1 / 22

Enhancing Patient Outcomes with Advanced Devices: A Comparative Analysis

This study examines the impact of current devices in heart and lung transplantation, focusing on outcomes, device strategies, and quality of life indicators. It analyzes data from two sources for improved understanding.

adam-williamson
Download Presentation

Enhancing Patient Outcomes with Advanced Devices: A Comparative Analysis

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Outcomes With Current Devices Are We Really Improving?

  2. 2005 ISHLT J Heart Lung Transplant 2005;24:1182-1187 ISHLT/MCSD Analysis, n=655 Intention to Treat n % of 655 Bridge to transplant 513 78.3% Bridge to recovery 35 5.3% Destination Therapy 78 11.9% Not specified 29 4.4% Total 655 100%

  3. INTERMACS: March 2006 – March 2008, n = 483 Device Strategy at Implant % Bridge to Recovery 27 5 % Bridge to Transplant 460 80 % Destination Therapy 90 15 % Total 483 100 %

  4. Quality of Live

  5. ISHLT/MCSD Analysis Infection Episodes (n=668) 175 Cumulative Events per 100 Patients Bleeding Episodes (n=396) 75 Thromboembolism Episodes (n=86) 18 Months after Device Implant

  6. INTERMACS first DATABASEBUT: • No standardized INDICATIONS • NO consensus between different CENTERS • Different VADs

  7. Personal experience with INCOR(14 pts) 5 transplanted 9 non trasplanted 4 died 1 perioperative 5 months 14 months 35 months 4 on going 1 recovery

  8. Personal experience with INCOR • Less neurological problems (more aggressive anticoagulation protocol) • High infective risk • Good Quality of Live

  9. Indications Devices Cultural IMPROVING

  10. INDICATIONS SHORT-TERM LONG-TERM • Bridge to Recovery • Bridge to Bridge • Bridge to TxC • Destination Therapy

  11. VAD as DIALYSIS

  12. VAD as CRT

  13. CULTURAL IMPROOVEMENT

  14. Patients Is it only a prosthesis?

  15. VAD CANDIDATES 282 CHF pts tx Medical therapy No Tx 3.5%

  16. VAD CANDIDATES in ITALY 129309 140000 120000 63985 pts x 3.5% = 2239 pts 100000 80000 60000 43183 40000 18661 20000 164 169 164 1644 0 < 1 1 - 14 15 - 24 25 - 44 45 - 64 65 - 74 >= 75

  17. Health providers Devices Batteries Hospital Ambulatory Follow up and manteinance VADs had to be paid for 3-5 years Who pays?

  18. today And tomorrow?

  19. The Value of Medical Spendingin the United States, 1960 –2000N Engl J Med 2006;355:920-7. Causes of Increases in Life Expectancy among Newborns, 1960–2000. Cause Increase in Life Relative Expectancy Contribution yr % Reduction in rate of death from cardiovascular disease 4.88 70 Reduction in rate of death in infancy 1.35 19 Reduction in rate of death from external causes 0.36 5 Reduction in rate of death from pneumonia or influenza 0.28 4 Reduction in rate of death from cancer 0.19 3 Total 6.97 100

More Related