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Outpatient Intravenous Diuretic Clinic: An Effective Strategy for Management of Volume Overload and Reducing Immediate Hospital Admissions
BACKGROUND: Heart failure (HF) readmissions pose a major burden to patients and the healthcare system. We evaluated whether outpatient intravenous (IV) diuretic clinic is a safe and effective strategy to reduce HF hospitalizations. METHODS: We reviewed 34 clinic encounters with 27 unique patients (m...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elmer Press
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8110218/ https://www.ncbi.nlm.nih.gov/pubmed/34007363 http://dx.doi.org/10.14740/jocmr4499 |
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author | Verma, Vivek Zhang, Manling Bell, Marilyn Tarolli, Karen Donalson, Elinor Vaughn, Jamie Hickey, Gavin W. |
author_facet | Verma, Vivek Zhang, Manling Bell, Marilyn Tarolli, Karen Donalson, Elinor Vaughn, Jamie Hickey, Gavin W. |
author_sort | Verma, Vivek |
collection | PubMed |
description | BACKGROUND: Heart failure (HF) readmissions pose a major burden to patients and the healthcare system. We evaluated whether outpatient intravenous (IV) diuretic clinic is a safe and effective strategy to reduce HF hospitalizations. METHODS: We reviewed 34 clinic encounters with 27 unique patients (median age 72) who had volume overload refractory to oral diuretics that were treated with IV furosemide in the outpatient clinic. One patient (2.9%) was admitted to the hospital directly, and the rest were discharged home. RESULTS: More than 80% of the patients had continued weight loss for 7 days (median weight loss 5.4 lb). During the median follow-up period of 15 months, 15 patients (56%) had subsequent HF hospitalizations. HF admission was delayed by a median of 22 days from the clinic visit and 138 days from the previous HF admission prior to clinic visit. Estimated cost saving per admission avoided was $10,395. One patient developed severe hypokalemia (< 3.0 mmol/L), and the remaining had no adverse events. CONCLUSION: Outpatient IV diuresis is effective and well tolerated. It leads to significant weight loss, persisting in the majority of patients for 7 days. In select patients, it should be considered as a strategy to rapidly improve symptoms, reduce hospitalizations and decrease costs. |
format | Online Article Text |
id | pubmed-8110218 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elmer Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-81102182021-05-17 Outpatient Intravenous Diuretic Clinic: An Effective Strategy for Management of Volume Overload and Reducing Immediate Hospital Admissions Verma, Vivek Zhang, Manling Bell, Marilyn Tarolli, Karen Donalson, Elinor Vaughn, Jamie Hickey, Gavin W. J Clin Med Res Original Article BACKGROUND: Heart failure (HF) readmissions pose a major burden to patients and the healthcare system. We evaluated whether outpatient intravenous (IV) diuretic clinic is a safe and effective strategy to reduce HF hospitalizations. METHODS: We reviewed 34 clinic encounters with 27 unique patients (median age 72) who had volume overload refractory to oral diuretics that were treated with IV furosemide in the outpatient clinic. One patient (2.9%) was admitted to the hospital directly, and the rest were discharged home. RESULTS: More than 80% of the patients had continued weight loss for 7 days (median weight loss 5.4 lb). During the median follow-up period of 15 months, 15 patients (56%) had subsequent HF hospitalizations. HF admission was delayed by a median of 22 days from the clinic visit and 138 days from the previous HF admission prior to clinic visit. Estimated cost saving per admission avoided was $10,395. One patient developed severe hypokalemia (< 3.0 mmol/L), and the remaining had no adverse events. CONCLUSION: Outpatient IV diuresis is effective and well tolerated. It leads to significant weight loss, persisting in the majority of patients for 7 days. In select patients, it should be considered as a strategy to rapidly improve symptoms, reduce hospitalizations and decrease costs. Elmer Press 2021-04 2021-04-27 /pmc/articles/PMC8110218/ /pubmed/34007363 http://dx.doi.org/10.14740/jocmr4499 Text en Copyright 2021, Verma et al. https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Verma, Vivek Zhang, Manling Bell, Marilyn Tarolli, Karen Donalson, Elinor Vaughn, Jamie Hickey, Gavin W. Outpatient Intravenous Diuretic Clinic: An Effective Strategy for Management of Volume Overload and Reducing Immediate Hospital Admissions |
title | Outpatient Intravenous Diuretic Clinic: An Effective Strategy for Management of Volume Overload and Reducing Immediate Hospital Admissions |
title_full | Outpatient Intravenous Diuretic Clinic: An Effective Strategy for Management of Volume Overload and Reducing Immediate Hospital Admissions |
title_fullStr | Outpatient Intravenous Diuretic Clinic: An Effective Strategy for Management of Volume Overload and Reducing Immediate Hospital Admissions |
title_full_unstemmed | Outpatient Intravenous Diuretic Clinic: An Effective Strategy for Management of Volume Overload and Reducing Immediate Hospital Admissions |
title_short | Outpatient Intravenous Diuretic Clinic: An Effective Strategy for Management of Volume Overload and Reducing Immediate Hospital Admissions |
title_sort | outpatient intravenous diuretic clinic: an effective strategy for management of volume overload and reducing immediate hospital admissions |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8110218/ https://www.ncbi.nlm.nih.gov/pubmed/34007363 http://dx.doi.org/10.14740/jocmr4499 |
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