Outcomes Research

HM2017 Abstract Number: 102

SAFETY AND EFFICACY OF THROMBOPOIETIN RECEPTOR AGONISTS IN PATIENTS WITH PREVIOUSLY TREATED CHRONIC IMMUNE THROMBOCYTOPENIA: A SYSTEMATIC REVIEW AND META-ANALYSIS

Background: The current American Society of Hematology (ASH) guideline recommends the use of thrombopoietin receptor agonists, eltrombopag or romiplostim as one of the second-line therapies for chronic immune thrombocytopenia (ITP). The efficacy and safety of [...]

By | 2017-04-20T19:04:59+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on SAFETY AND EFFICACY OF THROMBOPOIETIN RECEPTOR AGONISTS IN PATIENTS WITH PREVIOUSLY TREATED CHRONIC IMMUNE THROMBOCYTOPENIA: A SYSTEMATIC REVIEW AND META-ANALYSIS

HM2017 Abstract Number: 101

EFFECTIVENESS OF AN ADVANCED PRACTICE MODEL OF CARE ON POST-ACUTE OUTCOMES IN A TRANSITIONAL CARE UNIT

Background: The convergence of rising post-acute health care costs with incomparable outcomes havemade reform a priority resulting in the development of new models of care that often extend the scope of practice andjob duties among [...]

By | 2017-04-20T19:05:10+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on EFFECTIVENESS OF AN ADVANCED PRACTICE MODEL OF CARE ON POST-ACUTE OUTCOMES IN A TRANSITIONAL CARE UNIT

HM2017 Abstract Number: 100

A CROSS SECTIONAL STUDY REVEALS AN ASSOCIATION BETWEEN ELECTRONIC CIGARETTE USE AND MYOCARDIAL INFARCTION

Background:  Electronic cigarettes (E-cigarettes) have grown in popularity as an alternative to traditional cigarettes especially among consumers who want to reduce the risk of morbidity and mortality associated with smoking. Nonetheless, a recent study showed that [...]

By | 2017-04-20T19:05:28+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on A CROSS SECTIONAL STUDY REVEALS AN ASSOCIATION BETWEEN ELECTRONIC CIGARETTE USE AND MYOCARDIAL INFARCTION

HM2017 Abstract Number: 98

NUTRITION BASED INTERVENTIONS DECREASE READMISSION RATES AND LENGTH OF STAY AMONG MALNOURISHED HOSPITALIZED ADULT PATIENTS WITH CARDIOVASCULAR, ONCOLOGICAL, AND GASTROINTESTINAL DIAGNOSES

Background: Limited research exists exploring the impact of nutrition interventions, including oral nutritional supplement (ONS) usage, on clinical outcomes of patients at risk/with malnutrition. We aimed to assess the impact of a hospital-based, comprehensive nutrition-focused [...]

By | 2017-04-20T18:59:41+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on NUTRITION BASED INTERVENTIONS DECREASE READMISSION RATES AND LENGTH OF STAY AMONG MALNOURISHED HOSPITALIZED ADULT PATIENTS WITH CARDIOVASCULAR, ONCOLOGICAL, AND GASTROINTESTINAL DIAGNOSES

HM2017 Abstract Number: 97

OUTCOME OF TIMELY PALLIATIVE CARE CONSULTATION ON ICU PATIENTS WITH SEVERE SEPSIS/SEPTIC SHOCK

Background: In 2011, sepsis accounted for more than $20 billion (5.2%) of total US hospital costs.  The CDC estimates that hospitalizations for sepsis or septicemia increased from 621,000 to 1,141,000 in 2000 and 2008 respectively. [...]

By | 2017-04-20T19:05:41+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on OUTCOME OF TIMELY PALLIATIVE CARE CONSULTATION ON ICU PATIENTS WITH SEVERE SEPSIS/SEPTIC SHOCK

HM2017 Abstract Number: 96

CODE BLUE OUTCOMES: RELATION TO THE MODIFIED EARLY WARNING SCORE

Background: The Modified Early Warning Score (MEWS) is a physiological scoring system developed to identify patients in early stages of clinical deterioration and prevent delays in proper care. It consists of systolic blood pressure, heart [...]

By | 2017-04-20T19:05:53+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on CODE BLUE OUTCOMES: RELATION TO THE MODIFIED EARLY WARNING SCORE

HM2017 Abstract Number: 95

THE USE OF A PATIENT SAFETY CHECKLIST REDUCES HOSPITAL-ASSOCIATED INFECTIONS

Background: The Center for Disease Control and Prevention estimates that 1.7 million patients per year develop hospital-associated infections (HAI), of whom 99,000 die. HAIs financially impact the United States healthcare system with an estimated cost [...]

By | 2017-04-20T19:06:09+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on THE USE OF A PATIENT SAFETY CHECKLIST REDUCES HOSPITAL-ASSOCIATED INFECTIONS

HM2017 Abstract Number: 94

PREOPERATIVE STATIN THERAPY IN CARDIAC SURGERY AND ACUTE KIDNEY INJURY: A SYSTEMATIC REVIEW AND META-ANALYSIS OF CLINICAL TRIALS

Background: Acute kidney injury (AKI) following cardiac surgery occurs in 30% of cases with 1% requiring dialysis resulting in significant morbidity and mortality.  HMG-CoA Reductase Inhibitors (“statins”) have been postulated to be of benefit in [...]

By | 2017-04-20T19:06:24+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on PREOPERATIVE STATIN THERAPY IN CARDIAC SURGERY AND ACUTE KIDNEY INJURY: A SYSTEMATIC REVIEW AND META-ANALYSIS OF CLINICAL TRIALS

HM2017 Abstract Number: 93

IMPACT OF INPATIENT PENICILLIN ALLERGY TESTING ON ANTIBIOTIC SELECTION DURING HOSPITALIZATION

Background: A documented penicillin allergy is associated with increased length of hospital stay and an increased incidence of Clostridium difficile, methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterocci. These findings are attributed to use of broader-spectrum ‘second-line’ [...]

By | 2017-04-20T18:59:51+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on IMPACT OF INPATIENT PENICILLIN ALLERGY TESTING ON ANTIBIOTIC SELECTION DURING HOSPITALIZATION

HM2017 Abstract Number: 92

READMISSIONS, REDEFINED: A PATIENT-CENTRIC DEFINITION INCLUSIVE OF OUTPATIENT OBSERVATION AND INPATIENT STAYS

Background: Hospitals are incentivized to reduce 30-day readmissions under the Affordable Care Act. Medicare payments can be reduced when inpatient readmissions are excessive. The Centers for Medicare & Medicaid Services (CMS) readmission measure is defined [...]

By | 2017-04-20T19:06:39+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on READMISSIONS, REDEFINED: A PATIENT-CENTRIC DEFINITION INCLUSIVE OF OUTPATIENT OBSERVATION AND INPATIENT STAYS

HM2017 Abstract Number: 91

INFLUENCE OF PUBLIC OR PRIVATE ASSISTANCE IN THE CLINICAL CHARACTERISTICS AND OUTCOMES OF PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION

Background: Previous studies suggest that the type of healthcare is associated with distinct clinical characteristics and outcomes,  but there are few studies addressing this in patients with a ST-elevation myocardial infarction (STEMI) in our country. Methods: [...]

By | 2017-04-20T19:00:58+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on INFLUENCE OF PUBLIC OR PRIVATE ASSISTANCE IN THE CLINICAL CHARACTERISTICS AND OUTCOMES OF PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION

HM2017 Abstract Number: 90

FACTORS AFFECTING HOSPITAL VISITS AND LENGTH OF STAY IN ADULT PATIENTS WITH SICKLE CELL DISEASE

Background: Sickle cell disease (SCD) affects about 100,000 people in the US. The disease causes significant mortality, morbidity and frequent hospitalizations secondary to primary manifestations of the disease and its complications. We conducted a retrospective, [...]

By | 2017-04-20T19:06:56+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on FACTORS AFFECTING HOSPITAL VISITS AND LENGTH OF STAY IN ADULT PATIENTS WITH SICKLE CELL DISEASE

HM2017 Abstract Number: 88

REAL-WORLD EFFECTIVENESS OF SACRAL DRESSINGS TO PREVENT HOSPITAL-ACQUIRED PRESSURE INJURIES IN ACADEMIC MEDICAL CENTERS: AN OBSERVATIONAL COHORT STUDY

Background: Reduced payments from Medicare related to high rates of hospital-acquired pressure injuries has prompted hospitals to invest in new technologies and strategies to improve wound care and prevention. While many hospitals have increased the [...]

By | 2017-04-20T19:07:09+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on REAL-WORLD EFFECTIVENESS OF SACRAL DRESSINGS TO PREVENT HOSPITAL-ACQUIRED PRESSURE INJURIES IN ACADEMIC MEDICAL CENTERS: AN OBSERVATIONAL COHORT STUDY

HM2017 Abstract Number: 87

THE REAL-WORLD EFFECTIVENESS OF SACRAL DRESSINGS TO PREVENT HOSPITAL-ACQUIRED PRESSURE INJURIES IN ACADEMIC MEDICAL CENTERS: AN OBSERVATIONAL COHORT STUDY

Background: Reduced payments from Medicare related to high rates of hospital-acquired pressure injuries has prompted hospitals to invest in new technologies and strategies to improve wound care and prevention. While many hospitals have increased the [...]

By | 2017-04-20T19:07:22+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on THE REAL-WORLD EFFECTIVENESS OF SACRAL DRESSINGS TO PREVENT HOSPITAL-ACQUIRED PRESSURE INJURIES IN ACADEMIC MEDICAL CENTERS: AN OBSERVATIONAL COHORT STUDY

HM2017 Abstract Number: 86

MISSING THE YELLOW FLAGS: DOES A TARDY RESPONSE TRIGGER THE RAPID RESPONSE?

Background: A Rapid Response (RR) Team is activated when there is an acute change in a patient’s condition. Rapid responses are called when certain criteria are met. A delay in activation of the rapid response [...]

By | 2017-04-20T19:07:35+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on MISSING THE YELLOW FLAGS: DOES A TARDY RESPONSE TRIGGER THE RAPID RESPONSE?

HM2017 Abstract Number: 85

IMPACTS OF ANXIOLYTIC MEDICATION TYPE ON INTENSIVE CARE UNIT LENGTH OF STAY

Background: Mechanically ventilated patients are often administered analgesic medications such as dexmedetomidine (DEX) and lorazepam (LZP) to reduce pain and anxiety. Studies have suggested that benzodiazepines may increase the risk of developing acute brain dysfunction, [...]

By | 2017-04-20T19:07:53+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on IMPACTS OF ANXIOLYTIC MEDICATION TYPE ON INTENSIVE CARE UNIT LENGTH OF STAY

HM2017 Abstract Number: 84

ANTIMOTILITY USE IN PATIENTS WITH C DIFFICILE–POTENTIALLY SAFE?

Title: ANTI-MOTILITY USE IN PATIENTS WITH C. DIFFICILE --POTENTIALLY SAFE? Background: Anti-motility agents have typically been avoided in patients with Clostridium difficile diarrheal infections (CDI) due to fear of gastrointestinal complications such as toxic mega-colon. [...]

By | 2017-04-20T19:01:11+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on ANTIMOTILITY USE IN PATIENTS WITH C DIFFICILE–POTENTIALLY SAFE?

HM2017 Abstract Number: 83

PREVALENCE OF CHEMOPREVENTIVE AGENT USE AMONG HOSPITALIZED WOMEN AT HIGH RISK FOR BREAST CANCER: A CROSS-SECTIONAL STUDY

Background: Approximately 15% of women in the United States aged 35-79 year are at high risk for developing breast cancer, however less than 0.2% of these women reported taking chemoprevention to reduce their risk. Objective [...]

By | 2017-04-25T14:52:37+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on PREVALENCE OF CHEMOPREVENTIVE AGENT USE AMONG HOSPITALIZED WOMEN AT HIGH RISK FOR BREAST CANCER: A CROSS-SECTIONAL STUDY

HM2017 Abstract Number: 82

BURDEN OF 30-DAY READMISSIONS FOLLOWING HOSPITALIZATION FOR PNEUMONIA IN YOUNG AND MIDDLE-AGED ADULTS

Background: While pattern of readmissions in young survivors of acute myocardial infarction and heart failure has been described, burden of 30-day readmissions following hospitalization for pneumonia in young adults is poorly understood. Further, gender differences [...]

By | 2017-04-20T19:01:15+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on BURDEN OF 30-DAY READMISSIONS FOLLOWING HOSPITALIZATION FOR PNEUMONIA IN YOUNG AND MIDDLE-AGED ADULTS

HM2017 Abstract Number: 81

IMPACT OF ADMISSION URINE CULTURE ON ANTIBIOTIC USE AND HOSPTIAL LENGTH OF STAY

Background: Overuse of urine testing may result in downstream events that impact antibiotic use and hospital length of stay (LOS). The aims of this study were to examine the impact of inpatient urine culture testing [...]

By | 2017-04-20T19:08:23+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on IMPACT OF ADMISSION URINE CULTURE ON ANTIBIOTIC USE AND HOSPTIAL LENGTH OF STAY

HM2017 Abstract Number: 80

IDENTIFYING GAPS IN CARE OF MALNOURISHED PATIENTS AND THE EFFECTS ON LENGTH OF STAY AND READMISSION IN AN ACUTE CARE SETTING

Background: Malnourished patients compose 25% to 54% of the admitted patient population. Much attention has been given to identifying these malnourished patients. However, few published articles have focused on identifying the gaps in care that [...]

By | 2017-04-20T19:02:04+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on IDENTIFYING GAPS IN CARE OF MALNOURISHED PATIENTS AND THE EFFECTS ON LENGTH OF STAY AND READMISSION IN AN ACUTE CARE SETTING

HM2017 Abstract Number: 79

TRENDS IN INCIDENCE AND LIABILITY COSTS FROM DIAGNOSTIC ERROR IN INPATIENT SETTINGS: INSIGHTS FROM THE NATIONAL PRACTITIONER DATA BANK

Background: Although diagnostic errors are common in hospitals, little is known about the resulting economic burden. Whether the increasing attention to patient safety has led to a decrease in diagnostic error-related claims and cost over [...]

By | 2017-04-20T19:08:45+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on TRENDS IN INCIDENCE AND LIABILITY COSTS FROM DIAGNOSTIC ERROR IN INPATIENT SETTINGS: INSIGHTS FROM THE NATIONAL PRACTITIONER DATA BANK

HM2017 Abstract Number: 78

PRIOR STATIN USE MIGHT BE ASSOCIATED WITH LOWER SEPSIS MORTALITY – RESULTS FROM A “BIG DATA” STUDY

Background: The randomized controlled ANZ-STATInS trial demonstrated that de novo statin use did not alter interleukin-6 levels or Sequential Organ Failure Assessment (SOFA) score in of what before SEPSIS-3 was known as severe sepsis. Prospective [...]

By | 2017-04-20T19:08:58+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on PRIOR STATIN USE MIGHT BE ASSOCIATED WITH LOWER SEPSIS MORTALITY – RESULTS FROM A “BIG DATA” STUDY

HM2017 Abstract Number: 77

LONG-TERM CLINICAL AND ECONOMIC OUTCOMES OF INTENSIVE VS STANDARD BLOOD PRESSURE REDUCTION IN NON-DIABETICS AT HIGH CARDIOVASCULAR RISK – EXTRAPOLATIONS FROM THE SPRINT TRIAL

Background: Results from the recent SPRINT trial demonstrate lower rates of fatal and non-fatal major cardiovascular events and all-cause mortality in non-diabetics at high cardiovascular risk with intensive versus standard treatment, i.e., less than 120 [...]

By | 2017-04-20T19:09:11+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on LONG-TERM CLINICAL AND ECONOMIC OUTCOMES OF INTENSIVE VS STANDARD BLOOD PRESSURE REDUCTION IN NON-DIABETICS AT HIGH CARDIOVASCULAR RISK – EXTRAPOLATIONS FROM THE SPRINT TRIAL

HM2017 Abstract Number: 76

PREDICTORS OF COPD READMISSIONS – A RETROSPECTIVE STUDY

Background: The Centers for Medicare & Medicaid Services (CMS) started penalizing hospitals with “excess” 30-day readmissions, as determined by observed-to-expected ratio, for patients discharged after treatment for an acute exacerbation of chronic obstructive pulmonary disease [...]

By | 2017-04-20T19:09:22+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on PREDICTORS OF COPD READMISSIONS – A RETROSPECTIVE STUDY

HM2017 Abstract Number: 75

OUTCOME TRENDS FOLLOWING OUT-OF-HOSPITAL CARDIAC ARREST IN THE UNITED STATES: 1995-2013

Background: In the United States, studies have reported mixed results on outcomes following out–of–hospital cardiac arrest. We postulated that such variation is not only dependent on the populations included or excluded in these studies but [...]

By | 2017-04-20T19:02:15+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on OUTCOME TRENDS FOLLOWING OUT-OF-HOSPITAL CARDIAC ARREST IN THE UNITED STATES: 1995-2013

HM2017 Abstract Number: 74

COPING SELF-EFFICACY IN HIV-POSITIVE PATIENTS: WHAT THE NUMBERS LOOK LIKE

Background: As of 2016, there are approximately 36.7 million people living with HIV around the world. HIV infection is associated with tremendous psychological burden. Improvements in coping methods would be highly beneficial in this scenario. [...]

By | 2017-04-20T19:09:38+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on COPING SELF-EFFICACY IN HIV-POSITIVE PATIENTS: WHAT THE NUMBERS LOOK LIKE

HM2017 Abstract Number: 73

CHARACTERISTICS OF MORTALITY CASES WITH ADVANCE CARE PLANNING ISSUES

Background: The UCLA Department of Medicine (DOM) Rapid Mortality Review (RMR) is an innovative in-person, near real-time review of all deaths to capture the unique insight of the care providers into aspects of end-of-life care [...]

By | 2017-04-20T19:09:50+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on CHARACTERISTICS OF MORTALITY CASES WITH ADVANCE CARE PLANNING ISSUES

HM2017 Abstract Number: 72

THE RISK OF VENOUS THROMBOEMBOLISM WITH ASPIRIN COMPARED TO ANTICOAGULANTS AFTER HIP OR KNEE ARTHROPLASTY

Background: Recent guidelines include aspirin as an option to prevent venous thromboembolism (VTE) in selected patients undergoing hip or knee replacement surgery. However, the efficacy of aspirin after arthroplasty has not been well-defined, particularly in [...]

By | 2017-04-20T19:10:05+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on THE RISK OF VENOUS THROMBOEMBOLISM WITH ASPIRIN COMPARED TO ANTICOAGULANTS AFTER HIP OR KNEE ARTHROPLASTY

HM2017 Abstract Number: 71

PICTURE MAKES PERFECT: DOES ULTRASOUND GUIDANCE REDUCE COMPLICATIONS IN PARACENTESIS?

Background: Ultrasound-guidance has become the standard for bedside procedures in the Emergency and Inpatient setting due to its perceived impact on first success rate and reduced complications. However, literature data on the rate of complications [...]

By | 2017-04-20T19:02:24+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on PICTURE MAKES PERFECT: DOES ULTRASOUND GUIDANCE REDUCE COMPLICATIONS IN PARACENTESIS?

HM2017 Abstract Number: 70

A RISK TOOL TO PREDICT CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTION IN PATIENTS WITH PICCS

Background: Evidence suggests that risk of central line-associated bloodstream infection (CLABSI) between patients with traditional central venous catheters (CVC) vs. peripherally inserted central catheters (PICC) is similar. However, how best to predict CLABSI in patients [...]

By | 2017-04-20T19:11:39+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on A RISK TOOL TO PREDICT CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTION IN PATIENTS WITH PICCS

HM2017 Abstract Number: 69

A COMPARISON OF OUTCOMES OF PATIENTS WITH CONGESTIVE HEART FAILURE AND PNEUMONIA AMONG TEACHING AND NONTEACHING SERVICES

Background:   Congestive heart failure (CHF) and pneumonia are amongst the leading causes of hospitalization in the United States.  Although a growing number of hospitals use both teaching and nonteaching hospitalist services for patient care, [...]

By | 2017-04-20T19:12:08+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on A COMPARISON OF OUTCOMES OF PATIENTS WITH CONGESTIVE HEART FAILURE AND PNEUMONIA AMONG TEACHING AND NONTEACHING SERVICES

HM2017 Abstract Number: 68

OBESE PATIENTS WITH ACUTE BACTERIAL SKIN AND SKIN STRUCTURE INFECTIONS (ABSSSI) HAVE DOUBLE THE RATE OF KEY COMORBIDITIES COMPARED TO NON-OBESE PATIENTS WHICH IMPACTS ANTIBIOTIC SELECTION

Background: The successful management of ABSSSI requires prompt assessment and appropriate antibiotic therapy. Antibiotic selection requires consideration of patient comorbidities to ensure appropriate pathogen coverage and to avoid contraindications related to comorbidities and concomitant medications. [...]

By | 2017-04-20T19:03:14+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on OBESE PATIENTS WITH ACUTE BACTERIAL SKIN AND SKIN STRUCTURE INFECTIONS (ABSSSI) HAVE DOUBLE THE RATE OF KEY COMORBIDITIES COMPARED TO NON-OBESE PATIENTS WHICH IMPACTS ANTIBIOTIC SELECTION

HM2017 Abstract Number: 67

PREDICTORS OF 1 YEAR MORTALITY AMONG PATIENTS ADMITTED IN THE HOSPITAL WITH ACUTE HEART FAILURE

Background: Acute heart failure (AHF) is the major cause of hospital admission and death. Furthermore, patients admitted with AHF have high readmission rates and  postdischarge mortality. Although there have been some reports, which demonstrated the [...]

By | 2017-04-20T19:11:53+00:00 April 20th, 2017|Outcomes Research, Research Abstracts|Comments Off on PREDICTORS OF 1 YEAR MORTALITY AMONG PATIENTS ADMITTED IN THE HOSPITAL WITH ACUTE HEART FAILURE