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We agree with them that it would have been interesting to analyse emergency department visits as an outcome, but during the design of the study we favoured analysing just hospital readmissions for several reasons.</p><p id="par0010" class="elsevierStylePara elsevierViewall">First, we chose to evaluate hospital readmission only because this requires an objective assessment by medical staff. In this way, we would be assessing a phenomenon of proven clinical importance and more homogeneous severity. In contrast, the emergency department visit represents a much broader spectrum of severity, with, as they point out, a high percentage of patients who can be discharged directly from the emergency department.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> As this was the first study conducted to date in patients with preserved left ventricular ejection fraction (LVEF), we wanted to have a homogeneous result that would allow us to study the phenomenon rigorously, even at the expense of a less detailed description of the results.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Secondly, we agree with our colleagues that a multiview ultrasound assessment in the emergency department would help in risk stratification. However, we chose to perform only lung ultrasound, given the greater ease of the technique compared to echocardiography, which can be performed successfully even by relatively inexperienced operators.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2–4</span></a> It should also be noted that ventricular function was previously known in all patients included in our study, so performing a bedside echocardiogram to visually estimate LVEF did not add value to the intervention.</p><p id="par0020" class="elsevierStylePara elsevierViewall">We consider our study to be a good starting point for further research in lung ultrasound focusing on patients with preserved LVEF, both in inpatient wards and in hospital and out-of-hospital emergency care.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Rueda-Camino JA, Canora-Lebrato J. Respuesta a Gil-Rodrigo et al. Med Clin (Barc). 2022;158:241.</p>" ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">See related content at <span class="elsevierStyleInterRef" id="intr9005" href="http://dx.doi.org/10.1016/j.medcle.2021.04.024">doi:10.1016/j.medcle.2021.04.024</span>.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Analysis of how emergency physicians’ decisions to hospitalize or discharge patients with acute heart failure match the clinical risk categories of the MEESSI-AHF scale" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Ò. Mirò" 1 => "X. Rossello" 2 => "V. Gil" 3 => "F.J. Martín-Sánchez" 4 => "P. 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Journal Information
Vol. 158. Issue 5.
Pages 241 (March 2022)
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Vol. 158. Issue 5.
Pages 241 (March 2022)
Letter to the Editor
Reply
Respuesta
Visits
3
José Antonio Rueda-Camino
, Jesús Canora-Lebrato
Corresponding author
Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
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Med Clin. 2022;158:24010.1016/j.medcle.2021.04.024
Adriana Gil-Rodrigo, Guillermo Llopis-García, Víctor Gil
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