Improving Risk Stratification of Emergency Department Patients With Acute Heart Failure

N/AEnrolling By InvitationNCT06065761

Kaiser Permanente17,459 enrolled

Overview

The primary goal is to build and test a previously developed and validated risk model and clinical decision support tool embedded within the electronic health record to improve risk stratification of emergency department (ED) patients with acute heart failure (AHF).

The study team will build an electronic health record-embedded clinical decision support tool using a recently developed risk prediction model that curates patient-specific data in real-time, accurately estimates short-term patient risk, and presents tailored clinical recommendations. This will be a regional implementation study in which the tool is turned on at 21 emergency departments (ED) across Kaiser Permanente Northern California (KPNC). The study team will validate risk predictions and study key clinical outcomes as part of this trial.

Study Type

OBSERVATIONAL

Enrollment

17,459

Conditions

Heart Failure

Interventions

Comprehensive ED heart failure management toolOTHER

The investigators plan a regional implementation of an electronic health record-based heart failure decision support tool across 21 EDs of Kaiser Permanente Northern California (KPNC).

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Adult (≥18y) KPNC members treated in the ED for presumed acute heart failure Exclusion Criteria: * Children (\<18y). * Patients who left against medical advice or eloped prior to ED physician evaluation.

Locations (21)

Kaiser Permanente Antioch Emergency Department

Outcomes

Primary Outcomes

Number of patients with risk-stratified appropriate disposition

Risk-stratified appropriate disposition is defined as the proportion of ED encounters with concordant risk-based disposition (admission of high-risk patients and discharge of low-risk patients), assessed using STRATIFY risk calculator

Time frame: 24 hours

Secondary Outcomes

Number of patients with all-cause mortality

Time frame: 30 days from index ED visit

Number of patients with serious adverse events

Serious adverse events include mortality, cardiopulmonary resuscitation (CPR), intubation/ventilation, new end-stage renal disease (ESRD), balloon pump placement, or percutaneous coronary intervention (PCI)/coronary artery bypass grafting (CABG)

Time frame: 30 days from index ED visit

Number of patients with readmissions

Time frame: 30 days from index ED visit

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.