Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Seven-point system gauges seriousness of heart failure in elderly

13.11.2006
A simple points system may soon help guide treatment of elderly heart failure patients. Researchers at Washington University School of Medicine in St. Louis found that by counting how many of seven easy-to-obtain health factors a patient has, physicians can estimate the patient's risk of dying.
The points system may steer doctors toward considering more aggressive treatments such as implantable defibrillators and pacemakers for those at low risk of death. However, elderly patients with a high risk may want to avoid stressful and unnecessary medical intervention and may benefit most from palliative or hospice care.

"It has typically been very difficult to predict how long a person hospitalized with heart failure may survive," says senior author Michael W. Rich, M.D., associate professor of medicine and a geriatric cardiologist at Barnes-Jewish Hospital. "That has made it hard for the treating physician to know how aggressive to be with therapy."

Heart failure afflicts about 5 million people in the United States, hospitalizing more than a million patients each year. The incidence of heart failure increases with age, and with people 65 and older becoming the fastest growing segment of the population, the personal and financial burden of heart failure will likely increase.

In their study, which followed 282 elderly heart failure patients for up to 14 years, the researchers identified seven factors that most affect patient survival:

  • advanced age
  • a history of dementia (contributes to a host of conditions related to the inability to properly care for oneself)
  • coronary artery disease (arteries that supply blood to the heart muscle are hardened and narrowed)
  • peripheral vascular disease (similar to coronary artery disease but involving blood vessels outside of the heart and brain)
  • low sodium in the blood (an indication of neurohormonal imbalance)
  • high urea in the blood (a reflection of poor cardiac output that affects kidney function)
  • low blood pressure (a result of weakened heart function).

The study, published in the September 25th issue of the Archives of Internal Medicine, showed that patients with four or more of the risk factors had a low probability of surviving longer than six months. But if patients had none or just one of the factors, they had a good chance of living five years or more. Patients with two to three factors were likely to live at least a year. The patients in the study received a variety of treatments as determined by their physicians.

"The system is easy to use, and the variables don't require any specialized testing -- they are part of routine medical histories or basic lab tests," Rich says. "If the system can be validated by further studies, it can play a role in helping physicians tailor care to individual patients. If a person has a limited life expectancy, it may not be in his or her best interest to recommend invasive, uncomfortable or risky procedures. On the other hand, an elderly person with only one risk factor could potentially be considered a good candidate for an aggressive treatment such as a defibrillator."

Other factors that might have been expected to affect survival, such as the amount of blood the heart can eject during pumping or a patient's body mass index, didn't seem to influence survival times. Rich emphasizes that each of the factors identified has been linked in previous studies to poor prognosis in heart failure patients.

"We didn't find any new risk factors, which means there's good data to support that these factors truly are predictive," Rich says. "We've pinpointed the seven that are the most predictive and shown that the number of risk factors can give a reasonable estimate of the probability of living for six, 12 or 60 months."

The researchers next aim to better identify the heart failure patients not likely to survive six months so that they can be referred for hospice care.

"Hospice is very nurturing for both patients and family members," Rich says. "There is considerable evidence that patients derive significant benefit from it. If we can predict mortality within six months, we can more easily establish eligibility for hospice care."

Gwen Ericson | EurekAlert!
Further information:
http://www.wustl.edu

More articles from Health and Medicine:

nachricht Team discovers how bacteria exploit a chink in the body's armor
20.01.2017 | University of Illinois at Urbana-Champaign

nachricht Rabies viruses reveal wiring in transparent brains
19.01.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn

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: Traffic jam in empty space

New success for Konstanz physicists in studying the quantum vacuum

An important step towards a completely new experimental access to quantum physics has been made at University of Konstanz. The team of scientists headed by...

Im Focus: How gut bacteria can make us ill

HZI researchers decipher infection mechanisms of Yersinia and immune responses of the host

Yersiniae cause severe intestinal infections. Studies using Yersinia pseudotuberculosis as a model organism aim to elucidate the infection mechanisms of these...

Im Focus: Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.

While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...

Im Focus: Studying fundamental particles in materials

Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales

Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...

Im Focus: Designing Architecture with Solar Building Envelopes

Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.

As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Sustainable Water use in Agriculture in Eastern Europe and Central Asia

19.01.2017 | Event News

12V, 48V, high-voltage – trends in E/E automotive architecture

10.01.2017 | Event News

2nd Conference on Non-Textual Information on 10 and 11 May 2017 in Hannover

09.01.2017 | Event News

 
Latest News

Helmholtz International Fellow Award for Sarah Amalia Teichmann

20.01.2017 | Awards Funding

An innovative high-performance material: biofibers made from green lacewing silk

20.01.2017 | Materials Sciences

Ion treatments for cardiac arrhythmia — Non-invasive alternative to catheter-based surgery

20.01.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>