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Background and Objectives: The aim of this study was to define the following in patients with acute heart failure (AHF) discharged directly from accident and emergency (A&E): rates of reconsultation to A&E and hospitalisation for AHF, and all-cause death at 30 days, rate of combined event at 7 days and the factors associated with these rates., Patients and Method: The study included patients consecutively diagnosed with AHF during 2 months in 27 Spanish A&E departments who were discharged from A&E without hospitalisation. We collected 43 independent variables, monitored patients for 30 days and evaluated predictive factors for adverse events using Cox regression analysis., Results: We evaluated 785 patients (78±9) years, 54.7% women). The rates of reconsultation, hospitalisation, and death at 30 days and the combined event at 7 days were: 26.1, 15.7, 1.7 and 10.6%, respectively. The independent factors associated with reconsultation were no endovenous diuretics administered in A&E (HR 2.86; 95% CI 2.01-4.04), glomerular filtration rate (GFR)<60ml/min/m 2 (1.94; 1.37-2.76) and previous AHF episodes (1.48; 1.02-2.13); for hospitalisation these factors were no endovenous diuretics in A&E (2.97; 1.96-4.48), having heart valve disease (1.61; 1.04-2.48), blood oxygen saturation at arrival to A&E<95% (1.60; 1.06-2.42); and for the combined event no endovenous diuretics in A&E (3.65; 2.19-6.10), GFR<60ml/min/m 2 (2.22; 1.31-3.25), previous AHF episodes (1.95; 1.04-3.25), and use of endovenous nitrates (0.13; 0.02-0.99)., Conclusion: This is the first study in Spain to describe the rates of adverse events in patients with AHF discharged directly from A&E and define the associated factors. These data should help establish the most adequate approaches to managing these patients., (Copyright © 2017 Elsevier España, S.L.U. All rights reserved.)

Background and Objective: To compare technical quality, patient health outcomes, and satisfaction degree of patients admitted to hospital at home (HAH) from the emergency department (ED) with those with standard hospitalization (SH)., Patients and Methods: Comparative prospective study. Medical records of patients admitted to the HAH were reviewed and then they were also called and surveyed. The following variables were recorded: demographic and clinical aspects, patient health status at the time of phone survey, technical and perceived quality., Results: Patients included: 111 (65 from the ED and 46 from the SH). Phone survey was performed to 76 patients and 57 carers. Length of stay was significantly shorter in patients from the ED compared with those from SH (1.02 ± 0.44 vs 2.23 ± 0.94 days, P<.0005). No other differences were observed in patients' demographics, clinical aspects and health status, in technical quality, and in perceived quality between both groups., Conclusion: When HAH is an option, these results seem to indicate that patient hospital stay can be shortened if HAH admittance is obvious, after a period of patient treatment and stabilization, from the ED instead from HAH., (Copyright © 2011 Elsevier España, S.L. All rights reserved.)