scholarly journals Rationale and design of multicenter prospective observational study of types, GRAde, VariabilITY, associations and prognosis of orthostatic responses in Heart Failure (GRAVITY-HF)

2020 ◽  
Vol 25 (1) ◽  
pp. 78-82
Author(s):  
E. V. Shlyakhto ◽  
S. V. Villevalde ◽  
A. E. Soloveva ◽  
N. E. Zvartau ◽  
M. Yu. Sitnikova ◽  
...  
Keyword(s):  
Heart Failure ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Prognostic Significance ◽  
Adult Mortality ◽  
Population Based ◽  
Risk Of Death ◽  
Increased Risk ◽  
Multicenter Prospective Observational Study ◽  
Predictive Risk

Heart failure (HF) is one of the leading causes of adult mortality. Increased risk of death determines need for better understanding of the pathophysiological mechanisms, predictive risk stratification models and applicable methods to improve prognosis. One of the unfavorable prognostic factors may be an inadequate hemodynamic response to orthostatic stress. Orthostatic hypotension (OH) is known to be an independent predictor of many cardiovascular diseases, particularly HF, and death. Singlecenter study of HF population revealed that systolic blood pressure within 3-5 minutes after standing up may be a predictor of long-term unfavorable outcomes. Nevertheless, data about OH in patients with HF are limited and inconsistent due to heterogeneity of populations and different methodology in published studies. In this regard, a population-based study of the orthostatic response in patients with HF (stable and decompensated) is needed. The article describes the rationale and design of a multicenter prospective observational study aimed to assess the clinical and prognostic significance of orthostatic responses in HF patients.

scholarly journals The performance of the EMS triage (RETTS-p) and the agreement between the field assessment and final hospital diagnosis: a prospective observational study among children < 16 years

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Carl Magnusson ◽  
Johan Herlitz ◽  
Thomas Karlsson ◽  
Maria Jiménez-Herrera ◽  
Christer Axelsson
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Hospital Setting ◽  
Risk Of Death ◽  
Computerised Decision Support System ◽  
Field Assessment ◽  
Hospitalised Patients ◽  
Increased Risk ◽  
Life Threatening ◽  
Triage Level

Abstract Background The rapid triage and treatment system for paediatrics (RETTS-p) has been used by the emergency medical services (EMS) in the west of Sweden since 2014. The performance of the RETTS-p in the pre-hospital setting and the agreement between the EMS nurse’s field assessment and the hospital diagnosis is unknown. The aim of this study was to evaluate the performance of the RETTS-p in the EMS and the agreement between the EMS field assessment and the hospital diagnosis. Methods A prospective observational study was conducted among 454 patients < 16 years of age who were assessed and transported to the PED. Two instruments were used for comparison: 1) Classification of an emergent patient according to predefined criteria as compared to the RETTS-p and 2) Agreement between the EMS nurse’s field assessment and the hospital diagnosis. Results Among all children, 11% were identified as having vital signs associated with an increased risk of death and 7% were diagnosed in hospital with a potentially life-threatening condition. Of the children triaged with RETTS-p (85.9%), 149 of 390 children (38.2%) were triaged to RETTS-p red or orange (life-threatening, potentially life-threatening), of which 40 (26.8%) children were classified as emergent. The hospitalised children were triaged with the highest frequency to level yellow (can wait; 41.5%). In children with RETTS-p red or orange, the sensitivity for a defined emergent patient was 66.7%, with a corresponding specificity of 67.0%. The EMS field assessment was in agreement with the final hospital diagnosis in 80% of the cases. Conclusions The RETTS-p sensitivity in this study is considered moderate. Two thirds of the children triaged to life threatening or potentially life threatening were later identified as non-emergent. Of those, one in six was discharged from the PED without any intervention. Further, one third of the children were under triaged, the majority were found in the yellow triage level (can wait). The highest proportion of hospitalised patients was found in the yellow triage level. Our result is in agreement with previous studies using other triage instruments. A computerised decision support system might help the EMS triage to increase sensitivity and specificity.

scholarly journals Multicenter Prospective Observational Study on Acute and Chronic Heart Failure

2013 ◽  
Vol 6 (3) ◽  
pp. 473-481 ◽  
Author(s):  
Luigi Tavazzi ◽  
Michele Senni ◽  
Marco Metra ◽  
Marco Gorini ◽  
Giuseppe Cacciatore ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Multicenter Prospective Observational Study

scholarly journals Prognostic significance of polyvascular disease in patients admitted with acute decompensated heart failure: the ARIC Study Community Surveillance

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
Z Chunawala ◽  
A Qamar ◽  
S Arora ◽  
A Pandey ◽  
M Fudim ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Prognostic Significance ◽  
Decompensated Heart Failure ◽  
Arterial Disease ◽  
Public Institution ◽  
Risk Of Death ◽  
Increased Risk ◽  
Medical Histories ◽  
Aric Study

Abstract Introduction The prevalence and outcomes of polyvascular disease (PVD) in patients admitted with acute decompensated heart failure (ADHF) have not been previously reported, nor is it known whether associations differ for heart failure (HF) with reduced vs. preserved ejection fraction (HFrEF vs HFpEF, respectively). Purpose To investigate the relationship between atherosclerotic involvement of multiple arterial territories and mortality in patients hospitalized with ADHF. Methods The Atherosclerosis Risk in Communities (ARIC) study conducted hospital surveillance of adjudicated heart failure in 4 US areas from 2005–2014, with events verified by physician review. Medical histories were abstracted from the hospital record. PVD was defined by coexisting disease in ≥2 arterial beds, identified by prevalent coronary artery disease, peripheral arterial disease, and cerebrovascular disease. Mortality hazards of PVD vs. no PVD were analyzed separately for HFpEF and HFrEF, with adjustment for age, race, sex, year of admission and geographic region. All analyses were weighted by the inverse of the sampling probability. Results Of 24,936 ADHF hospitalizations (52% female, 32% Black, mean age 75 years), 19% had PVD (22% among HFrEF hospitalizations, 17% among HFpEF hospitalizations), Figure 1. There was an increasing trend in 1-year mortality with 0, 1 and ≥2 arterial bed involvement, both for patients with HFrEF (29% to 32% to 38%; P-trend=0.0006) and HFpEF (26% to 32% to 37%; P-trend &lt;0.0001). After adjustments, PVD was associated with a 20% higher hazard of 1-year mortality in patients with HFrEF (HR=1.23; 95% CI: 1.06–1.44) and a 30% higher hazard in patients with HFpEF (HR=1.33; 95% CI: 1.09–1.63), with no significant interaction by HF type (P-interaction = 0.5). Conclusion Patients hospitalized with ADHF and coexisting PVD have an increased risk of death, irrespective of HF type. Clinical attention should be directed toward PVD, with secondary prevention strategies enacted to improve the prognosis of this vulnerable population. FUNDunding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): National Institutes of Health Distributions of arterial disease Trends in 1-year mortality outcomes

Endoscope‐assisted transoral accessory parotid mass excision: Multicenter prospective observational study

2019 ◽  
Vol 130 (5) ◽  
pp. 1218-1226 ◽  
Author(s):  
Jin Pyeong Kim ◽  
Dong Kun Lee ◽  
Jeong Hwan Moon ◽  
Jun Sun Ryu ◽  
Seung Hoon Woo
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Multicenter Prospective Observational Study

scholarly journals Eye Tumors in Childhood as First Sign of Tumor Predisposition Syndromes: Insights from an Observational Study Conducted in Germany and Austria

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1876
Author(s):  
Madlen Reschke ◽  
Eva Biewald ◽  
Leo Bronstein ◽  
Ines B. Brecht ◽  
Sabine Dittner-Moormann ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Observational Study ◽  
Ciliary Body ◽  
Prospective Observational Study ◽  
Genetic Data ◽  
Detailed History ◽  
Cancer Early Detection ◽  
Physical Examinations ◽  
Eye Tumors ◽  
Multicenter Prospective Observational Study

Retinoblastoma and other eye tumors in childhood are rare diseases. Many eye tumors are the first signs of a genetic tumor predisposition syndrome and the affected children carry a higher risk of developing other cancers later in life. Clinical and genetic data of all children with eye tumors diagnosed between 2013–2018 in Germany and Austria were collected in a multicenter prospective observational study. In five years, 300 children were recruited into the study: 287 with retinoblastoma, 7 uveal melanoma, 3 ciliary body medulloepithelioma, 2 retinal astrocytoma, 1 meningioma of the optic nerve extending into the eye. Heritable retinoblastoma was diagnosed in 44% of children with retinoblastoma. One child with meningioma of the optic nerve extending into the eye was diagnosed with neurofibromatosis 2. No pathogenic constitutional variant in DICER1 was detected in a child with medulloepithelioma while two children did not receive genetic analysis. Because of the known association with tumor predisposition syndromes, genetic counseling should be offered to all children with eye tumors. Children with a genetic predisposition to cancer should receive a tailored surveillance including detailed history, physical examinations and, if indicated, imaging to screen for other cancer. Early detection of cancers may reduce mortality.

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