Risultati per: Scompenso Cardiaco. Gestione in MG dalla diagnosi al follow-up

Stroke, Volume 56, Issue Suppl_1, Page ATP70-ATP70, February 1, 2025. Introduction:A significant proportion of stroke patients are lost to follow up (LTFU) after discharge, which may be associated with increased risk of morbidity, mortality, and unnecessary hospitalization. We aimed to identify predictors of post-discharge LTFU and unplanned hospitalizations in a cohort of patients with acute stroke from a large academic hospital system.Methods:Using our institutional AHA Get With the Guidelines quality registry, we conducted a retrospective analysis of all patients who were hospitalized for acute stroke between January 1, 2016, and December 31, 2020 at a tertiary-care hospital in New York City. Our primary outcome was post-discharge LTFU, defined as having zero post-discharge encounters within 12 months. Our secondary outcomes included having one or more outpatient visits with a provider, unplanned hospitalizations, and emergency department (ED) visits within 30 days post-discharge. Multiple logistic regression was used to identify factors that were significantly associated with our primary and secondary outcomes, adjusted for confounding demographic and clinical factors.Results:We identified 2,597 patients hospitalized for acute stroke, of which 878 (33.8%) were LTFU. Of the 1,719 patients not LTFU, 974 (56.7%) had a provider visit, 405 (23.6%) had an unplanned admission, and 257 (14.9%) had an unplanned ED visit within 30 days post-discharge. Patients who were LTFU were significantly more likely to be male (52.9% vs. 47.4%); have an intracerebral (12.1% vs. 8.9%) hemorrhage; discharged to a skilled nursing facility (19.8% vs. 17.0%); and transferred from another hospital (48.0% vs. 40.7%). Clinically, these patients are more likely to have a history of DVT/PE (3.9% vs. 1.3%); receive catheter-based treatment (12.8% vs. 10.0%); and have a modified Rankin scale (mRS) score of 3 or greater at discharge. In the multivariable logistic regression, patients who were discharged to an acute care facility (adjusted odds ratio (aOR) 3.3), had a history of DVT/PE (aOR 3.1) or a discharge mRS of 3 (aOR 1.8) had significantly higher odds of LTFU, whereas patients who were discharged to an inpatient rehabilitation facility (aOR 0.65), had a family history of stroke (aOR 0.60) or depression (aOR 0.64) had significantly decreased odds of LTFU.Conclusions:In this study, patients LTFU after a stroke were more likely to have severe clinical conditions and specific discharge dispositions.

Stroke, Volume 56, Issue Suppl_1, Page ATP53-ATP53, February 1, 2025. Background:Post-discharge phone calls to stroke patients are a valuable tool to assess medication compliance, stroke education retention and prevention of emergency room visits. However, there is no optimal time frame defined by The Joint Commission for post-discharge follow-up calls. The purpose of this study was to determine if there is an optimal time frame to call patients and whether call fatigue affects call completion rate.Methods:Ischemic and hemorrhagic stroke patients discharged to home with and without home health from 2/2024 to 6/2024 were included. Participants received phone calls from a Stroke Certified Registered Nurse at 7 days (Group 1), 14 days (Group 2), and 21 days (Group 3) post-discharge. Two call attempts were made. Data collected included baseline demographics, call completion rates, stroke education and validation of knowledge retention. Call fatigue was assessed by capturing the number of times patient was contacted after discharge by health care team. Patients received a Knowledge Score of 0-6 based on recall of knowledge of diagnosis, stroke type, signs and symptoms of stroke, risk factors, medication knowledge and stroke prevention. R *** was used for data analysis.Results:178 patients were called, 64 (36%) Group 1, 61 (34%) Group 2, 53 (30%) Group 3. There were no differences in baseline demographics. 74% (131) of patients were reached successfully. There were no differences in completion among each group (49 {75%} Group 1, 42 {69%} Group 2, 40 {75%} Group 3) p=0.6 despite more calls being made by healthcare team members early on (7.09±4.55 in Group 1, 4.12±3.27 in Group 2, 3±2.89 in Group 3). There were no differences in Knowledge Score regardless of time phone call was made. Patients who were discharged home with home health had better Knowledge Score than those discharged home without home health (5.87(±0.61) vs 5.48(±1.36)) p=0.03.Conclusion:Implementing a post-discharge phone call program up to 21 days is feasible. There was no difference in call completion rates and retention of stroke knowledge despite a heavier call burden earlier on suggesting no call fatigue.

Objective
To investigate how various morbidities affect older patients’ performance on the Timed Up and Go (TUG) test.

Design
Cross-sectional study.

Setting
The seven government hospitals of Lahore, Pakistan, included are major tertiary care centres, representing an older patient population of Punjab, Pakistan.

Method
160 elderly participants completed the TUG test, frailty evaluations and Charlson Comorbidity Index (CCI) scoring to assess mobility, frailty and comorbidity burden. The Student’s t-test analysed differences between TUG groups (

This Viewpoint discusses California’s new law that will further strengthen tobacco control and whether the FDA and other states will follow California’s example.

Very well, with minimal breakdown of epinephrine.

Un servizio per le donne nelle prime settimane di gravidanza

Studio pubblicato nella rivista Nature Communications

Introduction
During the first wave of the COVID-19 outbreak in China, the surge of COVID-19 cases was rapid and drastic. Emerging evidence suggests that beyond the acute phase, patients with COVID-19 may experience a wide range of postacute or long COVID sequelae. However, the mechanism and burden of COVID-19, especially long COVID, have not yet been comprehensively clarified. To fill this knowledge gap, this large prospective follow-up study aims to investigate the short-term and long-term effects of COVID-19, explore the underlying biological mechanism and identify predictive neuroimaging and haematological biomarkers associated with these effects.

Methods and analysis
This multicentre study will recruit patients infected during the first wave of COVID-19 in China and healthy controls (HCs) with no history of COVID-19 infection from nine participating hospitals. Confirmed patients with mild or moderate COVID-19 will complete the following programmes during the acute infection phase and at 3, 12 and 24 months after infection: (a) blood test at the local laboratory, (b) multimodal brain and spine MRI scan and (c) the neuropsychological scales and questionnaires. Similarly, the uninfected HCs will complete the same programmes as the infected group mentioned above at the time of inclusion. At the first time point, 501 participants (418 patients and 83 HCs) from nine recruiting hospitals have been observed. Ultimately, all of these results will be analysed to explore the short-term and long-term effects of COVID-19.

Ethics and dissemination
Ethics approval was granted by Ethics Committee of the First Affiliated Hospital of Xi’an Jiaotong University (XJTU1AF2023LSK-013). Findings will be presented at national and international conferences, as well as published in peer-reviewed scientific journals.

Trial registration number
NCT05745805.

Studio della Karolinska Institutet con l’Università Milano-Bicocca

This Medical News article is an interview with Michael Pencina, PhD, Duke Health’s chief data scientist, about the need for health systems to collaborate to keep up with the AI revolution.

Life expectancy in the US may now vary by more than 2 decades based on demographic differences, according to a new systematic analysis. The largest gap between highest and lowest life expectancies was 12.6 years in 2000. It reached 13.9 years in 2010 and 15.8 years by 2019 before climbing to 20.4 years after the first 2 years of the COVID-19 pandemic—with the largest life expectancy difference being between Asian individuals and American Indian or Alaska Native people in the West.

Studio del Policlinico Federico II

Objective
To identify patient and provider factors associated with lower rates of follow-up for positive depression screens in outpatient settings.

Design
Retrospective cohort study with electronic health record analysis investigating factors associated with follow-up care for patients with moderate-to-severe depressive symptoms. Patient and provider variables were associated with rates of follow-up for positive depression screens.

Setting
University of Utah and University of Utah Health-affiliated primary care and specialty clinics.

Participants
Adults who screened positive for depressive symptoms (score≥10) on the Patient Health Questionnaire (PHQ-9) at an ambulatory visit between 1 January 2021 and 31 January 2022. A total of 17 651 patients were included in the study.

Outcome measures
Follow-up for positive depression screens was defined as a new antidepressant prescription or completed mental health visit. Variables associated with follow-up included patient demographic data, anthropometric measures, geographical classification, primary language, comorbidities and socioeconomic factors as well as provider demographics, level of training and clinic type.

Results
5396 patients (30.6%) did not receive follow-up care for a positive PHQ-9 screen. Factors associated with lower rates of follow-up included male patients (gender; p=0.013), older patients (age group; p=0.016), non-White patients (ethnicity; p

Un terzo dei pazienti finisce in una casa di cura entro 3 anni