Heart Failure, Acute Heart Failure
Conditions
Brief summary
Heart failure is one of the major causes of hospitalization in Brazil and worldwide. Recent studies attempt to identify readmission and prognostic markers at the time of discharge from these patients. The reassessment and possibility of early therapeutic adjustment may be relevant in this context. Therefore, the prospective and randomized comparative use of early re-evaluation in Hospital-day versus non-intervention group has not yet been described. The objective of this study was to evaluate the impact on the re-hospitalization rate in 30 days of the early re-evaluation of the patients in the day-hospital versus the non-intervention group in heart failure. For this, a unicentric, randomized and prospective study will be performed, in which the Hospital-Day strategy is performed versus no intervention in a comparative manner. Hospital data (test results, medical outcomes, complications) of patients will be analyzed for safety and effectiveness. The hypothesis of this study is that the Hospital-Day strategy is superior to the non-intervention strategy and causes fewer rehospitalizations within 30 days.
Interventions
OTHERmedical evaluation
return of medical evaluation after discharge
Sponsors
University of Sao Paulo General Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult men and women aged\> 18 years. * Presence of decomposed CF III or IV of NYHA characterized by\> 1 symptom (dyspnea, orthopnea or edema) + 1 clinical sign (rales, edema, ascites or pulmonary congestion on chest X-ray). * LVEF \<45% on transthoracic echocardiography. * BNP\> 400 pg / mL. * Clinical condition of hospital discharge. * Signed consent form.
Exclusion criteria
* Pregnancy * Body mass index greater than 40 kg / m2. * Chronic obstructive pulmonary disease. * Acute coronary syndrome. * Acute myocarditis. * Valvular heart disease. * Need to use vasoactive drug. * Cirrhosis of the liver Child C. * Chronic dialysis renal insufficiency or creatinine\> 3.0 mg / dL. * Indication of implantation device of artificial stimulation. * Pulmonary thromboembolism. * Neoplasm terminal. * Sepsis or septic shock.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Comparison of 30-days rehospitalization rate | 30 days | 30-days rehospitalization rate |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Mortality | 30 days | 30-days mortality rate |
Countries
Brazil
Contacts
Primary ContactAlexandre Soeiro, MD
Outcome results
None listed