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

Abstract

ObjectivesThis 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. MethodPatients 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. ResultsA 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). ConclusionThe hospitalization of patients with AHF in the SSU is associated with shorter hospital stays but there were no differences in short-term progress.