Risk stratification in unstable angina: prospective validation of the Braunwald classification

Article Abstract:

Four factors in the Braunwald classification for unstable angina as well as patient age and the coexistence of diabetes may independently predict the risk of major cardiac complications in patients with unstable angina. Braunwald's classification scheme is a scoring system for unstable angina that aids in diagnosis and patient management. Angina is chest pain. Researchers studied 393 patients with unstable angina who were admitted to coronary care units or intermediate care units. Twenty percent of these patients had major cardiac complications. Elements in the Braunwald classification that independently predicted the risk of major cardiac complications included having a heart attack within 14 days prior to admission, failure to receive a beta blocker or rate-lowering calcium channel blocker before admission, depression of the ST-segment on a baseline electrocardiogram, and the need for intravenous nitroglycerin on admission. Older patient age and the coexistence of diabetes were also significant predictors of major cardiac complications.

Models, Complications and side effects, Risk factors, Unstable angina, Heart diseases, Health risk assessment

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Critical care medicine

Article Abstract:

General infection (sepsis) and septic shock are the most common causes of death in intensive care units. Using antibiotics and fluids plus medication to contract capillaries and raise blood pressure is more effective than using either antibiotics or fluid plus medication therapy alone. Giving patients in septic shock antibodies against bacterial toxins can improve their outcome. Biotechnology techniques allow the manufacture of large amounts of antiendotoxin antibody. The survival rate from cardiac shock due to heart attack has not improved over time. This condition must be recognized early so that treatment can restore blood flow to the heart, preventing permanent damage. Extensive community cardiopulmonary resuscitation (CPR) education plus aggressive emergency medical teams can raise survival rates for patients with out-of-hospital heart attacks and ventricular fibrillation to 30%. If resuscitation has failed before arriving at the emergency room, the chances of survival are extremely low.

Innovations, Cardiac arrest

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Critical care medicine

Article Abstract:

Patients who are in shock often have low levels of oxygen, but supplying oxygen at supranormal levels only reduces mortality rates in patients who do not have sepsis. Antibodies against endotoxin and tumor necrosis factor have failed to improve survival rates in patients with septic shock. Several studies have tested models that predict which patients in intensive care units will survive. Some of the models were no more successful than the judgment of the physician. The models can estimate the probability of survival but this data may not be applicable to individual patients. In addition, it may be difficult to define inappropriate care.

Research, Critically ill

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