Haider Warraich
speaker
683 appearances
3 recordings
1 series
first heard Oct 2020
last heard Dec 2021
Haider Warraich’s voice in public audio — every appearance, attributed to the second.
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So one study we performed that was published
And JAMA cardiology showed that the median survival of heart failure patients discharged to hospice is only about 11 days.
And that's much shorter than that for cancer.
And of these patients, about a third of them actually die within the first three days of being discharged.
So many patients are being, even when we identify patients as being patients who might benefit from being discharged to hospice, we know that that decision is being made very late.
Great question.
And I feel like part of it is that there's a cultural issue, I think, amongst cardiologists and everyone else who takes care of these patients that we don't necessarily think of engaging in either primary palliative care or secondary palliative care when it comes to taking care of these patients.
Many of these patients don't have
you know, a clear inflection point, if you may, where, for example, you, you know, starting from diagnosis to sort of more further along in their natural history.
Prognostication can be very, very difficult in these patients.
So a lot of times, and we've shown this in one of the first projects that I did was, in fact, looking at the specific question of how good are physicians at assessing or estimating prognosis in patients with heart failure and
And we found essentially that physicians really across the spectrum of training are not very good at
getting a sense of how sick or how much time a patient with heart failure might have.
And that having more experience as a clinician actually doesn't really change that.
So whether you're a heart failure cardiologist or whether you're an intern, you are essentially as likely to be wrong or right about a patient with heart failure when it comes to assessing prognosis.
So I think that's really sort of critical information.
to why I think really we both underuse palliative care and hospice in patients with heart failure and that when we do, we don't use it well.
That is absolutely right.
That's certain.
Looking at the data and then also culturally, I would completely agree with you that we're at least 15 to 20 years behind integrating palliative care and palliative care concepts in the care of patients with advanced heart disease as we are to cancer.
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