Chronic Intravenous Inotropic Support as Palliative Therapy and Bridge Therapy for Patients With Advanced Heart Failure: A Single-Center Experience
| Autor: | Selma F. Mohammed, Hasan Javed, Nancy A. Crowell, Farooq H. Sheikh, Sherry S. Gholami, Ahmad Hamad, Diana Stewart, Maria E. Rodrigo, Hunter Groninger, Shantal Gupta, Kelley M. Anderson, Samer S. Najjar, Mark Hofmeyer, Said Hajouli, Anirudh Rao |
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| Rok vydání: | 2021 |
| Předmět: |
musculoskeletal diseases
Inotrope medicine.medical_specialty Cardiotonic Agents Palliative care 030204 cardiovascular system & hematology Single Center 03 medical and health sciences 0302 clinical medicine medicine Humans 030212 general & internal medicine Stage (cooking) Retrospective Studies Heart Failure integumentary system business.industry Mortality rate Palliative Care Cardiovascular Agents Retrospective cohort study medicine.disease Bridge (graph theory) Heart failure Emergency medicine Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Cardiac Failure. 27:974-980 |
| ISSN: | 1071-9164 |
| Popis: | Background Many patients with American College of Cardiology/American Heart Association Stage D (advanced) heart failure are discharged home on chronic intravenous inotropic support (CIIS) as bridge to surgical therapy or as palliative therapy. This study analyzed the clinical trajectory of patients with advanced heart failure who were on home CIIS. Methods We conducted a single-institution, retrospective cohort study of patients on CIIS between 2010 and 2016 (n = 373), stratified by indication for initiation of inotropic support. Study outcomes were time from initiation of CIIS to cessation of therapy, time to death for patients who did not receive surgical therapy and rates of involvement with palliative care. Results Overall, patients received CIIS therapy for an average of 5.9 months (standard deviation [SD] 7.3). Patients on CIIS as palliative therapy died in an average of 6.2 months (SD 6.6) from the time of initiation of CIIS, and those on CIIS as bridge therapy who did not ultimately receive surgical therapy died after an average of 8.6 months (SD 9.3). Patients who received CIIS as bridge therapy were significantly less likely to receive palliative-care consultation than those on inotropes as palliative therapy, whether or not they underwent surgery. Conclusions In this large cohort of patients with advanced HF, patients who on CIIS as palliative therapy survived for 6.2 months, on average, with wide variation among patients. Patients who were on CIIS as bridge therapy but did not ultimately receive surgical therapy received less palliative care despite the high mortality rate in this subgroup. |
| Databáze: | OpenAIRE |
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