Changes in the Use of Intensive and Supportive Care with Heart Failure in the Last Month of Life Between 2001 and 2013

Abstract Background Heart failure (HF) is a global epidemic affecting the elder globally. It is uncertain what care patients with heart failure receive at their end of life and what care trends are in the last month of life. OBJECTIVES: This study's objective was to investigate the changes in the use of intensive and supportive procedures for Taiwanese patients with heart failure in their last month of life during 2001-2013. Methods Analysis of claims data of 25,375 patients with heart failure obtained from the National Health Insurance Research Database was performed to investigate the changes in the use of intensive and supportive procedures for Taiwanese patients with heart failure in their last month of life during 2001-2013. Results Over the whole study period, 53.3% of patients with heart failure were admitted to intensive care units in their last month of life. The percentages of patients receiving mechanical ventilation (54.3%-41.5%), cardiopulmonary resuscitation (41.5%-16.7%), decreased over time. The percentages of patients receiving artificial hydration and nutrition (52.5.9%-56.8%) and extracorporeal membrane oxygenation(ECMO) (0.52%-1.78%) increased over time. Patients under 75 years old were more likely to be admitted to intensive care units. Conclusion Over time, supportive procedures increased, and intensive procedures decreased in patients with heart failure in the last month of life. This study highlights a need for research, guidelines, and training in how to provide palliative care for end-stage patients with heart failure.

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▾ Enoximone and ▾ milrinone – inotropic vasodilators for severe heart failure

Drug and Therapeutics Bulletin ◽

10.1136/dtb.29.10.39 ◽

1991 ◽

Vol 29 (10) ◽

pp. 39-40

Keyword(s):

Heart Failure ◽

Intensive Care ◽

Intensive Care Units ◽

Severe Heart Failure ◽

Phosphodiesterase Inhibitors ◽

First Line ◽

Short Term ◽

Failing Heart ◽

Patients With Heart Failure

Enoximone (Perfan – Merrell) and milrinone (Primacor – Sterling-Winthrop) are phosphodiesterase inhibitors marketed for short-term intravenous use in patients with heart failure on intensive care units. The manufacturers claim that enoximone is ‘a first-line inotrope for the failing heart’ while milrinone is advocated for ‘resistant heart failure’. Are these drugs useful additions to existing treatments?

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The association between serum albumia and length of stay of intensive care units in patients with heart failure

10.21203/rs.3.rs-618699/v1 ◽

2021 ◽

Author(s):

Tao Liu ◽

Haochen Xuan ◽

Lili Wang ◽

Xiaoqun Li ◽

Zhihao Lu ◽

...

Keyword(s):

Heart Failure ◽

Intensive Care ◽

Length Of Stay ◽

Intensive Care Units ◽

Medical Information ◽

Smooth Curve ◽

High Serum ◽

Outcome Variable ◽

Trend Test ◽

Patients With Heart Failure

Abstract Objective: To assess the relationship between serum albumia and length of stay (LOS) of the intensive care units (ICUs).Design and Participants: we retrospectively analyze 2843 patients from the medical information mart for intensive care III (the MIMIC-III ) database. Materials and Methods: The exposure variable of the present study was serum albumia, which was defined as serum albumia level at the time of admission to ICUs. The outcome variable was LOS of ICUs. The final models were established by multivariate linear regression, and trend test and smooth fitting curves were used to evaluate the association between serum albumia level and LOS of ICUs. The subgroups were conducted based on age, sex and body mass index (BMI). Results: Higher serum albumia level can reduce LOS of ICUs in patients with heart failure (HF) than lower serum albumia level (β: -1.18; 95%CI: -1.50, -0.86; P <0.001). Trend test and smooth curve fittings suggested that LOS of ICUs was gradually shorten when serum albumia level was gradually increased. The subgroups based on age, sex and BMI demonstrated similar results between serum albumia level and LOS of ICUs.Conclusion: The negative correlation between serum albumia level and LOS of ICUs among patients with HF was found. High serum albumia level might reduce LOS of ICUs in patients with HF, and the conclusion might guide clinical treatments and judge prognosis.

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Pain management for patients in cardiac surgical intensive care units has not improved over time

Australian Critical Care ◽

10.1016/j.aucc.2010.04.004 ◽

2010 ◽

Vol 23 (3) ◽

pp. 157-159 ◽

Cited By ~ 4

Author(s):

Snez Stolic ◽

Marion L. Mitchell

Keyword(s):

Intensive Care ◽

Pain Management ◽

Intensive Care Units ◽

Surgical Intensive Care ◽

Over Time

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Prognostic Value of Changes in Galectin-3 Levels Over Time in Patients With Heart Failure

Circulation Heart Failure ◽

10.1161/circheartfailure.112.000129 ◽

2013 ◽

Vol 6 (2) ◽

pp. 219-226 ◽

Cited By ~ 121

Author(s):

A. Rogier van der Velde ◽

Lars Gullestad ◽

Thor Ueland ◽

Pål Aukrust ◽

Yu Guo ◽

...

Keyword(s):

Heart Failure ◽

Prognostic Value ◽

Patients With Heart Failure ◽

Galectin 3 ◽

Over Time

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Noninvasive Home Telemonitoring for Patients With Heart Failure at High Risk for Recurrent Admission and Death. Relationship Between B-Type Natriuretic Peptides and Pulmonary Capillary Wedge Pressure in the Intensive Care Unit

Congestive Heart Failure ◽

10.1111/j.1527-5299.2005.04181.x ◽

2005 ◽

Vol 11 (5) ◽

pp. 272-273

Author(s):

David Tepper ◽

Imran S. Virk ◽

John R. Ip

Keyword(s):

Heart Failure ◽

Intensive Care Unit ◽

Intensive Care ◽

High Risk ◽

Pulmonary Capillary Wedge Pressure ◽

Natriuretic Peptides ◽

Home Telemonitoring ◽

Pulmonary Capillary ◽

Patients With Heart Failure ◽

Wedge Pressure

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COVID-19 in patients with heart failure: the new and the old epidemic

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2020-138080 ◽

2020 ◽

Vol 97 (1145) ◽

pp. 175-179

Author(s):

Nicolò Sisti ◽

Serafina Valente ◽

Giulia Elena Mandoli ◽

Ciro Santoro ◽

Carlotta Sciaccaluga ◽

...

Keyword(s):

Heart Failure ◽

Intensive Care ◽

Cardiovascular Diseases ◽

Chronic Heart Failure ◽

Poor Prognosis ◽

Myocardial Injury ◽

Careful Monitoring ◽

Clinical Challenge ◽

Patients With Heart Failure ◽

Acute Decompensation

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has spread in nearly 200 countries in less than 4 months since its first identification; accordingly, the coronavirus disease 2019 (COVID 2019) has affirmed itself as a clinical challenge. The prevalence of pre-existing cardiovascular diseases in patients with COVID19 is high and this dreadful combination dictates poor prognosis along with the higher risk of intensive care mortality. In the setting of chronic heart failure, SARS-CoV-2 can be responsible for myocardial injury and acute decompensation through various mechanisms. Given the clinical and epidemiological complexity of COVID-19, patiens with heart failure may require particular care since the viral infection has been identified, considering an adequate re-evaluation of medical therapy and a careful monitoring during ventilation.

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OP-039 BALLOON AORTIC VALVULOPLASTY (BAV) FOR END-STAGE CALCIFIED AORTIC STENOSIS IN PATIENTS WITH HEART FAILURE WHO ARE POORE CANDIDATES FOR SURGERY – IMMEDIATE HEMODYNAMIC AND MID-TERM CLINICAL RESULTS – SINGLE CENTER INITIAL EXPERIENCE

International Journal of Cardiology ◽

10.1016/s0167-5273(10)70041-3 ◽

2010 ◽

Vol 140 ◽

pp. S12

Author(s):

Krzysztof Wilczek ◽

Piotr Chodor ◽

Tomasz Niklewski ◽

Jan Glowacki ◽

Tomasz Podolecki ◽

...

Keyword(s):

Heart Failure ◽

Aortic Stenosis ◽

Clinical Results ◽

Initial Experience ◽

Single Center ◽

Balloon Aortic Valvuloplasty ◽

Patients With Heart Failure ◽

Aortic Valvuloplasty ◽

End Stage

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Incremental changes in QRS duration in serial ECGs over time identify high risk elderly patients with heart failure

Heart ◽

10.1136/heart.88.1.47 ◽

2002 ◽

Vol 88 (1) ◽

pp. 47-51 ◽

Cited By ~ 75

Author(s):

W Shamim

Keyword(s):

Heart Failure ◽

High Risk ◽

Elderly Patients ◽

Patients With Heart Failure ◽

Qrs Duration ◽

Over Time

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2312. Mortality of Severe Dengue Patients Admitted to Intensive Care Units over 15 Years: Have We Improved?

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1990 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S792-S792

Author(s):

Fernando Rosso ◽

Luis Gabriel Parra-Lara ◽

Ana M Sanz ◽

Gustavo A Ospina-Tascon ◽

Marcela Granados

Keyword(s):

Intensive Care ◽

Intensive Care Units ◽

Healthcare Management ◽

Severe Dengue ◽

Early Admission ◽

Early Access ◽

Monitoring Strategies ◽

Significant Difference ◽

Before And After ◽

Over Time

Abstract Background Dengue mortality can be preventable in endemic regions. However, access to intensive care units (ICU) and continuous monitoring strategies are limited in developing countries. In 2010, WHO dengue clinical practice guidelines (CPG) were implemented in the Americas region which strengthened hospital healthcare management and prioritized early ICU admission in severe dengue cases. We hypothesized that early access to the ICU might decrease the mortality of patients with dengue. This study aimed to describe trends in dengue cases and mortality in the ICU for 15 years in Cali, Colombia. Methods An observational retrospective study about dengue cases treated in adult ICU was conducted, in the Fundación Valle del Lili. We included cases between 2001 to 2015 years. Clinical data were collected from the ICU database and medical charts. A Cochran-Armitage test for trend was used to assess the presence of an association between fatal cases and total cases in dengue patients at ICU during the study period, and to evaluate differences in the mortality cases before and after the implementation of the dengue CPG. Results A total of 49,962 episodes of attention in ICU were analyzed, and 70 cases with severe dengue and dengue shock attended in ICU were included. The median age was 42 years (IQR = 24–60), eight cases were older than 65 years, and 54% were male. Five fatal cases were reported during this period. The fatal cases had a length of stay in ICU of 2 days (IQR = 1–4) vs. 2 days (IQR = 1–3) for nonfatal cases. Overall mortality for dengue cases in the ICU was 7.14%. The highest mortality was presented in 2007 with 33.33% (1/3), and after 2010 there were no fatal cases. Dengue mortality showed a decreasing linear variation over time in the ICU (p = 0.047); also there was a statistically significant difference over time in adults mortality before and after of implementation of dengue CPG (P = 0.029). Conclusion Dengue mortality cases in the ICU have decreased in the last 15 years, which is related to early admission to the ICU and continuous clinical monitoring. Disclosures All authors: No reported disclosures.

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