scholarly journals COMPREHENSIVE ASSESSMENT OF COMBORIDITY IN CLINICAL PRACTICE: METHODICAL APPROACHES AND PRACTICAL USE

2021 ◽  
Vol 2 (16) ◽  
pp. 32-38
Author(s):  
G.Z. Moroz ◽  
I.M. Hidzynska ◽  
T.S. Lasytsia
Keyword(s):  
Clinical Practice ◽  
Coronary Artery ◽  
Medical Records ◽  
Charlson Comorbidity Index ◽  
Clinical Medicine ◽  
Myocardial Revascularization ◽  
State Institution ◽  
Comprehensive Assessment ◽  
Coronary Artery Stenting ◽  
Comorbidity Index

Aim: to evaluate current approaches to the assessment of comorbidity in clinical practice and determine the prevalence of comorbidities in patients with coronary artery disease (CAD) who underwent coronary artery stenting. Material and methods. We performed a retrospective analysis of data from electronic medical records of 150 CAD patients below 75 yrs having undergone myocardial revascularization via percutaneous coronary intervention (coronary artery stenting). All of them were under the monitoring of the cardiologists of the State Institution of Science «Research and Practical Center of Preventive and Clinical Medicine” State Administrative Department. Comorbidity assessment was performed via diseases count; we have dealt only with diseases that are included in the Charlson Comorbidity Index (ССІ) and Combined Age Charlson Comorbidity Index (СА-ССІ) calculation proceeding. We used statistical software programs (Statistica v. 6.0) and Microsoft Excel 2007 applications for data analysis. Results. According to data of the medical records the most common comorbidities (among those used to calculate CCI and CA-CCI) in patients with CAD below 75 yrs who underwent coronary artery stenting were cerebrovascular disease (83.3 ± 3.0%), peripheral vascular diseases (42,7±4,0%), type 2 diabetes mellitus, and mild liver diseases (24,0±3,6%). It was found that the number of comorbid diseases in patients having been examined ranged from 2 to 7, with an average of 3,9±0,1. The mean number of diseases in patients of different ages did not differ significantly. The average CA-CCI value increased from 4,4±0,2 points in patients who had two diseases to 12,7±1,1 points in those with seven ones (р<0,05). Conclusions. Our study revealed a high prevalence of comorbidities in patients with CAD below 75 yrs who underwent coronary artery stenting. The use of CA-CCI allowed making a comprehensive assessment of patient’s conditions

Advanced measurements of coronary calcium scores: how does it affect current clinical practice?

2021 ◽  
Author(s):  
Antonio Nenna ◽  
Francesco Nappi ◽  
Cristiano Spadaccio ◽  
Salvatore Matteo Greco ◽  
Michele Pilato ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Coronary Artery ◽  
Prognostic Significance ◽  
Myocardial Revascularization ◽  
Scoring Systems ◽  
Coronary Calcification ◽  
Surgical Strategies ◽  
Percutaneous Procedures ◽  
Artery Disease ◽  
Evaluation Techniques

Coronary artery calcium (CAC) scoring has emerged as a marker of the burden of atheromatous disease and has been included in scoring systems. The practice of myocardial revascularization, considering percutaneous procedures or surgical strategies, is dramatically changing over years and the prognostic significance of CAC scoring is gradually being conceived. In this interdisciplinary scenario, vessel specific calcium scoring, mapping of coronary calcification and its integration with functional assessment of coronary artery disease might change the future decisions in the catheterization lab and operative theaters. This article summarizes CAC evaluation techniques and its implications in clinical practice.

scholarly journals The relationship of Charlson comorbidity index with stent restenosis and extent of coronary artery disease

2018 ◽  
Vol 10 (2) ◽  
pp. 70-75 ◽  
Author(s):  
Turgut Karabağ ◽  
Emіne Altuntaş ◽  
Belma Kalaycı ◽  
Bahar Şahіn ◽  
Mustafa Umut Somuncu ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Charlson Comorbidity Index ◽  
Stent Restenosis ◽  
Comorbidity Index ◽  
Artery Disease ◽  
Relationship Of ◽  
The Relationship

scholarly journals Comprehensive assessment of patients with chronic obstructive pulmonary disease by means of multicomponent ADO index and Charlson comorbidity index

2018 ◽  
pp. 182-184 ◽  
Author(s):  
E. Kochetova
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Correlation Coefficient ◽  
Charlson Comorbidity Index ◽  
Comprehensive Assessment ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Comorbidity Index

The purpose of this study was to investigate the ADO index, and index of comorbidity of Charlson in patients with chronic obstructive pulmonary disease (COPD). Materials and methods: 207 patients with chronic obstructive pulmonary disease (COPD) were observed. The investigated group was made by the patients having the long experience of smoking. Research of function of external breath was studied with multimodular installation of type «Master-Lab/Jaeger». Patients were determined the index ADO and of comorbidity of Charlson. Results: The index ADO increased with stage of COPD, minimum of level ADO was observed in patients with COPD 2 stage 2,23 ± 0,88, in patients with 3 stage COPD ADO was 5,05 ± 1,19, 4 stages of COPD 7,0 ± 1,0. The correlation coefficient between ADO index and and index of comorbidity Charlson was -0,71, p <0,005. The correlation coefficient between ADO and VC was -0,57, p <0,05, between ADO and ERV was -0,63, p <0,05. 

scholarly journals Evaluation of observation of the patients with coronary heart disease after surgical treatment

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
Z Bekbergenova ◽  
G Mauletbayeva ◽  
A Umbetzhanova ◽  
G Derbissalina ◽  
V Koikov ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Surgical Treatment ◽  
Medical Records ◽  
Hypertensive Crisis ◽  
Myocardial Revascularization ◽  
Functional Studies ◽  
Coronary Syndrome ◽  
Leading Position ◽  
Artery Disease ◽  
One Year

Abstract Background To reduce mortality from cardiovascular diseases in Kazakhstan, which occupies the leading position, patients are under observation. To evaluate of patients with coronary artery disease who have undergone myocardial revascularization by installing coronary artery stenting or bypass surgery. Methods A retrospective analysis of outpatient medical records of patients. Results Analysis included medical records of 4% patients at the age of 40-49 years, 49%-50-59 years, 22%-60-69 years, 11%-70-79 years, 4% patients older than 80 year. 92% patients were admitted to the hospital with acute coronary syndrome and were urgently operated. Patients with chronic heart failure were operated routinely. 12% patients received surgical treatment twice, including 4% patients routinely. All patients had comorbidities: 63% of people-arterial hypertension, 12%-cardiac arrhythmia, 14%-diabetes. The analysis showed that only 51% of patients were regularly observed in accordance with the standards of the survey during one year of observation. According to the standards the scheduled ECG study of the patients after surgery should be done after 1, 2, 3 and 6 months. In accordance of the standard 23% patients were examined, 3 times a year - 19% patients, 23% people-twice a year. Other functional studies-echocardiography 1 time per year have been studied on 14% people, treadmill test-5% patients. Coagulation monitoring during one year- 46% patients. One of the criteria of proper observation is the number of readmissions. 11% patients were readmitted where 5% of them in the first month after surgery-6% patient with hypertensive crisis, 11%-with an increase of CHF, 2%-with postoperative pleural effusion. 2% patients hospitalized with restenosis after 7 months. Conclusions It should be noted that irregular visits to the doctor questioned the compliance of patients to treatment. Due to the lack of control by medical workers, the patients were not fully examined. Key messages The continuity of work between hospital doctors and primary care organizations is necessary. Patients to improve the favorable prognosis requires regular medication.

scholarly journals Comorbidities in Patients before Surgical Myocardial Revascularization: Current State of the Problem. Part I

2021 ◽  
pp. 10-17
Author(s):  
Olena K. Gogayeva ◽  
Mariia A. Drobnich ◽  
Natalia O. Lytvyn ◽  
Oleksandra O. Nastenko ◽  
Roman I. Salo
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Chronic Kidney Disease ◽  
Cardiac Surgery ◽  
Coronary Artery ◽  
Surgical Treatment ◽  
Kidney Disease ◽  
Myocardial Revascularization ◽  
Comorbidity Index ◽  
Artery Disease

Every year we see an increase in the number of patients with indications for surgical treatment of coronary artery disease. In addition to the difficulties of the cardiac surgery process, no less important is the therapeutic support of patients, which in addition to cardiac subtleties requires guidance in concomitant nosologies. As the age of patients increases, there is a higher comorbidity which is associated with difficult management of patients, extensive prescription of drugs and higher cost of medical care. The aim. To analyze the current literature data on comorbidity in patients hospitalized for coronary artery bypass grafting. Results. According to the literature data, there is a high Charlson comorbidity index, in average 5.7 ± 1.7, in the baseline status of patients with coronary artery disease. High comorbidity index is known for its negative effect on the functioning of grafts in the long-term period after surgical myocardial revascularization. Among patients who underwent surgical revascularization of the myocardium, 22.8–46.9% had diabetes mellitus, 37.5% had obesity, 1.1% had rheumatoid arthritis and 10–12% suffered from chronic kidney disease. There is no statistical data on preoperative status of gastrointestinal tract, but the main complications and predictors of death were identified. Due to the increase in the occurrence of autoimmune diseases on the background of the COVID-19 pandemic, an increase in the number patients with connective tissue diseases in cardiac surgery is predicted, and perioperative management of such patients has its own characteristics and requires further in-depth study. Conclusions. Searching for comorbidity in cardiac surgery patients with coronary artery disease is an important component of their preoperative preparation and risk stratification. The influence of type 2 diabetes mellitus, obesity, autoimmune diseases, chronic kidney disease on the occurrence of postoperative complications and the result of surgical myocardial revascularization has been proven. SARS-CoV-2 infection in the surgical treatment of coronary artery disease is another challenge of today that requires further observation and research to help address prognosis, complications, and mortality.

scholarly journals ASSESSMENT OF ACHIEVING TARGET BLOOD PRESSURE LEVEL IN PATIENTS WITH CORONARY HEART DISEASE AND HYPERTENSION

2020 ◽  
Vol 4 (14) ◽  
pp. 26-32
Author(s):  
I.M. Hidzynska ◽  
G. Z. Moroz ◽  
A.V. Hriva ◽  
V.P. Rozanova ◽  
O.G. Trofimova
Keyword(s):  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Medical Records ◽  
Clinical Medicine ◽  
Science Research ◽  
State Institution ◽  
Target Level ◽  
The Mean

Purpose:  To evaluate the achievement of target blood pressure (BP) level in patients with coronary heart disease and hypertension who were under follow-up of cardiologists of the State  Institution  of  Science  «Research  and  Practical  Center  of  Preventive  and  Clinical  Medicine»  State  Administrative Department Materials and methods: We evaluated 1120 electronic medical records (medical software program “ESCUL’ap”) and carried out an analysis of target BP level’s achievement in 512 patients with coronary heart disease and hypertension who were under follow-up of cardiologists of the Therapeutic department of our institution and were reviewed by a cardiologist in 2019. The percentage of female patients was 30,1±2,0%. Patient`s age ranged from 37 to 91 years, the mean age was 72,1±0,4 years, 72,8±0,6 years in woman and 71,8±0,4 years in mans. We used statistical software programs (Statistica v. 6.0) and Microsoft Excel 2007 applications for data analysis. Categorical data were presented as absolute and relative (%) frequency. To enable comparisons, we calculated the mean value (M), and the the standard error of the mean (m). Student's t-test was used to compare the mean of data for groups. Results and discussion: According to data of the medical records the target level of BP (<140/90 mm Hg) was attained in 343 of 512 patients (67,0±2,1%) – in 70,1±2,4% of male patients and 59,7±4,0% of women (р>0,05). The highest rate of target BP achievement – 83,3±6,8% – was in 50-59 years old, the lowest – 61,5±3,2% – in 70-79 years old. Our results were significantly better than in the EUROASPIRE IV survey – according to the results of this study the target BP levels were achieved only by 38% of men and 47% of women in Ukraine and by 35% of men and 48% of women in other European countries. Conclusions. Our study demonstrates that 67,0±2,1% (70,1±2,4% of mans and 59,7±4,0% of women) of patients with coronary heart disease and hypertension who were under follow-up of cardiologists achieved the target level of BP (<140/90 mm Hg). These data confirms the effectiveness of the model of medical care for patients with hypertension, introduced in the State  Institution  of  Science  «Research  and  Practical  Center  of  Preventive  and  Clinical  Medicine»  State  Administrative Department

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