We urgently need a large trial that compares inpatient vs outpatient based acute heart failure treatment. There is also substantial cost-savings to this approach. Outpatient based treatment appeared safe, with no excess mortality, and significantly increased the number of days alive out of hospital by 30 days follow-up. We conducted a small pilot single centre RCT that was published in 2020 comparing inpatient vs outpatient based IV diuretic treatment. Please would the authors elaborate what proportion of patients in the standard of care group who were admitted to hospital receiving IV diuretics? Please email me at by the end of September 2021 if you are interested to collaborate in a patient-level meta-analysis comparing IV diuretic treatment as Inpatient vs Outpatient for acute decompensated heart failure. If admitted, the subject will be treated in the usual manner. According to the detailed study protocol, the standard of care arm will be admitted or discharged from the emergency room based on the discretion of the physicians involved. This important trial demonstrated IV furosemide (biweekly over for 1 month) was more effective than IV saline at reducing 30-day rehospitalization for heart failure (3.7% vs 23%, p=0.037) However, no significant difference in outcome was reported comparing IV frusemide with standard of care (control arm).
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