Risultati per: ESC 2022: Linea guida sulla cardio-oncologia

Primario al Gemelli, autore di molti studi scientifici

Objective
To examine trends in the prevalence of depression and anxiety during the COVID-19 pandemic among US adult cancer patients and survivors (CPS) in comparison to those of non-CPS (NCPS).

Methods and analysis
National Health Interview Survey 2019–2022 data were analysed using spline logistic regression.

Results
A total of 115 664 participants completed the survey (mean age (SD), 52.8 (18.4) years; 54.3% female; 12.6% CPS). The age-adjusted prevalence of depression significantly increased from 26.53% in 2019 to 29.78% in 2022 among CPS, while that of anxiety increased from 24.02% in 2019 to 28.08% in 2022. Throughout the pandemic, there were consistently significant annual increases in the prevalence of both depression and anxiety with CPS experiencing significantly faster rates of increase compared with NCPS (average annual absolute increase 0.72% in NCPS vs 1.08% in CPS, p

Objective
To describe the incidence and key demographic, socioeconomic and clinical characteristics of individuals with liver disease in Wales.

Design and setting
This study is designed as a retrospective observational study that linked data of anonymised identified individuals from primary, secondary care and mortality data from the Secure Anonymised Information Linkage (SAIL) Databank in Wales.

Participants
All Welsh residents who registered with a SAIL-contributing general practitioner (GP) and diagnosed with liver disease from 2004 to 2022.

Primary and secondary outcome measures
Our primary outcome is the annual age-standardised incidence rate of liver disease. Secondary outcome is the numbers and frequencies of underlying aetiology and the associated comorbidities.

Results
Between 2004 and 2022, 111 098 individuals received a diagnosis of liver disease in Wales and were included in this study. The incidence of liver disease increased threefold during the study period (97.7 per 100 000 inhabitants in 2004 to 316.2 per 100 000 inhabitants in 2022). A total of 79 992 individuals (72%) entered the cohort with the underlying aetiology of liver disease, including alcohol-related liver disease, non-alcoholic fatty liver disease (NAFLD), viral hepatitis, metabolic, haemochromatosis and autoimmune liver diseases. NAFLD has contributed to most of the change in incidence.

Conclusions
We observed increasing incidence rates of liver disease in Wales, with NAFLD showing a particularly sharp increase and frequently identified as an underlying condition. A better understanding of the incidence of liver disease is the first step towards effective prevention, early detection and targeted intervention to improve patient outcomes.

Sip, ‘il focus deve spostarsi dal peso alla salute’

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

This study examines trends in cold-related mortality overall and by demographic characteristics between 1999 and 2022 in the US.

Il caso del mieloma multiplo, come stanno cambiando le cure

This cross-sectional study examines demographic characteristics of adults treated at outpatient mental health treatment centers using data from the 2022 US National Survey of Drug Use and Health.

Stroke, Volume 56, Issue Suppl_1, Page ATMP37-ATMP37, February 1, 2025. Introduction:Limited studies have examined racial disparities in long-term survival after acute ischemic stroke (AIS) with inconsistent findings. We examined these disparities among Medicare fee-for-service (FFS) beneficiaries in U.S.Methods:We analyzed data on 1,997,487 Medicare FFS beneficiaries aged ≥65 years hospitalized with incident AIS (ICD-10 code I63) and survived >30 days from January 1, 2000 to December 31, 2017, and were followed-up until December 31, 2022. Cox proportional hazard models estimated the adjusted hazard ratio (aHR, 95% CI) and adjusted survival curves by race/ethnicity (non-Hispanic White (White), non-Hispanic Black (Black), Hispanic and Other). Models were adjusted for age, sex, and comorbidities.Results:The median age at AIS hospitalization was 78 years (IQR 72.0-84.0); 57.0% were women; 81.8%, 10.8%, 4.8% and 2.6% were White, Black, Hispanic and Other, respectively. Over a median follow-up of 4.9-years (IQR 1.7-8.8), there were 1,738,452 all-cause deaths. Adjusted 5-year survival after AIS improved from 2000-2004 to 2015-2017 for White (46.5% (95% CI 46.4-46.6) to 50.9% (50.7-51.1)), and Black (46.0% (45.8-46.3) to 48.9% (48.3-49.2)). For Hispanic and Other, survival remained largely unchanged: 54.4% (54.1-54.8) to 54.2% (53.6-54.8)) for Hispanic and 55.9% (55.4-56.4) to 54.7% (54.0-55.5) for Other. A clear pattern of long-term survival after AIS emerged by race/ethnicity showing similar survival between Hispanic and Other and between White and Black people (Figure). Stroke mortality risk was ~25% higher for White and Black compared to Hispanic and Other (aHR 1.25 (1.24-1.26)). This pattern was consistent across age groups and sex.Conclusions:Long-term survival after AIS has improved for White and Black Medicare FFS beneficiaries over time, while it remained largely unchanged for Hispanic and Other groups. This indicates persistent racial disparities in stroke outcomes.

Stroke, Volume 56, Issue Suppl_1, Page ATP327-ATP327, February 1, 2025. Self-reported stroke prevalence has increased among US adults aged 18-64 over the past decade and is projected to rise. As younger stroke survivors live longer, access to healthcare is essential for the detection, treatment, and monitoring of cardiovascular disease (CVD) risk factors to prevent recurrent stroke or other acute CVD events. Adults aged 1 personal healthcare provider, the ability to afford to see a doctor in the past year, and a routine checkup within the past year).Most stroke survivors reported healthcare access: 86.3% (95% CI 85.7 – 86.8 had insurance coverage and >1 personal healthcare provider); 26.6% (95% CI 25.9 – 27.3) couldn’t afford a doctor in the past year; and 81.2% (95% CI 80.6 – 81.1) had a routine checkup in the past year. Statistically significant differences (p < 0.05) were found across all sociodemographic groups. Younger adults (aged 18-29 and 30-44), men, and those with lower education reported less healthcare access. Varying measures of access were reported across racial/ethnic groups.Overall, most stroke survivors reported access to healthcare, although opportunities exist to improve access for younger adults, men, different racial/ethnic minorities, and those with lower education. Prior access to healthcare might have contributed to stroke survival for some individuals. Continued and improved healthcare access could help prevent recurrent stroke or other acute CVD event among stroke survivors.

Stroke, Volume 56, Issue Suppl_1, Page ATMP27-ATMP27, February 1, 2025. Background:In 2022, stroke shifted from the fourth to the fifth leading cause of death in the U.S. as COVID-19 temporarily took its place. Despite this change, stroke remains a significant cause of mortality and long-term disability in the U.S. This study analyzes trends in in-hospital mortality among stroke-related hospitalizations in California from 2016 to 2022, with a particular focus on the pandemic years.Methods:This retrospective analysis utilized patient discharge data from the California Department of Health Care Access and Information, screening nearly 25 million inpatient events for stroke-related ICD-10-CM diagnosis codes (I60-I63) among individuals 20 and older. Multivariate logistic regression (MLR) analysis assessed the impact of the pre- and post-COVID-19 periods on in-hospital mortality, adjusting for confounders such as age, gender, race and ethnicity, geographic regions, and payer source. Results were interpreted using Adjusted Odds Ratios (AOR).Results:The study identified 590,801 stroke-related hospitalizations and 66,096 in-hospital deaths (11.2%). Initially, the age-and-sex-adjusted in-hospital mortality rate decreased from 28.88 per 100,000 in 2016 to 27.38 in 2019. However, with the onset of COVID-19 in 2020, the rate increased to 27.94, peaking in 2021 at 30.78 during the pandemic’s height. In 2022, the rate slightly declined to 28.30 but remained above pre-pandemic levels.Similar trends from 2016 to 2022 were observed in age-adjusted rates for males, which increased from 27.77 to 29.73, and for females, which decreased from 29.91 to 26.98. The gap between male and female mortality rates widened significantly during the pandemic, with male mortality peaking in 2021 with a difference of 3.75.MLR analysis revealed a 22.6% increase in in-hospital mortality during the post-COVID period compared to the pre-COVID period (AOR=1.23, p

Stroke, Volume 56, Issue Suppl_1, Page ADP13-ADP13, February 1, 2025. Background:People with stroke are at high risk of dementia. There have been reductions in stroke case fatality and disability but temporal trends in the incidence and absolute burden of post-stroke dementia have not been described.Methods:We did a population-wide analysis of over 15 million people in Ontario, Canada between 2002-2022. Using linked administrative databases, we identified all 90-day dementia-free survivors of first acute ischemic stroke or intracerebral hemorrhage (ICH). We evaluated dementia incidence from 90-days after stroke onwards using a validated definition which included hospitalization, physician claims, and dementia medications. We calculated 1-year and 5-year incidence of dementia as percentages and per 100 person-years for each fiscal year, age-/sex-standardized by the 2002 population and with follow-up until March 2022. We stratified incidence trends by sex, stroke type, and severity (90-day home time of