Managing protocol of the intensive diagnosis unit in heart failure

Introduction: Acute heart failure (AHF) is a global public health problem and one of the most frequent causes of consultation in emergency services. The heart failure observation unit (HFU) provides a place for the treatment of acute heart failure and offers the possibility of avoiding admissions or shortening the period of hospitalization. Objectives: To evaluate the results of the implementation of the HFU in our Emergency Service, with specific criteria for inclusion, exclusion and discharge. A successful HFU was defined when patient was discharged within 12 hours (h) without readmission in the next 30 days. Predictors of lack of success were evaluated. Results: 59 consecutive patients were prospectively included with a mean age of 73 +/- 9.8 years and an ejection fraction (EF) of 44.8 +/- 14.1%. The duration of the HFU was 7 (5-8) h, with a total average diuresis of 2028 +/- 678 ml. Seven patients (11.9%) were hospitalized, 3 initially and 4 in the following 30 days, representing a success rate of 88.1%. In multivariate analysis, EF < 35 % was associated with lack of HFU success. Conclusions: The HFU protocol developed at our institution proved to be safe, with a short hospital stay in the Emergency Service and a low rate of hospitalization