Isr Med Assoc J
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Serum natriuretic peptide levels are useful diagnostic and prognostic markers in patients with acute decompensated heart failure, but have been little used to stratify urgency of treatment in the outpatient situation. ⋯ In heart failure patients referred to an outpatient specialized heart failure center, an upper tertile NT-proBNP level identified patients at high risk for mortality. A single high > 550 pg/ml NT-proBNP measurement appears to be useful for selecting patients for care in a heart failure center, and a level > 2000 pg/ml for assigning patients to high priority management.
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Syncope is a common clinical problem that often remains undiagnosed despite extensive and expensive diagnostic evaluation. ⋯ Hospitalization in a tertiary referral center for syncope is associated with increased mortality for most etiologies (except vasovagal), cardiac more than non-cardiac. Despite high costs of inpatient evaluation, associated with more diagnostic tests, longer in-hospital stay and higher mortality rates, nearly half of the patients were discharged undiagnosed. Outpatient evaluation should be considered when medically possible.
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Comparative Study
A simplified fall-risk assessment tool for patients hospitalized in medical wards.
Falls are a common problem among hospitalized patients, having a significant impact on quality of life and resource utilization. ⋯ Our new simple and easy-to-use fall-risk assessment tool identified most of the fall-prone patients. These findings suggest that this tool may enable us to prevent two-thirds of falls on the medical ward by providing effective fall-prevention facilities to only one-third of the patients.