Thinking beyond the risk factors

European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Eugene H Blackstone

Abstract

For each risk factor for Black Death he discovered, John Graunt in 1662 made a recommendation for action, such as fleeing the night air brought to the City of London docks on foreign ships. These stopped the plague for 200 years! In this honored guest lecture, I focus on thinking beyond the risk factors to their neutralization by effective action without waiting for perfect knowledge of mechanisms. For example, the decreasing risk of repairing atrioventricular septal defect resulted from risk factors that stimulated focused research to devise a better operation. General reduction in risk reduced mortality of aortic valve replacement in patients with chronic aortic regurgitation and severe left ventricular dysfunction. Optimal timing of surgery after stabilizing patients reduced risk of the Norwood procedure. Managing intractable cardiogenic shock reduced risk-adjusted mortality in post-infarct ventricular septal defect. However, we must think beyond traditional risk factors to neutralization of those brought by patient characteristics, imponderables, treatment delivery systems, institutions delivering care to groups of patients, and society caring for its population. There are limitations to thinking beyond risk factors. First,...Continue Reading

Citations

Mar 6, 2009·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·J F GummertJ Cremer
Nov 27, 2008·European Heart Journal·Brigitte R OsswaldEugene H Blackstone
Jan 6, 2012·Journal of Environmental and Public Health·Charumathi SabanayagamR Turner Goins
Jan 22, 2009·The Journal of Thoracic and Cardiovascular Surgery·Thomas W Rice, Eugene H Blackstone
Oct 29, 2008·The Journal of Thoracic and Cardiovascular Surgery·Emile A BachaPedro J del Nido
Mar 22, 2008·The Annals of Thoracic Surgery·Apur R KamdarMilind Y Desai
Jan 29, 2010·The Journal of Thoracic and Cardiovascular Surgery·Dustin Y YoonBruce W Lytle
Jan 15, 2013·The Journal of Thoracic and Cardiovascular Surgery·Gösta B PetterssonBruce W Lytle
Aug 26, 2010·Anesthesia and Analgesia·Vanessa M BanzDaniel Inderbitzin

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiogenic Shock

Cardiogenic shock is a devastating consequence of acute myocardial infarction and is associated with an extremely high mortality. Here is the latest research.