ARTICLE IN PRESS G Model Med Clin (Barc). 2017;xxx(xx):xxx–xxx www.elsevier.es/medicinaclinica Original article Short-term reconsultation, hospitalisation, and death rates after discharge from the emergency department in patients with acute heart failure and analysis of the associated factors. The ALTUR-ICA Study  Òscar Miró a , Víctor Gil a , Francisco Javier Martín-Sánchez b , Pablo Herrero c , Javier Jacob d , Carolina Sánchez a , Carolina Xipell a , Sira Aguiló a , Pere Llorens e,∗ , on behalf of the ICA-SEMES group ♦ a Grupo de Investigación «Urgencias: Procesos y Patologías», Área de Urgencias, Hospital Clínic, Institut D’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain b Servicio de Medicina Preventiva, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, Spain c Servicio de Urgencias, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain d Servicio de Urgencias, Hospital Universitario de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain e Servicio de Urgencias, Corta Estancia y Hospitalización a Domicilio, Hospital General de Alicante, Departamento de Medicina Clínica, Universidad Miguel Hernández, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-FISABIO), Alicante, Spain a r t i c l e i n f o Article history: Received 23 January 2017 Accepted 8 June 2017 Available online xxx Keywords: Acute heart failure Death Reconsultation Hospitalisation Accident and emergency a b s t r a c t Background and objectives: The aim of this study was to define the following in patients with acute heart failure (AHF) discharged directly from accident and emergency (A&E): rates of reconsultation to A&E and hospitalisation for AHF, and all-cause death at 30 days, rate of combined event at 7 days and the factors associated with these rates. Patients and method: The study included patients consecutively diagnosed with AHF during 2 months in 27 Spanish A&E departments who were discharged from A&E without hospitalisation. We collected 43 independent variables, monitored patients for 30 days and evaluated predictive factors for adverse events using Cox regression analysis. Results: We evaluated 785 patients (78 ± 9) years, 54.7% women). The rates of reconsultation, hospitalisa- tion, and death at 30 days and the combined event at 7 days were: 26.1, 15.7, 1.7 and 10.6%, respectively. The independent factors associated with reconsultation were no endovenous diuretics administered in A&E (HR 2.86; 95% CI 2.01–4.04), glomerular filtration rate (GFR) < 60 ml/min/m 2 (1.94; 1.37–2.76) and previous AHF episodes (1.48; 1.02–2.13); for hospitalisation these factors were no endovenous diuret- ics in A&E (2.97; 1.96–4.48), having heart valve disease (1.61; 1.04–2.48), blood oxygen saturation at arrival to A&E < 95% (1.60; 1.06–2.42); and for the combined event no endovenous diuretics in A&E (3.65; 2.19–6.10), GFR < 60 ml/min/m 2 (2.22; 1.31–3.25), previous AHF episodes (1.95; 1.04–3.25), and use of endovenous nitrates (0.13; 0.02–0.99). Conclusion: This is the first study in Spain to describe the rates of adverse events in patients with AHF discharged directly from A&E and define the associated factors. These data should help establish the most adequate approaches to managing these patients. © 2017 Elsevier Espa ˜ na, S.L.U. All rights reserved.  Please cite this article as: Miró Ò, Gil V, Martín-Sánchez FJ, Herrero P, Jacob J, Sánchez C, et al. Tasas de reconsulta, hospitalización y muerte a corto plazo tras el alta directa desde Urgencias de pacientes con insuficiencia cardiaca aguda y análisis de los factores asociados. Estudio ALTUR-ICA. Med Clin (Barc). 2017. https://doi.org/10.1016/j.medcli.2017.06.004 ∗ Corresponding author. E-mail address: llorens ped@gva.es (P. Llorens). ♦ The other members of the ICA-SEMES group are listed in Appendix A. 2387-0206/© 2017 Elsevier Espa ˜ na, S.L.U. All rights reserved. MEDCLE-4147; No. of Pages 11