Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

New bedside tool gauges mortality risk in heart failure patients

02.02.2005


For the first time, UCLA researchers have developed a new evaluation tool that can predict mortality risk in patients hospitalized with heart failure. The new tool -- used right at the bedside -- will help clinicians quickly decide upon hospital admission which patients are at a greater mortality risk that may require higher monitoring and earlier, more intensive intervention.



Published in the February 2, 2005 edition of JAMA, the new tool utilizes the combination of three simple measures obtained through laboratory blood tests and by measuring vital signs. Heart failure is a condition that affects five million Americans and is the leading cause of hospitalization for those over age 65.

"The new tool is a first for the treatment of acute heart failure, and offers a simple quick way for clinicians to assess mortality risk upon hospital admission and quickly decide on a treatment strategy," said Dr. Gregg C. Fonarow, lead study author, The Eliot Corday Chair in Cardiovascular Medicine and Science, professor of cardiology, David Geffen School of Medicine at UCLA and director, Ahmanson-UCLA Cardiomyopathy Center.


Using data from a national registry of over 100,000 heart failure patients called the Acute Decompensated Heart Failure National Registry (ADHERE®), researchers developed a risk model after analyzing 33,046 hospitalizations. The model was developed using a relatively new statistical technique know as Classification and Regression Tree Analysis (CART). The validity of the model was then tested using data from an additional 32,229 hospitalizations.

Researchers evaluated 39 possible factors as survival indicators upon hospital admission and found that the best single predictor for mortality was a high blood urea nitrogen level, (above 43 mg/dL), followed by a low systolic blood pressure (above 115 mm Hg) and a high serum creatinine (higher than 2.75 mg/dL).

"This validated risk tree provides clinicians with a practical, easy tool to use at the bedside" said Fonarow. "We were surprised that the risk tool using only three variables was able to dramatically distinguish between low, intermediate, and high risk heart failure patients."

The overall mortality risk for patients hospitalized with acute heart failure was 4.1 percent. The model determined mortality risk levels starting from low risk at 2.1 percent, up to 21.9 percent for patients at the highest mortality risk.

Fonarow adds that two of the top mortality risk indicators -- blood urea nitrogen level and serum creatinine -- involve renal or kidney function, which emphasizes the importance of this area in heart failure patients that may warrant further study.

The new risk evaluation tool is now ready for clinical use, according to Fonarow, and can be applied at hospitals across the country. In addition, the new model may provide a more effective way to design clinical trials for evaluating heart failure therapies since researchers now have the ability to easily categorize patients by high and low mortality risk.

The study was funded by Scios, Inc., a biopharmaceutical company and member of the Johnson and Johnson Family of Companies. The ADHERE Registry, also funded by Scios, Inc., collects observational data from across the United States in order to track and study the medical management of patients hospitalized with acute heart failure. ADHERE is overseen by an independent scientific advisory committee of nationally recognized heart failure experts, including the study authors.

Additional study authors include: Dr. Kirkwood F. Adams, Jr., Division of Cardiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Dr. William T. Abraham, Department of Cardiology, The Ohio State University Medical Center, Columbus, Ohio; Dr. Clyde W. Yancy, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas; and W. John Boscardin, Ph.D., Department of Biostatisics, University of California, Los Angeles.

Rachel Champeau | EurekAlert!
Further information:
http://www.mednet.ucla.edu

More articles from Health and Medicine:

nachricht Correct connections are crucial
26.06.2017 | Charité - Universitätsmedizin Berlin

nachricht One gene closer to regenerative therapy for muscular disorders
01.06.2017 | Cincinnati Children's Hospital Medical Center

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Can we see monkeys from space? Emerging technologies to map biodiversity

An international team of scientists has proposed a new multi-disciplinary approach in which an array of new technologies will allow us to map biodiversity and the risks that wildlife is facing at the scale of whole landscapes. The findings are published in Nature Ecology and Evolution. This international research is led by the Kunming Institute of Zoology from China, University of East Anglia, University of Leicester and the Leibniz Institute for Zoo and Wildlife Research.

Using a combination of satellite and ground data, the team proposes that it is now possible to map biodiversity with an accuracy that has not been previously...

Im Focus: Climate satellite: Tracking methane with robust laser technology

Heatwaves in the Arctic, longer periods of vegetation in Europe, severe floods in West Africa – starting in 2021, scientists want to explore the emissions of the greenhouse gas methane with the German-French satellite MERLIN. This is made possible by a new robust laser system of the Fraunhofer Institute for Laser Technology ILT in Aachen, which achieves unprecedented measurement accuracy.

Methane is primarily the result of the decomposition of organic matter. The gas has a 25 times greater warming potential than carbon dioxide, but is not as...

Im Focus: How protons move through a fuel cell

Hydrogen is regarded as the energy source of the future: It is produced with solar power and can be used to generate heat and electricity in fuel cells. Empa researchers have now succeeded in decoding the movement of hydrogen ions in crystals – a key step towards more efficient energy conversion in the hydrogen industry of tomorrow.

As charge carriers, electrons and ions play the leading role in electrochemical energy storage devices and converters such as batteries and fuel cells. Proton...

Im Focus: A unique data centre for cosmological simulations

Scientists from the Excellence Cluster Universe at the Ludwig-Maximilians-Universität Munich have establised "Cosmowebportal", a unique data centre for cosmological simulations located at the Leibniz Supercomputing Centre (LRZ) of the Bavarian Academy of Sciences. The complete results of a series of large hydrodynamical cosmological simulations are available, with data volumes typically exceeding several hundred terabytes. Scientists worldwide can interactively explore these complex simulations via a web interface and directly access the results.

With current telescopes, scientists can observe our Universe’s galaxies and galaxy clusters and their distribution along an invisible cosmic web. From the...

Im Focus: Scientists develop molecular thermometer for contactless measurement using infrared light

Temperature measurements possible even on the smallest scale / Molecular ruby for use in material sciences, biology, and medicine

Chemists at Johannes Gutenberg University Mainz (JGU) in cooperation with researchers of the German Federal Institute for Materials Research and Testing (BAM)...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Plants are networkers

19.06.2017 | Event News

Digital Survival Training for Executives

13.06.2017 | Event News

Global Learning Council Summit 2017

13.06.2017 | Event News

 
Latest News

Study shines light on brain cells that coordinate movement

26.06.2017 | Life Sciences

Smooth propagation of spin waves using gold

26.06.2017 | Physics and Astronomy

Switchable DNA mini-machines store information

26.06.2017 | Information Technology

VideoLinks
B2B-VideoLinks
More VideoLinks >>>