Baseline characteristics of patients with suspected ADHF in the emergency department
| Characteristic | LFTs—normal range N=1342 | LFTs—abnormal range N=1842 | LFTs—missing N=2139 | P value* |
| Age at ED visit—mean in years±SD | 71±16 | 67±16 | 68±16 | <0.001 |
| Sex identified—number (%) | ||||
| Male | 633 (47%) | 1036 (56%) | 1113 (53%) | <0.001 |
| Female | 709 (53%) | 806 (44%) | 1026 (48%) | |
| Race and ethnicity—number (%) | ||||
| Non-Hispanic Asian | 303 (23%) | 459 (25%) | 442 (21%) | <0.001 |
| Non-Hispanic Black or African American | 236 (18%) | 375 (20%) | 401 (19%) | |
| Non-Hispanic White | 546 (41%) | 658 (36%) | 918 (43%) | |
| Hispanic, any race | 134 (10%) | 202 (11%) | 181 (9%) | |
| Other | 108 (8%) | 132 (7%) | 174 (8%) | |
| Unknown/declined to state | 15 (1%) | 16 (1%) | 20 (1%) | |
| Insurance† number (%) | ||||
| Private | 147 (11%) | 274 (13%) | 295 (14%) | <0.001 |
| MediCal | 218 (16%) | 382 (21%) | 367 (17%) | |
| Medicare | 927 (69%) | 1086 (59%) | 1357 (64%) | |
| Other | 49 (4%) | 23 (1.3%) | 117 (5%) | |
| Diuretics in the ED? | ||||
| Yes | 250 (19%) | 449 (24%) | 483 (23%) | 0.001 |
| No | 1092 (81%) | 1393 (76%) | 1656 (77%) | |
| BNP in the ED? | ||||
| High BNP (>700 mg/dL) | 308 (23%) | 636 (35%) | 618 (29%) | <0.001 |
| Intermediate high BNP (300–700 mg/dL) | 278 (21%) | 357 (19%) | 441 (21%) | |
| Intermediate low BNP (100–300 mg/dL) | 339 (25%) | 376 (20%) | 455 (21%) | |
| Low BNP (<100 mg/dL) | 417 (31%) | 473 (26%) | 625 (29%) | |
| Past medical history | ||||
| History of asthma | 251 (19%) | 244 (13%) | 379 (18%) | <0.001 |
| History of COPD | 345 (26%) | 412 (22%) | 580 (27%) | 0.002 |
| History of smoking | 699 (52%) | 928 (50%) | 1129 (53%) | 0.012 |
| ED diagnosis‡ | ||||
| ADHF | 107 (8%) | 274 (15%) | 281 (13%) | <0.001 |
| Pneumonia | 175 (13%) | 243 (13%) | 330 (15%) | 0.025 |
| COPD exacerbation | 124 (9%) | 96 (5%) | 235 (11%) | <0.001 |
| Asthma exacerbation | 27 (2%) | 28 (2%) | 68 (3%) | 0.001 |
| Acute upper respiratory infection | 2 (0.2%) | 1 (0.1%) | 8 (0.4%) | 0.028 |
| Any liver pathology§ | 12 (1%) | 107 (6%) | 16 (1%) | <0.001 |
| Final discharge diagnosis¶ | ||||
| ADHF | 283 (21%) | 549 (30%) | 622 (29%) | <0.001 |
| Not ADHF | 1059 (79%) | 1293 (70%) | 1517 (71%) | |
*P values based on χ2 analysis for categorical variables and ANOVA for continuous variables.
†Insurance is categorised as ‘Private’ (Aetna, Blue Cross, Blue Shield, GCSS/GHP, Capitation, Charity, Commercial, Covered California, Covered California – MediCal, HealthNet, Institutional, and Kaiser), ‘MediCal’ (Medicaid/MIA/CMSP, MediCal managed care, MediCal pending, MediCal standard) ‘Medicare’ (Medicare, Medicare Advantage HMO/Senior, Medicare Advantage PFFS) and ‘Other’ (Self-pay, United Health Care, Worker’s compensation).
‡ED Diagnosis was obtained through specification of ICD10 codes for respiratory diagnoses and liver-related diseases.
§Any liver pathology includes ICD10 codes for the following: alcoholic liver disease, toxic liver disease, hepatic failure (not elsewhere specified), chronic hepatitis (not elsewhere specified), fibrosis and cirrhosis of liver, other inflammatory liver diseases, other diseases of the liver, liver disorders in diseases of the liver (classified elsewhere).
¶Final discharge diagnosis of ADHF is based on ICD10 codes for a diagnosis of heart failure named on the discharge summary for a patient’s specific encounter.
**Suspected ADHF is defined as patients who had a BNP ordered in the ED.
ADHF, acute decompensated heart failure; ANOVA, analysis of variance; BNP, brain natriuretic peptide; COPD, Chronic Obstructive Pulmonary Disease; ED, emergency department; LFTs, liver function tests.