scholarly journals The CONFINE (Comorbidities and Outcome iN patients with chronic heart Failure: a study in INternal mEdicine units) study: a new epidemiologic observational study on heart failure in the internal medicine departments in Italy

2013 ◽  
pp. 57-64
Author(s):  
P. Biagi
Keyword(s):  
Internal Medicine ◽  
Heart Failure ◽  
Observational Study ◽  
Inflammatory Diseases ◽  
Correct Diagnosis ◽  
Cognitive Disorders ◽  
Epidemiological Data ◽  
Chronic Kidney Failure ◽  
Chronic Obstructive ◽  
Quality Life

BACKGROUND The burden of heart failure (HF) is enormous and its prevalence increases sharply with age. It has been estimated that heart failure affects up to 3% of the general population and 10% of the elderly. It contributes to hospital admission for most of them, mainly elder adults (admitted in internal medicine units) with more than one comorbidity, cognitive disorders, impairment and so on. Despite the increasing prevalence of heart failure, its exact incidence and prevalence remain largely unknown and probably underestimated due to a lack of accurate epidemiological data and difficulties associated with comorbidities and correct diagnosis: over 40% of recurrent hospitalization causes, either cardiac or extracardiac, cannot be determined due to the lack of data. AIM OF THE STUDY The objective of this study estimated the prevalence and the primary care burden associated with comorbidities in internal medicine units. METHOD The design: a longitudinal multicentric observational study using spot analysis three data sheets were filled in during the hospital stay according to three crucial moments: enrolment (“the index day”), admission and discharge. Will be analyzed the following primary outcomes: total and cardiovascular mortality, intensive unit care admission, recurrent cardiovascular disorders, length of stay, hospital readmission, changes in activities of daily living, need for care. Second outcomes: clinical, therapeutic, instrumental and laboratory changes during the admission process. Deep analysis of the following comorbidities will be also taken into account: acute and chronic kidney failure, anaemia, chronic obstructive pulmonary disease, muscle loss, nutritional status, cirrhosis of the liver, neoplasms, blood cell disorders, chronic inflammatory diseases. Further evalutation items: cognitive impairment, self-sufficiency and perception of quality life.

scholarly journals A Tale of Two Specialties: Differences between Heart Failure Patients Admitted to Internal Medicine and Cardiology

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Vanja Petrovic MD ◽  
Sirar Ibrahim MD ◽  
Valerie A. Palda MD MSc
Keyword(s):  
Internal Medicine ◽  
Heart Failure ◽  
Complex Disease ◽  
Systolic Function ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Risk Of Mortality ◽  
Clinical Profiles

The authors described and compared the clinical profiles of patients hospitalized with heart failure (HF) to internal medicine (IM) and cardiology services. Data on age, gender, length of stay, and left ventricular systolic function, as well as specific co-morbidities and clinical parameters, were recorded retrospectively to allow the assessment of provider-related differences in HF populations.IM patients were significantly older, more likely to be female, and more likely to have preserved left ventricular function. IM patients also suffered a significantly greater number of co-morbidities, in particular chronic obstructive pulmonary disease, pneumonia, other lung diseases, thromboembolic disease, anemia, and arthritis. Finally, significantly more IM patients had a high risk of mortality at the time of hospital admission compared with cardiology patients. In summary, IM patients were older, “sicker,” and more likely to die within the next year. Complex disease and advanced age may affect outcomes, therapeutic strategies, and impact on diagnostic accuracy.  

Receiving care according to national heart failure guidelines is associated with lower total costs: an observational study in Region Halland, Sweden

2020 ◽  
Author(s):  
Zayed M Yasin ◽  
Philip D Anderson ◽  
Markus Lingman ◽  
Japneet Kwatra ◽  
Awais Ashfaq ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Observational Study ◽  
Health Care Utilization ◽  
Inpatient Care ◽  
Quality Care ◽  
Prescribing Patterns ◽  
Care Utilization ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

Abstract Aims Patients with heart failure (HF) have high costs, morbidity, and mortality, but it is not known if appropriate pharmacotherapy (AP), defined as compliance with international evidence-based guidelines, is associated with improved costs and outcomes. The purpose of this study was to evaluate HF patients’ health care utilization, cost and outcomes in Region Halland (RH), Sweden, and if AP was associated with lower costs. Methods and results A total of 5987 residents of RH in 2016 carried HF diagnoses. Costs were assigned to all health care utilization (inpatient, outpatient, emergency department, primary health care, and medications) using a Patient Encounter Costing methodology. Care of HF patients cost €58.6 M, (€9790/patient) representing 8.7% of RH’s total visit expenses and 14.9% of inpatient care (IPC) expenses. Inpatient care represented 57.2% of this expenditure, totalling €33.5 M (€5601/patient). Receiving AP was associated with significantly lower costs, by €1130 per patient (P < 0.001, 95% confidence interval 574–1687). Comorbidities such as renal failure, diabetes, chronic obstructive pulmonary disease, and cancer were significantly associated with higher costs. Conclusion Heart failure patients are heavy users of health care, particularly IPC. Receiving AP is associated with lower costs even adjusting for comorbidities, although causality cannot be proven from an observational study. There may be an opportunity to decrease overall costs and improve outcomes by improving prescribing patterns and associated high-quality care.

Evaluation of epidemiological data on effect of therapy with Ipigrix® on motor and sensory functions in ambulatory patients with various diseases ofperipheral nervous system

2019 ◽  
Vol 1 (2) ◽  
pp. 11-14
Author(s):  
O. S. Levin ◽  
O. V. Matvievskaya
Keyword(s):  
Nervous System ◽  
Observational Study ◽  
Peripheral Nervous System ◽  
Epidemiological Data ◽  
Comprehensive Analysis ◽  
Ambulatory Patients ◽  
Effect Of Therapy ◽  
Sensory Functions

The article contains a comprehensive analysis of the summary epidemiological data obtained during the observational study to assess the effect of therapy with Ipigrix® on the dynamics of motor and sensory functions, as well as the severity of pain in outpatient patients with various diseases of the peripheral nervous system: mononeuropathy, polyneuropathy and polyradiculopathy of various origins.

Advance care planning in chronic disease: finding the known in the midst of the unknown

2018 ◽  
Author(s):  
Karen Detering ◽  
Elizabeth Sutton ◽  
Scott Fraser
Keyword(s):  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Advance Care Planning ◽  
Chronic Obstructive ◽  
Care Planning ◽  
Health Care Teams ◽  
Management Options ◽  
Medical Decisions ◽  
Obstructive Pulmonary Disease ◽  
Advance Care

People are living longer lives with a greater burden of disease. Diseases which contribute significantly to this burden are chronic kidney disease; chronic obstructive pulmonary disease and heart failure. Technologies exist that can sustain life for patients with these disease, however patients and their families/loved ones need to know the likely outcome of their disease, its course, and all management options. Advance care planning (ACP) can assist with this process as well as ensuring that patients, families, and health care teams are aware of what treatment a patient wants—or does not want. ACP also enables the appointment of a decision maker to act on behalf of the patient should they lose capacity to make medical decisions. This chapter discusses the benefits of ACP and why it needs to be introduced early in the course of any life-limiting illness.

Combined Renal-Pulmonary Extracorporeal Support with Low Blood Flow Techniques: A Retrospective Observational Study (CICERO Study)

2021 ◽  
pp. 1-10
Author(s):  
Guglielmo Consales ◽  
Lucia Zamidei ◽  
Franco Turani ◽  
Diego Atzeni ◽  
Paolo Isoni ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Observational Study ◽  
Multiorgan Failure ◽  
Invasive Mechanical Ventilation ◽  
Respiratory Acidosis ◽  
Kidney Injury ◽  
Protective Ventilation ◽  
Retrospective Observational Study ◽  
Organ Support ◽  
Chronic Obstructive

<b><i>Background:</i></b> Critically ill patients with acute respiratory failure frequently present concomitant lung and kidney injury, within a multiorgan failure condition due to local and systemic mediators. To face this issue, extracorporeal carbon dioxide removal (ECCO<sub>2</sub>R) systems have been integrated into continuous renal replacement therapy (CRRT) platforms to provide a combined organ support, with efficient clearance of CO<sub>2</sub> with very low extracorporeal blood flows (&#x3c;400 mL/min). <b><i>Objectives:</i></b> To evaluate efficacy and safety of combined ECCO<sub>2</sub>R-CRRT support with PrismaLung®-Prismaflex® in patients affected by hypercapnic respiratory acidosis associated with AKI in a second level intensive care unit. <b><i>Methods:</i></b> We carried out a retrospective observational study enrolling patients submitted to PrismaLung®-Prismaflex® due to mild to moderate acute respiratory distress syndrome (ARDS) or acute exacerbation of chronic obstructive pulmonary disease (aeCOPD). The primary endpoints were the shift to protective ventilation and extubation of mechanically ventilated patients and the shift to invasive mechanical ventilation of patients receiving noninvasive ventilation (NIV). Clinical-laboratoristic data and operational characteristics of ECCO<sub>2</sub>R-CRRT were recorded. <b><i>Results:</i></b> Overall, 12/17 patients on mechanical ventilation shifted to protective ventilation, CO<sub>2</sub> clearance was satisfactorily maintained during the whole observational period, and pH was rapidly corrected. Treatment prevented NIV failure in 4 out of 5 patients. No treatment-related complications were recorded. <b><i>Conclusion:</i></b> ECCO<sub>2</sub>R-CRRT was effective and safe in patients with aeCOPD and ARDS associated with AKI.

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