For patients with heart failure, follow-up care within seven days of discharge from the emergency department is associated with lower rates of long-term mortality and subsequent admissions, according to a study published in the Dec. 17 issue of CMAJ, the journal of the Canadian Medical Association.
Clare L. Atzema, M.D., from the University of Toronto, and colleagues conducted a retrospective cohort study among adult patients discharged from one of 163 emergency departments with a primary diagnosis of heart failure.
The researchers found that 47.1 and 83.6 percent of 34,519 patients obtained follow-up care within seven and 30 days, respectively. The rate of mortality over one year was lower for patients with follow-up care within seven days versus those with follow-up within eight to 30 days (hazard ratio, 0.92); in addition, the rate of hospital admission over 90 days and one year was reduced (hazard ratios, 0.87 and 0.92, respectively) for those with follow-up care within seven days. There was a trend toward a lower mortality rate over 90 days. Compared with patients without 30-day follow-up, follow-up care within 30 days was correlated with a reduction in one-year mortality (hazard ratio, 0.89) but not hospital admission.
"Obtaining early follow-up for all of these patients will require a transition in systematic care between emergency and longitudinal care, via collaboration between administrators, researchers, clinicians, and information technology specialists," the authors write.