NEW YORK, NY--(Marketwired - Oct 8, 2013) - Daxor Corporation (NYSE MKT: DXR) -- A Mayo Clinic study presented at the recent annual Heart Failure Society of America meeting reported the results of congestive heart failure patients who had blood volume measurements after admission and prior to discharge. This study involved blood volume measurements on 29 patients hospitalized for acute heart failure for an average of 5 - 7 days. The lead investigator was Wayne Miller, M.D., PhD.
While performing these blood volume measurements utilizing the Daxor BVA-100, physicians were actually able to determine whether the fluid removed by the use of powerful diuretics came from the blood volume itself or came from water in the interstitial space, which is the water between the cells of the body. This is the first time this type of information had ever been available on congestive heart failure patients. This information is important for physicians' optimal treatment of patients.
Diuretic drugs are drugs which cause the kidneys to excrete extra salt and water and diminish the blood volume. Additional drugs are various categories of vasodilators which relax the blood vessels and cause a drop in blood pressure. Over treatment with these medications may result in kidney damage, leading to kidney failure. Inadequate treatment may result in a condition called pulmonary hypertension which may result in liver failure, severe fluid retention, and cardiac arrhythmias resulting in sudden death.
The overwhelming majority of patients are treated by their physicians without actual knowledge of the blood volume derangement of the patients. Physicians treat these patients on the basis of indirect measures which have been shown to be inaccurate when compared to actual measurements of blood volume. In 2003 a published study from Columbia Presbyterian Medical Center showed that experienced cardiologists were only correct 51% of the time using these indirect methods of evaluation in determining whether their patients were blood volume expanded, had a normal blood volume, or a low blood volume.
A major problem in the treatment of heart failure patients is that many of them are discharged in a severely unstable condition. As a result, even at the best hospitals, 20 - 25% of these patients are readmitted within 30 days or less. Until last year, hospitals were reimbursed fully for each time a patient was readmitted, as if it was a completely new problem. Beginning in 2013 Medicare instituted a penalty system by which hospitals could be fined up to 1% of all fees they receive on Medicare patients for excessive readmissions. In 2014 the rate goes up again to 2%; in 2015 up to 3%. Many hospitals function on a borderline financial stability level. In New York, for example, St. Vincent's Medical Center, a 140 year old institution, was forced to declare bankruptcy and close its facilities. Multiple other small hospitals have also closed.
Congestive heart failure admissions are the #1 medical expense for Medicare. The estimated total of direct and indirect cost of heart failure in the United States for 2008 is $34.8 billion with the greatest share being hospitalizations. The death rate is 25 - 40% within one year for patients admitted to a hospital with the diagnosis of acute decompensated heart failure. The initial and primary derangement in congestive heart failure is an expansion of the blood volume due to salt and water retention.
At the recent Heart Failure Society conference almost one quarter of the meetings had a primary focus on how to avoid these medical penalties rather than improving the quality of care in treating heart failure. The implications of the Mayo Clinic study are important because they demonstrate the potential for treating heart failure patients in a more precise manner. The imposition of just the financial penalty to the hospitals will put them in a position where utilization of diagnostic tools such as blood volume measurement will provide an opportunity to discharge patients in a more stable condition and avoid the stiff penalties associated with readmission of patients.