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Severity of heart failure in elderly can be measured with a seven-point system

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  • low sodium in the blood (an indication of neurohormonal imbalance)

  • high urea in the blood (a reflection of poor cardiac output that affects kidney function)

  • low blood pressure (a result of weakened heart function).

  • The study, published in the September 25th issue of the Archives of Internal Medicine, showed that patients with four or more of the risk factors had a low probability of surviving longer than six months. But if patients had none or just one of the factors, they had a good chance of living five years or more. Patients with two to three factors were likely to live at least a year. The patients in the study received a variety of treatments as determined by their physicians.

    'The system is easy to use, and the variables don't require any specialized testing — they are part of routine medical histories or basic lab tests,' Rich says. 'If the system can be validated by further studies, it can play a role in helping physicians tailor care to individual patients. If a person has a limited life expectancy, it may not be in his or her best interest to recommend invasive, uncomfortable or risky procedures. On the other hand, an elderly person with only one risk factor could potentially be considered a good candidate for an aggressive treatment such as a defibrillator.'

    Other factors that might have been expected to affect survival, such as the amount of blood the heart can eject during pumping or a patient's body mass index, didn't seem to influence survival times. Rich emphasizes that each of the factors identified has been linked in previous studies to poor prognosis in heart failure patients.

    'We didn't find any new risk factors, which means there's good data to support that these factors truly are predictive,' Rich says. 'We've pinpointed the seven that are the most predictive and shown that the number of risk factors can give a reasonable estimate of the probability
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