title: Multidisciplinary Assessment to Personalize Length of Stay in Acute Decompensated Heart Failure (OPTIMA II ADHF).
abstract: BACKGROUND
  Acute decompensated heart failure (ADHF) causes a substantial burden for health care systems. Data to rationally define the need for hospitalization or the appropriate length of stay (LOS) is limited. Our aim was to personalize length of stay in patients admitted to hospital for acute decompensated heart failure.
  
  
  METHODS
  Consecutive patients with ADHF presenting to our emergency department were prospectively followed. We daily conducted a multidisciplinary risk assessment and compared proposed with actually observed triage decisions.
  
  
  RESULTS
  At presentation, all patients required hospitalization. Median LOS was 11 days including 1 day after reaching medical stability. In 42.7% of patients, hospitalization was prolonged after medical stability mainly for nursing and organizational reasons. Within 30 days of enrollment, 7 (9.3%) patients were rehospitalized, 3 of them for persisting or relapsing heart failure.
  
  
  CONCLUSIONS
  There appears to be potential to shorten inhospital stay in patients with ADHF mainly by providing post discharge ambulatory nursing care in order to improve resource utilization and to diminish "hospitalization-associated disability".
authors.affiliation: Medical University Department of the University of Basel, Kantonsspital Aarau, Aarau, Switzerland.
authors.forename: Frank
authors.initials: F
authors.lastname: Dusemund
authors.forename: Martin
authors.initials: M
authors.lastname: Steiner
authors.forename: Andre
authors.initials: A
authors.lastname: Vuilliomenet
authors.forename: Christian
authors.initials: C
authors.lastname: Muller
authors.forename: Rita
authors.initials: R
authors.lastname: Bossart
authors.forename: Katharina
authors.initials: K
authors.lastname: Regez
authors.forename: Ursula
authors.initials: U
authors.lastname: Schild
authors.forename: Antoinette
authors.initials: A
authors.lastname: Conca
authors.forename: Andreas
authors.initials: A
authors.lastname: Huber
authors.forename: Barbara
authors.initials: B
authors.lastname: Reutlinger
authors.forename: Beat
authors.initials: B
authors.lastname: Muller
authors.forename: Werner C
authors.initials: WC
authors.lastname: Albrich