ARCHETYPE INTERMACS profile (openEHR-EHR-OBSERVATION.intermacs_profile.v0)

ARCHETYPE IDopenEHR-EHR-OBSERVATION.intermacs_profile.v0
ConceptINTERMACS profile
DescriptionCategorisation of the severity and level of limitation of advanced heart failure on at patient at the time of implant of a mechanical support, as defined by the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) data registry.
UseUse to record the INTERMACS profile of a patient at the time of implant of a mechanical support.
PurposeTo record the INTERMACS profile of a patient at the time of implant of a mechanical support.
ReferencesBarge-Caballero E, Paniagua-Martín MJ, Marzoa-Rivas R, Campo-Pérez R, Rodríguez-Fernández JÁ, Pérez-Pérez A, García-Bueno L, Blanco-Canosa P, Cancela ZG, Solla-Buceta M, et al. Usefulness of the INTERMACS Scale for predicting outcomes after urgent heart transplantation. Rev Esp Cardiol. 2011 Mar;64(3):193-200. doi: 10.1016/j.recesp.2010.08.001. Epub 2011 Feb 12. PubMed PMID: 21316834.

Stevenson LW, Pagani FD, Young JB, Jessup M, Miller L, Kormos RL, Naftel DC, Ulisney K, Desvigne-Nickens P, Kirklin JK. INTERMACS profiles of advanced heart failure: the current picture. J Heart Lung Transplant. 2009 Jun;28(6):535-41. doi: 10.1016/j.healun.2009.02.015. PubMed PMID: 19481012.
Copyright© openEHR Foundation
AuthorsAuthor name: Vanessa Pereira
Organisation: Marand d.o.o.
Email: vanessa.pereira@marand.si
Date originally authored: 2018-11-02
Other Details LanguageAuthor name: Vanessa Pereira
Organisation: Marand d.o.o.
Email: vanessa.pereira@marand.si
Date originally authored: 2018-11-02
OtherDetails Language Independent{licence=This work is licensed under the Creative Commons Attribution-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/4.0/., custodian_organisation=openEHR Foundation, references=Barge-Caballero E, Paniagua-Martín MJ, Marzoa-Rivas R, Campo-Pérez R, Rodríguez-Fernández JÁ, Pérez-Pérez A, García-Bueno L, Blanco-Canosa P, Cancela ZG, Solla-Buceta M, et al. Usefulness of the INTERMACS Scale for predicting outcomes after urgent heart transplantation. Rev Esp Cardiol. 2011 Mar;64(3):193-200. doi: 10.1016/j.recesp.2010.08.001. Epub 2011 Feb 12. PubMed PMID: 21316834. Stevenson LW, Pagani FD, Young JB, Jessup M, Miller L, Kormos RL, Naftel DC, Ulisney K, Desvigne-Nickens P, Kirklin JK. INTERMACS profiles of advanced heart failure: the current picture. J Heart Lung Transplant. 2009 Jun;28(6):535-41. doi: 10.1016/j.healun.2009.02.015. PubMed PMID: 19481012., original_namespace=org.openehr, original_publisher=openEHR Foundation, custodian_namespace=org.openehr, MD5-CAM-1.0.1=9440ACA127EC2682989C924325DE58EA, build_uid=97b226f9-69cc-42bc-ac64-50c23f7d1aa9, revision=0.0.1-alpha}
KeywordsINTERMACS, heart failure, profiles
Lifecyclein_development
UIDc4c1a64a-62b4-4735-9490-2a95b53a52c8
Language useden
Citeable Identifier1013.1.3698
Revision Number0.0.1-alpha
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Heather Leslie, Atomica Informatics, Australia, originalLanguage=en, translators=, subjectOfData=unconstrained, archetypeTranslationTree=null, topLevelToAshis={identities=[], other_participations=[], credentials=[], description=[], relationships=[], ism_transition=[], activities=[], items=[], data=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0006], code=at0006, itemType=ELEMENT, level=4, text=Profile, description=Categorisation of the level of limitation at the time of implant., comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=1: Critical cardiogenic shock [Patients with life-threatening hypotension despite rapidly escalating inotropic support, critical organ hypoperfusion, often confirmed by worsening acidosis and/or lactate levels. “Crash and burn".]
2: Progressive decline on inotropic support [Patient with declining function despite intravenous inotropic support, may be manifest by worsening renal function, nutritional depletion, inability to restore volume balance “Sliding on inotropes.” Also describes declining status in patients unable to tolerate inotropic therapy.]
3: Stable but inotrope dependent [Patient with stable blood pressure, organ function, nutrition, and symptoms on continuous intravenous inotropic support (or a temporary circulatory support device or both), but demonstrating repeated failure to wean from support due to recurrent symptomatic hypotension or renal dysfunction “Dependent stability".]
4: Resting symptoms [Patient can be stabilized close to normal volume status but experiences daily symptoms of congestion at rest or during ADL. Doses of diuretics generally fluctuate at very high levels. More intensive management and surveillance strategies should be considered, which may in some cases reveal poor compliance that would compromise outcomes with any therapy. Some patients may shuttle between 4 and 5.]
5: Exertion intolerant [Comfortable at rest and with ADL but unable to engage in any other activity, living predominantly within the house. Patients are comfortable at rest without congestive symptoms, but may have underlying refractory elevated volume status, often with renal dysfunction. If underlying nutritional status and organ function are marginal, patient may be more at risk than INTERMACS 4, and require definitive intervention.]
6: Exertion limited [Patient without evidence of fluid overload is comfortable at rest, and with activities of daily living and minor activities outside the home but fatigues after the first few minutes of any meaningful activity. Attribution to cardiac limitation requires careful measurement of peak oxygen consumption, in some cases with hemodynamic monitoring to confirm severity of cardiac impairment. “Walking wounded".]
7: Advanced NYHA Class III symptoms [A placeholder for more precise specification in future, this level includes patients who are without current or recent episodes of unstable fluid balance, living comfortably with meaningful activity limited to mild physical exertion.]
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