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Related Concept Videos

Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

978
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
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Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

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Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
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Heart Failure I: Introduction01:27

Heart Failure I: Introduction

927
Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
927
Hospitals-II00:59

Hospitals-II

1.2K
Hospitals provide inpatient and outpatient services. Inpatient services provide care to patients that stay in the hospital for an extended period, ranging from days to months. Examples of inpatient services include intensive care units, hospital wards, or surgeries. Outpatient services provide care to patients who come to a hospital for a diagnostic or treatment but do not stay overnight —for example, diagnostic tests, surgical procedures, or health education.
Nurses that work in...
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Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

368
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
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Hospitals-I01:28

Hospitals-I

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Hospitals offer medical and surgical care to the sick and injured, along with accommodation while they recover. At the same time, they also provide outpatient, emergency, psychiatric, and rehabilitation services to meet various community needs. In addition to providing medical care, hospitals also act as hubs for medical research and training. Hospitals use clinical procedures and evidence-based practice standards to deliver patient care. To deliver safe and efficient care, a nurse must stay up...
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A Hospital Level Analysis of 30-Day Readmission Performance for Heart Failure Patients and Long-Term Survival: Findings from Get With The Guidelines-Heart Failure.

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Early impact of guideline publication on angiotensin-receptor neprilysin inhibitor use among patients hospitalized for heart failure.

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Author Spotlight: Workflow for Integrating POCUS Data into EHR for Managing Heart Failure Patients
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Home-Time After Discharge Among Patients Hospitalized With Heart Failure.

Stephen J Greene1, Emily C O'Brien2, Robert J Mentz1

  • 1Duke Clinical Research Institute, Durham, North Carolina; Division of Cardiology, Duke University School of Medicine, Durham, North Carolina.

Journal of the American College of Cardiology
|June 9, 2018
PubMed
Summary
This summary is machine-generated.

Home-time, a measure of days alive outside healthcare facilities, is significantly reduced for many heart failure patients post-hospitalization. This patient-centered outcome strongly correlates with mortality and hospital readmissions.

Keywords:
heart failurehospitalizationoutcomespatient-centeredpost-discharge

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Area of Science:

  • Cardiology
  • Health Services Research

Background:

  • Patient-centered outcomes are increasingly prioritized in cardiovascular disease research.
  • Home-time, defined as days alive and out of healthcare institutions, is a key patient-valued outcome.
  • This metric has not been previously evaluated in heart failure (HF) populations.

Purpose of the Study:

  • To characterize home-time following hospitalization for heart failure (HF).
  • To assess the relationship between home-time and patient characteristics.
  • To evaluate the association of home-time with established clinical outcomes.

Main Methods:

  • Utilized Get With The Guidelines-Heart Failure (GWTG-HF) registry data for patients hospitalized with HF.
  • Included patients aged 65 years and older discharged alive between 2011 and 2014.
  • Calculated post-discharge home-time using Medicare claims over 30-day and 1-year periods, excluding hospital, skilled nursing facility (SNF), or rehabilitation facility stays.

Main Results:

  • Analyzed data from 59,736 patients with high follow-up rates (97.1% at 30 days, 70.6% at 1 year).
  • Mean home-time was 21.6 days at 30 days and 243.9 days at 1 year.
  • Reduced home-time was associated with conditions like COPD, renal insufficiency, and dementia; home-time strongly correlated with mortality (tau=0.72) and death/HF readmission (tau=0.59) over 1 year.

Conclusions:

  • Home-time is substantially reduced for many heart failure patients post-hospitalization.
  • This metric is easily calculable from administrative claims data.
  • Home-time serves as a novel, patient-centered endpoint for evaluating interventions in HF research.