Chronic obstructive pulmonary disease and heart failure in real life: the tip of the iceberg in the sea of comorbidities. A prospective observational study

Monaldi Archives for Chest Disease, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 4, 2025

Chronic obstructive pulmonary disease (COPD) and heart failure (HF) are two of the most common conditions treated in internal medicine. Although it is known that these diseases often coexist, specific characteristics affected patients prognostic implications not yet well understood. Managing with both COPD HF requires an integrated treatment approach. The aim study was to examine association between HF. We conducted a prospective observational cohort study. All consenting admitted Internal Medicine Department from Emergency or strongly suspected were enrolled. A total 144 included, 47.2% them also having HF, distributed among various subcategories as follows: 10.4% reduced ejection fraction (HFrEF), 3.5% mild-reduced fraction, 33.3% preserved (HFpEF). This result consistent literature, which suggests higher prevalence HFpEF compared HFrEF. Doppler echocardiography performed during hospitalization. Some variables showed statistically significant difference when comparing those without Interestingly, follow-up at 3 6 months post-discharge revealed mortality odds ratio (95% confidence interval) 10.0 (1.2-82.2). could contribute better understanding arising coexistence emphasizing importance patient-centered approach managing multiple comorbidities.

Language: Английский

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Comanagement of surgical patients between neurosurgeons and internal-medicine clinicians: observational cohort study

Internal and Emergency Medicine, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 11, 2025

Abstract The rising prevalence of chronic diseases have contributed to a population with high complexity care. There has been an increasing need for new organizational model based on the interaction in same department between specialist skills surgical and medical disciplines. This study aims describe implementation hospitalist co-management program Neurosurgery Department (ND) its impact incidence complications, 30 days readmission rate causes, number transfers Intensive Care Units (ICU)/Neurosurgical Unit (NICU) or wards (MW), length-of stay (LOS), mortality satisfaction health workers. We conducted observational comparing changes before after Internal medicine-Neurosurgical Comanagement (INC) intervention. retrospective evaluation patients enrolled INC intervention prospective those was implemented. defined pre-INC group as 380 admitted ND neurosurgical disease January 2022 April post-INC 367 2023 2023. associated significant decrease complications during hospital (OR 0.52; 95% CI; 0.39–0.70, p < 0.001), in-hospital reasons 0.95; CI 0.93–0.97, 0.001) numbers ICU/NICU 0.31; 0.17–0.55, MW 0.51; 0.33–0.77, = 0.002). During period, we observed workers, evaluated by standardized questionnaire. In our study, LOS, 30-day were not significantly INC. Hospitalist Neurosurgical Departments reduced 30-days among healthcare but without LOS rate.

Language: Английский

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Descriptions of advanced multimorbidity: A scoping review with content analysis

Journal of Multimorbidity and Comorbidity, Journal Year: 2025, Volume and Issue: 15

Published: March 1, 2025

Multimorbidity is associated with adverse clinical outcomes, including increased symptom burden and healthcare utilisation, particularly towards the end of life. Despite this, there no accepted method to identify point at which individuals deteriorating health due long-term conditions are nearing life or might benefit from a palliative care approach - conceptualised as 'Advanced Multimorbidity'. This scoping review explored how Advanced described operationalised within literature. Multiple electronic databases Grey Literature sources were searched following frameworks. Two reviewers independently performed screening data extraction. Content analysis was used examine different descriptions Multimorbidity. Stakeholder consultations undertaken clinicians, academics public participants. Patient involvement separately integrated throughout this conceptualisation, design reporting. Forty-four identified 38 publications. These varied in terms descriptors used. Eighteen relied on single indicator Multimorbidity; 24 multidimensional approach. highlighted need for that user-friendly actionable. The lack standardised definition risks variance research practice, potentially affecting patient care. A consensus defining would enable better identification patients who could approach, ensuring more consistent person-centred care, well supporting policy development.

Language: Английский

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Co-management hospitalist services for neurosurgery. Where are we?

European Journal of Internal Medicine, Journal Year: 2024, Volume and Issue: 132, P. 148 - 149

Published: Sept. 27, 2024

Language: Английский

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Cardiovascular disease (CVD) outcomes and associated risk factors in a medicare population without prior CVD history: an analysis using statistical and machine learning algorithms

Internal and Emergency Medicine, Journal Year: 2023, Volume and Issue: 18(5), P. 1373 - 1383

Published: June 9, 2023

Language: Английский

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Roles considered important for hospitalist and non-hospitalist generalist practice in Japan: a survey study

BMC Primary Care, Journal Year: 2023, Volume and Issue: 24(1)

Published: July 7, 2023

An increased focus on quality and patient safety has led to the evolution of hospitalists. The number hospitalists covering ward outpatient care is rise in Japan. However, it unclear what roles hospital workers themselves consider important their practice. Therefore, this study investigated non-hospitalist generalists Japan for practice specialty.This was an observational that included Japanese (1) currently working a general medicine (GM) or internal department (2) at hospital. Using originally developed questionnaire items, we surveyed items generalists.There were 971 participants (733 hospitalists, 238 non-hospitalist) study. response rate 26.1%. Both non-hospitalists ranked evidence-based as most In addition, diagnostic reasoning inpatient medical management second third practice, while elderly third.This first investigating comparing those generalists. Many considered are within outside academic societies. We found areas likely see further specifically emphasized them. future, expect suggestions research enhancing value emphasise upon.

Language: Английский

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Teorías del envejecimiento biológico: una revisión integradora

Revista Española de Geriatría y Gerontología, Journal Year: 2024, Volume and Issue: 59(6), P. 101530 - 101530

Published: July 11, 2024

Language: Английский

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Clinical assessment and management of patients with multimorbidity

Vnitřní lékařství, Journal Year: 2023, Volume and Issue: 69(3), P. 173 - 180

Published: May 16, 2023

Internal medicine specialists, also known as general internal specialists are specialist physicians trained to manage particularly complex or multisystem disease conditions that single-organ-disease may not be deal with. The management of multimorbidity, however, is often complex, and requires specific clinical skills corresponding experience in appropriate diagnostic therapeutic procedures. Multimorbidity associated with a decline many aspects health consequence an increase hospital admissions, polypharmacy, use care social resouces. When prescribing patients all the risks benefits, well possible interactions should carefully considered. prescription appropriateness can assessed by validated tools like STOPP-START criteria. Beneficial part good deprescribing - planned supervised process dose reduction withdrawal medications no longer needed circumstances patient.

Language: Английский

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