Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada.
Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada; Canadian VIGOUR Centre, Edmonton, Alberta, Canada.
Can J Cardiol. 2014 Mar;30(3):312-9. doi: 10.1016/j.cjca.2014.01.001. Epub 2014 Jan 3.
Acute heart failure is a leading reason for emergency department visits, hospital admissions, and readmissions. Despite the high rate of hospitalization for heart failure and the high resource burden attributable to acute heart failure, limitations of clinical decisions have been demonstrated. Risk stratification methods might provide guidance to clinicians who care for patients with acute heart failure syndromes, and might improve decision-making in emergent care when decisions must be made quickly and accurately. Although many acute heart failure risk models have been developed in hospitalized cohorts to predict in-hospital mortality, there are fewer methods to enable prognostication broadly among all patients in a community-based setting. As validated predictive risk algorithms become increasingly accessible, they may be applied to select optimal therapies, determine how patients will be cared for in the emergency department, and improve decisions pertaining to patient disposition and follow-up.
急性心力衰竭是导致急诊科就诊、住院和再住院的主要原因。尽管心力衰竭的住院率很高，急性心力衰竭造成的资源负担也很高，但临床决策仍存在局限性。风险分层方法可以为急性心力衰竭综合征患者的临床医生提供指导，并在需要快速准确地做出决策时改善紧急护理的决策。尽管已经在住院患者队列中开发了许多急性心力衰竭风险模型来预测院内死亡率，但在基于社区的环境中广泛预测所有患者的预后的方法却较少。随着经过验证的预测风险算法变得越来越容易获得，它们可以用于选择最佳治疗方法，确定在急诊科如何照顾患者，并改善与患者处置和随访相关的决策。
