Home Cardiology American Thoracic Society, May 19-24

American Thoracic Society, May 19-24

The American Thoracic Society’s 2017 International Conference

The annual meeting of the American Thoracic Society was held from May 19 to 24 in Washington, D.C., and attracted more than 14,000 participants from around the world, including clinicians, academicians, allied health professionals, and others interested in pulmonary disease. The conference highlighted recent advances in the prevention, detection, and treatment of pulmonary conditions as well as provided insight into critical care medicine and sleep disorders.

In one study, Heather Giannini, M.D., of the Hospital of the University of Pennsylvania in Philadelphia, and colleagues used a machine-learning algorithm and clinical and administrative data from their local health system to create a predictive alert that detects septic shock more than 12 hours prior to onset in their hospitalized non-intensive care unit, non-emergency department patients.

“We implemented this alert at our three urban hospitals for a two-month period to evaluate the alert’s test characteristics (i.e., sensitivity/specificity) and to better understand who the algorithm is detecting within our patient population,” Giannini said.

Machine learning allowed the investigators to integrate a significant amount of patient data (greater than 500 variables) into a predictive alert.

“The alert was able to identify patients at risk for septic shock, with a positive likelihood ratio for septic shock of 13, meaning patients who received an alert were 13 times more likely to experience septic shock than not,” Giannini said. “Machine learning may represent an opportunity to capitalize on the wealth of data from electronic health records to affect critical care outcomes.”

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In another study, Ken Kunisaki, M.D., of the University of Minnesota and the Minneapolis VA Health Care System, and colleagues found that patients with chronic obstructive pulmonary disease (COPD) appear to be especially vulnerable to events like sudden death, myocardial infarction, and stroke following COPD exacerbations.

“Cardiovascular disease (CVD) is very common in persons with COPD,” Kunisaki said. “We hypothesized that exacerbations of COPD would be associated with an increased risk for CVD after the exacerbation. We tested this hypothesis in a study of over 16,000 persons with COPD and with cardiovascular disease or cardiovascular risk factors. The study included blinded adjudication of cardiovascular events, which is the major advance over the few previous studies addressing this question.”

The investigators found that exacerbations were followed by an increased risk of cardiovascular disease events, particularly in the first 30 days after the exacerbation and especially in those who were hospitalized.

“Clinicians and patients should be vigilant for CVD following COPD exacerbations,” Kunisaki said.

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