Heart failure mortality prediction using PRISM score and development of a classification and regression tree model to refer patients for palliative care consultation
ConclusionOur study suggests PRISM score performed as well as modified SHFM for one-year mortality prediction. Moreover, the addition of modified SHFM to PRISM score increases discriminatory ability in predicting 1-year mortality in heart failure patients compared to either of the two models alone. Together, when combined in a CART model, they can be used to identify the population subset with the highest mortality risk and hence guide goals of care discussion.
Conclusions: Endovascular brachytherapy is a novel, safe and effective therapeutic modality for non-resectable primary cardiac sarcomas either for palliation of obstruction, or tumor mass reduction to allow complete resection. PMID: 31969917 [PubMed]
Today, people are living longer with heart disease while its prevalence is increasing. Historical trends that have limited the integration of palliative care in cardiology and HF care are shifting. Over the last 10 years, there has been growing evidence to support palliative care interventions for HF pat ients and their families, as well as integrating interdisciplinary HF, palliative care, and hospice. Patients with HF require complex pharmacological and self-care regimens to control symptoms and prevent recurrent hospitalizations.
Family caregivers (CGs) provide high levels of care to persons with advanced heart failure and are at high risk for distress and poor quality of life (QoL).
Palliative care (PC) for advanced stage heart failure (HF) is recommended by national organizations and guidelines, however there are few tested integrated HF PC models.
Heart failure (HF) often comes with high symptom burden and increased morbidity and mortality. Because the trajectory of HF is difficult to predict, however, the opportunity to refer patients to palliative care (PC) to clarify care preferences is often missed. Patient frailty is strongly associated with poorer prognosis and, thus, might be a useful trigger for referral of HF patients to PC for timely advance care planning.
Therapeutic yoga (TY) gently supports the body in therapeutic positions and may include relaxation breathing, comforting touch, and mindfulness meditation (MM). Evidence suggests that yoga, relaxation, and MM can help reduce anxiety, pain, nausea, and constipation. We piloted a feasibility project at a large New York teaching hospital to expand an established palliative care TY/MM program to include supportive cardiology patients. These are patients with advanced heart failure who are often awaiting (or have received) cardiac transplant, ventricular assistive devices, or total artificial heart support.
Use of long-term, continuous intravenous inotropic support (CIIS) has increased in prevalence over the past decade. Published evidence indicates that CIIS improves NYHA functional class but does not impact survival.
Guidelines recommend integration of palliative care (PC) in heart failure (HF), but little is known about factors associated with who completes PC interventions as designed and the most beneficial PC “dose” (i.e. amount, duration, frequency, intensity).
By GRACE CORDOVANO PhD, BCPA Being a patient or a carepartner can be a lonely, powerless place. There’s no high powered legal or lobbying team to help support you in your or your loved one’s health care journey. There’s no PR team at your beck and call. There’s no advisory board, no executive committee, no assistants, no chatbots or AI-powered technology coming to the rescue. There’s no funding or a company sponsoring your efforts. There’s no course in how to be a professional patient or carepartner. There’s no one there in the stillness and dark of the night, when you ...
Journal of Palliative Medicine, Ahead of Print.