{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T01:58:11Z","timestamp":1788055091126,"version":"build-2784847793"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":582,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,7,16]],"date-time":"2024-07-16T00:00:00Z","timestamp":1721088000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"British Heart Foundation Clinical Research Collaborative and the University of Liverpool INSPIRE"},{"DOI":"10.13039\/100015819","name":"Manchester University NHS Foundation Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015819","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015819","name":"Research and Innovation Division, Manchester University NHS Foundation Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015819","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Patients with acutely decompensated heart failure (ADHF) are usually admitted to hospital for management. There is growing interest in delivering intravenous (IV) diuretic therapy at home, in the community or at hospital day-care units; the safety and effectiveness of outpatient-based management (OPM) for ADHF has not been established. We conducted a systematic literature review and meta-analysis to investigate the short-term safety and effectiveness of OPM compared with inpatient management (IPM) of ADHF. Pre-specified endpoints were 30 day mortality and 30 day hospitalization. The meta-analysis was conducted using RevMan 5.4 software. Twenty-nine studies of OPM were identified, including 7683 patients. Only five studies directly compared OPM (n = 1303) with IPM (n = 2047), including three observational studies, and two randomized controlled trials (RCTs). The other 24 studies only stated OPM outcomes. For the five studies comparing IPM versus OPM, patients were generally aged &amp;gt;75 years and of similar age for each strategy, with a similar proportion of men (56%). In a study-level, aggregate analysis, 30 day all-cause mortality was 9.3% (121\/1303) for OPM, compared with 15.6% (320\/2047) for IPM [OR 0.29 (95% CI 0.09, 0.93) P = 0.04]. Four studies reported 30 day all-cause hospitalization; 22.0% for IPM versus 16.8% for OPM [OR 0.73 (95% CI 0.61, 0.89), P = 0.001]. In the two RCTs, we found no difference in 30 day mortality or hospitalization. In observational studies, OPM of ADHF is associated with lower 30 day hospitalization and lower 30 day mortality; such differences were not observed in two small, single-centre RCTs. A substantial, multicentre RCT is required to confirm the safety and effectiveness of OPM for ADHF.<\/jats:p>","DOI":"10.1002\/ehf2.14841","type":"journal-article","created":{"date-parts":[[2024,7,16]],"date-time":"2024-07-16T22:36:10Z","timestamp":1721169370000},"page":"761-769","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Outpatient Treatment of Decompensated Heart Failure: A Systematic Review and Study Level Meta-Analysis"],"prefix":"10.1093","volume":"12","author":[{"given":"Jameela","family":"Bahar","sequence":"first","affiliation":[{"name":"Department of Cardiology, Lancashire Cardiac Centre , Blackpool ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amna","family":"Rahman","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Lancashire Cardiac Centre , Blackpool ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace 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,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Taylor","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Lancashire Cardiac Centre , Blackpool ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet","family":"Fuat","sequence":"additional","affiliation":[{"name":"Durham University \u00a0","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iain","family":"Squire","sequence":"additional","affiliation":[{"name":"NIHR Cardiovascular Research Centre, Glenfield Hospital , Leicester ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John G.F.","family":"Cleland","sequence":"additional","affiliation":[{"name":"British Heart Foundation Centre of Research Excellence, School of Cardiovascular and Metabolic Health, University of Glasgow , Glasgow 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S.","family":"Joseph","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Lancashire Cardiac Centre , Blackpool ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth Y.K.","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Lancashire Cardiac Centre , Blackpool ,","place":["UK"]},{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool , Liverpool ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,7,16]]},"reference":[{"key":"2026021804015018600_ehf214841-bib-0001","author":"British Heart Foundation, Heart and Circulatory Disease Statistics 2022","year":"2022"},{"key":"2026021804015018600_ehf214841-bib-0002","volume-title":"National Heart Failure Audit 2022 summary report (2020\/2021 data) [Internet]","author":"National Institute for Cardiovascular Outcomes 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