Navigation Links
Simple blood test at discharge could help reduce hospital readmissions for heart failure patients
Date:2/28/2011

An inexpensive, routine blood test could hold the key to why some patients with congestive heart failure do well after being discharged from the hospital and why others risk relapse, costly readmission or death within a year, new Johns Hopkins research suggests.

In a study reported online by the American Journal of Cardiology, Henry J. Michtalik, M.D., M.P.H., and his colleagues tested heart failure patients on admission and discharge for levels of a protein that's considered a marker for heart stress. In previous studies, the levels of this protein, N-terminal pro-B-type natriuretic peptide, or NT-proBNP, have been correlated with heart failure symptoms and have been associated with an increase in adverse outcomes.

They found that patients whose protein levels dropped by less than 50 percent over the course of their hospital stay were 57 percent more likely to be readmitted or die within a year than those whose levels dropped by a greater percentage.

Testing for NT-proBNP at the beginning and end of hospitalization, Michtalik says, could help doctors and hospitals make better decisions about which patients are truly ready to be released and which ones are at higher risk for relapse, readmission or worse. Typically, he adds, patients are already tested for this heart failure marker upon admission.

"These patients feel better. They look better. But this study suggests many of them may not be completely better," says Michtalik, a research and clinical fellow in the Johns Hopkins University School of Medicine's Division of General Internal Medicine. "Even though a doctor has determined the patient is ready to go home, a change in this biological marker of less than 50 percent means the patients are at much higher risk and would likely benefit from more intensive treatment, monitoring or outpatient follow up."

Congestive heart failure occurs when the heart can't pump enough blood to meet the demands of the body, resulting in heart enlargement and fluid swelling. It is most often caused by coronary artery disease, high blood pressure, heart valve disease and alcohol abuse. Roughly 5.7 million people in the United States have heart failure, which kills about 300,000 each year, and results in repeat hospitalizations for many patients. Readmission rates are a focus of efforts to reduce health care costs, Michtalik notes.

Michtalik and his colleagues studied 241 heart failure patients admitted to The Johns Hopkins Hospital between June 2006 and April 2007 who were treated with intravenous diuretics to remove fluid from the body.

Within the first 24 hours, blood was drawn from the patients and tested for NT-proBNP, and patients were treated for their symptoms by their individual doctors. Though the patients' NT-proBNP levels were tested again at discharge, the decision for or against discharge was determined by clinical judgment alone and the treating physicians were not aware of the protein's level at discharge.

Analysis showed that patients whose protein levels decreased by less than 50 percent over the course of the several days to a week that they were in the hospital were at the highest risk for readmission or death.

"Our research suggests that maybe clinical judgment isn't enough to decide whether a heart failure patient is ready to be discharged," he says. "These patients may benefit from being treated until the heart failure marker, NT-proBNP, decreases by a certain percentage, something that is not considered now."

Michtalik says a good next step would be a prospective randomized trial that examines whether hospitalized heart failure patients do better when their doctors work intensively to decrease the heart failure marker over the course of their hospital stays.


'/>"/>

Contact: Stephanie Desmon
sdesmon1@jhmi.edu
410-955-8665
Johns Hopkins Medical Institutions
Source:Eurekalert

Related medicine news :

1. Radio-guided surgery a safe and simple way to remove potentially cancerous nodules in the lung
2. Simple spit and blood tests might detect burnout before it happens
3. Quick, Simple Test Can Detect Concussion in Athletes
4. Toward a fast, simple test for detecting cholera rampaging in 40 countries
5. Simple feedback could be effective therapy for addictive behaviors
6. Simple Screen May Help Spot Depression in College Students
7. Wounded Congresswoman Responds to Simple Commands
8. Simple fingertip test may identify breast cancer patients at risk for carpal tunnel syndrome
9. Simple Travel Tips Can Help Keep Pets Safe
10. Simple tools help parents understand a childs risk of obesity, make positive changes
11. Simpler and cheaper antibiotic prophylaxis with insertion of nutrition catheter in the stomach
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/6/2016)... ... May 06, 2016 , ... Norwood Insurance Group, serving ... beneficiary of their ongoing community enrichment program. The current campaign is being extended ... faces many more months of treatments, leaving his family in great need of ...
(Date:5/6/2016)... ... May 06, 2016 , ... US Sports Camps has ... camp held at Oregon State University this summer. Employing world-class rugby figures, including former ... all skill levels with training on key fundamentals, match play, fitness and more. , ...
(Date:5/6/2016)... ... ... Logically, spring weather, with its moderate humidity and temperatures, should be ideal ... hot, water on the eye surface can evaporate, creating uncomfortable dry eye symptoms. In ... one problem, according to radio show and water advocate Sharon Kleyne: Spring is also ...
(Date:5/6/2016)... ... May 06, 2016 , ... The International Yoga Teacher Training schoo ... of the island close to the town famous for its sunsets, Oia. This all ... “We continue to have an amazing experience in Greece, we just can’t stay away” ...
(Date:5/6/2016)... ... 2016 , ... In honor of Military Spouse Appreciation Day ... the National Military Family Association, a nonprofit that works to strengthen and protect ... recipient of 2016. , “Being awarded this scholarship by Career Step, is ...
Breaking Medicine News(10 mins):
(Date:5/5/2016)... 2016 Global NASH market ... with rise in obesity will fuel the demand ... few years. The NASH Market is growing at ... account of rising number of obesity among young ... market with no FDA approved therapeutics. Antioxidants, anti-diabetic ...
(Date:5/5/2016)... DUBLIN , May 5, 2016  Endo ... ENL) today announced that Brian Lortie , ... down from his position upon the appointment of ... and led its U.S. Pharmaceuticals business with responsibility ... sales and marketing, strategy and portfolio development, commercial ...
(Date:5/5/2016)... 2016 , First quarter 2016 ... of $964 million , First quarter reported ... , Company revises 2016 financial guidance; now ... billion and 2016 adjusted diluted non-GAAP earnings per share to ... provides updates regarding Generics business and manufacturing facility restructuring ...
Breaking Medicine Technology: