,424). Conclusión La hospitalización de los pacientes con ICA en UCE se asocia con estancias más cortas sin diferencias en la evolución a corto plazo (AU)

Objectives This work aims to analyze if hospitalization in short-stay units (SSU) of patients diagnosed in the emergency department with acute heart failure (AHF) is effective in terms of the length of hospital stay and if it is associated with differences in short-term progress. Method Patients from the EAHFE registry diagnosed with AHF who were admitted to the SSU (SSU group) were included and compared to those hospitalized in other departments (non-SSU group) from all hospitals (comparison A) and, separately, those from hospitals with an SSU (comparison B) and without an SSU (comparison C). For each comparison, patients in the SSU/non-SSU groups were matched by propensity score. The length of hospital stay (efficacy), 30-day mortality, and post-discharge adverse events at 30 days (safety) were compared. Results A total of 2,003 SSU patients and 12,193 non-SSU patients were identified. Of them, 674 pairs of patients were matched for comparison A, 634 for comparison B, and 588 for comparison C. The hospital stay was significantly shorter in the SSU group in all comparisons (A: median 4 days (IQR = 2–5) versus 8 (5–12) days, p < 0.001; B: 4 (2–5) versus 8 (5–12), p < 0.001; C: 4 (2–5) versus 8 (6–12), p < 0.001). Admission to the SSU was not associated with differences in mortality (A: HR = 1.027, 95%CI = 0.681–1.549; B: 0.976, 0.647–1.472; C: 0.818, 0.662–1.010) or post-discharge adverse events (A: HR = 1.002, 95%CI = 0.816–1.232; B: 0.983, 0.796–1.215; C: 1.135, 0.905–1.424). Conclusion The hospitalization of patients with AHF in the SSU is associated with shorter hospital stays but there were no differences in short-term progress (AU)