XML Feed for RxPG News   Add RxPG News Headlines to My Yahoo!   Javascript Syndication for RxPG News

Research Health World General
 
  Home
 
 Latest Research
 Cancer
 Psychiatry
 Genetics
 Surgery
 Aging
 Ophthalmology
 Gynaecology
 Neurosciences
 Pharmacology
 Cardiology
  Hypertension
  CAD
  Myocardial Infarction
  CHF
  Clinical Trials
 Obstetrics
 Infectious Diseases
 Respiratory Medicine
 Pathology
 Endocrinology
 Immunology
 Nephrology
 Gastroenterology
 Biotechnology
 Radiology
 Dermatology
 Microbiology
 Haematology
 Dental
 ENT
 Environment
 Embryology
 Orthopedics
 Metabolism
 Anaethesia
 Paediatrics
 Public Health
 Urology
 Musculoskeletal
 Clinical Trials
 Physiology
 Biochemistry
 Cytology
 Traumatology
 Rheumatology
 
 Medical News
 Health
 Opinion
 Healthcare
 Professionals
 Launch
 Awards & Prizes
 
 Careers
 Medical
 Nursing
 Dental
 
 Special Topics
 Euthanasia
 Ethics
 Evolution
 Odd Medical News
 Feature
 
 World News
 Tsunami
 Epidemics
 Climate
 Business
 
 India
Search

Last Updated: Nov 18, 2006 - 12:32:53 PM

CHF Channel
subscribe to CHF newsletter

Latest Research : Cardiology : CHF

   DISCUSS   |   EMAIL   |   PRINT
Seven-point system gauges seriousness of heart failure in elderly
Nov 10, 2006 - 5:06:00 PM, Reviewed by: Dr. Sanjukta Acharya

"It has typically been very difficult to predict how long a person hospitalized with heart failure may survive. That has made it hard for the treating physician to know how aggressive to be with therapy."

 
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."
 

- Huynh BC, Rovner A, Rich MW. Long-term survival in elderly patients hospitalized for heart failure. Archives of Internal Medicine September 2006;166:1892-1898.
 

medinfo.wustl.edu

 
Subscribe to CHF Newsletter
E-mail Address:

 

Funding from the Washington University School of Medicine Mentors in Medicine Program and the National Heart, Lung, and Blood Institute supported this research.

Washington University School of Medicine's full-time and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children's hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked fourth in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children's hospitals, the School of Medicine is linked to BJC HealthCare.


Related CHF News

Seven-point system gauges seriousness of heart failure in elderly
Famotidine may help to slow progression of chronic heart failure
Ilk gene underlies heart failure
Nocturnal Hypertension Increase Congestive Heart Failure Risk
Gender-based differences seen in predictive value of exercise test results of heart failure patients
Training program may reverse underlying abnormalities in heart failure more effectively than drug treatment
Acetazolamide improves sleep apnea associated with heart failure
NT-proBNP test results comparable to those of BNP blood test in patients with kidney disease
Moderate exercise may delay congestive heart failure
Pulmonary artery catheter in critically ill has neutral effect


For any corrections of factual information, to contact the editors or to send any medical news or health news press releases, use feedback form

Top of Page

 

© Copyright 2004 onwards by RxPG Medical Solutions Private Limited
Contact Us