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Abstract 116: Improvements in the Medical Management and Survival of Patients Hospitalized with Heart Failure

2013· article· en· W2621835107 on OpenAlexaff
Samuel Joffe, David D. McManus, Matthew C. DeWolf, Jeffrey Shih, Michael S. Kiernan, Frederick A. Spencer, Darleen Lessard, Joel M. Gore, Robert J. Goldberg

Bibliographic record

VenueCirculation Cardiovascular Quality and Outcomes · 2013
Typearticle
Languageen
FieldMedicine
TopicHeart Failure Treatment and Management
Canadian institutionsMcMaster University
Fundersnot available
KeywordsMedicineHeart failureConcomitantDigoxinAspirinInternal medicineAcute decompensated heart failureMedical recordHospital readmissionDiseaseIntensive care medicineAnemiaEmergency medicine

Abstract

fetched live from OpenAlex

Background: Despite the availability of effective therapies, heart failure (HF) remains a highly prevalent, morbid and costly disease. Few data are available, however, describing long-term trends in the medical management and outcomes of patients hospitalized with acute decompensated heart failure (ADHF). Methods: We reviewed the medical records of 9,748 patients hospitalized with ADHF at all 11 central Massachusetts medical centers from 1995 to 2004, and abstracted information on patient’s demographic, clinical, and treatment characteristics. Mortality was calculated in-hospital and at 30 days and 1, 2, and 5 years after discharge. Results: Between 1995 and 2004 respectively, the use of recommended discharge medications including beta-blockers (26%; 74%), angiotensin pathway inhibitors (50%; 61%), statins (6%; 45%), and aspirin (40%; 63%) increased markedly, while the use of digoxin (55%; 33%), nitrates (68%; 47%), and calcium channel blockers (40%; 30%) declined significantly; nearly all patients received diuretics. Females, the elderly, and patients with chronic lung disease, anemia, incident HF, and multiple comorbidities were less likely to receive recommended medications than respective comparison groups. Between 1995 and 2004, in-hospital mortality decreased from 8.5% to 6.8%; 5-year survival increased from 19% to 28%, a relative improvement of 47%. Conclusion: The use of effective HF therapies increased markedly following the issuance of ACC-AHA guidelines for HF in 1995, with a concomitant increase in survival. Nonetheless, the prognosis for patients hospitalized with HF remains poor, as fewer than 1 in 3 patients survives 5 years. Opportunities exist to further improve the use of HF therapeutics.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.007
Threshold uncertainty score0.358

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.020
GPT teacher head0.276
Teacher spread0.257 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations0
Published2013
Admission routes1
Has abstractyes

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