Prognosis
Without therapy, polyarteritis nodosa is usually severe, and the prognosis in these cases is poor.
The prognosis has – with appropriate therapy – improved significantly in recent years. While the disease was usually fatal until about 25 years ago, the survival rate after five years is currently about 90 percent. The prognosis of PAN depends primarily on which organ is affected. If the kidneys, heart, gastrointestinal tract or nervous system are affected, the prognosis is somewhat worse.
In general, the earlier PAN is diagnosed and treated, the better organ damage can be prevented. In many cases, the symptoms even disappear completely.
Prevention
Since the causes of polyarteritis nodosa are not fully understood, no specific prevention is possible. However, vaccination against hepatitis B can reduce the risk of developing PAN.
- Legally insured persons: To determine the need for care, the patient or a relative must first submit an application to the long-term care insurance fund (located at the health insurance fund). The long-term care insurance fund then commissions the Medical Service of the Health Insurance Funds (MDK) or another independent expert to determine the patient’s need for long-term care.
- Privately insured persons: A privately insured patient or a relative must submit the application for classification as a person in need of care to the respective private insurance company. The insurance company then commissions the MEDICPROOF medical service to determine the need for care.
Appointment for the assessment
The assessor (nursing specialist or physician) does not come unannounced to the house or facility where the patient lives. He or she makes an appointment for the assessment with the patient or his or her relatives or caregivers.
At this appointment notice, the assessor also asks the applicant to have relevant documents ready for the assessment. This includes, for example, reports from care services, care diaries (*) and comparable records kept by the insured person, medical records, information on medications currently being used, as well as reports and notices from other social benefit agencies.
What is assessed?
The assessor evaluates the following six areas of life (“modules”):
- Mobility (physical agility, e.g. getting up in the morning, going to the bathroom, climbing stairs, etc.)
- cognitive and communicative abilities (e.g., orientation about place and time, comprehension of facts, recognition of risks, understanding what other people say)
- behavioral and psychological problems (such as anxiety, aggression, resistance to care, restlessness at night)
- Self-care (e.g., independent washing, using the toilet, dressing, eating, drinking)
- Coping with and dealing independently with illness- or therapy-related demands and stresses (taking medication independently, going to the doctor independently, etc.)
- Organization of everyday life and social contacts (independent organization of daily routine, establishing contact with other people, independent participation in social events, etc.).
