Hospital Readmission Alert for Heart Failure Patients

• US 20110009760A1
• Filed: 05/26/2010
• Published: 01/13/2011
• Est. Priority Date: 07/10/2009
• Status: Abandoned Application

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Zhang, Yi, Averina, Viktoria A.
• Application Number:
  US12/787,789
• Publication Number:
  US 20110009760A1
• Time in Patent Office: Days
• US Class Current: 600/529
• CPC Class Codes: A61B 5/08 Detecting, measuring or recording devices for evaluating the respiratory organs A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/7275 Determining trends in physiological measurement data; Predicting development of a medical condition based on physiological measurements, e.g. determining a risk factor
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 40/67 for remote operation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment

Abstract

Physiologic data is collected for a heart failure patient during hospitalization and after discharge of the heart failure patient from a hospital, and analyzed for a change in the collected physiologic data. Deterioration of the patient'"'"'s heart failure status is detected based at least in part on detecting an acute deleterious change in the collected physiologic data indicative of an abnormality in one or more physiologic parameters represented by the physiologic data. A readmission alert is generated in response to the acute deleterious change in the collected physiologic data. The readmission alert indicates that further deterioration in the patient'"'"'s heart failure status may require readmission of the patient to the hospital.

Claims

1. A method, comprising:

collecting respiration data for a heart failure patient at least during hospitalization and a time after discharge of the heart failure patient from a hospital;

measuring, using the collected respiration data, a median respiration rate (MedRR) and a maximum respiration rate (MaxRR);

analyzing the MedRR and MaxRR for a change in the MedRR and MaxRR;

detecting further deterioration of the patient'"'"'s heart failure status based at least in part on detecting an acute deleterious change in the MedRR and MaxRR indicative of an abnormality in MedRR and MaxRR; and

generating a readmission alert in response to detecting the acute deleterious change in the MedRR and MaxRR, the readmission alert indicating that the further deterioration in the patient'"'"'s heart failure status may require readmission of the patient to the hospital.

2. The method of claim 1, wherein:

detecting further deterioration of the patient'"'"'s heart failure status comprises;

determining whether the acute deleterious change in the MedRR exceeds a first threshold; and

determining whether the acute deleterious change in the MaxRR exceeds a second threshold; and

generating the readmission alert comprises generating the readmission alert in response to the acute deleterious change in the MedRR and MaxRR exceeding the first and second thresholds, respectively.

3. The method of claim 2, wherein:

the first threshold is developed using the MedRR collected before discharge of the heart failure patient from the hospital;

determining whether the acute deleterious change in the MedRR exceeds the first threshold is based on a comparison of at least an MedRR collected after discharge of the heart failure patient from the hospital relative to the MedRR collected before discharge;

the second threshold is developed using the MaxRR collected before discharge of the heart failure patient from the hospital; and

determining whether the acute deleterious change in the MaxRR exceeds the second threshold is based on a comparison of at least a MaxRR collected after discharge of the heart failure patient from the hospital relative to the MaxRR collected before discharge.

4. The method of claim 2, wherein each of the first and second thresholds is developed using respiration data collected during a specified period of time prior to patient discharge from the hospital, and the acute deleterious change in the MedRR and MaxRR is detected within about one day to about two months after patient discharge from the hospital.

5. The method of claim 2, wherein each of the first and second thresholds is developed using respiration data collected during a specified period of time prior to patient discharge from the hospital, and the acute deleterious change in the MedRR and MaxRR is detected within about one day to about one month after patient discharge from the hospital.

6. The method of claim 1, comprising:

developing a baseline and a threshold for each of the MedRR and MaxRR using respiration data collected during hospitalization of the heart failure patient;

measuring the MedRR and the MaxRR after discharge of the heart failure patient from the hospital; and

detecting further deterioration of the patient'"'"'s heart failure status is based at least in part on detecting an acute deleterious change in the post-discharge MedRR and MaxRR relative to their respective baselines and thresholds.

7. The method of claim 6, comprising receiving a discharge notification associated with a time of heart failure patient discharge from the hospital, and using the discharge notification to distinguish between respiration data collected during hospitalization and respiration data collected after discharge of the heart failure patient from the hospital.

8. The method of claim 1, comprising:

collecting patient activity data for the patient; and

generating the readmission alert in response to the acute deleterious change in the MedRR and MaxRR and the patient activity data indicating that the patient is not engaged in patient activity.

9. The method of claim 1, comprising:

measuring, using the respiration data, a minimum respiration rate (MinRR);

analyzing the MinRR for a change in the MinRR; and

generating the readmission alert in response to the acute deleterious change in the MedRR and MaxRR and a substantially non-elevated MinRR.

10. The method of claim 1, wherein collecting, analyzing, detecting, and generating processes are performed by a medical device implanted in the patient.

11. The method of claim 1, comprising communicating the readmission alert to a network server for access by a clinician.

22. The system of claim 21, wherein the processor executes program instructions that configure the processor to perform any of the processes of claim 1 through claim 11.

12. A method, comprising:

collecting physiologic data for a heart failure patient at least during hospitalization and a time after discharge of the heart failure patient from a hospital;

analyzing the collected physiologic data for a change in the collected physiologic data;

detecting further deterioration of the patient'"'"'s heart failure status based at least in part on detecting an acute deleterious change in the collected physiologic data indicative of an abnormality in one or more physiologic parameters represented by the physiologic data; and

generating a readmission alert in response to the acute deleterious change in the collected physiologic data, the readmission alert indicating that the further deterioration in the patient'"'"'s heart failure status may require readmission of the patient to the hospital.

13. The method of claim 12, comprising:

developing one or more baselines and thresholds for physiologic data collected during hospitalization of the heart failure patient;

analyzing, using physiologic data collected after discharge of the heart failure patient from the hospital, the collected physiologic data for a change in the post-discharge collected physiologic data; and

detecting further deterioration of the patient'"'"'s heart failure status is based at least in part on detecting an acute deleterious change in the post-discharge collected physiologic data relative to the one or more baselines and thresholds.

14. The method of claim 13, comprising receiving a discharge notification associated with a time of heart failure patient discharge from the hospital, and using the discharge notification to distinguish between physiologic data collected during hospitalization and physiologic data collected after discharge of the heart failure patient from the hospital.

15. The method of claim 13, wherein the one or more thresholds are developed using physiologic data collected during a specified period of time prior to patient discharge from the hospital, and the acute deleterious change in the post-discharge collected physiologic data is detected within about one day to about two months after patient discharge from the hospital.

16. The method of claim 13, wherein the one or more thresholds are developed using physiologic data collected during a specified period of time prior to patient discharge from the hospital, and the acute deleterious change in the post-discharge collected physiologic data is detected within about one day to about one months after patient discharge from the hospital.

17. The method of claim 12, wherein collecting, analyzing, detecting, and generating are performed by a medical device implanted in the patient.

18. The method of claim 12, comprising communicating the readmission alert to a network server for access by a clinician.

19. The method of claim 12, wherein detecting further deterioration of the patient'"'"'s heart failure status comprises comparing the change in the collected physiologic data to one or more thresholds, the one or more thresholds comprising at least one of a predetermined change in the collected physiologic data, a predetermined rate of change in the collected physiologic data, and a predetermined variance in the collected physiologic data.

20. The method of claim 12, wherein the physiologic data comprises at least one of respiration data, respiration metrics, blood pressure data, intra-abdominal pressure sensor, heart sounds data, heart rate variability data, lead impedance data, electrogram data, electrocardiogram data, electrical activation sequence data, cardiac vector axis data, QRS axis data, mechanical sensor data, mechanical contractile sequence data, vascular tone data, neuro-hormonal data, hemodynamic data, intrathoracic impedance data, transthoracic impedance data, intracardiac impedance data, heart sounds data, physiological response to activity data, pulmonary arterial pressure data, central venous pressure data, electro-mechanical delay data, patient weight data, patient posture data, and patient symptom questionnaire data.

21. A medical system, comprising:

a respiration sensor configured to generate a signal indicative of patient respiration;

respiration information circuitry coupled to the respiration sensor, the respiration information circuitry configured to collect respiration data for a heart failure patient and to measure a median respiration rate (MedRR) and a maximum respiration rate (MaxRR) using the collected respiration data;

a processor coupled to the respiration information circuitry, the processor executing program instructions that configure the processor to;

cause the respiration information circuitry to collect the respiration data for the heart failure patient during hospitalization and after discharge of the heart failure patient from a hospital;

analyze the MedRR and MaxRR for a change in the MedRR and MaxRR and;

detect further deterioration of the patient'"'"'s heart failure status based at least in part on detecting an acute deleterious change in the MedRR and MaxRR indicative of an abnormality in MedRR and MaxRR; and

an output device coupled to the processor and configured to generate a readmission alert in response to detection of the acute deleterious change in the MedRR and MaxRR, the readmission alert indicating that the further deterioration in the patient'"'"'s heart failure status may require readmission of the patient to the hospital.