Cargando…
Use of CIED Generated Heart Failure Risk Score (HFRS) Alerts in an Integrated, Multi-Disciplinary Approach to HF Management—A Prospective Cohort Study
Aim: To evaluate use of CIED-generated Heart Failure Risk Score (HFRS) alerts in an integrated, multi-disciplinary approach to HF management. Methods: We undertook a prospective, single centre outcome study of patients implanted with an HFRS-enabled Medtronic CIED, generating a “high risk” alert bet...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8914972/ https://www.ncbi.nlm.nih.gov/pubmed/35270971 http://dx.doi.org/10.3390/s22051825 |
_version_ | 1784667891049693184 |
---|---|
author | Garner, Daniel Lunt, Lindsay Leung, Wing Llewellyn, Jennifer Kahn, Matthew Wright, David Jay Rao, Archana |
author_facet | Garner, Daniel Lunt, Lindsay Leung, Wing Llewellyn, Jennifer Kahn, Matthew Wright, David Jay Rao, Archana |
author_sort | Garner, Daniel |
collection | PubMed |
description | Aim: To evaluate use of CIED-generated Heart Failure Risk Score (HFRS) alerts in an integrated, multi-disciplinary approach to HF management. Methods: We undertook a prospective, single centre outcome study of patients implanted with an HFRS-enabled Medtronic CIED, generating a “high risk” alert between November 2018 and November 2020. All patients generating a “high risk” HFRS alert were managed within an integrated HF pathway. Alerts were shared with local HF teams, prompting patient contact and appropriate intervention. Outcome data on health care utilisation (HCU) and mortality were collected. A validated questionnaire was completed by the HF teams to obtain feedback. Results: 367 “High risk” alerts were noted in 188 patients. The mean patient age was 70 and 49% had a Charlson Comorbidity Score of >6. Mean number of alerts per patients was 1.95 and 44 (23%) of patients had >3 “high risk” alerts in the follow up period. Overall, 75 (39%) patients were hospitalised in the 4–6-week period of the alert; 53 (28%) were unplanned of which 24 (13%) were for decompensated HF. A total of 33 (18%) patients died in the study period. Having three or more alerts significantly increased the risk of hospitalisation for heart failure (HR 2.5, CI 1.1–5.6 p = 0.03). The feedback on the pathway was positive. Conclusions: Patients with “high risk” alerts are co-morbid and have significant HCU. An integrated approach can facilitate timely risk stratification and intervention. Intervention in these patients is not limited to HF alone and provides the opportunity for holistic management of this complex cohort. |
format | Online Article Text |
id | pubmed-8914972 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-89149722022-03-12 Use of CIED Generated Heart Failure Risk Score (HFRS) Alerts in an Integrated, Multi-Disciplinary Approach to HF Management—A Prospective Cohort Study Garner, Daniel Lunt, Lindsay Leung, Wing Llewellyn, Jennifer Kahn, Matthew Wright, David Jay Rao, Archana Sensors (Basel) Article Aim: To evaluate use of CIED-generated Heart Failure Risk Score (HFRS) alerts in an integrated, multi-disciplinary approach to HF management. Methods: We undertook a prospective, single centre outcome study of patients implanted with an HFRS-enabled Medtronic CIED, generating a “high risk” alert between November 2018 and November 2020. All patients generating a “high risk” HFRS alert were managed within an integrated HF pathway. Alerts were shared with local HF teams, prompting patient contact and appropriate intervention. Outcome data on health care utilisation (HCU) and mortality were collected. A validated questionnaire was completed by the HF teams to obtain feedback. Results: 367 “High risk” alerts were noted in 188 patients. The mean patient age was 70 and 49% had a Charlson Comorbidity Score of >6. Mean number of alerts per patients was 1.95 and 44 (23%) of patients had >3 “high risk” alerts in the follow up period. Overall, 75 (39%) patients were hospitalised in the 4–6-week period of the alert; 53 (28%) were unplanned of which 24 (13%) were for decompensated HF. A total of 33 (18%) patients died in the study period. Having three or more alerts significantly increased the risk of hospitalisation for heart failure (HR 2.5, CI 1.1–5.6 p = 0.03). The feedback on the pathway was positive. Conclusions: Patients with “high risk” alerts are co-morbid and have significant HCU. An integrated approach can facilitate timely risk stratification and intervention. Intervention in these patients is not limited to HF alone and provides the opportunity for holistic management of this complex cohort. MDPI 2022-02-25 /pmc/articles/PMC8914972/ /pubmed/35270971 http://dx.doi.org/10.3390/s22051825 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Garner, Daniel Lunt, Lindsay Leung, Wing Llewellyn, Jennifer Kahn, Matthew Wright, David Jay Rao, Archana Use of CIED Generated Heart Failure Risk Score (HFRS) Alerts in an Integrated, Multi-Disciplinary Approach to HF Management—A Prospective Cohort Study |
title | Use of CIED Generated Heart Failure Risk Score (HFRS) Alerts in an Integrated, Multi-Disciplinary Approach to HF Management—A Prospective Cohort Study |
title_full | Use of CIED Generated Heart Failure Risk Score (HFRS) Alerts in an Integrated, Multi-Disciplinary Approach to HF Management—A Prospective Cohort Study |
title_fullStr | Use of CIED Generated Heart Failure Risk Score (HFRS) Alerts in an Integrated, Multi-Disciplinary Approach to HF Management—A Prospective Cohort Study |
title_full_unstemmed | Use of CIED Generated Heart Failure Risk Score (HFRS) Alerts in an Integrated, Multi-Disciplinary Approach to HF Management—A Prospective Cohort Study |
title_short | Use of CIED Generated Heart Failure Risk Score (HFRS) Alerts in an Integrated, Multi-Disciplinary Approach to HF Management—A Prospective Cohort Study |
title_sort | use of cied generated heart failure risk score (hfrs) alerts in an integrated, multi-disciplinary approach to hf management—a prospective cohort study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8914972/ https://www.ncbi.nlm.nih.gov/pubmed/35270971 http://dx.doi.org/10.3390/s22051825 |
work_keys_str_mv | AT garnerdaniel useofciedgeneratedheartfailureriskscorehfrsalertsinanintegratedmultidisciplinaryapproachtohfmanagementaprospectivecohortstudy AT luntlindsay useofciedgeneratedheartfailureriskscorehfrsalertsinanintegratedmultidisciplinaryapproachtohfmanagementaprospectivecohortstudy AT leungwing useofciedgeneratedheartfailureriskscorehfrsalertsinanintegratedmultidisciplinaryapproachtohfmanagementaprospectivecohortstudy AT llewellynjennifer useofciedgeneratedheartfailureriskscorehfrsalertsinanintegratedmultidisciplinaryapproachtohfmanagementaprospectivecohortstudy AT kahnmatthew useofciedgeneratedheartfailureriskscorehfrsalertsinanintegratedmultidisciplinaryapproachtohfmanagementaprospectivecohortstudy AT wrightdavidjay useofciedgeneratedheartfailureriskscorehfrsalertsinanintegratedmultidisciplinaryapproachtohfmanagementaprospectivecohortstudy AT raoarchana useofciedgeneratedheartfailureriskscorehfrsalertsinanintegratedmultidisciplinaryapproachtohfmanagementaprospectivecohortstudy |