ReDS Vest Use in the Emergency Department: Identifying High Risk Heart Failure Patients

• Published in: Journal of cardiac failure Vol. 25; no. 8; pp. S68 - S69
• Main Authors: Volz, Elizabeth, Tordella, Meaghan, Miller, Robert, Spence, Bethany, Hall, Cyndi, Chien, Christopher
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.08.2019
• ISSN: 1071-9164; 1532-8414
• DOI: 10.1016/j.cardfail.2019.07.195

Resource expenditures continue to grow in the heart failure (HF) population, including emergency department (ED) visits, hospitalization and readmission penalty costs. The Sensible Medical ReDS Vest is a non-invasive tool that can rapidly and accurately measure lung fluid content in HF patients. We aimed to use the ReDS Vest on patients with known HF presenting to the ED with dyspnea and/or edema, to see if it could aid in risk assessment. High lung fluid content, as measured by the ReDS Vest, can identify patients at increased risk for hospitalization and readmission. We implemented a protocol for performing ReDS Vest measurements in our ED. Patients were stratified by lung fluid content into 3 groups: Green (≤35%, normal); Yellow (36-39%, moderately elevated); Red (≥40%, severely elevated). ED providers could discharge patients in the Green zone with follow-up in HF clinic within 1 week. We retrospectively reviewed the charts of patients who had ReDS readings and collected baseline demographics. Admission and 30-day readmission data were gathered from review of the electronic health record (EHR), including access to local institutions using the same EHR. Admissions and readmissions were compared using chi-squared and Fisher's exact tests. Fifty-five patients had a ReDS Vest reading. Mean age was 73 years and 62% were male. There was a trend towards higher mean proBNP across ReDS groups: Green 4851, Yellow 8472, Red 12961 (p=0.051). Twenty-three patients (46%) had LVEF ≤40%. More patients in the Red group had LVEF ≤40% than Yellow/Green groups (p=0.017). Higher lung fluid content correlated with an increased likelihood of needing hospitalization (Table 1, p=0.003). Patients with lung fluid content ≥40% (Red group) were more likely to be readmitted within 30 days than those with lung fluid content <40% (37.5% vs 9.7%, p=0.021). Lung fluid content, as measured by the ReDS Vest, can be used in the ED to assist in triage of HF patients and can help assess risk. Patients in the Green zone were at low risk for admission or readmission. Patients in the Red zone were noted to have high risk for readmission.