Revolutionizing Atrial Fibrillation Management: Sturm Family Foundation Impact Update Winter 2022
Giving up isn’t an option at the University of Colorado Anschutz Medical Campus. The doors to groundbreaking research possibilities are always open. It’s what drives us; the desire to do more, to stretch the boundaries of science and explore leading edge research that can make a difference in people’s lives. Thanks to the philanthropic investment from the Sturm Family Foundation, the dream of developing an atrial fibrillation (AF) center of excellence at CU Anschutz is becoming a reality. Your gift has enacted real change as we continue to identify more patients for whom we can minimize hospitalization and optimize follow-up care. Under the direction of Dr. Wendy Tzou, the clinical research being done on our campus has enormous potential to change the trajectory of AF management as we look for ways to not only make patients feel better but do better to improve longer-term outcomes like survival. As an academic medical institution with direct ties to the hospital system, CU Anschutz is uniquely situated to revolutionize AF management. We are ready to be a leader in this space.
Your Generosity in Action The initial $100K investment from the Sturm Family Foundation is fueling research that otherwise may not have been possible. With your support, we are pioneering the future of AF management and patient care. Over the last year, Dr. Tzou’s team has made incredible progress, including: Extremely promising research with respect to incorporating lifestyle improvements to reduce secondary risk factors like weight gain and sleep apnea have helped improve the way we manage AF patients. Leveraging your gift for additional help and resources to acquire data and analyze it on a scale that would be difficult for Dr. Tzou to achieve on her own. Encouraging other researchers in Dr. Tzou’s group to be enthusiastic about the project, which builds comradery and gives the team a sense of pride for their combined work efforts. Support in training fellows who can take what they’ve learned from this project to improve system processes at other medical institutions and health centers. The charts on the next page depict a pattern of improved and timely intervention for AF patients. While much progress has been made, Dr. Tzou’s research suggests the need for infrastructure change and an automated process to better streamline AF management.
Comparing patients presenting with primary diagnosis of AF to the Emergency Department CHART 1: Number of patients discharged from the Emergency Department on the same day and who are in sinus rhythm within a week
This data represents the proactiveness in which Dr. Tzou and her team have carried out their effort to get more patients out of the hospital. While the COVID-19 pandemic has added momentum, this data shows they are headed in the right direction.
vs.
34 of 131, or 26% 12/1/2020 – 8/31/2021
11 of 127, or 9% 12/1/2019 – 8/31/2020
- p value 0.003 (highly significant) statistically significant is p<0.05
CHART 2: Number of outpatient follow-up appointments arranged post-Emergency Department discharge to ensure continuity of AF care
vs.
104/131, or 79% 12/1/2020 – 8/31/2021
78/127, or 61% 12/1/2019 – 8/31/2020
AF is a chronic process that we must treat proactively and indefinitely. In the past, just under half of patients who were previously discharged didn’t have systematic follow-up care arranged. Follow-up care is critical to treat risk factors associated with or worsen prognosis of AF, including hypertension, stroke, obesity, obstructive sleep apnea and heart failure. Without appropriate clinical follow-up, outcomes of patients with AF are worse. - p value 0.002 (highly significant) statistically significant is p<0.05
Estimated cost savings for patients based on same-day discharge vs. hospitalization
$906K
SAVINGS IN HOSPITAL ADMISSION RATES
$7K
SAVINGS PER PATIENT
Comparing expected versus actual admission rates between December 2020 – August 2021 and December 2019 – August 2020. Overall patient savings is based on insurance claims and overall costs saved for patients compared between treatment periods. Average costs a patient would save not being admitted to the hospital. Comparison between cohorts treated during December 2020-August 2021 versus December 2019-August 2020 using a relative difference calculation. Perpatient admission versus discharge costs in the more contemporary cohort were calculated based on the relative cost difference observed in the historical cohort.
The Patient Perspective As hospitals around the country are understaffed and inundated with new surges of COVID-19 patients, there has never been a more critical time to lessen the burden on our healthcare system. Additionally, keeping patients in the hospital for long periods of time limits how active they can be, which can then predispose them to deconditioning or other concomitant illnesses. Furthermore, growing evidence has heightened awareness about the importance of earlier and more aggressive intervention to manage AF, which can improve survival, as well as quality of life. Through your gifts, we are transforming AF patient management to reduce hospitalizations and the toll on the healthcare system, as well as to improve overall prognosis. Imagine you’re an AF patient living in Longmont, Colorado, who recently had a procedure and returned home only to have another recurring episode. Under normal circumstances, a visit back to the Longmont Emergency Department might lead to hospitalization, with a potential wait of days before cardioversion could be performed or, worse, you might be discharged, still symptomatic but with heart rate “controlled” in AF, without a clear follow-up plan arranged. At CU Anschutz, we take a different approach. The Doc Line Center involves Dr. Tzou or her Arrhythmia Team (Cardiac Electrophysiology) colleagues from the outset to receive consult calls from places like Longmont where she can instruct their emergency department to cardiovert the patient right away, send them home and schedule a follow-up appointment at our clinic. This new streamlined approach to expedite the management of patients with symptomatic AF at the emergency department has the potential to permeate out into the community and other hospitals, ultimately improving patient care.
Hope on the Horizon Because of your initial investment, we are in a better place to understand what AF patients go through and how we can make their lives better. One exciting area of development is a recent partnership Dr. Tzou initiated with an industry sponsor who specializes in heart ablations. They have unique pathways to accelerate how we are capturing people with AF. With the sponsor’s help to build this forward, we can set the groundwork for a more systematic approach to capture these people, ensure follow-up care and downstream management. This would create a holistic, multidisciplinary approach to AF where we treat the whole person to address other health components like diet and sleep apnea. There is also increased interest in the medical community to explore genetic predisposition links with respect to cardiomyopathies and heart disease. This will likely become a focus area for AF as we look to incorporate better lifestyle management and tailor treatment based on genetics. Dr. Tzou is also interested in researching different populations of people with AF including patients who live in higher altitude climates and how it could affect their treatment plan. Our progress would not be possible without your generosity. We are grateful for your support and look forward to our continued partnership in the years to come.
I don’t know how to express in words the gratitude I feel to the Sturm Family Foundation for having given this gift. Their support will be far more reaching in its impact than just the direct gift provides. I’m incredibly thankful for the opportunity to extend what can be done for patients with atrial fibrillation and improve the lives of many, many people. Thank you for helping us make a difference. Wendy Tzou, MD Director, Cardiac Electrophysiology