Navigation Links
Validated pre-procedure risk score reduces bleeding complications and can shorten stays

A clinical decision support tool helped physicians identify patients at high risk of bleeding complications prior to undergoing a coronary intervention procedure and helped guide the use of bleeding avoidance strategies, leading to less complications and a shorter hospital stay, according to a study being presented March 10 at the American College of Cardiology Scientific Sessions.

More than 1.3 million percutaneous coronary interventions (PCIs) are performed each year in the United States. Bleeding during and after these procedures is a common risk (3 6%).

"Bleeding complications after PCI can lead to worse outcomes for the patient, including death, as well as an increase in the length of stay in the hospital, which leads to an increase in hospital costs," says the study's lead author Craig E. Strauss, MD, MPH, a research cardiologist at the Minneapolis Heart Institute Foundation and physician at the Minneapolis Heart Institute at Abbott Northwestern Hospital in Minneapolis.

Therefore, the cardiologists across the Allina Health System used a validated pre-PCI bleeding risk score to accurately identify high-risk patients, allowing them to employ strategies to avoid bleeding and improve patient outcomes. Among those strategies, bivalirudin (Angiomax, The Medicines Company) is a direct thrombin inhibitor that has been shown to reduce bleeding complications in PCI.

"This risk-stratification tool can be used real-time in the cath lab to identify and mitigate a patient's risk for bleeding around the time of the procedure," says Strauss. "The cath lab team uses a web-based calculator, which takes less than 1-2 minutes, and determines the risk category of each patient." Due to the ease of use, the tool achieved a high adoption rate of 92 percent at three high-volume PCI centers in Minnesota.

Among the 2,608 PCI cases performed at the three PCI centers, 24.4 percent of the patients were identified as high risk for bleeding complications. The use of bivalirudin as a bleeding avoidance strategy in high-risk patients increased from 24.2 percent pre-implementation of the risk-stratification protocol to 60.3 percent after the implementation of the protocol.

Among high bleeding risk patients, the researchers reported significant reductions in overall complications (22.8% vs. 14.9%), bleeding events within 72 hours (7.7% vs. 2.1%), and median length of hospital stay (2.9 vs. 2.3 days) following protocol implementation. There also was a reduction in the use of blood transfusions and death. Finally, the total variable costs decreased from approximately $15,000 to $14,200.

"This clinical decision support tool helps cardiologists objectively validate which patients are at high risk for bleeding complications based on existing evidence," Strauss says. "Previously, we could attempt to identify which patients were at risk based on clinical intuition, but this tool gives a much more accurate assessment, as shown through the improved patient outcomes. Furthermore, this tool can help reduce the variability in practice patterns among physicians that can be costly to the healthcare system."


Contact: Steve Goodyear
Minneapolis Heart Institute Foundation

Related medicine news :

1. First validated method for analyzing flavanols and procyanidins in cocoa products could help scientists and the industry in standardized reporting
2. Teleconcussion validated in Mayo Clinic case study
3. Study shows link between pre-pregnancy obesity and lower test scores
4. Delaying ADHD Meds Could Hurt Kids Math Scores
5. Kids Born Even a Little Early Have Lower School Scores: Study
6. Fit Brains, online portfolio of cognitive games, reaches milestone of 75 million brain scores
7. 2 NIH studies show power of epidemiology research; Underscore need to address health disparities
8. Smoking in pregnancy tied to lower reading scores
9. ACNP: Novel NMDA receptor modulator significantly reduces depression scores within hours
10. New Study Finds Eating More Produce Boosts Mental Health, Underscores Value of Health Enhancement Systems Approach
11. Score Points for Hosting a Healthy Super Bowl Party
Post Your Comments:
(Date:10/13/2015)... ... October 13, 2015 , ... Tempe Dental Care, a leading Tempe dentists’ office, ... IV sedation dentistry for more than 5 years. A leading cause of emergency ... painful if treatment is not timely. , Sedation dentistry provides an ...
(Date:10/13/2015)... Wyoming (PRWEB) , ... October 13, 2015 , ... Local ... the Gold’s Gym International Conference on August 26. Berry, who owns and operates ... standards for the fastest growing Gold’s Gyms in the United States. A brand leader ...
(Date:10/13/2015)... ... October 13, 2015 , ... Thermi, an award-winning and ... to introduce the latest development, ThermiVa® temperature controlled radiofrequency to the medical community. ... Obstetrics and Gynecology and a pioneer in the field of laparoscopy. On June ...
(Date:10/13/2015)... ... October 13, 2015 , ... In an ongoing effort ... , a Southlake, Texas, child development and pediatric therapy center, is working with ... families about their options for receiving this kind of care for affected children. ...
(Date:10/13/2015)... (PRWEB) , ... October 13, 2015 , ... Just under ... would-be customers, eMarketing Concepts began a $1 promotion – effectively offering all of their ... success, and within weeks the company was flooded with phone calls from interested buyers. ...
Breaking Medicine News(10 mins):
(Date:10/12/2015)... Va. , Oct. 12, 2015  Today, Divurgent is ... of Advisory Services. As a former CIO, Paul brings 15 ... not just understand or sympathize with today,s CIOs, he is ... the same challenges Paul has faced, and his new role ... in ensuring technology efficiencies across an organization. ...
(Date:10/12/2015)... DENVER , Oct. 12, 2015 Beginning ... ICD-10 Codes. Therapy Partner, the fastest growing practice management ... automated technology that easily converts all patient diagnostic codes ... --> --> ... Brief for all mental health practitioners to easily understand ...
(Date:10/12/2015)... INDIANAPOLIS , Oct. 12, 2015 Eli ... ACCELERATE study,s academic leadership have accepted the recommendation of ... 3 trial of the investigational medicine evacetrapib, due to ... the treatment of high-risk atherosclerotic cardiovascular disease and will ... --> --> The independent data ...
Breaking Medicine Technology: