New European guidelines seek to help doctors decide when to discharge patients with acute heart failure from hospital.
The guidelines, issued by the European Society of Cardiology, offer a novel algorithm, setting out the order of decisions and what to consider at each step.
Developers say doctors tend to act cautiously with these patients, admitting them to hospital or keeping them in.
Developer Professor Christian Mueller, chair of the acute heart failure study group, said: “The hospital is not always the best place to care for acutely ill patients.
“While in hospital, patients with acute heart failure – who are 78 years old on average – are at risk of developing infections and they have problems sleeping. There is also pressure on hospitals to avoid expensive admissions when possible.
"But patients do benefit from more intense follow up while in hospital.”
He added: “Only half of patients discharged from hospital with acute heart failure are alive in three years, even though they felt fine,” he continued.
“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 guidelines are published today in the European Heart Journal: Acute Cardiovascular Care.
Professor Mueller said: “The paper aims to kick start the process of emergency medicine physicians and cardiologists joining forces to apply or adjust the algorithm so that it works locally.
"The patient pathway and decisions on place of treatment will vary depending on reimbursement policies and logistics.”
European Society of Cardiology – Acute Cardiovascular Care Association position paper on safe discharge of acute heart failure patients from the emergency department. European Heart Journal: Acute Cardiovascular Care 22 February 2016; doi: 10.1177/2048872616633853 [abstract]
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