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The evidence base on treating chronic heart failure (HF) has grown substantially; evidence on managing acute HF exacerbations is much thinner. Researchers in Canada have now tested an intervention for acute HF in which emergency clinicians used a validated point-of-care algorithm to estimate a patient's mortality risk, with suggestions for clinical action tailored to that risk: for higher-risk patients, hospitalization; for lower-risk patients, early discharge (within 3 days) and enrollment in an ambulatory clinic that offered rapid follow-up for the subsequent month.
Ten participating hospitals were randomized to staggered start dates for one-way crossover from a control phase, involving usual care for acute HF, to the intervention phase. T…