Author + information
- Mohammad-Ali Jazayeria,b,
- Holly Rodina,b,
- Melissa Madsena,b,
- Steven Goldsmitha,b,
- Bradley Barta,b and
- Gautam Shroffa,b
Background: Heart failure (HF) readmission poses a major public health challenge with patient care and reimbursement implications. We compared the prognostic utility of discharge clinical examination, patient symptoms, NT-proBNP and echocardiographic parameters using hand carried ultrasound (HCU) to predict HF events.
Methods: HF patients in a teaching hospital were prospectively recruited on day of discharge. A medical resident trained in echocardiographic assessment of right and left (R/L) filling pressure evaluated guideline specified echocardiography parameters blinded to clinical data. Treatment teams blinded to HCU were surveyed for clinical assessment of R/L filling pressures. Patients completed a validated assessment of symptoms. NT-proBNP was collected. Logistic regression was used to identify predictors of the composite endpoint of HF readmission, ED HF visit, or death 30 days post discharge.
Results: In 38 patients enrolled over 8 weeks, the composite endpoint occurred in 13% (Table). Strong univariate predictors were discharge NT-proBNP (p = 0.04) and average E/e’ (p = 0.02). In multiple regression analysis neither remained significant, likely due to collinearity. Other echo parameters, clinical exam and patient symptoms were not predictive.
Conclusions: NT-proBNP and average E/e’ measured by a trainee with HCU are univariate predictors of a composite 30-day HF outcome. HCU R/L filling pressure assessment at discharge may help identify patients at high risk for adverse events.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Innovative Use of Echocardiography
Abstract Category: 28. Non Invasive Imaging: Echo
Presentation Number: 1197-226
- 2017 American College of Cardiology Foundation