Comorbidity and Functional Outcomes in Older Patients with Heart Failure

老年心力衰竭患者的合并症和功能结果

• 批准号: 8265260
• 负责人: Sarwat I Chaudhry
• 金额: $ 7.73万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-08-01 至 2014-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8265260
• 关键词: Activities of Daily Living; Address; Adherence; Affect; Age; Aging; Area; Award; Behavior; Body Weight; Cardiovascular system; Caring; Chronic; Chronic Disease; Chronic Kidney Insufficiency; Chronic Obstructive Airway Disease; Clinical; Clinical Research; Cognition; Comorbidity; Coronary Arteriosclerosis; Data; Data Analyses; Data Set; Dementia; Development; Diabetes Mellitus; Diagnosis; Disease; Elderly; Epidemiology; Evaluation; Future; Generations; Goals; Health; Healthcare; Healthcare Systems; Hearing; Hearing Aids; Heart failure; High Prevalence; Hospitalization; Hospitals; Impaired cognition; Impairment; Individual; Intervention; Kidney Failure; Lead; Literature; Maintenance; Measurement; Measures; Medical; Medicine; Mental Depression; Mentors; Modeling; NCI Scholars Program; Outcome; Patient Care; Patients; Persons; Pharmaceutical Preparations; Physical Capacity; Population; Population Study; Prospective Studies; Psychotherapy; Public Health; Quality Indicator; Regimen; Relative (related person); Research; Research Personnel; Self Care; Services; Signs and Symptoms; Sodium-Restricted Diet; Syndrome; System; Testing; Time; Vision; Wood material; Work; aged; base; career development; clinical care; clinical practice; comparison group; critical period; data management; depressive symptoms; design; disability; follow-up; functional decline; functional disability; functional outcomes; functional status; hearing impairment; improved; inattention; indexing; knowledge base; mortality; next generation; older patient; outcome forecast; programs; psychologic; research study

PROJECT SUMMARY: Heart failure (HF) is the number one cause of hospitalization among persons aged 65 years or older; yet our medical system has been slow to develop strategies to optimize the care of older patients with HF. The traditional disease-oriented model, which underlies most HF research and clinical care, focuses on individual diseases. This model fails to consider the broad spectrum of comorbidity, which includes impairments (in physical capacity, cognition, vision, hearing and psychological status) that often burden older patients with HF. These impairments may impede the ability of older patients to manage their illness, yet comorbid impairments remain largely invisible within the HF literature and quality indicators. Over the course of this 5-year award, Dr. Chaudhry will conduct two projects to enhance the scientific knowledge base about how comorbid impairments and diseases affect the functional outcomes of older patients with HF. In the first project, she will analyze data from the Cardiovascular Health Study (which now has over 10 years of follow-up) to compare the long-term functional outcomes of older persons with and without HF, and determine the relative contributions of comorbid impairments and diseases to the onset of functional disability. In the second project, she will conduct a prospective study to characterize the burden of comorbid impairments and diseases in older patients at the time of HF hospitalization and evaluate the relationship of these comorbidities to functional decline after hospital discharge. To enhance her career development, Dr. Chaudhry will complete formal coursework in chronic disease epidemiology, longitudinal data analysis, and data management. These activities, combined with the guidance of mentors from the Yale Program on Aging/Pepper Center and Robert Wood Johnson Clinical Scholars Program, will enable Dr. Chaudhry to establish an independent research program to improve the care of older patients with HF. RELEVANCE: Despite the billions of dollars spent each year caring for older patients with HF, outcomes have not improved in this population over the past decade. The results of the proposed research have the potential to fundamentally change our understanding of HF from an isolated disease to a true cardiogeriatric syndrome. Ultimately, these results will help to guide the development of more "gerocentric" HF care based on routine management of comorbid impairments, and to inform the next generation of HF quality indicators.

项目摘要：心力衰竭 (HF) 是老年人住院的第一大原因 65岁或以上；然而，我们的医疗系统在制定优化老年人护理的策略方面进展缓慢 心力衰竭患者。传统的以疾病为导向的模式是大多数心力衰竭研究和临床护理的基础， 专注于个体疾病。该模型未能考虑广泛的合并症， 包括经常出现的损伤（身体能力、认知、视力、听力和心理状态） 老年心力衰竭患者的负担。这些障碍可能会妨碍老年患者管理自己的能力 疾病，但合并症损伤在心力衰竭文献和质量指标中仍然基本上不可见。 在这个为期 5 年的奖项期间，乔杜里博士将开展两个项目，以加强科学 关于共病障碍和疾病如何影响老年人功能结果的知识库 心力衰竭患者。在第一个项目中，她将分析心血管健康研究的数据（现在该研究 有超过 10 年的随访）来比较老年人的长期功能结果 无心力衰竭，并确定共病损伤和疾病对心力衰竭发作的相对影响 功能障碍。在第二个项目中，她将进行一项前瞻性研究来描述 心力衰竭住院时老年患者的共病损伤和疾病，并评估 这些合并症与出院后功能下降的关系。为了提升她的事业 发展，乔杜里博士将完成慢性病流行病学、纵向 数据分析、数据管理。这些活动，结合耶鲁大学导师的指导 衰老/胡椒中心项目和罗伯特·伍德·约翰逊临床学者计划将使博士能够成为可能。 乔杜里建立一个独立的研究计划来改善老年心力衰竭患者的护理。 相关性：尽管每年花费数十亿美元来照顾老年心力衰竭患者，但结果 过去十年来，这一人群的情况并没有改善。拟议研究的结果有 有可能从根本上改变我们对心力衰竭的理解，从一种孤立的疾病转变为一种真正的心脏病学 综合症。最终，这些结果将有助于指导更加“以老年人为中心”的心力衰竭护理的发展 共病损伤的常规管理，并为下一代心力衰竭质量指标提供信息。

项目成果

Do age and comorbidity affect intensity of pharmacological therapy for poorly controlled diabetes mellitus?

年龄和合并症是否会影响控制不佳的糖尿病的药物治疗强度？

• DOI: 10.1111/j.1532-5415.2005.53370.x
• 发表时间: 2005
• 期刊: Journal of the American Geriatrics Society
• 影响因子: 6.3
• 作者: Chaudhry,SarwatI;Berlowitz,DanR;Concato,John
• 通讯作者: Concato,John

The Reply.

回复。

• DOI: 10.1016/j.amjmed.2017.12.043
• 发表时间: 2018
• 期刊: The American journal of medicine
• 作者: Vaduganathan,Muthiah;Qamar,Arman;Gupta,Ankur;Bajaj,Navkaranbir;Golwala,HarshB;Pandey,Ambarish;Bhatt,DeepakL
• 通讯作者: Bhatt,DeepakL

Detection of errors by attending physicians on a general medicine service.

由主治医生在一般医疗服务中发现错误。

• DOI: 10.1046/j.1525-1497.2003.20919.x
• 发表时间: 2003
• 期刊: Journal of general internal medicine
• 影响因子: 5.7
• 作者: Chaudhry,SarwatI;Olofinboba,KolawoleA;Krumholz,HarlanM
• 通讯作者: Krumholz,HarlanM