{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T13:59:22Z","timestamp":1792677562284,"version":"4.5.0"},"reference-count":0,"publisher":"SEMES (Sociedad Espanola de Medicina de Urgencias y Emergencias)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Emergencias"],"abstract":"<jats:p>Objetivos. Analizar si la hospitalizaci\u00f3n domiciliaria (HDom) directamente desde los servicios de urgencias (SU) de pacientes con insuficiencia cardiaca aguda (ICA) resulta eficiente y si se asocia con diferencias en evoluci\u00f3n a corto y largo plazo comparada con hospitalizaci\u00f3n convencional (HCon). M\u00e9todo. An\u00e1lisis secundario del registro Epidemiology Acute Heart Failure in Emergency departments (EAHFE), que es un registro multice\u0301ntrico, multiporp\u00f3sito, anal\u00edtico no intervencionista, con seguimiento prospectivo que incluye de forma consecutiva a los pacientes que acuden por episodio de ICA al SU. Se incluyeron, retrospectivamente, todos los pacientes diagnosticados de ICA en dos SU ingresados directamente en HDom entre marzo de 2016 y febrero de 2019 (3 a\u00f1os) y se compararon sus resultados con los pacientes diagnosticados de ICA incluidos en el registro EAHFE por esos 2 SU e ingresados en HCon durante los periodos marzo-abril 2016 (EAHFE-5), enero-febrero 2018 (EAHFE-6), y enero-febrero 2019 (EAHFE-7) (6 meses). Los resultados se ajustaron por las caracter\u00edsticas basales y cl\u00ednicas del episodio de descompensaci\u00f3n. Resultados. Se incluyeron 370 pacientes en HDom y 646 en HCon. El grupo HDom ten\u00eda mayor edad, mayor comorbilidad y peor situaci\u00f3n funcional basal, pero menor gravedad del episodio de descompensaci\u00f3n, m\u00e1s frecuentemente desencadenado por anemia y menos por crisis hipertensiva y s\u00edndrome coronario agudo. La duraci\u00f3n del ingreso fue mayor [mediana (RIC) 9 (7-14) d\u00edas frente a 7 (5-11) d\u00edas, p &lt; 0,001], pero no hubo diferencias en mortalidad intrahospitalaria (7,0% frente a 8,0%, p = 0,56), eventos adversos a 30 d\u00edas posalta (30,9% frente a 32,9%, p = 0,31) ni mortalidad al a\u00f1o (41,6% frente a 41,4%, p = 0,84). En el modelo ajustado, el riesgo asociado a HDom tampoco difiri\u00f3 significativamente en mortalidad intrahospitalaria (OR = 0,90, IC 95% = 0,41-1,97), eventos adversos posalta a 30 d\u00edas (HR = 0,88, IC95% = 0,62-1,26) ni mortalidad al a\u00f1o (HR = 1,03, IC 95% = 0,76-1,39). El coste directo promedio del episodio en HDom y HCon fue 1.309 y 5.433 euros, respectivamente. Conclusi\u00f3n. En la ICA, la HDom directamente desde el SU es m\u00e1s prolongada que la HCon, pero consigue los mismos resultados a corto y largo plazo, y su coste es inferior.<\/jats:p>","DOI":"10.55633\/s3me\/e060.2023","type":"journal-article","created":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T09:07:18Z","timestamp":1716541638000},"source":"Crossref","is-referenced-by-count":3,"title":["Safety and efficiency of discharge to home hospitalization directly after emergency department care of patients with acute heart failure"],"prefix":"10.55633","author":[{"given":"Carolina","family":"S\u00e1nchez Marcos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bego\u00f1a","family":"Espinosa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Coloma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"San Inocencio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonja","family":"Pilarcikova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Guzm\u00e1n Mart\u00ednez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariona","family":"Ram\u00f3n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Carratal\u00e1 Ballesta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Saavedra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Ivars Obermeie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernest","family":"Bragulat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Gil-Rodrigo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ainoa","family":"Ugarte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pere","family":"Llorens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d2scar","family":"Mir\u00f3","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"33356","published-online":{"date-parts":[[2024,5,24]]},"container-title":["Emergencias"],"original-title":["An\u00e1lisis de seguridad y eficiencia de la hospitalizaci\u00f3n a domicilio directamente desde urgencias en pacientes con insuficiencia cardiaca aguda"],"deposited":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T09:07:22Z","timestamp":1716541642000},"score":1,"resource":{"primary":{"URL":"https:\/\/revistaemergencias.org\/numeros-anteriores\/volumen-35\/numero-3\/analisis-de-seguridad-y-eficiencia-de-la-hospitalizacion-a-domicilio-directamente-desde-urgencias-en-pacientes-con-insuficiencia-cardiaca-aguda\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,24]]},"references-count":0,"URL":"https:\/\/doi.org\/10.55633\/s3me\/e060.2023","relation":{},"ISSN":["1137-6821","2386-5857"],"issn-type":[{"value":"1137-6821","type":"print"},{"value":"2386-5857","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,24]]}}}