Friday, May 15, 2009
The heartache of heart failure
Heart failure is already the #1 reason people over age 65 years old are hospitalized. What with the Baby Boomers getting older, and the transition of ACS from a life-threatening problem to a more chronic disease, it will soon become "something hospitalists deal with on a daily basis," said John B. O'Connell, MD, at the annual SHM conference in Chicago today.
(O'Connell is executive director of the heart failure program at St. Joseph Heart and Vascular Institute in Atlanta.)
Here's the scary part: By the time a person's heart failure is bad enough to warrant admission to the hospital, his or her chances aren't so great. The post-discharge event rate--ie, either readmission or death-- for Acute Heart Failure Syndromes is a whopping 35% at 60 days.
Also scary is the fact that there isn't a great deal of solid evidence on how to treat heart failure. Rather than being mostly "evidence-based", or level A evidence, a whopping 86% of HFSA Guidelines are level C-- ie, based on expert opinion. "Instead of 'evidence-based medicine', it's 'eminence-based', Dr. O'Connell quipped. "The fact is, we are all flying by the seat of our pants."
Rather than adding yet another drug to the regimen of treatment for HF, Dr. O'Connell thinks the future lies in a genetic, molecular and cellular approach to therapy. As well, devices will become more sophisticated such that they will go beyond pacing and defibrillating, to sending meaningful information back to the doctor and perhaps instituting treatment automatically.
Labels: heart failure, Hospital Medicine 2009
posted by Jessica Berthold at
7:53 PM
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- Housing for the chronically ill homeless
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