0000000001085595

AUTHOR

Tiziana Tognin

showing 11 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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What changed in the Italian internal medicine and geriatric wards during the lockdown

2021

A total of 48 internal medicine or geriatric wards among the 93 adhering to the register REPOSI answered an online questionnaire aimed to investigate the characteristics and activities of converted and non-converted wards in the crucial period of the first wave of the epidemic, 22 February-4 May 2020

2019-20 coronavirus outbreakCoronavirus disease 2019 (COVID-19)Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)Aged; Humans; Italy; Hospitals; Internal MedicineMEDLINEgeriatricSocio-culturalelaw.inventionlockdownHospitalPatient TransportlawPandemicHospital dischargemedicineInternal MedicineAged Hospitals Humans Internal Medicine ItalyHumansLetter to the EditorInternal medicineAgedLS7_9business.industrygeriatric patientsmedicine.diseaseIntensive care unitHospitalsInternal medicine geriatric patients lockdown covid-19Italycovid-19Medical emergencybusinessHuman
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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
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Appropriateness of oral anticoagulant therapy prescription and its associated factors in hospitalized older people with atrial fibrillation

2018

Aims: Although oral anticoagulants (OACs) are effective in preventing stroke in older people with atrial fibrillation (AF), they are often underused in this particularly high-risk population. The aim of the present study was to assess the appropriateness of OAC prescription and its associated factors in hospitalized patients aged 65 years or older. Methods: Data were obtained from the retrospective phase of Simulation-based Technologies to Improve the Appropriate Use of Oral Anticoagulants in Hospitalized Elderly Patients With Atrial Fibrillation (SIM-AF) study, held in 32 Italian internal medicine and geriatric wards. The appropriateness of OAC prescription was assessed, grouping patients …

MaleOralappropriateness of prescriptionappropriateness of prescription atrial fibrillation internal medicine geriatric wards older patients oral anticoagulantSocio-culturaleAdministration OralHemorrhageInappropriate PrescribingDrug Prescriptionsinternal medicine and geriatric wardDose-Response Relationshipolder patientRisk Factorsoral anticoagulant80 and overHumansatrial fibrillationPharmacology (medical)Prospective StudiesAgedRetrospective StudiesAged 80 and overPharmacologygeriatric wardsDose-Response Relationship DrugSettore MED/09 - MEDICINA INTERNAAge FactorsAnticoagulantsinternal medicine and geriatric wardsOriginal Articlesolder patientsappropriateness of prescription; atrial fibrillation; internal medicine and geriatric wards; older patients; oral anticoagulant;appropriateness of prescription; atrial fibrillation; internal medicine and geriatric wards; older patients; oral anticoagulant; Pharmacology; Pharmacology (medical)Strokeinternal medicineappropriateness of prescription; atrial fibrillation; internal medicine and geriatric wards; older patients; oral anticoagulantAdministrationFemaleDrug
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Sex-Differences in the Pattern of Comorbidities, Functional Independence, and Mortality in Elderly Inpatients: Evidence from the RePoSI Register

2019

Background: The RePoSi study has provided data on comorbidities, polypharmacy, and sex dimorphism in hospitalised elderly patients. Methods: We retrospectively analysed data collected from the 2010, 2012, 2014, and 2016 data sets of the RePoSi register. The aim of this study was to explore the sex-differences and to validate the multivariate model in the entire dataset with an expanded follow-up at 1 year. Results: Among 4714 patients, 51% were women and 49% were men. The disease distribution showed that diabetes, coronary artery disease, chronic obstructive pulmonary disease, chronic kidney disease, and malignancy were more frequent in men but that hypertension, anaemia, osteoarthritis, de…

medicine.medical_specialtyMultivariate analysislcsh:MedicineSocio-culturaleDisease030204 cardiovascular system & hematologyelderlyArticleCoronary artery disease03 medical and health sciences0302 clinical medicineInternal medicineMedicine030212 general & internal medicineDepression (differential diagnoses)Polypharmacybusiness.industrylcsh:RGeneral Medicinemedicine.diseaseComorbidityelderly sex profiles disease distribution in-hospital mortality 3-month mortality 1-year mortalityMood disordersdisease distribution1-year mortality3-month mortalitysex profilesbusiness1-year mortality; 3-month mortality; disease distribution; elderly; in-hospital mortality; sex profilesKidney diseasein-hospital mortality
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Pattern of comorbidities and 1-year mortality in elderly patients with COPD hospitalized in internal medicine wards: data from the RePoSI Registry

2020

Currently, chronic obstructive pulmonary disease (COPD) represents the fourth cause of death worldwide with significant economic burden. Comorbidities increase in number and severity with age and are identified as important determinants that influence the prognosis. In this observational study, we retrospectively analyzed data collected from the RePoSI register. We aimed to investigate comorbidities and outcomes in a cohort of hospitalized elderly patients with the clinical diagnosis of COPD. Socio-demographic, clinical characteristics and laboratory findings were considered. The association between variables and in-hospital, 3-month and 1-year follow-up were analyzed. Among 4696 in-patient…

Malemedicine.medical_specialtyChronic ObstructiveCirrhosisSocio-culturaleComorbidity030204 cardiovascular system & hematologycomorbiditieselderlyPulmonary Disease03 medical and health sciencesPulmonary Disease Chronic Obstructive0302 clinical medicineInternal medicinemedicine80 and overCOPDHumans030212 general & internal medicineLS4_4RegistriesHospital MortalityCOPD comorbidities elderly internal medicine in-hospital mortality.Depression (differential diagnoses)Cause of deathAgedRetrospective Studies1-year mortality; 3-month mortality; COPD; comorbidities; elderly; internal medicine; in-hospital mortalityAged 80 and overCOPDbusiness.industry1-year mortality; 3-month mortality; COPD comorbidities elderly internal medicine in-hospital mortalitymedicine.diseaseIm - Original1-year mortality; 3-month mortality; COPD comorbidities elderly internal medicine in-hospital mortality; Aged; Aged 80 and over; Comorbidity; Female; Humans; Internal Medicine; Male; Pulmonary Disease Chronic Obstructive; Registries; Retrospective Studies; Hospital Mortalityinternal medicineClinical diagnosisCohortEmergency Medicine1-year mortality3-month mortalityCOPD comorbidities elderly internal medicine in-hospital mortality1-year mortality 3-month mortality COPD comorbidities elderly internal medicine in-hospital mortality.Observational studyFemalebusiness1 year mortalityin-hospital mortality
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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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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
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Prevalence of use and appropriateness of antidepressants prescription in acutely hospitalized elderly patients.

2019

Depression is often under-recognized in older patients, even if antidepressants (AD) are commonly prescribed, with a prevalence of use that increase with ageing [ 1 ]. Nevertheless, even if a diagnosis of depression is established, inappropriate treatment can occur [ 2 ]. Beers criteria are the most widely screening tools used to detect inappropriate prescription of drugs in people aged 65 years or more [ 3 ]. Since 2010, attempts to adapt the Beers' criteria have been made in Europe [ 4 , 5 ]. Tricyclic drugs are the ADs to be always avoided in the elderly, owing to their anticholinergic side effects, such as cognitive impairment, delirium, urinary retention and falls [ 3 ]. Selective sero…

Malemedicine.medical_specialtySocio-culturaleInappropriate Prescribing-Potentially inappropriate medication olderPractice Patternsdepression hospitalized patients drugselderlydrugsantidepressivi anzianoPolypharmacy | Inappropriate Prescribing | Medications PIMsantidepressant agent escitalopram paroxetineInternal MedicinemedicineHospital dischargeolderEscitalopramHumansLS4_4Medical prescriptionPractice Patterns Physicians'Depression (differential diagnoses)AgedPolypharmacySertralinePhysicians'antidepressantbusiness.industryTrazodonehospitalized patientsAntidepressive AgentsHospitalizationAcute Disease; Aged; Antidepressive Agents; Female; Humans; Inappropriate Prescribing; Italy; Male; Practice Patterns Physicians'; Hospitalizationantidepressants; elderlyItalyantidepressantsEmergency medicinedepressionAcute DiseasePolypharmacy Inappropriate Prescribing Medications PIMDeliriumFemalePotentially inappropriate medicationmedicine.symptombusinessmedicine.drugEuropean journal of internal medicine
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Appropriateness of oral anticoagulant therapy prescription and its associated factors in hospitalized older people with atrial fibrillation

2018

Aims Although oral anticoagulants (OACs) are effective in preventing stroke in older people with atrial fibrillation (AF), they are often underused in this particularly high-risk population. The aim of the present study was to assess the appropriateness of OAC prescription and its associated factors in hospitalized patients aged 65 years or older. Methods Data were obtained from the retrospective phase of Simulation-based Technologies to Improve the Appropriate Use of Oral Anticoagulants in Hospitalized Elderly Patients With Atrial Fibrillation (SIM-AF) study, held in 32 Italian internal medicine and geriatric wards. The appropriateness of OAC prescription was assessed, grouping patients in…

Pharmacologymedicine.medical_specialtyeducation.field_of_studybusiness.industryPopulationAtrial fibrillation030204 cardiovascular system & hematologymedicine.diseaseLogistic regression03 medical and health sciences0302 clinical medicineEmergency medicineAntithromboticmedicineOral anticoagulantPharmacology (medical)030212 general & internal medicineMedical prescriptionOlder peopleeducationbusinessStrokeBritish Journal of Clinical Pharmacology
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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
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