Mortality risk score in patients with heart failure in populations with Chagas prevalence: short term decisions implications of high complexity procedures

• Grant number: 09/07162-0
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• Start date: September 01, 2009
• End date: August 31, 2011
• Field of knowledge: Health Sciences - Medicine
• Principal Investigator: Edimar Alcides Bocchi
• Grantee: José Ramón Lanz Luces
• Host Institution: Instituto do Coração Professor Euryclides de Jesus Zerbini (INCOR). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil

Abstract

Actual public health requires efficacious politics that aim a correct administration of government resources. In order to minimize costs and to bring better efficacy in treating complex procedures we search to create technologies, or data bases, generating mathematical equations or risk score which could be broadly use and in a daily basis by the different health care units who evaluates patients with heart failure. In a main context, heart failure is a syndrome which is a common final way of most cardiac diseases and for this is the high relevance on every health politics that pretends to ameliorate the principal outcomes in these type of patients. This kind of programs is only possible by the informatization of data and the inclusion of multidisciplinary groups in the evaluation of this particular patient. Actually, the Seattle score is worldwide used, showing its utility in patients with heart failure. Nevertheless, is lack of prognosis information regarding patients derived from an ambulatory setup, mainly due because its stratification was done base on patients from trials, additionally does not have any further prognosis for heart failure patients with Chagas. To have a better control of patient data in ambulatory patients will reach broadly over integral politics made treating heart failure in every day practice by local hospitals, with a subsequent diminution over mortality rates, that could be possible by the determination of cut off values that help to optimize pre-transplants in populations with Chagas prevalence. The study will be a rare opportunity in creating politics with accuracy previously to highly complex procedures, such as heart transplant by determining the ideal time to indicate the procedure, beneficing all the existing groups. As a device, we plan to use premiered tools, such as the SIS3 system, created in the Heart Institute of São Paulo (InCor) and adapt it to our special conditions in this project. The team will be lead by professor Edimar Bocchi, Chief of the heart failure unit of the InCor, Marco Antonio Gutierrez, chief director of technology and informatics and executed by a pos doc student, Dr. José Ramón Lanz Luces, beside a team of physicians from the heart failure ambulatory unit and additionally will be open a place to be cover as scientific initiation. The project will hit initially on health costs, parallel will permit to the physician to determine throughout the risk score prognosis stratification within his ambulatory, and on the heart transplant units will optimized the time in which the patient should receive the organ with concomitant mortality reduction, mainly avoiding the mortality that happens waiting transplant. An adequacy management of this type of information would create further solid bases to a national registry by unifying criteria over different heart units. (AU)