0000000000180622

AUTHOR

Alessia Valentina Giraudo

showing 5 related works from this author

Choice and Outcomes of Rate Control versus Rhythm Control in Elderly Patients with Atrial Fibrillation: A Report from the REPOSI Study

2018

Background: Among rate-control or rhythm-control strategies, there is conflicting evidence as to which is the best management approach for non-valvular atrial fibrillation (AF) in elderly patients. Design: We performed an ancillary analysis from the ‘Registro Politerapie SIMI’ study, enrolling elderly inpatients from internal medicine and geriatric wards. Methods: We considered patients enrolled from 2008 to 2014 with an AF diagnosis at admission, treated with a rate-control-only or rhythm-control-only strategy. Results: Among 1114 patients, 241 (21.6%) were managed with observation only and 122 (11%) were managed with both the rate- and rhythm-control approaches. Of the remaining 751 patie…

MaleAnti-Arrhythmia Agents/therapeutic useantiarrhythmic agentComorbidityAged; Aged 80 and over; Anti-Arrhythmia Agents; Atrial Fibrillation; Comorbidity; Diabetes Mellitus; Female; Heart Failure; Heart Rate; Hospitalization; Humans; Male; Odds Ratio; Polypharmacy; Prevalence; Geriatrics and Gerontology; Pharmacology (medical)030204 cardiovascular system & hematologyanticoagulant agentDiabetes Mellitus/drug therapy0302 clinical medicineHeart RateAtrial Fibrillation80 and overOdds RatioPrevalencePharmacology (medical)030212 general & internal medicineLS4_4Aged 80 and overantiarrhythmic agent anticoagulant agent antithrombocytic agent calcium channel blocking agent digoxinHeart Rate/drug effectsDiabetes MellituAtrial fibrillationantithrombocytic agentdigoxinHospitalizationAnti-Arrhythmia AgentFemaleAnti-Arrhythmia AgentsHumanmedicine.medical_specialtySocio-culturale-Geriatrics and Gerontology; Pharmacology (medical)03 medical and health sciencesInternal medicineDiabetes mellitusHeart rateantiarrhythmic agent; anticoagulant agent; antithrombocytic agent; calcium channel blocking agent; digoxinmedicineDiabetes MellitusHumansAgedPolypharmacyHeart Failurebusiness.industryAtrial Fibrillation/drug therapyOdds ratiomedicine.diseaseHeart Failure/drug therapyComorbidityConfidence intervalcalcium channel blocking agentHeart failurePolypharmacyAged; Aged 80 and over; Anti-Arrhythmia Agents; Atrial Fibrillation; Comorbidity; Diabetes Mellitus; Female; Heart Failure; Heart Rate; Hospitalization; Humans; Male; Odds Ratio; Polypharmacy; PrevalenceGeriatrics and Gerontologybusiness
researchProduct

Hospital Care of Older Patients With COPD: Adherence to International Guidelines for Use of Inhaled Bronchodilators and Corticosteroids

2019

Abstract Objectives We aimed to analyze the prevalence and impact of COPD in older patients hospitalized in internal medicine or geriatric wards, and to investigate adherence to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, associated clinical factors, and outcomes. Design Data were obtained from REgistro POliterapie SIMI (REPOSI), a prospective multicenter observational registry that enrolls inpatients aged ≥65 years. Setting and Participants Older hospitalized patients enrolled from 2008 to 2016 with a diagnosis of COPD. Measures We evaluated adherence to the 2018 GOLD guidelines at admission and discharge, by examining the prescription of inhaled bronchodi…

Malemajor clinical eventmajor clinical eventsPulmonary Disease Chronic Obstructive0302 clinical medicineOlder patientsAdrenal Cortex Hormones80 and over030212 general & internal medicineLS4_4adherenceProspective StudiesGeneral NursingNursing (all)2901 Nursing (miscellaneous)Aged 80 and overCOPDHealth PolicyGeneral MedicineCOPD guidelines adherence major clinical events older patientsolder patientsObstructive lung diseaseBronchodilator Agentsguidelines adherenceHospitalizationInhalationCOPD; guidelines adherence; major clinical events; older patients; Administration Inhalation; Adrenal Cortex Hormones; Aged; Aged 80 and over; Bronchodilator Agents; Female; Humans; Male; Prospective Studies; Pulmonary Disease Chronic Obstructive; Guideline Adherence; HospitalizationAdministrationFemaleGuideline AdherenceCOPD guidelinesCOPD; guidelines adherence; major clinical events; older patients; Nursing (all)2901 Nursing (miscellaneous); Health Policy; Geriatrics and GerontologyChronic Obstructivemedicine.medical_specialtySocio-culturalePulmonary Disease03 medical and health sciencesolder patientInternal medicineAdministration InhalationmedicineHumansCOPDMedical prescriptionAgedPolypharmacybusiness.industrySettore MED/09 - MEDICINA INTERNAOdds ratiomedicine.diseaseConfidence intervalrespiratory tract diseasesCOPD; guidelines adherence; major clinical events; older patientsObservational studyGeriatrics and Gerontologybusiness030217 neurology & neurosurgery
researchProduct

Adherence to antithrombotic therapy guidelines improves mortality among elderly patients with atrial fibrillation: insights from the REPOSI study

2016

Background: Atrial fibrillation (AF) is associated with a substantial risk of thromboembolism and mortality, significantly reduced by oral anticoagulation. Adherence to guidelines may lower the risks for both all cause and cardiovascular (CV) deaths. Methods: Our objective was to evaluate if antithrombotic prophylaxis according to the 2012 European Society of Cardiology (ESC) guidelines is associated to a lower rate of adverse outcomes. Data were obtained from REPOSI; a prospective observational study enrolling inpatients aged ≥65 years. Patients enrolled in 2012 and 2014 discharged with an AF diagnosis were analysed. Results: Among 2535 patients, 558 (22.0 %) were discharged with a diagnos…

Antithrombotic therapy; Atrial fibrillation; Elderly; Guidelines; Outcomes; Cardiology and Cardiovascular MedicineMaleRegistrieTime Factorsantithrombotic therapy; atrial fibrillation; elderly; guidelines; outcomesAtrial fibrillation (AF)Practice PatternsKaplan-Meier Estimate030204 cardiovascular system & hematologyGuidelineoutcomesCoronary artery disease0302 clinical medicineElderlyRisk FactorsAtrial FibrillationAntithrombotic80 and overAge Factor030212 general & internal medicineRegistriesguidelinesAntithrombotic therapy Atrial fibrillation Elderly Guidelines OutcomesPractice Patterns Physicians'OutcomeAged 80 and overFibrinolytic AgentAge FactorsAtrial fibrillationGeneral MedicineTreatment OutcomeItalyAtrial fibrillation (AF) thromboembolism antithrombotic prophylaxisPractice Guidelines as TopicCardiologyFemaleGuideline AdherenceCardiology and Cardiovascular MedicineHumanAntithrombotic therapy; Atrial fibrillation; Elderly; Guidelines; Outcomes; Age Factors; Aged; Aged 80 and over; Atrial Fibrillation; Chi-Square Distribution; Female; Fibrinolytic Agents; Guideline Adherence; Humans; Italy; Kaplan-Meier Estimate; Logistic Models; Male; Practice Patterns Physicians'; Proportional Hazards Models; Registries; Risk Assessment; Risk Factors; Thromboembolism; Time Factors; Treatment Outcome; Practice Guidelines as Topic; Cardiology and Cardiovascular Medicinemedicine.medical_specialtyLogistic ModelTime FactorSocio-culturaleLower riskRisk Assessment03 medical and health sciencesFibrinolytic AgentsInternal medicineThromboembolismmedicineHumansProportional Hazards ModelsAgedAntithrombotic therapyPhysicians'Chi-Square Distributionbusiness.industryProportional hazards modelRisk FactorSettore MED/09 - MEDICINA INTERNAGuidelinethromboembolismmedicine.diseaseAtrial fibrillationLogistic ModelsProportional Hazards Modelantithrombotic prophylaxisbusinessChi-squared distributionFibrinolytic agent
researchProduct

Polypharmacy in older people: lessons from 10 years of experience with the REPOSI register

2018

As a consequence of population aging, we have witnessed in internal medicine hospital wards a progressive shift from a population of in-patients relatively young and mainly affected by a single ailment to one of ever older and more and more complex patients with multiple chronic diseases, followed as out-patients by many different specialists with poor integration and inevitably treated with multiple medications. Polypharmacy (defined as the chronic intake of five or more drugs) is associated with increased risks of drug-drug interactions and related adverse effects, prescription and intake errors, poor compliance, re-hospitalization and mortality. With this background, the Italian Society …

Malemedicine.medical_specialtyPopulation ageingDeprescribing; Inappropriate prescription; Medication reconciliation; Multimorbidity; PolypharmacyPopulationSocio-culturale030204 cardiovascular system & hematology03 medical and health sciences0302 clinical medicineDeprescribingRisk Factors80 and overDeprescribing; Inappropriate prescription; Medication reconciliation; Multimorbidity; Polypharmacy; Internal Medicine; Emergency MedicineInternal MedicinemedicineDeprescribing Inappropriate prescription Medication reconciliation Multimorbidity PolypharmacyHumansMultimorbidityRegistries030212 general & internal medicineMedical prescriptionAdverse effecteducationAgedAged 80 and overPolypharmacyGeriatricseducation.field_of_studybusiness.industryMultimorbidityPatient DischargeHospitalizationDeprescribing; Inappropriate prescription; Medication reconciliation; Multimorbidity; Polypharmacy; Aged; Aged 80 and over; Female; Geriatrics; Hospitalization; Humans; Italy; Male; Multimorbidity; Patient Discharge; Registries; Risk Factors; PolypharmacyItalyGeriatricsFamily medicinePolypharmacyEmergency MedicineMedication reconciliationFemaleDeprescribingbusinessDeprescribing; Inappropriate prescription; Medication reconciliation; Multimorbidity; Polypharmacy;Inappropriate prescriptionInternal and Emergency Medicine
researchProduct

Heart failure and chronic kidney disease in a registry of internal medicine wards

2014

Background: The aim of the present study was to evaluate the association between heart failure (HF) and chronic kidney disease (CKD) in tertiary care centers using the clinical records of patients enrolled in internal medicine departments.Patients and methods: We used the clinical records of 1380 elderly patients to identify patients with a history of HF and CKD using admission ICD codes and glomerular filtration rate (GFR) formulas. Magnitude and strength of such associations were investigated by univariable and multivariable analysis.Results: Of the 1380 patients enrolled, 27.9% had HF (age 80 ± 7, BMI 27 ± 6 kg/m2) and 17.4% CKD (age 81 ± 7, BMI 26.8 ± 6 kg/m2). Both groups were signific…

medicine.medical_specialtyChronic kidney disease; Elderly; Heart failure; REPOSI; Gerontology; Geriatrics and GerontologyHeart failure; Elderly; Chronic kidney disease; REPOSIChronic kidney disease; Elderly; Heart failure; REPOSI; Humans; Sleep Apnea Syndromes; Noninvasive Ventilation; Gerontology; Geriatrics and GerontologyChronic kidney disease; Elderly; Heart failure; REPOSIRenal functionHeart failure; chronic kidney disease; elderly; registry; REPOSIHeart failureregistryTertiary careSleep Apnea SyndromeElderlySleep Apnea SyndromesInternal medicineChronic kidney diseaseEpidemiologymedicineHumansNoninvasive Ventilationbusiness.industryREPOSIChronic kidney disease; Elderly; Heart failure; REPOSI; Humans; Sleep Apnea Syndromes; Noninvasive Ventilation; Geriatrics and Gerontology; Gerontologymedicine.diseaseHeart failureHeart failure Elderly Chronic kidney disease REPOSIIcd codesGeriatrics and GerontologybusinessClinical recordBody mass indexGerontologyKidney diseaseHuman
researchProduct