scholarly journals Good performance in the management of acute heart failure in cardiogeriatric departments: the ICREX-94 experience

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Emmanuelle Berthelot ◽  
◽  
Amaury Broussier ◽  
Thibaud Damy ◽  
Cristiano Donadio ◽  
...  
Keyword(s):  
Heart Failure ◽  
Observational Study ◽  
Elderly Patients ◽  
Human Development ◽  
Acute Heart Failure ◽  
Human Development Index ◽  
Independent Living ◽  
Neurocognitive Disorder ◽  
Precipitating Factors ◽  
Development Index

Abstract Context A growing number of elderly patients hospitalized for Acute Heart Failure (AHF) are being managed in cardiogeriatrics departments, but their characteristics and prognosis are poorly known. This study aimed to investigate the profile and outcome (rehospitalization at 90 days) of patients hospitalized for AHF in cardiogeriatrics departments in the Val-de-Marne area in the suburbs of Paris, and to compare them to AHF patients hospitalized in cardiology departments in the same area. Methods Observational study, ICREX-94, conducted in seven cardiology departments in France and three specific cardiogeriatrics departments in Val-de-Marne. Results A total of 308 patients were hospitalized for AHF between October 2017 and January 2019. During the 90 days following discharge, 29.6% patients were readmitted to the hospital. Compared with patients hospitalized in cardiology departments, patients in cardiogeriatrics departments were older (p < 0.001), less independent (living more often alone or in an institution) (p < 0.001), more often depressed (p < 0.001), had more often major neurocognitive disorder (p < 0.001), had a higher Human Development Index (HDI, p < 0.001), and were less often diagnosed with amyloidosis (p < 0.001). There was no difference in outcome whether patients were discharged from cardiology or cardiogeriatrics departments. The most frequent precipitating factors underlying AHF decompensation between the first and second hospitalization were arrhythmia and infection. Conclusion AHF patients discharged from cardiogeriatrics departments, compared to cardiology departments, showed clinical differences but had the same prognosis regarding AHF rehospitalization at 90 days.

scholarly journals Good Performance in the Management of Acute Heart Failure in Cardiogeriatric Departments : The ICREX-94 Experience

2021 ◽  
Author(s):  
Emmanuelle Berthelot ◽  
Amaury Broussier ◽  
Thibaud Damy ◽  
Cristiano Donadio ◽  
Stephane Cosson ◽  
...  
Keyword(s):  
Heart Failure ◽  
Observational Study ◽  
Elderly Patients ◽  
Human Development ◽  
Acute Heart Failure ◽  
Human Development Index ◽  
Independent Living ◽  
Neurocognitive Disorder ◽  
Precipitating Factors ◽  
Development Index

Abstract Context: A growing number of elderly patients hospitalized for Acute Heart Failure (AHF) are being managed in cardiogeriatrics departments, but their characteristics and prognosis are poorly known. This study aimed to investigate the profile and outcome (rehospitalization at 90 days) of patients hospitalized for AHF in cardiogeriatrics departments in the Val-de-Marne area in the suburbs of Paris, and to compare them to AHF patients hospitalized in cardiology departments in the same area. Methods: Observational study, ICREX-94, conducted in seven cardiology departments in France and three specific cardiogeriatrics departments in Val-de-Marne. Results: A total of 308 patients were hospitalized for AHF between October 2017 and January 2019. During the 90 days following discharge, 29.6% patients were readmitted to the hospital. Compared with patients hospitalized in cardiology departments, patients in cardiogeriatrics departments were older (p<0.001), less independent (living more often alone or in an institution) (p<0.001), more often depressed (p<0.001), had more often major neurocognitive disorder (p<0.001), had a higher Human Development Index (HDI, p<0.001), and were less often diagnosed with amyloidosis (p<0.001). There was no difference in outcome whether patients were discharged from cardiology or cardiogeriatrics departments. The most frequent precipitating factors underlying AHF decompensation between the first and second hospitalization were arrhythmia and infection.Conclusion: AHF patients discharged from cardiogeriatrics departments, compared to cardiology departments, showed clinical differences but had the same prognosis regarding AHF rehospitalization at 90 days.

scholarly journals Early and comprehensive care bundle in elderly for acute heart failure in the emergency department: study protocol of The ELISABETH stepped wedge cluster randomized trial

2018 ◽  
Author(s):  
Yonathan Freund ◽  
Judith Gorlick ◽  
Marine Cachanado ◽  
Sarah Salhi ◽  
Vanessa Lemaitre ◽  
...  
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Elderly Patients ◽  
Acute Heart Failure ◽  
Control Period ◽  
Care Bundle ◽  
Stepped Wedge ◽  
Precipitating Factors ◽  
Intervention Period ◽  
Cluster Randomized

Abstract Background: Acute heart failure (AHF) is one of the most common diagnoses for elderly patients in the emergency department (ED), with an admission rate higher than 80% and 1-month mortality around 10%. The European guidelines for the management of AHF are based on moderate levels of evidence, due to the lack of randomized controlled trials and the scarce evidence of any clinical added value of a specific treatment to improve outcomes. Recent reports suggest that the very early administration of full recommended therapy may decrease mortality. However, several studies highlighted that elderly patients often received suboptimal treatment. Our hypothesis is that an early care bundle that comprises early and comprehensive management of symptoms, along with prompt detection and treatment of precipitating factors should improve AHF outcome in elderly patients. Method/design: ELISABETH is a stepped-wedge, controlled cluster randomized, clinical trial in 15 emergency departments in France recruiting all patients aged 75 years and older with a diagnosis of AHF. The tested intervention is a care bundle with a checklist that mandates detection and early treatment of AHF precipitating factors, early and intensive treatment of congestion with intravenous nitrates boluses, and application of other recommended treatment (low dose diuretics, non-invasive ventilation when indicated, and preventive low molecular weight heparin). Each centre are randomized to the order in which they will switch from “control period” to “intervention period”. All centers begin the trials with the control period for two weeks, then after each two-weeks step a new centre will be in the intervention period. At the end of the trial, all clusters will receive the intervention regimen. The primary outcome is the number of days alive and out of the hospital at 30 days. Discussion: If our hypothesis is confirmed, this trial will strengthen the level of evidence of AHF guidelines and stress the importance of the associated early and comprehensive treatment of precipitating factors. This trial could be the first to report a reduction in short term morbidity and mortality in elderly AHF patients. Registration: NCT03683212, prospectively registered on September 25th 2018 Keywords: Elderly, acute heart failure, emergency department

106 Precipitating factors in the elderly patients admitted with the diagnosis of heart failure. Are easy to find?

2006 ◽  
Vol 5 (1) ◽  
pp. 25-26
Author(s):  
R VIDALPEREZ ◽  
E ABUASSI ◽  
M PARAMODEVEGA ◽  
P VELOSO ◽  
A VARELAROMAN ◽  
...  
Keyword(s):  
Heart Failure ◽  
Elderly Patients ◽  
The Elderly ◽  
Precipitating Factors

What Does Human Development Index Rating Mean in Terms of Individualism/Collectivism?

2003 ◽  
Vol 8 (2) ◽  
pp. 97-100 ◽  
Author(s):  
Maria José Sotelo ◽  
Luis Gimeno
Keyword(s):  
Human Development ◽  
Human Development Index ◽  
Principal Component ◽  
General Idea ◽  
Development Index ◽  
Low Levels ◽  
The Relationship

The authors explore an alternative way of analyzing the relationship between human development and individualism. The method is based on the first principal component of Hofstede's individualism index in the Human Development Index rating domain. Results suggest that the general idea that greater wealth brings more individualism is only true for countries with high levels of development, while for middle or low levels of development the inverse is true.

Capaian pembangunan manusia: analisis komparatif Provinsi Banten, Jawa Barat dan DKI Jakarta

2018 ◽  
Vol 13 (1) ◽  
Author(s):  
Adriwati Adriwati
Keyword(s):  
Human Development ◽  
Human Development Index ◽  
Human Population ◽  
Provincial Government ◽  
Healthy Life ◽  
Development Index ◽  
Long Life ◽  
The Difference ◽  
The Government ◽  
Development Paradigm

Human development is a development paradigm that puts human (population) as the focus and final target of all development activities, namely the achievement of control over resources (income to achieve decent living), improvement of health status (long life and healthy life) and improve education. To see the success rate of human development, UNDP publishes an indicator of Human Development Index (HDI). This study discusses the achievements of human development that have been pursued by the government. The problem analyzed in this research is the difference of human development achievement in some provincial government in Indonesia. This paper aims to compare the achievements of human development in some provincial governments seen from the achievement of human development index of each province. Research location in Banten Province, West Java and DKI Jakarta.Keywords:Human Development Index, Human Development Achievement

The comparison of MCDM Methods including AHP, TOPSIS and MAUT with an Application on Gender Inequality Index

2016 ◽  
Vol 4 (2) ◽  
pp. 183 ◽  
Author(s):  
Latife Sinem Sarul ◽  
Özge Eren
Keyword(s):  
European Union ◽  
Human Development ◽  
Gender Inequality ◽  
Human Development Index ◽  
The European Union ◽  
Inequality Index ◽  
Development Index ◽  
Important Barrier ◽  
Alternative Ranking

Gender Inequality Index is a major indicator presenting level of development of the countries as Human Development Index, which is calculated regularly every year by UN. In this study, an alternative calculation has been proposed for measuring gender inequality index which is an important barrier for the human development. Each indicator in the index integrated as MAUT- AHP and also AHP-TOPSIS and these methods carried out again for the alternative ranking member and candidate countries of the European Union. The main objective here is to represent that the indicators form gender inequality index can be reclassified with different weights for each indicator.

Asymmetric Policy of Border Area Development in Indonesia

2019 ◽  
Vol 118 (2) ◽  
pp. 81-85
Author(s):  
Rusdiyanta ◽  
M.Si¹ DanBambangPujiyono ◽  
MM ◽  
M.Si2
Keyword(s):  
Human Development ◽  
Social Services ◽  
Human Development Index ◽  
Development Policy ◽  
Innovative Development ◽  
Autonomous Region ◽  
Development Index ◽  
Left Behind ◽  
Border Areas ◽  
Area Development

The condition of the border areas in Indonesia is largely isolated, lagging, poor, and backward so as to require an affirmafive and innovative development policy. This study discusses the asymmetrical policy of Jokowi-JK government in the development of border areas in Indonesia. Most of the border areas are Underdeveloped Regions, so a symmetrical or special policy is required so that the development of border areas is not left behind with other regions or other countries. The implementation of the policy was carried out with the development of infrastructure and basic social services for the community as well as financial distribution, implementation of specific policies and arranging the formation of New Autonomous Region (DOB) in welfare-oriented border areas. This asymmetric policy encourages accelerated development in border areas so as to improve the human development index.

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