0000000001085525

AUTHOR

Deborah Chiesa

showing 6 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
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Pooled analysis of who surgical safety checklist use and mortality after emergency laparotomy

2019

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients incl…

AdultMalebarriershumanoschecklist; surgery; human development indexGlobalSurg CollaborativeWHO Surgical Safety Checklist mortality emergency laparotomyWorld Health Organizationseguridad del pacienteNOCohort Studieslista de controlestudios prospectivosHumanstasa de supervivenciaProspective Studiesimplementationestudios de cohortesSurgery; implementation; health; barriersEmergency Treatment11 Medical and Health Sciencesmediana edadDigestive System Surgical ProceduresAgedancianoLaparotomyScience & TechnologyhealthOriginal ArticlesadultoMiddle Agedchecklist WHOprocedimientos quirúrgicos del sistema digestivoChecklistSurvival RateElective Surgical Procedureslaparotomíatratamiento de urgenciaSurgeryOriginal ArticleFemalePatient SafetyLife Sciences & Biomedicine
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Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multice…

2018

Background Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the Globa…

Malehumanosfactores socioeconómicospaíses desarrolladosGlobal Healthglobal suregryincidenciaArticleNOCohort StudiesRisk Factorspaíses en desarrolloestudios prospectivossurgical site infection; global suregry; human development indexfactores de riesgoHumansSurgical Wound Infectiongastrointestinal surgeryProspective Studiesestudios de cohortesDeveloping CountriesPovertyDigestive System Surgical ProceduresCross InfectionDeveloped CountriesIncidencesurgical site infectionssurgical site infectioninfectionprocedimientos quirúrgicos del sistema digestivoInfectious Diseases surgical site infection gastrointestinal surgeryInfectious DiseasesSocioeconomic Factorshuman development indexinfección de la herida operatoriasurgical siteFemaleinfección hospitalaria
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Global economic burden of unmet surgical need for appendicitis

2022

Abstract Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capita…

surgical unmetneedno keywords listedsurgical unmetneed; appendicitis; global surgeryFinancial StressHealth Care Costsglobal surgeryAppendicitisFinancial StreHealth Care CostCost of IllnessHumansappendicitiseconomic burden surgerySurgeryAppendicitiHuman
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Antipsychotic prescription and mortality in hospitalized older persons

2017

Background Recent scientific reports have shown that older persons treated with antipsychotics for dementia-related behavioural symptoms have increased mortality. However, the impact of these drugs prescribed during hospitalization has rarely been assessed. We aimed to investigate whether antipsychotics are associated with an increased risk of mortality during hospitalization and at 3-month follow-up in elderly inpatients. Methods We analyzed data gathered during two waves (2010 and 2012) by the REPOSI (Registro Politerapie Societa Italiana Medicina Interna). All new prescriptions of antipsychotic drugs during hospitalization, whether maintained or discontinued at discharge, were collected,…

medicine.medical_specialtyMultivariate analysis030214 geriatricsbusiness.industrymedicine.medical_treatmentmedicine.diseaseLogistic regression03 medical and health sciencesPsychiatry and Mental health0302 clinical medicineRating scaleNormal cognitionInternal medicinemedicineHaloperidolDementiaGeriatrics and GerontologyMedical prescriptionAntipsychoticbusinessPsychiatryGerontology030217 neurology & neurosurgerymedicine.drugPsychogeriatrics
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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
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