is There Any Evidence-based Medicine for the Very Old?
is There Any Evidence-based Medicine for the Very Old?
is There Any Evidence-based Medicine for the Very Old?
You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
Effects of a Multid<strong>is</strong>ciplinary Intervention to Prevent <strong>the</strong><br />
Readm<strong>is</strong>sion of Patients with Heart Failure<br />
(Washington University HF d<strong>is</strong>ease management trial)<br />
• Study group<br />
– 282 patients, selected among 1306<br />
– Mean age 79 ys; female, 65%<br />
– NYHA: 2.4 +1.1; EF: 41+13%<br />
• Randomization<br />
– Intervention vs control groups<br />
• Personnel<br />
– Nurse, dietician, social ass<strong>is</strong>tant,<br />
geriatrician, cardiolog<strong>is</strong>t<br />
• Follow-up<br />
– 90 days<br />
• Results<br />
– n.s. mortality<br />
– hospitalizations<br />
– costs ( $153/month/pt.)<br />
– compliance and quality of life<br />
60<br />
50<br />
40<br />
30<br />
20<br />
10<br />
0<br />
Control<br />
Intervention<br />
n.s.<br />
Mortality<br />
% patients Days/patient<br />
0.03<br />
> 1<br />
0.01<br />
> 2<br />
18<br />
16<br />
14<br />
12<br />
10<br />
8<br />
6<br />
4<br />
2<br />
Hospitalizations<br />
0.04<br />
0<br />
Days/patient<br />
Rich et al., NEJM 1995;333:1190
Change language