INTRODUCTION Ischemic heart disease is the leading cause of death worldwide in hospitalized patients. Cardiovascular morbidity and mortality increases exponentially from 75 years-old . Approximately, 30% of patients admitted for acute myocardial infarction (AMI) are over 75 years old, and represent 50% of ischemic heart disease mortality [2,3]. Elderly patients have a higher risk for AMI short- and long-term mortality than younger patients [4,5]. On the other hand, nonagenarians with AMI non admitted to Coronary Care Unit (CCU) are increasing progressively . Factors associated with the admission decision are not clearly understood, and the evidence is scarce. Older patients non admitted to CCU are treated less frequently with invasive …show more content…
Mostly of previous studies in patients with AMI, applied the complete version of Charlson index [21,22]. In our work, we used the modified Charlson index , since it is simple and validated in elderly population- comcretely with AMI. A higher rate of the male gender and dyspnea in AMI elderly with comorbidity, has been consistently reported [21,22,30,31]. It could determine an underdiagnosis, undertreatment or therapeutic failure in clinical practice, which is frequent in patients with these basal characteristics. No differences were observed for psychofunctional basal status and principal prognostic factors, anyway limitations of the study (as discussed below) should be considered. The presence of comorbidity, did not an influence in short- and long-term mortality. It is controversial according to previous literature, because comorbidity is defined as a prognostic factor [32,33], as well as other studies demonstrate a poor prediction value in very elderly . Probably, the use of the modified Charlson index to assess comorbidity, would be more accurate to determine short-term mortality and other outcomes than long-term mortality. Furthermore, hemoglobin levels or anemia (that are not included in usual comorbidity indexes), perhaps have a stronger impact on …show more content…
In this sense, patients with associated comorbidity presented more frequently atypical symptoms at presentation, whereas in patients with an active functional status chest pain was the common initial symptom. Moreover, the impact of these factors on the coronary care decisions were different. Although comorbidity had no effects in the decision-making, dyspnea and basal functional status were major factors to determine CCU admission. Consequently, to detect patients with an active functional status and atypical presentation represents a challenge for clinicians, mainly in relation to patients with comorbidity in which this presentation is commonly observed., Furthermore, AMI in nonagenarians patients would be correctly assessed from a holistic point of view (biopshycosocial), due to the risk of misdiagnosis, mistreatment and prognosis repercussion. In this context, an accurate patient selection based on possible benefits of intensive treatment remains crucial. Future studies to define plausible selection criteria should be
Click here to unlock this and over one million essaysShow More
The Mt. Pleasant State Hospital, located in Mt. Pleasant, Iowa. The hospital was opened on February 26, 1861 under its original name of Iowa Lunatic Asylum. It was constructed between the years of 1855 and 1865. The asylum when it opened, became the first asylum that was public in Iowa. Mt. Pleasant also housed alcoholics and drug addicts.
This paper will discuss a more in depth look into the symptoms, diagnosis process, treatment options, medications, prognosis, and ongoing research. What
30 Day readmissions for CHF patients David Herbetko Thomas Jefferson University 30 Day readmissions for CHF patients Abstract Hospital readmissions are a prominent healthcare issue today. The Centers for Medicare and Medicaid Services are experiencing financial losses in the billions in regards to this patient population. Within the Patient Protection and Affordable Care Act, Section 3025 passed the Hospital Readmissions Reduction Program. This program identifies hospitals with large-scale readmission rates for patients within thirty days of discharge related to congestive heart failure, heart attack, and pneumonia, and marked them liable for the penalties of the program.
Chuc Tran T. Hollis-GInes ENG 101- Argumentative 23 October 2015 Physician-assisted Suicide The legalization of physician-assisted suicide has became an increasingly debatable topic in the United States today. The practice of assisted suicide pertains to a terminally ill patient who wants to end his or her life along with a physician’s acknowledgement of that patient’s desire to die.
Congestive Heart Failure Acute Decompensated Heart Failure (ADHF) is a clinical syndrome of worsening signs or symptoms of heart failure requiring hospitalization or other unscheduled medical care (Felker 2014). ADHF formerly known as congestive heart failure is one of the leading cause for hospitalizations in the United States. ADHF accounts for approximately 1 million hospitalizations per year in the United States (Arnold & Porepa 2012). According to the Acute Decompensated Heart Failure National Registry, patients hospitalized with ADHF have a substantial risk of in-hospital mortality and rehospitalization. Pathophysiology
Introduction With aging and disease comes many complications; the body is pushed to mental, physical, and emotional extremes. Many people experience pain and suffering with these changes and struggle to cope with it. Since the process of aging and the course of disease is a natural process it becomes a challenge to decide when enough is enough. Is palliative care enough or should assisted suicide be considered? Whether it be from the natural aging progression or onset of disease, the process of dying is inevitable and brings a variety of complications; therefore assisted suicide should be of consideration.
Ryan Hogan OT-525 9-21-15 While taking the health risk assessment I knew right from the start that some of the information would be off. The assessment asked about things such as blood pressure and cholesterol, and I do not know these measures right of the top of my head. While looking at the results, it stated that I am at risk of dying within the next 10 years. When comparing my risk percentages to the average 27 year old male, I did very well and was average compared to the others. However one factor that I scored above average on was the chance of a heart attack.
Assignment – There are five common purposes for medical records. List each of these purposes and provide an example of each in healthcare. Having good medical records is very important, for the proper care of patients. “Medical records can be used to manage healthcare, track healthcare, provide clinical data, meet regulatory requirements, and document healthcare” (Allen, 2013, P. 57). Without the proper documentation there is no proof that it was ever done.
Readmission causes vary between countries, regions and healthcare centers, at least part of them can be avoidable (3-5). In the US by the Centers for Medicare and Medicaid Services in 2009 readmission causes are reported for pneumonia, congestive heart failure, and acute myocardial infarction (6). Previous studies addressing the risk of readmission proposed risk models for specific
Introduction About the Institute of Population Health The Institute of Population Health (IPH) is a public health institute that is acting in place of the former Detroit Department of Health and Wellness Promotion. The mission of IPH is to advance positive health outcomes in populations and communities. IPH provides services in the areas of behavioral health, worksite health and wellness programs, specialized trainings, and community and consumer engagement which includes but is not limited to HIV counseling, testing and referral prevention. HIV Prevalence in Detroit, Michigan
Like on 12K, their population is usually renal failure to heart failure. The cardiac insult has led to the renal insult, and so there is a difference in medications they are using to repair the original problem. On medical, a lot of times it is sepsis, so you are not a cardiac indicator for what is happening and more antibiotics and that type of
They wanted to find the predictors that can lead to a longer, more healthy life with less dependency on extended care. Between 1955 and 1959 the study followed 270 subjects between the ages of 60 to 94 years. The researchers looked at a multitude of data through physical, mental, social and laboratory tests. They then retested the remaining 26 test subjects 25 years later and with the results they estimated the subject’s life