An Evaluation of the Prevalence and Severity of Pain and Other Symptoms in Acute Decompensated Heart Failure

Shah, Ankit B.; Udeoji, Dioma U.; Baraghoush, Afshan; Bharadwaj, Parag; Yennurajalingam, Sriram; Schwarz, Ernst R.

doi:10.1089/jpm.2012.0248

Cited by 40 publications

(25 citation statements)

References 22 publications

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“…Supplemental Table 6 provides criteria from multiple acute HF, global HF, and non-HF sources to aid in determining the timing of consultation in CS. 15,278,[295][296][297][298][299][300][301][302][303][304][305][306][307][308][309][310] We suggest that the multidisciplinary assessment team include a palliative care physician, regardless of MCS candidacy, given the risk of peri-implantation death.…”

Section: Suggestions For Clinical Carementioning

confidence: 99%

Contemporary Management of Cardiogenic Shock: A Scientific Statement From the American Heart Association

Diepen¹,

Katz²,

Albert³

et al. 2017

Circulation

1,282

1,165

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Cardiogenic shock is a high-acuity, potentially complex, and hemodynamically diverse state of end-organ hypoperfusion that is frequently associated with multisystem organ failure. Despite improving survival in recent years, patient morbidity and mortality remain high, and there are few evidence-based therapeutic interventions known to clearly improve patient outcomes. This scientific statement on cardiogenic shock summarizes the epidemiology, pathophysiology, causes, and outcomes of cardiogenic shock; reviews contemporary best medical, surgical, mechanical circulatory support, and palliative care practices; advocates for the development of regionalized systems of care; and outlines future research priorities. Cardiogenic shock (CS) is a low-cardiac-output state resulting in life-threatening end-organ hypoperfusion and hypoxia.1,2 Acute myocardial infarction (MI) with left ventricular (LV) dysfunction remains the most frequent cause of CS. 1,3 Advances in reperfusion therapy have been associated with improvements in survival, but significant regional disparities in evidence-based care have been reported, and in-hospital mortality remains high (27%-51%).1,4-9 Management recommendations are distributed between disease-specific statements and guidelines, and a dedicated and comprehensive clinical resource in this area is lacking. Thus, consolidating the evidence to define contemporary best medical and surgical CS practices for both MI-associated CS and other types of CS may be an important step in knowledge translation to help attenuate disparities in evidence-based care.Regional systems of care coupled with treatment algorithms have improved survival in high-acuity time-sensitive conditions such as MI, out-of-hospital cardiac arrest (OHCA), and trauma.10-12 Applying a similar framework to CS management may lead to similar improvements in survival, and CS systems of care are emerging within existing regional cardiovascular emergency care networks; however, guidance from a national expert group on structure and systems of care has not been available. 13,14 Accordingly, the purposes of this American Heart Association (AHA) scientific statement on CS are to summarize our contemporary understanding of the epidemiology, pathophysiology, and in-hospital best care practices into a single clinical resource document; to suggest a stepwise management algorithm that integrates medical, surgical, and mechanical circulatory support (MCS) therapies; and to propose a Mission: Lifelinesupported pathway for the development of integrated regionalized CS systems of care. DEFINITION OF CSAcute cardiac hemodynamic instability may result from disorders that impair function of the myocardium, valves, conduction system, or pericardium, either in isolation HISTORICAL PERSPECTIVESBefore the routine use of early revascularization, MIassociated CS had an in-hospital mortality exceeding 80%. A registry trial of 250 patients with acute MI described the association between bedside physical examination (Killip classification) for the as...

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Section: Suggestions For Clinical Carementioning

confidence: 99%

Contemporary Management of Cardiogenic Shock: A Scientific Statement From the American Heart Association

Diepen¹,

Katz²,

Albert³

et al. 2017

Circulation

1,282

1,165

View full text Add to dashboard Cite

show abstract

“…(17) Within other branches of oncology, ESAS has been used by medical oncologists,(59, 60) radiation oncologists,(61) surgical oncologists,(62, 63) and gynecological oncologists. (64, 65) Outside of oncology, ESAS has also been adopted for symptom assessment in patients with kidney diseases,(66, 67) heart failure,(68, 69) pulmonary disorders,(70) hepatic diseases,(71) and sickle cell anemia. (72)…”

Section: Present Applicationsmentioning

confidence: 99%

The Edmonton Symptom Assessment System 25 Years Later: Past, Present, and Future Developments

Hui

Bruera

2017

Journal of Pain and Symptom Management

537

428

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Context Routine symptom assessment represents the cornerstone of symptom management. ESAS is one of the first quantitative symptom assessment batteries that allows for simple and rapid documentation of multiple patient-reported symptoms at the same time. Objective To discuss the historical development of ESAS, its current uses in different settings, and future developments. Methods Narrative review Results Since its development in 1991, ESAS has been psychometrically validated and translated into over 20 languages. We will discuss the variations, advantages and limitations with ESAS. From the clinical perspective, ESAS is now commonly used for symptom screening and longitudinal monitoring in patients seen by palliative care, oncology, nephrology, and other disciplines in both inpatient and outpatient settings. From the research perspective, ESAS has offered important insights into the nature of symptom trajectory, symptom clusters and symptom modulators. Furthermore, multiple clinical studies have incorporated ESAS as a study outcome and documented the impact of various interventions on symptom burden. On the horizon, multiple groups are actively investigating further refinements to ESAS, such as incorporating it in electronic health records, employing ESAS as a trigger for palliative care referral, and coupling ESAS with personalized symptom goals to optimize symptom response assessment. Conclusion ESAS has evolved over the past 25 years to become an important symptom assessment instrument in both clinical practice and research. Future efforts are needed to standardize this tool and explore its full potential to support symptom management.

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“…1 Chronic pain in people hospitalized with HF was reported as 60% at one hospital. 2 Chronic pain is associated with multiple negative consequences that include increased depression 3 and decreased physical activity, 4 both of which increase burden and further reduce the quality of life for people living with HF. 5 Non-cardiac pain reported by people with HF ranges in intensity, and pain interference with activity from mild 6 to severe, with severe ratings reported by 38.9%.…”

Section: Introductionmentioning

confidence: 99%

A closer look: Alternative pain management practices by heart failure patients with chronic pain

McDonald

Soutar

Chan³

et al. 2015

Heart & Lung

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An Evaluation of the Prevalence and Severity of Pain and Other Symptoms in Acute Decompensated Heart Failure

Abstract: Pain is a common, underrecognized symptom in patients with chronic but acute decompensated heart failure. Decreased well-being, shortness of breath, and tiredness are the most common and severe symptoms in patients with chronic heart failure, regardless of ejection fraction.

Cited by 40 publications

References 22 publications

Contemporary Management of Cardiogenic Shock: A Scientific Statement From the American Heart Association

Contemporary Management of Cardiogenic Shock: A Scientific Statement From the American Heart Association

The Edmonton Symptom Assessment System 25 Years Later: Past, Present, and Future Developments

A closer look: Alternative pain management practices by heart failure patients with chronic pain

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