PS:Filière post urgences

Filière post urgences insuffisance cardiaque aigûe   Population concernée: Insuffisance cardiaque aiguë après avoir écarté un SCA.
Traitement : VNI et/ou CiPAP et dérivé nitré et/ou diurétiques   Calcul du score MEESSI : Pour Barthel et Troponine : cocher « Unknown » Score de MESSI
    • Risque haut : Hospitalisation encouragée, en cardiologie.
    • Risque bas : Traitement ambulatoire, fonction du contexte.
    • Risque intermédiaire : Orientation selon jugement du médecin.   Préciser dans la conclusion le niveau de risque selon MEESSI.   Pour chaque patient concerné : Faire une demande de consultation en externe en précisant :         « Filière ICA », y compris pour les patients hospitalisés   plus d'info:

MEESSI-AHF is a risk model to predict 30-day mortality in patients attending Emergency Departments (ED) with a diagnosis of Acute Heart Failures (AHF).

The MEESSI-AHF score was derived on 4867 consecutive AHF patients admitted to Spanish ED during 2009-2011, and then validated in 3229 consecutive AHF patients during 2014. (Note patients also with ST elevation myocardial infarction are excluded)

The MEESSI-AHF risk model includes 13 variables readily available on arrival to Emergency Department. The 40% of patients classified as LOW RISK (30-day mortality: <2%) should be considered as potential candidates to be early discharged from Emergency Department without admission after adequate response to initial treatment. The 10% of patients classified as VERY HIGH RISK (30-day mortality: >2%) may clearly benefit from hospital admission.

For some patients troponin, NT-proBNP and/or Barthel index values may be unknown. In such cases we still enable the risk score to be derived.

Reference: Miro O et al. Predicting 30-day Mortality for Patients with Acute Heart Failure Who Are in the Emergency Department: A Cohort Study. Ann Intern Med 2017.