(This is an excerpt of the Health Rounds newsletter, where we present latest medical studies on Tuesdays and Thursdays)
By Nancy Lapid
(Reuters) -Older adults hospitalized for respiratory syncytial virus (RSV) face an elevated risk of developing heart failure and a dangerous heart rhythm problem, a Canadian study found.
The risk for heart failure was seen even in individuals without a history of heart problems, researchers reported in the Journal of the American Geriatrics Society.
The researchers reviewed data on more than 100,000 adults aged 65 and older hospitalized in Ontario between 2011 and 2020 for either RSV, influenza, urinary tract infection, or a fracture.
The proportion of patients with a subsequent cardiovascular event was 18.5% after an RSV-related hospitalization, compared to 17.7%, 12.1% and 8.4% after hospitalizations for influenza, urinary tract infection, or fracture, respectively.
In comparisons of patients who were closely matched according to demographics and risk factors, heart failure (10%–11%) was the most common outcome for RSV patients, occurring in 10% to 11%. Next most common was the heart rhythm disorder atrial fibrillation, occurring in 5% to 6% of RSV patients.
The risk for those outcomes, as well as for heart attack, “was at least two to three times higher in patients with a pre-existing cardiovascular condition compared to those without,” the researchers also said.
“Our findings reinforce the importance of RSV vaccination in older adults and suggest that monitoring for signs of heart disease following an RSV illness may be pragmatic,” study leader Chris Verschoor of Health Sciences North Research Institute in Sudbury, Ontario, said in a statement.
DYE TEST CAN HELP AVOID INTESTINE SURGERY
Sending dye through the small intestine to look for blockages has been sparing a significant proportion of patients from needing to undergo surgery, a new study shows.
The dye, Gastrografin from Bracco Diagnostics Inc., is administered to symptomatic patients before an X-ray or CT scan so that surgeons can see the location and severity of any so-called adhesive small bowel obstructions.
Researchers reviewed nationwide data on more than 20,000 patients with suspected small bowel obstruction managed in two periods – 2012 to 2016, before Gastrografin was widely used for this purpose, and 2019 to 2023, when using Gastrografin to visualize intestinal blockages was a standard of care.
They found nearly a 45% decrease in surgeries for small bowel obstruction in the Gastrografin era, from 13,257 to 7,333.
Small bowel obstruction accounts for 15% of hospital admissions in the U.S., with about 20% of cases needing surgery to reconstruct the intestine, the researchers said. The resulting healthcare costs total over $3 billion each year.
Despite better small bowel obstruction outcomes overall, post-surgery mortality increased from 4.4% to 5.9% after use of the dye became standard, and reoperations within 30 days rose from 4.7% to 6.2% – likely because surgeries were probably more complex in the later era, the researchers said.
Gastrografin testing had weeded out patients with relatively mild obstructions who ultimately didn’t need surgery, they added.
“Previously, patients who had a relatively mild adhesive small bowel obstruction would have been operated on, as we didn’t have an alternative option,” study leader Dr. Robert McLoughlin from the University of Connecticut School of Medicine in Farmington said in a statement.
“This meant that in the post-Gastrografin era, the surgeries were more complex and challenging, hence the increased morbidity and mortality.”
Still, because surgeons have gotten better at managing patients after surgery for small bowel obstructions, patients in the Gastrografin group averaged 6 days in the hospital, versus about 10 days for patients treated before the Gastrografin era, the researchers reported in the Journal of Surgical Research.
The current study was not designed to prove that any of the outcomes were the result of Gastrografin use, the article pointed out.
McLoughlin recalled that during a discussion with a younger colleague about managing small bowel obstructions, he mentioned that when he was in training, surgeons operated “on a lot more” of these patients.
That recollection prompted the current study, he said.
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(Reporting by Nancy Lapid; additional reporting by Shawana Alleyne-Morris; editing by Aurora Ellis)
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