0000000001071351

AUTHOR

F. Pignatti

showing 9 related works from this author

Adherence to antibiotic treatment guidelines and outcomes in the hospitalized elderly with different types of pneumonia.

2015

none 22 no Background: Few studies evaluated the clinical outcomes of Community Acquired Pneumonia (CAP), Hospital-Acquired Pneumonia (HAP) and Health Care-Associated Pneumonia (HCAP) in relation to the adherence of antibiotic treatment to the guidelines of the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS) in hospitalized elderly people (65 years or older). Methods: Data were obtained from REPOSI, a prospective registry held in 87 Italian internal medicine and geriatric wards. Patients with a diagnosis of pneumonia (ICD-9 480-487) or prescribed with an antibiotic for pneumonia as indication were selected. The empirical antibiotic regimen was defined t…

MaleAntibiotic regimenGuidelines adherenceSettore MED/09 - Medicina InternaAntibioticsLogistic regressionElderlyCommunity-acquired pneumoniaAntibiotics80 and overElderly peopleAge FactorHospital MortalityAged 80 and overTreatment regimenMedicine (all)Age FactorsOptimal managementAntibiotics; Elderly; Guidelines adherence; Mortality; Pneumonia; Re-hospitalization; Age Factors; Aged; Aged 80 and over; Anti-Bacterial Agents; Female; Hospital Mortality; Humans; Logistic Models; Male; Pneumonia; Practice Guidelines as Topic; Treatment Outcome; Guideline Adherence; Hospitalization; Internal Medicine; Medicine (all)Anti-Bacterial AgentsHospitalizationTreatment OutcomePractice Guidelines as TopicFemaleGuideline AdherenceHumanmedicine.medical_specialtyLogistic Modelmedicine.drug_classSocio-culturaleantibiotic treatment; guidelines; pneumonia; elderly;Internal medicineRe-hospitalizationAnti-Bacterial AgentmedicineInternal MedicineHumanselderly pmeumonia antibiotics guidelines adherence mortality re-hospitalizationpmeumoniaMortalityIntensive care medicineAntibiotics; Elderly; Guidelines adherence; Mortality; Pneumonia; Re-hospitalization; Age Factors; Aged; Aged 80 and over; Anti-Bacterial Agents; Female; Hospital Mortality; Humans; Logistic Models; Male; Pneumonia; Practice Guidelines as Topic; Treatment Outcome; Guideline Adherence; Hospitalization; Internal MedicineAgedbusiness.industrySettore MED/09 - MEDICINA INTERNAAntibioticPneumoniamedicine.diseasePneumoniaAntibiotics; Elderly; Guidelines adherence; Mortality; Pneumonia; Re-hospitalizationLogistic ModelsAntibiotics; Elderly; Guidelines adherence; Mortality; Pneumonia; Re-hospitalization; Age Factors; Aged; Aged 80 and over; Anti-Bacterial Agents; Female; Hospital Mortality; Humans; Logistic Models; Male; Pneumonia; Practice Guidelines as Topic; Treatment Outcome; Guideline Adherence; Hospitalizationbusiness
researchProduct

Joint use of cardio-embolic and bleeding risk scores in elderly patients with atrial fibrillation

2013

Background Scores for cardio-embolic and bleeding risk in patients with atrial fibrillation are described in the literature. However, it is not clear how they co-classify elderly patients with multimorbidity, nor whether and how they affect the physician's decision on thromboprophylaxis. Methods Four scores for cardio-embolic and bleeding risks were retrospectively calculated for ≥ 65 year old patients with atrial fibrillation enrolled in the REPOSI registry. The co-classification of patients according to risk categories based on different score combinations was described and the relationship between risk categories tested. The association between the antithrombotic therapy received and t…

RegistrieMaleEmbolismAtrial fibrillation; Bleeding risk; Cardioembolic risk; Elderly; Prediction guides; Thromboprophylaxis; Aged; Aged; 80 and over; Anticoagulants; Atrial Fibrillation; Embolism; Female; Hemorrhage; Humans; Logistic Models; Male; Platelet Aggregation Inhibitors; Retrospective Studies; Stroke; Warfarin; Registries; Risk Assessment; Internal MedicineRetrospective Studiearitmiableeding risk scoreAtrial Fibrillation80 and overatrial fibrillationRegistriesStrokeAged 80 and overAspirineducation.field_of_studyElderly Atrial fibrillation Prediction guides Bleeding risk Cardioembolic risk ThromboprophylaxisPrediction guidesAtrial fibrillationCardiovascular diseaseStrokecardio-embolic scorePlatelet aggregation inhibitorcardio-embolic scores; bleeding risk scores; elderly; Atrial FibrillationFemaleRisk assessmentmedicine.drugHumanmedicine.medical_specialtyLogistic Modelcardio-embolic scoresPopulationHemorrhageRisk AssessmentelderlyCARDIOEMBOLIC RISKNOBLEEDING RISKInternal medicinemedicineElderly; Atrial fibrillation; Prediction guides; Bleeding risk; Cardioembolic riskbleeding risk scoresPrediction guideInternal MedicineHumanseducationThromboprophylaxisAgedRetrospective StudiesELDERLYbusiness.industryPlatelet Aggregation InhibitorSettore MED/09 - MEDICINA INTERNAWarfarinAnticoagulantAnticoagulantsRetrospective cohort studyAtrial fibrillation; Bleeding risk; Cardioembolic risk; Elderly; Prediction guides; Thromboprophylaxis; Aged; Aged 80 and over; Anticoagulants; Atrial Fibrillation; Embolism; Female; Hemorrhage; Humans; Logistic Models; Male; Platelet Aggregation Inhibitors; Retrospective Studies; Stroke; Warfarin; Registries; Risk Assessment; Internal Medicinemedicine.diseaseSurgeryLogistic ModelsThromboprophylaxiWarfarinbusinessPlatelet Aggregation Inhibitors
researchProduct

Gout, allopurinol intake and clinical outcomes in the hospitalized multimorbid elderly.

2014

Background: Increased serum uric acid has been considered a cardiovascular risk factor but no study has assessed its relation with hospital mortality or length of stay. On the basis of data obtained from a prospective registry, the prevalence of gout/hyperuricemia and its association with these and other clinical parameters was evaluated in an Italian cohort of elderly patients acutely admitted to internal medicine or geriatric wards. Methods: While the prevalence of gout was calculated by counting patients with this diagnosis hyperuricemia was inferred in patients taking allopurinol at hospital admission or discharge, on the assumption that this drug was only prescribed owing to the findin…

MaleKidney DiseaseSettore MED/09 - Medicina InternahyperuricemiaComorbiditieschemistry.chemical_compoundCardiovascular Diseasegout elderlyAllopurinol; Comorbidities; Elderly; Gout; Hyperuricemia; Outcomes; Age Factors; Aged; Aged 80 and over; Allopurinol; Cardiovascular Diseases; Chronic Disease; Comorbidity; Female; Gout; Hospital Mortality; Hospitalization; Humans; Hyperuricemia; Kidney Diseases; Length of Stay; Male; Treatment Outcome; Uric Acid; Internal Medicine; Medicine (all)80 and overMedicineAge FactorHyperuricemiaHospital MortalityOutcomeAged 80 and overOUTCOMESMedicine (all)Age FactorsHospitalizationcomorbidityTreatment OutcomeCardiovascular DiseasesAllopurinol; Comorbidities; Elderly; Gout; Hyperuricemia; OutcomesCohortFemaleKidney DiseasesComorbiditieAllopurinol; Comorbidities; Elderly; Gout; Hyperuricemia; Outcomes; Age Factors; Aged; Aged 80 and over; Allopurinol; Cardiovascular Diseases; Chronic Disease; Comorbidity; Female; Gout; Hospital Mortality; Hospitalization; Humans; Hyperuricemia; Kidney Diseases; Length of Stay; Male; Treatment Outcome; Uric AcidHumanmedicine.drugmusculoskeletal diseasesmedicine.medical_specialtycongenital hereditary and neonatal diseases and abnormalitiesAllopurinolAllopurinol; Comorbidities; Elderly; Gout; Hyperuricemia; Outcomes; Age Factors; Aged; Aged 80 and over; Allopurinol; Cardiovascular Diseases; Chronic Disease; Comorbidity; Female; Gout; Hospital Mortality; Hospitalization; Humans; Hyperuricemia; Kidney Diseases; Length of Stay; Male; Treatment Outcome; Uric Acid; Internal MedicineallopurinolNOgoutGout allopurinol hyperuricemia comorbidities outcomes elderlyInternal medicineInternal MedicineHumansRisk factorIntensive care medicineAdverse effectAgedELDERLYgout allopurinol hyperuricemia comorbidities outcomes elderlybusiness.industrynutritional and metabolic diseasesLength of Staymedicine.diseaseComorbidityGoutUric AcidchemistryChronic DiseaseUric acidbusiness
researchProduct

Prevalence and Risk Factors Associated with Use of QT-Prolonging Drugs in Hospitalized Older People

2016

Aims: The objective of this study was to evaluate the prevalence of the prescription of QT-prolonging drugs at hospital admission and discharge and the risk factors associated with their use in older people (aged 65 years and older). Methods: Data were obtained from the REPOSI (REgistro POliterapie SIMI [Società Italiana di Medicina Interna]) registry, which enrolled 4035 patients in 2008 (n = 1332), 2010 (n = 1380), and 2012 (n = 1323). Multivariable logistic regression was performed to determine the risk factors independently associated with QT-prolonging drug use. QT-prolonging drugs were classified by the risk of Torsades de Pointes (TdP) (definite, possible, or conditional) acc…

MaleTORSADES-DE-POINTES INTERVAL PROLONGATION PATIENT CIPROFLOXACIN COHORT DEATH MULTIMORBIDITY AMIODARONE MORTALITY AIFA.Amiodarone030204 cardiovascular system & hematologyCIPROFLOXACINLogistic regressionAmiodaroneElectrocardiography0302 clinical medicineRisk FactorsTorsades de PointesAtrial Fibrillation80 and overPrevalencePharmacology (medical)030212 general & internal medicineAged; Aged 80 and over; Amiodarone; Atrial Fibrillation; Electrocardiography; Female; Humans; Long QT Syndrome; Male; Middle Aged; Patient Discharge; Prevalence; Risk Factors; Torsades de Pointes; Hospitalizationmedia_commonAged 80 and overTorsades de PointeAged; Aged 80 and over; Amiodarone; Atrial Fibrillation; Electrocardiography; Female; Humans; Long QT Syndrome; Male; Middle Aged; Patient Discharge; Prevalence; Risk Factors; Torsades de Pointes; Hospitalization; Pharmacology (medical); Geriatrics and Gerontology; Medicine (all)Medicine (all)DEATHMiddle AgedPatient DischargeHospitalizationLong QT SyndromeCohortHospitalized Older PeopleFemalemedicine.drugHumanDrugmedicine.medical_specialtymedia_common.quotation_subjectMULTIMORBIDITYTorsades de pointesPATIENT03 medical and health sciencesPharmacotherapyInternal medicineINTERVAL PROLONGATIONmedicineHumansTORSADES-DE-POINTESCOHORTMedical prescriptionAIFAAgedbusiness.industryMORTALITYRisk FactorSettore MED/09 - MEDICINA INTERNAOdds ratiomedicine.diseaseQT-Prolonging DrugAged; Aged 80 and over; Amiodarone; Atrial Fibrillation; Electrocardiography; Female; Humans; Long QT Syndrome; Male; Middle Aged; Patient Discharge; Prevalence; Risk Factors; Torsades de Pointes; Hospitalization; Geriatrics and Gerontology; Pharmacology (medical)Physical therapyGeriatrics and Gerontologybusiness
researchProduct

Brain and kidney, victims of atrial microembolism in elderly hospitalized patients? Data from the REPOSI study

2015

Abstract Background It is well known that atrial fibrillation (AF) and chronic kidney disease (CKD) are associated with a higher risk of stroke, and new evidence links AF to cognitive impairment, independently from an overt stroke (CI). Our aim was to investigate, assuming an underlying role of atrial microembolism, the impact of CI and CKD in elderly hospitalized patients with AF. Methods We retrospectively analyzed the data collected on elderly patients in 66 Italian hospitals, in the frame of the REPOSI project. We analyzed the clinical characteristics of patients with AF and different degrees of CI. Multivariate logistic analysis was used to explore the relationship between variables an…

MaleSettore MED/09 - Medicina InternaREPOSI studyKidneyDisability EvaluationRetrospective StudieRisk Factorshospitalized patientAtrial Fibrillation80 and overOdds RatioLS4_4Renal InsufficiencyChronicMultivariate AnalysiStrokeAged 80 and overMedicine (all)BrainAtrial fibrillationStrokeFemaleatrial microembolismHumanGlomerular Filtration Ratemedicine.medical_specialtySocio-culturaleRenal functionelderlyCognition DisorderInternal medicineThromboembolismmedicineInternal MedicineHumansRenal insufficiency chronicHeart AtriaIntensive care medicineAged; Anticoagulants; Atrial fibrillation; Dementia; Renal insufficiency chronic; Stroke; Aged; Aged 80 and over; Anticoagulants; Atrial Fibrillation; Brain; Cognition Disorders; Dementia; Disability Evaluation; Female; Glomerular Filtration Rate; Heart Atria; Humans; Kidney; Male; Multivariate Analysis; Odds Ratio; Renal Insufficiency Chronic; Retrospective Studies; Risk Factors; Stroke; ThromboembolismAgedRetrospective Studiesbusiness.industryRisk FactorSettore MED/09 - MEDICINA INTERNAAnticoagulantAnticoagulantsRetrospective cohort studyOdds ratiomedicine.diseaseAtrial fibrillationBlood pressureHeart failureMultivariate AnalysisAged Anticoagulants Atrial fibrillation Dementia Renal insufficiency chronic Stroke.Aged; Anticoagulants; Atrial fibrillation; Dementia; Renal insufficiency chronic; Strokeatrial microembolism; elderly; hospitalized patients; REPOSI study;DementiabusinessCognition DisordersKidney diseaseAged; Anticoagulants; Atrial fibrillation; Dementia; Renal insufficiency chronic; Stroke; Aged; Aged 80 and over; Anticoagulants; Atrial Fibrillation; Brain; Cognition Disorders; Dementia; Disability Evaluation; Female; Glomerular Filtration Rate; Heart Atria; Humans; Kidney; Male; Multivariate Analysis; Odds Ratio; Renal Insufficiency Chronic; Retrospective Studies; Risk Factors; Stroke; Thromboembolism; Internal Medicine; Medicine (all)
researchProduct

Multimorbidity and polypharmacy in the elderly: Lessons from REPOSI

2014

none 10 no The dramatic demographic changes that are occurring in the third millennium are modifying the mission of generalist professionals such as primary care physicians and internists. Multiple chronic diseases and the related prescription of multiple medications are becoming typical problems and present many challenges. Unfortunately, the available evidence regarding the efficacy of medications has been generated by clinical trials involving patients completely different from those currently admitted to internal medicine: much younger, affected by a single disease and managed in a highly controlled research environment. Because only registries can provide information on drug effectiven…

Adverse drug effects; Aging; Drug prescription; Multidimensional evaluation; Multimorbidity; Polypharmacy; Aged; Aged; 80 and over; Female; Humans; Internal Medicine; Italy; Male; Registries; Societies; Medical; Comorbidity; Geriatrics; Polypharmacy; Internal Medicine; Emergency MedicineMalemedicine.medical_specialtyAgingmedia_common.quotation_subjectDrug prescriptionMEDLINEAdverse drug effects; Aging; Drug prescription; Multidimensional evaluation; Multimorbidity; Polypharmacy; Aged; Aged 80 and over; Female; Humans; Internal Medicine; Italy; Male; Registries; Societies Medical; Comorbidity; Geriatrics; Polypharmacy; Internal Medicine; Emergency MedicineDiseaseComorbidityAdverse drug effects; Aging; Drug prescription; Multidimensional evaluation; Multimorbidity; PolypharmacyelderlyAdverse drug effectsPromotion (rank)MedicalmedicineAdverse drug effect80 and overInternal MedicineHumansRegistriesMedical prescriptionmedia_commonAgedGeriatricsPolypharmacyAdverse drug effects; Aging; Drug prescription; Multidimensional evaluation; Multimorbidity; Polypharmacy; Emergency Medicine; Internal MedicineMultimorbidity Polypharmacy Aging Drug prescription Multidimensional evaluation Adverse drug effectsMultidimensional evaluationbusiness.industrySettore MED/09 - MEDICINA INTERNAMultimorbiditymedicine.diseaseComorbidityelderly multimorbidity polypharmacyClinical trialItalyGeriatricsFamily medicinePolypharmacyEmergency MedicineFemaleMedical emergencyAdverse drug effects; Aging; Drug prescription; Multidimensional evaluation; Multimorbidity; Polypharmacy; Internal Medicine; Emergency MedicinebusinessSocietiesmultimorbidity; polypharmacy; aging; drug prescription; multidimensional evaluation; adverse drug effectsMultimorbidity; Polypharmacy; Aging; Drug prescription; Multidimensional evaluation
researchProduct

Rilevazione nazionale in tema di formazione specifica di medicina generale in Italia

2017

Physicians have to get a “specific” diploma attending a threeyear training course provided by each regional health service in order to practice as General Practitioners in Italy. In the last years, there has been an ongoing debate about the need to evolve the specific regional courses into integrated specialization training courses, organized and managed by universities with the contribution of regional health services. The Italian Junior Doctors Association and the Giotto Movement carried out a national survey with the aim to identify strengths and weaknesses of the specific regional training courses. Three-hundred-two junior General Practitioners in training (61,2% females) answered to a …

formazione medica post-laureamformazione medica post-lauream; medicina generale; surveysurveySettore MED/42 - Igiene Generale E Applicatamedicina generale
researchProduct

Prophylaxis of venous thromboembolism in elderly patients with multimorbidity

2013

none 327 si Pharmacological thromboprophylaxis (TP) is known to reduce venous thromboembolism (VTE) in medical inpatients, but the criteria for risk-driven prescription, safety and impact on mortality are still debated. We analyze data on elderly patients with multimorbidities admitted in the year 2010 to the Italian internal medicine wards participating in the REPOSI registry to investigate the rate of TP during the hospital stay, and analyze the factors that are related to its prescription. Multivariate logistic regression, area under the ROC curve and CART analysis were performed to look for independent predictors of TP prescription. Association between TP and VTE, bleeding and death in …

MaleTVPSettore MED/09 - Medicina InternaComorbidityLogistic regressionFondaparinuxVENOUS THROMBOEMBOLISM; THROMBOPROPHYLAXIS; Medical PatientsMedical patients; Thromboprophylaxis; Venous thromboembolism; Aged; Aged 80 and over; Area Under Curve; Comorbidity; Female; Hospital Mortality; Hospitalization; Humans; Logistic Models; Male; Propensity Score; Venous Thromboembolism; Internal Medicine; Emergency MedicineThromboprophylaxis Venous thromboembolism Medical patients80 and overHospital MortalityAged 80 and overSettore MED/45 - Scienze Infermieristiche Generali Cliniche E PediatricheMedical patients; Thromboprophylaxis; Venous thromboembolism; Aged; Aged; 80 and over; Area Under Curve; Comorbidity; Female; Hospital Mortality; Hospitalization; Humans; Logistic Models; Male; Propensity Score; Venous Thromboembolism; Internal Medicine; Emergency Medicineprophylaxis; venous thromboembolism; elderlyHospitalizationArea Under CurveEmergency MedicineFemaleprophylaxismedicine.drugVenous thromboembolismmedicine.medical_specialtyThromboprophylaxis; Venous thromboembolismmultimorbidityBarthel indexvenous thromboembolismMEDLINEMedical patients; Thromboprophylaxis; Venous thromboembolism; Aged; Aged 80 and over; Area Under Curve; Comorbidity; Female; Hospital Mortality; Hospitalization; Humans; Logistic Models; Male; Propensity Score; Venous Thromboembolism; Emergency Medicine; Internal Medicineelderly patientselderlyMedical patientsInternal medicineInternal MedicinemedicineHumansMedical prescriptionprophylaxis; venous thromboembolism; elderly patientsPropensity ScoreIntensive care medicineThromboprophylaxisAgedbusiness.industryprophylaxiMedical patients; Thromboprophylaxis; Venous thromboembolismprophylaxis; Venous thromboembolism; Elderly; multimorbidity; medical patients; thromboprophylaxismedicine.diseaseComorbidityLogistic ModelsPropensity score matchingbusinessVenous thromboembolism
researchProduct

The stigma of low opioid prescription in the hospitalized multimorbid elderly in Italy.

2015

The primary aim of this study was to evaluate the prevalence of opioid prescriptions in hospitalized geriatric patients. Other aims were to evaluate factors associated with opioid prescription, and whether or not there was consistency between the presence of pain and prescription. Opioid prescriptions were gathered from the REgistro POliterapie Societa` Italiana di Medicina Interna (REPOSI) data for the years 2008, 2010 and 2012. 1,380 in-patients, 65+ years old, were enrolled in the first registry run, 1,332 in the second and 1,340 in the third. The prevalence of opioid prescription was calculated at hospital admission and discharge. In the third run of the registry, the degree of pain was…

RegistrieMalePoison controlOlder personComorbidityPractice PatternsDrug PrescriptionOlder persons Pain Analgesic opioids80 and overRegistriesPractice Patterns Physicians'Pain MeasurementAged 80 and overAnalgesicsAnalgesic opioids; Older persons; Pain; Emergency Medicine; Internal MedicineAnalgesics OpioidHospitalizationItalyEmergency MedicineFemaleTramadolHumanmedicine.drugmedicine.medical_specialtyAttitude of Health PersonnelAnalgesicPainOpioidelderlyDrug PrescriptionsInjury preventionmedicineInternal MedicineHumansAnalgesic opioidsMedical prescriptionAgedPhysicians'business.industryCodeineSettore MED/09 - MEDICINA INTERNAAnalgesic opioidmedicine.diseaseComorbidityOlder persons Pain Analgesic opioidsOpioidOlder personsEmergency medicinebusinessAnalgesic opioids; Older persons; Pain; Aged; Aged 80 and over; Analgesics Opioid; Comorbidity; Drug Prescriptions; Female; Humans; Italy; Male; Pain; Pain Measurement; Practice Patterns Physicians'; Registries; Attitude of Health Personnel; Hospitalization; Internal Medicine; Emergency MedicineAnalgesic opioids; Older persons; Pain; Aged; Aged 80 and over; Analgesics Opioid; Comorbidity; Drug Prescriptions; Female; Humans; Italy; Male; Pain; Pain Measurement; Practice Patterns Physicians'; Registries; Attitude of Health Personnel; Hospitalization; Emergency Medicine; Internal Medicine
researchProduct