Deborah Budge

TL;DR: An innovative and inexpensive method of detecting significant differences between open and closed AV is described and patients with open AV are shown to have higher average wave amplitudes, and took a larger percentage of time to reach max amplitude as shown by the skewness.

Abstract: OBJECTIVE Develop and evaluate an automated identification and predictive risk report for hospitalized heart failure (HF) patients. METHODS Dictated free-text reports from the previous 24 h were analyzed each day with natural language processing (NLP), to help improve the early identification of hospitalized patients with HF. A second application that uses an Intermountain Healthcare-developed predictive score to determine each HF patient's risk for 30-day hospital readmission and 30-day mortality was also developed. That information was included in an identification and predictive risk report, which was evaluated at a 354-bed hospital that treats high-risk HF patients. RESULTS The addition of NLP-identified HF patients increased the identification score's sensitivity from 82.6% to 95.3% and its specificity from 82.7% to 97.5%, and the model's positive predictive value is 97.45%. Daily multidisciplinary discharge planning meetings are now based on the information provided by the HF identification and predictive report, and clinician's review of potential HF admissions takes less time compared to the previously used manual methodology (10 vs 40 min). An evaluation of the use of the HF predictive report identified a significant reduction in 30-day mortality and a significant increase in patient discharges to home care instead of to a specialized nursing facility. CONCLUSIONS Using clinical decision support to help identify HF patients and automatically calculating their 30-day all-cause readmission and 30-day mortality risks, coupled with a multidisciplinary care process pathway, was found to be an effective process to improve HF patient identification, significantly reduce 30-day mortality, and significantly increase patient discharges to home care.

TL;DR: While recovery of ventricular function is the usual course, some PPCM patients will continue to have left ventricular dysfunction and whether these patients experience worse outcomes is underreported.

TL;DR: Left ventricular assist devices (LVADs) have proven beneficial for the treatment of advanced heart failure, however infection remains a common cause of morbidity and mortality, and the effects of material and size on DLES healing were examined.