Search results for "DMIS"
showing 10 items of 286 documents
Water and Sodium in Heart Failure: A Spotlight on Congestion.
2014
Despite all available therapies, the rates of hospitalization and death from heart failure (HF) remain unacceptably high. The most common reasons for hospital admission are symptoms related to congestion. During hospitalization, most patients respond well to standard therapy and are discharged with significantly improved symptoms. Post-discharge, many patients receive diligent and frequent follow-up. However, rehospitalization rates remain high. One potential explanation is a persistent failure by clinicians to adequately manage congestion in the outpatient setting. The failure to successfully manage these patients post-discharge may represent an unmet need to improve the way congestion is …
Right Heart Dysfunction and Readmission Risk Across Left Ventricular Ejection Fraction Status in Patients With Acute Heart Failure.
2021
BACKGROUND: Right heart dysfunction (RHD) parameters are increasingly important in heart failure (HF). This study aimed to evaluate the association of advanced RHD with the risk of recurrent admissions across the spectrum of left ventricular ejection fraction (LVEF). METHODS AND RESULTS: We included 3383 consecutive patients discharged for acute HF. Of them, in 1435 patients (42.4%), the pulmonary artery systolic pressure could not be measured accurately, leaving a final sample size of 1948 patients. Advanced RHD was defined as the combination of a ratio of tricuspid annular plane systolic excursion/pulmonary artery systolic pressure of less than 0.36 and significant tricuspid regurgitation…
Grip strength predicts cardiac adverse events in patients with cardiac disorders: an individual patient pooled meta-analysis.
2019
ObjectiveGrip strength is a well-characterised measure of weakness and of poor muscle performance, but there is a lack of consensus on its prognostic implications in terms of cardiac adverse events in patients with cardiac disorders.MethodsArticles were searched in PubMed, Cochrane Library, BioMed Central and EMBASE. The main inclusion criteria were patients with cardiac disorders (ischaemic heart disease, heart failure (HF), cardiomyopathies, valvulopathies, arrhythmias); evaluation of grip strength by handheld dynamometer; and relation between grip strength and outcomes. The endpoints of the study were cardiac death, all-cause mortality, hospital admission for HF, cerebrovascular accident…
Appropriateness of admission and hospital stay in obstetric wards: an Italian cross-sectional study comparing Sicilian settings
2015
Appropriateness is one of the main topics of health policy and should be estimable in order to analyze the efficacy of hospital services. The Review and Use of the Hospital Protocol (in Italian: Protocollo di Revisione dell’Uso dell’ Ospedale-PRUO) allowed us to evaluate the appropriateness of hospitalizations, starting from daily available clinical records in a selected hospital. Methods The cross-sectional study applied the PRUOmethod on a sample of medical records (N=575; years: 2008–2010) related to ordinary admissions to obstetric wards of Lipari and Pantelleria Hospital (both Minor Islands of Sicily: MI) and to the Teaching Hospital of the University of Palermo (P) in order to evaluat…
Adaptation and Refinement of Validated Risk Screening Tools in the Spanish Healthcare System
2013
Abstract The aim of this study is to develop a tool to screen elders at risk of hospital readmissions adapted to Spanish target population. The development of this new tool is based on the validated instrument The Community Assessment Risk Screen – CARS –, which is being applied in a sample of 1.000 older patients. The adaptation and refinement of CARS is being carried out through the compilation of new potential variables from primary care clinicians to predict patients at risk of readmissions. The introduction of this new instrument adapted to Spanish target population will provide a potential tool to identify prematurel y patients at risk of hospital readmissions.
Quality of life as a therapeutic objective in the management of hepatic encephalopathy and the potential role of rifaximin-α
2021
Objective Quality of life (QoL) is impaired in patients with hepatic encephalopathy and rifaximin-α can improve QoL within 6 months. This study assessed the importance of QoL as a therapeutic objective in hepatic encephalopathy management; whether QoL is routinely assessed in hepatic encephalopathy patients in clinical practice and the role of rifaximin-α in this context. Methods A survey was conducted of healthcare professionals (HCPs) from Europe and Australia involved in hepatic encephalopathy management. HCPs rated the importance of a range of therapeutic objectives on a 1–7 Likert scale (1 = not at all important; 7 = extremely important). HCPs were also required to provide three patien…
Rehospitalization burden and morbidity risk in patients with heart failure with mid-range ejection fraction
2020
Aims Heart failure with mid-range ejection fraction (HFmrEF) has been proposed as a distinct HF phenotype, but whether patients on this category fare worse, similarly, or better than those with HF with reduced EF (HFrEF) or preserved EF (HFpEF) in terms of rehospitalization risks over time remains unclear. Methods and results We prospectively included 2961 consecutive patients admitted for acute HF (AHF) in our institution. Of them, 158 patients died during the index admission, leaving the sample size to be 2803 patients. Patients were categorized according to their EF: HFrEF if EF ≤ 40% (n = 908, 32.4%); HFmrEF if EF = 41–49% (n = 449, 16.0%); and HFpEF if EF ≥ 50% (n = 1446, 51.6%). Covar…
The Female Sex Confers Different Prognosis in Heart Failure: Same Mortality but More Readmissions
2021
Introduction: Heart failure (HF) is a major cause of morbimortality both in men and women. Differences between sex in etiopathogenesis, response to treatment, and quality of care have been found in patients with HF. Females are usually under-represented in clinical trials and there is no solid evidence demonstrating the influence of sex in the prognostic of chronic HF. The primary objective of this study was to analyse the differences in mortality and probability of hospital readmission between males and females with HF. The secondary objective was to compare mortality and probability of hospital readmission by ejection fraction (reduced vs. preserved).Methods: Patients with decompensated H…
Effect of insulin on readmission for heart failure following a hospitalization for acute heart failure
2020
AIMS: Type 2 diabetes mellitus (T2DM) is common in patients with heart failure (HF) and is related with worse outcomes. Insulin treatment is associated with sodium and water retention, weight gain, and hypoglycaemia-all pathophysiological mechanisms related to HF decompensation. This study aimed to evaluate the association between insulin treatment and the risk of 1year readmission for HF in patients discharged for acute HF.; METHODS AND RESULTS: We prospectively included 2895 consecutive patients discharged after an episode of acute HF in a single tertiary hospital. Multivariable Cox regression, adapted for competing events, was used to assess the association between insulin treatment and …
Ylioppilastutkinnon, tavoiteorientaatioiden ja muiden motivaatiotekijöiden yhteys luokanopettajakoulutukseen hakeneiden menestymiseen VAKAVA-valintak…
2019
Tässä tutkimuksessa selvitettiin ylioppilastutkinnon yleisarvosanan, tavoiteorientaatioiden ja muiden motivaatiotekijöiden yhteyttä menestymiseen valtakunnallisessa kasvatusalan valintayhteistyöverkoston toteuttamassa opiskelijavalintakokeessa (VAKAVA). Tutkimukseen osallistuivat Jyväskylän yliopiston luokanopettajakoulutukseen pyrkineet hakijat vuosina 2014 ja 2015 (n = 399). Tutkimusaineisto koostui VAKAVAkoepistemääristä sekä hakijoiden itsearvioinneista, jotka liittyivät erilaisiin tavoiteorientaatioihin (oppimis-, saavutus-, suoritus-lähestymis-, suoritus-välttämis- ja välttämisorientaatio) sekä muihin motivaatiotekijöihin (kokemus opiskelun mielekkyydestä, luovutusherkkyys ja epäonnis…