CVD Risk Assessment for 20 Patients

CVD Risk Assessment for 20 Patients and Grant ProposalMitch Hayes VMS 3August 28, 2016

CasePMHHLDT2DMHTNGoutSH: single, one child, smokes 1/2 ppd, drinks occasionally, drives forkliftFH: father died at 49 of CAD

Case continuedPE: P 85, BP 132/74, RR 18, BMI 29.6CV: no rubs, murmurs, gallopsResp: CTABAbd: nontender, NABSLabs: Total chol 194, HDL 52 Meds: multiple

ASCVD Risk Calculation 2015: age 56Total chol 194, HDL 52 (with statin therapy) SBP 122 from annual clinic visit+HTN tx, +DM, current smoker (1/2ppd for >32 years)10 year risk for coronary death, nonfatal MI, and all stroke: 23.8%

Deaths due to CVD have decreased in recent years

But CVD continues to be #1 cause of death in USA

Many community resources available for improvement

ASCVD Risk calculation

Grant Proposal: Smoking Cessation as a Target of Risk ReductionSmoking cessationWhy? Huge impact on CVD risk Huge impact on other risks and overall healthRates of smoking have decreased significantly in recent decades Increased awareness of smoking as a health risk

Planned interventionPCPs will screen patients who smoke and may be interested in quittingPay health coach $5000 to spend 15 minutes with patients who smoke to develop plans to quit smoking Follow up in 1 year to track success rate

Metric to determine improvementTrack patient-reported success rate of smoking cessation at 1 year Continue to provide support to patientsContinue to track smoking use amongst patients

Time courseReview annual physical notes for update on smoking cessation progress at 1, 2, and 5 years

DefenseSmoking continues to be a risk factor for many diseases including CVDSmoking cessation interventions can make a huge impact on a patients overall healthImprovement in health outcomes can lead to huge cost savings $5000 pales in comparison to even one hospitalization due to nonfatal MI or stroke

Thank you

dump.xlsSexRaceAgeHDLTotal cholDiabetesHTN txSBPSmokingASCVD 10ASCVD life31472871PtSex1MW5254220noNo122no4.14631472871PtRaceW2.6531472871PtAge5231266851PtSex2FW6079153noNo130no1.92731266851PtRaceW2.1831266851PtAge6037925252PtSex3FW5155225yesyes122no4.45037925252PtRaceW0.9837925252PtAge519574062PtSex4FB5442158noyes114no3.2399574062PtRaceB1.689574062PtAge5428844892PtSex5FW7164172noyes98no7.928844892PtRaceW7.728844892PtAge719436262PtSex6FW6365180noyes128no5.29436262PtRaceW3.29436262PtAge6332548794PtSex7FW5953180nono104no1.92732548794PtRaceW2.1832548794PtAge5936904514PtSex8MW541599nono100no4.2536904514PtRaceW2.9536904514PtAge5431629355PtSex9FW7634190noyes146no26.331629355PtRaceW1231629355PtAge7624040255PtSex10FW6492229noyes169no9.824040255PtRaceW3.624040255PtAge6416716086PtSex11FW7864263yesno151no56.516716086PtRaceW16.616716086PtAge7835413657PtSex12FW6274181nono78no1.635413657PtRaceW2.935413657PtAge6234469197PtSex13MW8044177yesno126yes50.234469197PtRaceW2434469197PtAge8022315527PtSex14MW7939163noyes119no30.622315527PtRaceW22.622315527PtAge7917455007PtSex15FW4867197nono141no0.83917455007PtRaceW0.6817455007PtAge483319688PtSex16FB5550161noyes114no2.7393319688PtRaceB1.683319688PtAge5534017228PtSex17MB5742194yesyes122yes23.86934017228PtRaceB3.9534017228PtAge5720033007PtSex18FW69109251nono144no8.820033007PtRaceW5.620033007PtAge6933740879PtSex19MW7449173noyes123no22.633740879PtRaceW16.233740879PtAge7425427949PtSex20FW69243107nono148no10.425427949PtRaceW6.225427949PtAge69

Sheet1Pt#SexRaceAgeHDLTotal CholDMHTN txSBPSmoke?ASCVD risk1MW5254220noNo122no4.1462FW6079153noNo130no1.9273FW5155225yesyes122no4.4504FB5442158noyes114no3.2395FW7164172noyes98no7.96FW6365180noyes128no5.27FW5953180nono104no1.9278MW541599nono100no4.259FW7634190noyes146no26.310FW6492229noyes169no9.811FW7864263yesno151no56.512FW6274181nono78no1.613MW8044177yesno126yes50.214MW7939163noyes119no30.615FW4867197nono141no0.83916FB5550161noyes114no2.73917MB5742194yesyes122yes23.86918FW69109251nono144no8.819MW7449173noyes123no22.620FW69243107nono148no10.4