Fozia Z. Ahmed
Ambulatory intravenous furosemide for decompensated heart failure: safe, feasible, and effective
Ahmed, Fozia Z.; Taylor, Joanne K.; John, Anju V.; Khan, Muhammad A.; Zaidi, Amir M.; Mamas, Mamas A.; Motwani, Manish; Cunnington, Colin
Authors
Joanne K. Taylor
Anju V. John
Muhammad A. Khan
Amir M. Zaidi
Mamas Mamas m.mamas@keele.ac.uk
Manish Motwani
Colin Cunnington
Abstract
AIMS: This study aims to establish the feasibility, safety, and efficacy of outpatient intravenous (IV) diuretic treatment for the management of decompensated heart failure (HF) for patients enrolled in the HeartFailure@Home service. METHODS AND RESULTS: We retrospectively analysed the clinical episodes of decompensated HF for patients enrolled in the HeartFailure@Home service, managed by ambulatory IV diuretic treatment either at home or on a day-case unit. A control group consisting of HF patients admitted to hospital for IV diuretics (standard-of-care) was also evaluated. In total, 203 episodes of decompensated HF (n = 154 patients) were evaluated. One hundred and fourteen episodes in 79 patients were managed exclusively by the ambulatory IV diuretic service-78 (68.4%) on a day-case unit and 36 (31.6%) domiciliary; 84.1% of patient episodes under the HF@Home service were successfully managed entirely in an out-patient setting without hospitalization. Eleven patients required admission in order to administer higher doses of IV diuretics than could be provided in the ambulatory setting. During follow-up, there were 20 (17.5%) 30 day re-admissions with HF or death in the ambulatory IV group and 29 (32.6%) in the standard-of-care arm (P = 0.02). There was no difference in 30 day HF readmissions between the two groups (14.9% ambulatory vs. 13.5% inpatients, P = 0.8), but 30 day mortality was significantly lower in the ambulatory group (3.5% vs. 21.3% inpatients, P < 0.001). CONCLUSIONS: Outpatient ambulatory management of decompensated HF with IV diuretics given either on a day case unit or in a domiciliary setting is feasible, safe, and effective in selected patients with decompensated HF. This should be explored further as a model in delivering HF services in the outpatient setting during COVID-19.
Journal Article Type | Article |
---|---|
Acceptance Date | Apr 1, 2021 |
Online Publication Date | Aug 12, 2021 |
Publication Date | 2021-10 |
Publicly Available Date | May 30, 2023 |
Journal | ESC Heart Failure |
Print ISSN | 2055-5822 |
Publisher | Wiley Open Access |
Peer Reviewed | Peer Reviewed |
Volume | 8 |
Issue | 5 |
Pages | 3906-3916 |
DOI | https://doi.org/10.1002/ehf2.13368 |
Keywords | Heart failure; Intravenous; Diuretics; Ambulatory; Elderly |
Publisher URL | https://doi.org/10.1002/ehf2.13368 |
Files
ehf2.13368.pdf
(759 Kb)
PDF
Publisher Licence URL
https://creativecommons.org/licenses/by/4.0/
You might also like
Downloadable Citations
About Keele Repository
Administrator e-mail: research.openaccess@keele.ac.uk
This application uses the following open-source libraries:
SheetJS Community Edition
Apache License Version 2.0 (http://www.apache.org/licenses/)
PDF.js
Apache License Version 2.0 (http://www.apache.org/licenses/)
Font Awesome
SIL OFL 1.1 (http://scripts.sil.org/OFL)
MIT License (http://opensource.org/licenses/mit-license.html)
CC BY 3.0 ( http://creativecommons.org/licenses/by/3.0/)
Powered by Worktribe © 2024
Advanced Search