Hospital Medicine Alert – October 1, 2017
October 1, 2017
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Advance Care Planning Must Advance Forward
In a systematic review of 795,909 people in 150 studies, researchers found many Americans have not completed an advance directive.
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Palliative Care-based Intervention Improves Quality of Life in Chronic Heart Failure
Among patients with advanced heart failure, implementation of an interdisciplinary palliative care intervention was associated with improved quality of life.
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Percutaneous Coronary Interventions in Nonagenarians
Nonagenarians can undergo percutaneous coronary interventions with low in-lab complication rates, but 30-day and one-year mortality is considerably higher than in younger patients.
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Frailty as a Patient Assessment Tool Prior to Aortic Valve Replacement
Assessment of frailty adds important prognostic information about risk of death and disability following both surgical aortic valve replacement and transcatheter aortic valve replacement. Among the available instruments for assessing frailty, a scale known as the Essential Frailty Toolkit demonstrated the best correlation with outcomes.
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Functional Outcomes After Receiving Life-sustaining Therapy in the ICU
Among patients who have spent at least three days in an ICU and required even brief mechanical ventilation and/or vasopressor support, almost half are dead and only one-third return to their baseline at six months. Several factors present on the first day of admission are associated with not returning to baseline status.