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2. Geriatric Interdisciplinary Home Rehabilitation After Hip Fracture in People with Dementia – A Subgroup Analysis of a Randomized Controlled Trial

Author

Karlsson Å, Berggren M, Olofsson B, Stenvall M, Gustafson Y, Nordström P, and Lindelöf N

Subjects
accidental falls, activities of daily living, cognitive impairment, length of stay, walking ability, Geriatrics, RC952-954.6
Abstract

Åsa Karlsson,1 Monica Berggren,2 Birgitta Olofsson,3 Michael Stenvall,2 Yngve Gustafson,2 Peter Nordström,2 Nina Lindelöf1 1Department of Community Medicine and Rehabilitation, Geriatric Medicine and Physiotherapy, Umeå University, Umeå, Sweden; 2Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden; 3Department of Nursing and Department of Surgical and Perioperative Science, Orthopedics, Umeå University, Umeå, SwedenCorrespondence: Åsa KarlssonDepartment of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå SE- 901 87, SwedenTel +46 90 785 87 66Email asa.karlsson@umu.sePurpose: To investigate if the effects of geriatric interdisciplinary home rehabilitation after hip fracture were different among people with dementia compared to those without dementia and to describe the overall outcome after hip fracture in people with dementia.Patients and Methods: A post hoc subgroup analysis of a randomized controlled trial was conducted including 205 people with hip fracture, aged ≥ 70, living in ordinary housing or residential care facilities. Early discharge followed by individually designed interdisciplinary home rehabilitation for a maximum of 10 weeks was compared to in-hospital geriatric care according to a multifactorial rehabilitation program. Outcomes were hospital length of stay (LOS), readmissions, falls, mortality, performance in activities of daily living (ADL), and walking ability.Results: Interdisciplinary home rehabilitation vs in-hospital care had comparable effects on falls and mortality between discharge and 12 months and on ADL and walking ability at 3 and 12 months regardless of whether the participants had dementia or not (P≥ 0.05 for all). Among participants with dementia, postoperative LOS was a median of 18 days (interquartile range [IQR] 14– 30) in the home rehabilitation group vs 23 days (IQR 15– 30) in the control group (P=0.254) with comparable numbers of readmissions after discharge. Dementia was associated with increased risk of falling (odds ratio [OR] 3.86; 95% confidence interval [CI]: 2.05– 7.27; P< 0.001) and increased mortality (OR 4.20; 95% CI 1.79– 9.92, P=0.001) between discharge and 12 months and with greater dependence in ADL and walking at 3 and 12 months compared to participants without dementia (P< 0.001 for all).Conclusion: The effects of geriatric interdisciplinary home rehabilitation vs in-hospital geriatric care did not differ in participants with and without dementia. However, the statistical power of this subgroup analysis was likely insufficient to detect differences between the groups. Dementia was associated with a substantial negative impact on the outcomes following the hip fracture. Our findings support offering interdisciplinary home rehabilitation after hip fracture to people with dementia.Keywords: accidental falls, activities of daily living, cognitive impairment, length of stay, walking ability

Published
2020

9. Differing prognostic value of pulse pressure in patients with heart failure with reduced or preserved ejection fraction: results from the MAGGIC individual patient meta-analysis

Author

Jackson, Colette E., Castagno, Davide, Maggioni, Aldo P., Køber, Lars, Squire, Iain B., Swedberg, Karl, Andersson, Bert, Richards, A. Mark, Bayes-Genis, Antoni, Tribouilloy, Christophe, Dobson, Joanna, Ariti, Cono A., Poppe, Katrina K., Earle, Nikki, Whalley, Gillian, Pocock, Stuart J., Doughty, Robert N., McMurray, John J.V., Berry, C., Doughty, R., Granger, C., Køber, L., Massie, B., McAlister, F., McMurray, J., Pocock, S., Poppe, K., Swedberg, K., Somaratne, J., Whalley, G., Ahmed, A., Andersson, B., Bayes-Genis, A., Berry, C., Cowie, M., Cubbon, R., Doughty, R., Ezekowitz, J., Gonzalez-Juanatey, J., Gorini, M., Gotsman, I., Grigorian-Shamagian, L., Guazzi, M., Kearney, M., Køber, L., Komajda, M., di Lenarda, A., Lenzen, M., Lucci, D., Macín, S., Madsen, B., Maggioni, A., Martínez-Sellés, M., McAlister, F., Oliva, F., Poppe, K., Rich, M., Richards, M., Senni, M., Squire, I., Taffet, G., Tarantini, L., Tribouilloy, C., Troughton, R., Tsutsui, H., Whalley, G., Doughty, R., Earle, N., Gamble, G.D., Poppe, K., Whalley, G., Ariti, C., Dobson, J., Pocock, S., Poppe, K., Doughty, R.N., Whalley, G., Andersson, B., Hall, C., Richards, A.M., Troughton, R., Lainchbury, J., Berry, C., Hogg, K., Norrie, J., Stevenson, K., Brett, M., McMurray, J., Pfeffer, M.A., Swedberg, K., Granger, C.B., Held, P., McMurray, J.J.V., Michelson, E.L., Olofsson, B., Östergren, J., Yusuf, S., Køber, L., Torp-Pedersen, C., Lenzen, M.J., Scholte op Reimer, W.J.M., Boersma, E., Vantrimpont, P.J.M.J., Follath, F., Swedberg, K., Cleland, J., Komajda, M., Gotsman, I., Zwas, D., Planer, D., Azaz-Livshits, T., Admon, D., Lotan, C., Keren, A., Grigorian-Shamagian, L., Varela-Roman, A., Mazón-Ramos, P., Rigeiro-Veloso, P., Bandin-Dieguez, M.A., Gonzalez-Juanatey, J.R., Guazzi, M., Myers, J., Arena, R., McAlister, F.A., Ezekowitz, J., Armstrong, P.W., Cujec, Bibiana, Paterson, Ian, Cowie, M.R., Wood, D.A., Coats, A.J.S., Thompson, S.G., Suresh, V., Poole-Wilson, P.A., Sutton, G.C., Martínez-Sellés, M., Robles, J.A.G., Prieto, L., Muñoa, M.D., Frades, E., Díaz-Castro, O., Almendral, J., Tarantini, L., Faggiano, P., Senni, M., Lucci, D., Bertoli, D., Porcu, M., Opasich, C., Tavazzi, L., Maggioni, A.P., Kirk, V., Bay, M., Parner, J., Krogsgaard, K., Herzog, T.M., Boesgaard, S., Hassager, C., Nielsen, O.W., Aldershvile, J., Nielsen, H., Kober, L., Macín, S.M., Perna, E.R., Cimbaro Canella, J.P., Alvarenga, P., Pantich, R., Ríos, N., Farias, E.F., Badaracco, J.R., Madsen, B.K., Hansen, J.F., Stokholm, K.H., Brons, J., Husum, D., Mortensen, L.S., Bayes-Genis, A., Vazquez, R., Puig, T., Fernandez-Palomeque, C., Bardají, A., Pascual-Figal, D., Ordoñez-Llanos, J., Valdes, M., Gabarrus, A., Pavon, R., Pastor, L., Gonzalez-Juanatey, J.R., Almendral, J., Fiol, M., Nieto, V., Macaya, C., Cinca, J., Cygankiewitz, I., Bayes de Luna, A., Newton, J.D., Blackledge, H.M., Squire, I.B., Wright, S.P., Whalley, G.A., Doughty, R.N., Kerzner, R., Gage, B.F., Freedland, K.E., Rich, M.W., Huynh, B.C., Rovner, A., Freedland, K.E., Carney, R.M., Rich, M.W., Taffet, G.E., Teasdale, T.A., Bleyer, A.J., Kutka, N.J., Luchi, R.J., Tribouilloy, C., Rusinaru, D., Mahjoub, H., Soulière, V., Lévy, F., Peltier, M., Tsutsui, H., Tsuchihashi, M., Takeshita, A., MacCarthy, P.A., Kearney, M.T., Nolan, J., Lee, A.J., Prescott, R.J., Shah, A.M., Brooksby, W.P., Fox, K.A.A., Varela-Roman, A., Gonzalez-Juanatey, J.R., Basante, P., Trillo, R., Garcia-Seara, J., Martinez-Sande, J.L., and Gude, F.

Published
2015
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12. Heart failure in younger patients: the Meta-analysis Global Group in Chronic Heart Failure (MAGGIC)

Author

Wong, Chih M., Hawkins, Nathaniel M., Petrie, Mark C., Jhund, Pardeep S., Gardner, Roy S., Ariti, Cono A., Poppe, Katrina K., Earle, Nikki, Whalley, Gillian A., Squire, Iain B., Doughty, Robert N., McMurray, John J.V., Berry, C., Doughty, R., Granger, C., Køber, L., Massie, B., McAlister, F., McMurray, J., Pocock, S., Poppe, K., Swedberg, K., Somaratne, J., Whalley, G., Ahmed, A., Andersson, B., Bayes-Genis, A., Berry, C., Cowie, M., Cubbon, R., Doughty, R., Ezekowitz, J., Gonzalez-Juanatey, J., Gorini, M., Gotsman, I., Grigorian-Shamagian, L., Guazzi, M., Kearney, M., Køber, L., Komajda, M., di Lenarda, A., Lenzen, M., Lucci, D., Macín, S., Madsen, B., Maggioni, A., Martínez-Sellés, M., McAlister, F., Oliva, F., Poppe, K., Rich, M., Richards, M., Senni, M., Squire, I., Taffet, G., Tarantini, L., Tribouilloy, C., Troughton, R., Tsutsui, H., Whalley, G., Doughty, R., Earle, N., Gamble, G.D., Poppe, K., Whalley, G., Ariti, C., Dobson, J., Pocock, S., Poppe, K., Doughty, R.N., Whalley, G., Andersson, B., Hall, C., Richards, A.M., Troughton, R., Lainchbury, J., Berry, C., Hogg, K., Norrie, J., Stevenson, K., Brett, M., McMurray, J., Pfeffer, M.A., Swedberg, K., Granger, C.B., Held, P., McMurray, J.J.V., Michelson, E.L., Olofsson, B., Östergren, J., Yusuf, S., Køber, L., Torp-Pedersen, C., Ahmed, Ali, Lenzen, M.J., Scholte op Reimer, W.J.M., Boersma, E., Vantrimpont, P.J.M.J., Follath, F., Swedberg, K., Cleland, J., Komajda, M., Gotsman, I., Zwas, D., Planer, D., Azaz-Livshits, T., Admon, D., Lotan, C., Keren, A., Grigorian-Shamagian, L., Varela-Roman, A., Mazón-Ramos, P., Rigeiro-Veloso, P., Bandin-Dieguez, M.A., Gonzalez-Juanatey, J.R., Guazzi, M., Myers, J., Arena, R., McAlister, F.A., Ezekowitz, J., Armstrong, P.W., Cujec, Bibiana, Paterson, Ian, Cowie, M.R., Wood, D.A., Coats, A.J.S., Thompson, S.G., Suresh, V., Poole-Wilson, P.A., Sutton, G.C., Martínez-Sellés, M., Robles, J.A.G., Prieto, L., Muñoa, M.D., Frades, E., Díaz-Castro, O., Almendral, J., Tarantini, L., Faggiano, P., Senni, M., Lucci, D., Bertoli, D., Porcu, M., Opasich, C., Tavazzi, L., Maggioni, A.P., Kirk, V., Bay, M., Parner, J., Krogsgaard, K., Herzog, T.M., Boesgaard, S., Hassager, C., Nielsen, O.W., Aldershvile, J., Nielsen, H., Kober, L., Macín, S.M., Perna, E.R., Cimbaro Canella, J.P., Alvarenga, P., Pantich, R., Ríos, N., Farias, E.F., Badaracco, J.R., Madsen, B.K., Hansen, J.F., Stokholm, K.H., Brons, J., Husum, D., Mortensen, L.S., Bayes-Genis, A., Vazquez, R., Puig, T., Fernandez-Palomeque, C., Bardají, A., Pascual-Figal, D., Ordoñez-Llanos, J., Valdes, M., Gabarrus, A., Pavon, R., Pastor, L., Gonzalez-Juanatey, J.R., Almendral, J., Fiol, M., Nieto, V., Macaya, C., Cinca, J., Bayes de Luna, A., Newton, J.D., Blackledge, H.M., Squire, I.B., Wright, S.P., Whalley, G.A., Doughty, R.N., Kerzner, R., Gage, B.F., Freedland, K.E., Rich, M.W., Huynh, B.C., Rovner, A, Freedland, KE, Carney, RM, Rich, MW, Taffet, GE, Teasdale, T.A., Bleyer, A.J., Kutka, N.J., Luchi, R.J., Tribouilloy, C., Rusinaru, D., Mahjoub, H., Soulière, V., Lévy, F., Peltier, M., Tsutsui, H., Tsuchihashi, M., Takeshita, A., MacCarthy, P.A., Kearney, M.T., Nolan, J., Lee, A.J., Prescott, R.J., Shah, A.M., Brooksby, W.P., Fox, K.A.A., Varela-Roman, A., Gonzalez-Juanatey, J.R., Basante, P., Trillo, R., Garcia-Seara, J., Martinez-Sande, J.L., and Gude, F.

Published
2014
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18. Development of dementia in patients with femoral neck fracture who experience postoperative delirium—A three-year follow-up study

Author

Olofsson, B, Persson, M, Bellelli, G, Morandi, A, Gustafson, Y, Stenvall, M, Olofsson, B., Persson, M., Bellelli, G., Morandi, A., Gustafson, Y., Stenvall, M., Olofsson, B, Persson, M, Bellelli, G, Morandi, A, Gustafson, Y, Stenvall, M, Olofsson, B., Persson, M., Bellelli, G., Morandi, A., Gustafson, Y., and Stenvall, M.

Abstract

Objectives: It remains unclear to what extent postoperative delirium (POD) affects the incidence of dementia in hip fracture patients, and the methods used to detect delirium and dementia require validation. The aim of this study was to investigate the development of dementia within 3 years of femoral neck fracture repair surgery, with a focus on POD as a potential predictive factor. Methods: Patients were assessed for cognition, delirium, depression, psychological well-being, and nutritional status during their hospitalization as well as 4, 12, and 36 months after the operation. Logistic regression models were used to analyse factors associated with POD and factors associated with the development of dementia. Results: The study sample consisted of 135 patients without a history of dementia, of whom 20 (14.8%) were delirious preoperatively and 75 (55.5%) postoperatively. Three years after their operations, 43/135 patients (31.8%) were diagnosed with dementia. A greater portion of patients diagnosed with dementia (39/43, 90.6%) than patients with no dementia (36/92, 39.1%) were included among the 75 patients who had experienced POD (P < 0.001). In a logistic regression model, after adjustment for covariates (age, sex, diabetes, delirium pre-and postoperatively, hyperactive delirium, days with delirium, urinary tract infection, and Mini Nutritional Assessment score), POD emerged an independent predictor for the development of new dementia (odds ratio, 15.6; 95% confidence interval, 2.6–91.6) within 3 years after the operation. Conclusion: Geriatric hip fracture patients who exhibit POD should be monitored closely for the development of dementia.

Published
2018

31. Prognostic significance of anaemia in patients with heart failure with preserved and reduced ejection fraction: Results from the MAGGIC individual patient data meta-analysis

Author

Berry, C, Poppe, K, Gamble, G, Earle, N, Ezekowitz, J, Squire, I, Mcmurray, J, Mcalister, F, Komajda, M, Swedberg, K, Maggioni, A, Ahmed, A, Whalley, G, Doughty, R, Tarantini, L, Granger, C, Køber, L, Massie, B, Pocock, S, Somaratne, J, Andersson, B, Bayes-Genis, A, Cowie, M, Cubbon, R, Gonzalez-Juanatey, J, Gorini, M, Gotsman, I, Grigorian-Shamagian, L, Guazzi, M, Kearney, M, Di Lenarda, A, Lenzen, M, Lucci, D, Macín, S, Madsen, B, Martínez-Sellés, M, Oliva, F, Rich, M, Richards, M, Senni, M, Taffet, G, Tribouilloy, C, Troughton, R, Tsutsui, H, Ariti, C, Dobson, J, Hall, C, Lainchbury, J, Hogg, K, Norrie, J, Stevenson, K, Brett, M, Pfeffer, M, Held, P, Michelson, E, Olofsson, B, Östergren, J, Yusuf, S, Torp-Pedersen, C, Scholte op Reimer, W, Boersma, E, Vantrimpont, P, Follath, F, Cleland, J, Zwas, D, Planer, D, Azaz-Livshits, T, Admon, D, Lotan, C, Keren, A, Varela-Roman, A, Mazón-Ramos, P, Rigeiro-Veloso, P, Bandin-Dieguez, M, Myers, J, Arena, R, Armstrong, P, Cujec, B, Paterson, I, Wood, D, Coats, A, Thompson, S, Suresh, V, Poole-Wilson, P, Sutton, G, Robles, J, Prieto, L, Muñoa, M, Frades, E, Díaz-Castro, O, Almendral, J, Faggiano, P, Bertoli, D, Porcu, M, Opasich, C, Tavazzi, L, Kirk, V, Bay, M, Parner, J, Krogsgaard, K, Herzog, T, Boesgaard, S, Hassager, C, Nielsen, O, Aldershvile, J, Nielsen, H, Kober, L, Perna, E, Cimbaro Canella, J, Alvarenga, P, Pantich, R, Ríos, N, Farias, E, Badaracco, J, Hansen, J, Stokholm, K, Brons, J, Husum, D, Mortensen, L, Vazquez, R, Puig, T, Fernandez-Palomeque, C, Bardají, A, Pascual-Figal, D, Ordoñez-Llanos, J, Valdes, M, Gabarrus, A, Pavon, R, Pastor, L, Fiol, M, Nieto, V, Macaya, C, Cinca, J, Cygankiewitz, I, Bayes De Luna, A, Newton, J, Blackledge, H, Wright, S, Kerzner, R, Gage, B, Freedland, K, Huynh, B, Rovner, A, Carney, R, Teasdale, T, Bleyer, A, Kutka, N, Luchi, R, Rusinaru, D, Mahjoub, H, Soulière, V, Lévy, F, Peltier, M, Tsuchihashi, M, Takeshita, A, Maccarthy, P, Nolan, J, Lee, A, Prescott, R, Shah, A, Brooksby, W, Fox, K, Basante, P, Trillo, R, Garcia-Seara, J, Martinez-Sande, J, Gude, F, Berry C, Poppe KK, Gamble GD, Earle NJ, Ezekowitz JA, Squire IB, McMurray JJV, McAlister FA, Komajda M, Swedberg K, Maggioni AP, Ahmed A, Whalley GA, Doughty RN, Tarantini L, Granger C, Køber L, Massie B, Pocock S, Somaratne J, Andersson B, Bayes-Genis A, Cowie M, Cubbon R, Gonzalez-Juanatey J, Gorini M, Gotsman I, Grigorian-Shamagian L, Guazzi M, Kearney M, Di Lenarda A, Lenzen M, Lucci D, Macín S, Madsen B, Martínez-Sellés M, Oliva F, Rich M, Richards M, Senni M, Taffet G, Tribouilloy C, Troughton R, Tsutsui H, Ariti C, Dobson J, Hall C, Lainchbury J, Hogg K, Norrie J, Stevenson K, Brett M, Pfeffer MA, Held P, Michelson EL, Olofsson B, Östergren J, Yusuf S, Torp-Pedersen C, Scholte op Reimer W, Boersma E, Vantrimpont PJMJ, Follath F, Cleland J, Zwas D, Planer D, Azaz-Livshits T, Admon D, Lotan C, Keren A, Varela-Roman A, Mazón-Ramos P, Rigeiro-Veloso P, Bandin-Dieguez MA, Myers J, Arena R, Armstrong PW, Cujec B, Paterson I, Wood DA, Coats AJS, Thompson SG, Suresh V, Poole-Wilson PA, Sutton GC, Robles JAG, Prieto L, Muñoa MD, Frades E, Díaz-Castro O, Almendral J, Faggiano P, Bertoli D, Porcu M, Opasich C, Tavazzi L, Kirk V, Bay M, Parner J, Krogsgaard K, Herzog TM, Boesgaard S, Hassager C, Nielsen OW, Aldershvile J, Nielsen H, Kober L, Perna ER, Cimbaro Canella JP, Alvarenga P, Pantich R, Ríos N, Farias EF, Badaracco JR, Hansen JF, Stokholm KH, Brons J, Husum D, Mortensen LS, Vazquez R, Puig T, Fernandez-Palomeque C, Bardají A, Pascual-Figal D, Ordoñez-Llanos J, Valdes M, Gabarrus A, Pavon R, Pastor L, Fiol M, Nieto V, Macaya C, Cinca J, Cygankiewitz I, Bayes De Luna A, Newton JD, Blackledge HM, Wright SP, Kerzner R, Gage BF, Freedland KE, Huynh BC, Rovner A, Carney RM, Teasdale TA, Bleyer AJ, Kutka NJ, Luchi RJ, Rusinaru D, Mahjoub H, Soulière V, Lévy F, Peltier M, Tsuchihashi M, Takeshita A, MacCarthy PA, Nolan J, Lee AJ, Prescott RJ, Shah AM, Brooksby WP, Fox KAA, Basante P, Trillo R, Garcia-Seara J, Martinez-Sande JL, Gude F, Berry, C, Poppe, K, Gamble, G, Earle, N, Ezekowitz, J, Squire, I, Mcmurray, J, Mcalister, F, Komajda, M, Swedberg, K, Maggioni, A, Ahmed, A, Whalley, G, Doughty, R, Tarantini, L, Granger, C, Køber, L, Massie, B, Pocock, S, Somaratne, J, Andersson, B, Bayes-Genis, A, Cowie, M, Cubbon, R, Gonzalez-Juanatey, J, Gorini, M, Gotsman, I, Grigorian-Shamagian, L, Guazzi, M, Kearney, M, Di Lenarda, A, Lenzen, M, Lucci, D, Macín, S, Madsen, B, Martínez-Sellés, M, Oliva, F, Rich, M, Richards, M, Senni, M, Taffet, G, Tribouilloy, C, Troughton, R, Tsutsui, H, Ariti, C, Dobson, J, Hall, C, Lainchbury, J, Hogg, K, Norrie, J, Stevenson, K, Brett, M, Pfeffer, M, Held, P, Michelson, E, Olofsson, B, Östergren, J, Yusuf, S, Torp-Pedersen, C, Scholte op Reimer, W, Boersma, E, Vantrimpont, P, Follath, F, Cleland, J, Zwas, D, Planer, D, Azaz-Livshits, T, Admon, D, Lotan, C, Keren, A, Varela-Roman, A, Mazón-Ramos, P, Rigeiro-Veloso, P, Bandin-Dieguez, M, Myers, J, Arena, R, Armstrong, P, Cujec, B, Paterson, I, Wood, D, Coats, A, Thompson, S, Suresh, V, Poole-Wilson, P, Sutton, G, Robles, J, Prieto, L, Muñoa, M, Frades, E, Díaz-Castro, O, Almendral, J, Faggiano, P, Bertoli, D, Porcu, M, Opasich, C, Tavazzi, L, Kirk, V, Bay, M, Parner, J, Krogsgaard, K, Herzog, T, Boesgaard, S, Hassager, C, Nielsen, O, Aldershvile, J, Nielsen, H, Kober, L, Perna, E, Cimbaro Canella, J, Alvarenga, P, Pantich, R, Ríos, N, Farias, E, Badaracco, J, Hansen, J, Stokholm, K, Brons, J, Husum, D, Mortensen, L, Vazquez, R, Puig, T, Fernandez-Palomeque, C, Bardají, A, Pascual-Figal, D, Ordoñez-Llanos, J, Valdes, M, Gabarrus, A, Pavon, R, Pastor, L, Fiol, M, Nieto, V, Macaya, C, Cinca, J, Cygankiewitz, I, Bayes De Luna, A, Newton, J, Blackledge, H, Wright, S, Kerzner, R, Gage, B, Freedland, K, Huynh, B, Rovner, A, Carney, R, Teasdale, T, Bleyer, A, Kutka, N, Luchi, R, Rusinaru, D, Mahjoub, H, Soulière, V, Lévy, F, Peltier, M, Tsuchihashi, M, Takeshita, A, Maccarthy, P, Nolan, J, Lee, A, Prescott, R, Shah, A, Brooksby, W, Fox, K, Basante, P, Trillo, R, Garcia-Seara, J, Martinez-Sande, J, Gude, F, Berry C, Poppe KK, Gamble GD, Earle NJ, Ezekowitz JA, Squire IB, McMurray JJV, McAlister FA, Komajda M, Swedberg K, Maggioni AP, Ahmed A, Whalley GA, Doughty RN, Tarantini L, Granger C, Køber L, Massie B, Pocock S, Somaratne J, Andersson B, Bayes-Genis A, Cowie M, Cubbon R, Gonzalez-Juanatey J, Gorini M, Gotsman I, Grigorian-Shamagian L, Guazzi M, Kearney M, Di Lenarda A, Lenzen M, Lucci D, Macín S, Madsen B, Martínez-Sellés M, Oliva F, Rich M, Richards M, Senni M, Taffet G, Tribouilloy C, Troughton R, Tsutsui H, Ariti C, Dobson J, Hall C, Lainchbury J, Hogg K, Norrie J, Stevenson K, Brett M, Pfeffer MA, Held P, Michelson EL, Olofsson B, Östergren J, Yusuf S, Torp-Pedersen C, Scholte op Reimer W, Boersma E, Vantrimpont PJMJ, Follath F, Cleland J, Zwas D, Planer D, Azaz-Livshits T, Admon D, Lotan C, Keren A, Varela-Roman A, Mazón-Ramos P, Rigeiro-Veloso P, Bandin-Dieguez MA, Myers J, Arena R, Armstrong PW, Cujec B, Paterson I, Wood DA, Coats AJS, Thompson SG, Suresh V, Poole-Wilson PA, Sutton GC, Robles JAG, Prieto L, Muñoa MD, Frades E, Díaz-Castro O, Almendral J, Faggiano P, Bertoli D, Porcu M, Opasich C, Tavazzi L, Kirk V, Bay M, Parner J, Krogsgaard K, Herzog TM, Boesgaard S, Hassager C, Nielsen OW, Aldershvile J, Nielsen H, Kober L, Perna ER, Cimbaro Canella JP, Alvarenga P, Pantich R, Ríos N, Farias EF, Badaracco JR, Hansen JF, Stokholm KH, Brons J, Husum D, Mortensen LS, Vazquez R, Puig T, Fernandez-Palomeque C, Bardají A, Pascual-Figal D, Ordoñez-Llanos J, Valdes M, Gabarrus A, Pavon R, Pastor L, Fiol M, Nieto V, Macaya C, Cinca J, Cygankiewitz I, Bayes De Luna A, Newton JD, Blackledge HM, Wright SP, Kerzner R, Gage BF, Freedland KE, Huynh BC, Rovner A, Carney RM, Teasdale TA, Bleyer AJ, Kutka NJ, Luchi RJ, Rusinaru D, Mahjoub H, Soulière V, Lévy F, Peltier M, Tsuchihashi M, Takeshita A, MacCarthy PA, Nolan J, Lee AJ, Prescott RJ, Shah AM, Brooksby WP, Fox KAA, Basante P, Trillo R, Garcia-Seara J, Martinez-Sande JL, and Gude F

Abstract

Background: Anaemia is common among patients with heart failure (HF) and is an important prognostic marker. Aim: We sought to determine the prognostic importance of anaemia in a large multinational pooled dataset of prospectively enrolled HF patients, with the specific aim to determine the prognostic role of anaemia in HF with preserved and reduced ejection fraction (HF-PEF and HF-REF, respectively). Design: Individual person data meta-analysis. Methods: Patients with haemoglobin (Hb) data fromthe MAGGIC dataset were used. Anaemia was defined as Hb < 120 g/l in women and <130 g/l inmen. HF-PEF was defined as EF ≥ 50%; HF-REF was EF < 50%. Cox proportional hazardmodelling, with adjustment for clinically relevant variables, was undertaken to investigate factors associated with 3-year all-causemortality. Results: Thirteen thousand two hundred and ninety-five patients with HF from 19 studies (9887 with HF-REF and 3408 with HF-PEF). The prevalence of anaemia was similar among those with HF-REF and HF-PEF (42.8 and 41.6% respectively). Compared with patients with normal Hb values, those with anaemia were older, were more likely to have diabetes, ischaemic aetiology, New York Heart Association class IV symptoms, lower estimated glomerular filtration rate and were more likely to be taking diuretic and less likely to be taking a beta-blocker. Patients with anaemia had higher all-cause mortality (adjusted hazard ratio [aHR] 1.38, 95% confidence interval [CI] 1.25-1.51), independent of EF group: aHR 1.67 (1.39-1.99) in HFPEF and aHR 2.49 (2.13-2.90) in HF-REF. Conclusions: Anaemia is an adverse prognostic factor in HF irrespective of EF. The prognostic importance of anaemia was greatest in patients with HF-REF.

Published
2016

34. Senile Systemic Amyloidosis

Author

Cornwell, G. G., III, Westermark, P., Kyle, R. A., Pitkanen, P., Benson, L., Olofsson, B.-O., Glenner, George G., editor, Osserman, Elliott F., editor, Benditt, Earl P., editor, Calkins, Evan, editor, Cohen, Alan S., editor, and Zucker-Franklin, Dorothea, editor

Published
1986
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39. The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction: an individual patient data meta-analysis

Author

Berry, C, Doughty, R, Granger, C, Kober, L, Massie, B, Mcalister, F, Mcmurray, J, Pocock, S, Poppe, K, Swedberg, K, Somaratne, J, Whalley, G, Ahmed, A, Andersson, B, Bayes-Genis, A, Cowie, M, Cubbon, R, Ezekowitz, J, Gonzalez-Juanatey, J, Gorini, M, Gotsman, I, Grigorian-Shamagian, L, Guazzi, M, Kearney, M, Komajda, M, di Lenarda, A, Lenzen, M, Lucci, D, Macin, S, Madsen, B, Maggioni, A, Martinez-Selles, M, Oliva, F, Rich, M, Richards, M, Senni, M, Squire, I, Taffet, G, Tarantini, L, Tribouilloy, C, Troughton, R, Tsutsui, H, Earle, N, Perera, K, Dobson, J, Hall, C, Richards, A, Lainchbury, J, Hogg, K, Norrie, J, Stevenson, K, Brett, M, Pfeffer, M, Held, P, Michelson, E, Olofsson, B, Ostergren, J, Yusuf, S, Torp-Pedersen, C, Reimer, W, Boersma, E, Vantrimpont, P, Follath, F, Cleland, J, Zwas, D, Planer, D, Azaz-Livshits, T, Admon, D, Lotan, C, Keren, A, Varela-Roman, A, Mazon-Ramos, P, Rigeiro-Veloso, P, Bandin-Dieguez, M, Myers, J, Arena, R, Armstrong, P, Cujec, B, Paterson, I, Wood, D, Coats, A, Thompson, S, Suresh, V, Poole-Wilson, P, Sutton, G, Robles, J, Prieto, L, Munoa, M, Frades, E, Diaz-Castro, O, Almendral, J, Faggiano, P, Bertoli, D, Porcu, M, Opasich, C, Tavazzi, L, Kirk, V, Bay, M, Parner, J, Krogsgaard, K, Herzog, T, Boesgaard, S, Hassager, C, Nielsen, O, Aldershvile, J, Nielsen, H, Perna, E, Canella, J, Alvarenga, P, Pantich, R, Rios, N, Farias, E, Badaracco, J, Hansen, J, Stokholm, K, Brons, J, Husum, D, Mortensen, L, Vazquez, R, Puig, T, Fernandez-Palomeque, C, Bardaji, A, Pascual-Figal, D, Ordonez-Llanos, J, Valdes, M, Gabarrus, A, Pavon, R, Pastor, L, Fiol, M, Nieto, V, Macaya, C, Cinca, J, de Luna, A, Newton, J, Blackledge, H, Wright, S, Kerzner, R, Gage, B, Freedland, K, Huynh, B, Rovner, A, Carney, R, Teasdale, T, Bleyer, A, Kutka, N, Luchi, R, Rusinaru, D, Mahjoub, H, Souliere, V, Levy, F, Peltier, M, Tsuchihashi, M, Takeshita, A, Maccarthy, P, Nolan, J, Lee, A, Prescott, R, Shah, A, Brooksby, W, Fox, K, Basante, P, Trillo, R, Garcia-Seara, J, Martinez-Sande, J, Gude, F, Berry C, Doughty RN, Granger C, Kober L, Massie B, McAlister F, McMurray J, Pocock S, Poppe K, Swedberg K, Somaratne J, Whalley GA, Ahmed A, Andersson B, Bayes-Genis A, Cowie M, Cubbon R, Ezekowitz J, Gonzalez-Juanatey J, Gorini M, Gotsman I, Grigorian-Shamagian L, Guazzi M, Kearney M, Komajda M, di Lenarda A, Lenzen M, Lucci D, Macin S, Madsen B, Maggioni A, Martinez-Selles M, Oliva F, Rich M, Richards M, Senni M, Squire I, Taffet G, Tarantini L, Tribouilloy C, Troughton R, Tsutsui H, Earle N, Perera K, Dobson J, Whalley G, Hall C, Richards AM, Lainchbury J, Hogg K, Norrie J, Stevenson K, Brett M, Pfeffer MA, Granger CB, Held P, McMurray JJV, Michelson EL, Olofsson B, Ostergren J, Yusuf S, Torp-Pedersen C, Lenzen MJ, Reimer WJMS, Boersma E, Vantrimpont PJMJ, Follath F, Cleland J, Zwas D, Planer D, Azaz-Livshits T, Admon D, Lotan C, Keren A, Varela-Roman A, Mazon-Ramos P, Rigeiro-Veloso P, Bandin-Dieguez MA, Gonzalez-Juanatey JR, Myers J, Arena R, McAlister FA, Armstrong PW, Cujec B, Paterson I, Cowie MR, Wood DA, Coats AJS, Thompson SG, Suresh V, Poole-Wilson PA, Sutton GC, Robles JAG, Prieto L, Munoa MD, Frades E, Diaz-Castro O, Almendral J, Faggiano P, Bertoli D, Porcu M, Opasich C, Tavazzi L, Maggioni AP, Kirk V, Bay M, Parner J, Krogsgaard K, Herzog TM, Boesgaard S, Hassager C, Nielsen OW, Aldershvile J, Nielsen H, Macin SM, Perna ER, Canella JPC, Alvarenga P, Pantich R, Rios N, Farias EF, Badaracco JR, Madsen BK, Hansen JF, Stokholm KH, Brons J, Husum D, Mortensen LS, Vazquez R, Puig T, Fernandez-Palomeque C, Bardaji A, Pascual-Figal D, Ordonez-Llanos J, Valdes M, Gabarrus A, Pavon R, Pastor L, Fiol M, Nieto V, Macaya C, Cinca J, de Luna AB, Newton JD, Blackledge HM, Squire IB, Wright SP, Kerzner R, Gage BF, Freedland KE, Rich MW, Huynh BC, Rovner A, Carney RM, Taffet GE, Teasdale TA, Bleyer AJ, Kutka NJ, Luchi RJ, Rusinaru D, Mahjoub H, Souliere V, Levy F, Peltier M, Tsuchihashi M, Takeshita A, MacCarthy PA, Kearney MT, Nolan J, Lee AJ, Prescott RJ, Shah AM, Brooksby WP, Fox KAA, Basante P, Trillo R, Garcia-Seara J, Martinez-Sande JL, Gude F, Berry, C, Doughty, R, Granger, C, Kober, L, Massie, B, Mcalister, F, Mcmurray, J, Pocock, S, Poppe, K, Swedberg, K, Somaratne, J, Whalley, G, Ahmed, A, Andersson, B, Bayes-Genis, A, Cowie, M, Cubbon, R, Ezekowitz, J, Gonzalez-Juanatey, J, Gorini, M, Gotsman, I, Grigorian-Shamagian, L, Guazzi, M, Kearney, M, Komajda, M, di Lenarda, A, Lenzen, M, Lucci, D, Macin, S, Madsen, B, Maggioni, A, Martinez-Selles, M, Oliva, F, Rich, M, Richards, M, Senni, M, Squire, I, Taffet, G, Tarantini, L, Tribouilloy, C, Troughton, R, Tsutsui, H, Earle, N, Perera, K, Dobson, J, Hall, C, Richards, A, Lainchbury, J, Hogg, K, Norrie, J, Stevenson, K, Brett, M, Pfeffer, M, Held, P, Michelson, E, Olofsson, B, Ostergren, J, Yusuf, S, Torp-Pedersen, C, Reimer, W, Boersma, E, Vantrimpont, P, Follath, F, Cleland, J, Zwas, D, Planer, D, Azaz-Livshits, T, Admon, D, Lotan, C, Keren, A, Varela-Roman, A, Mazon-Ramos, P, Rigeiro-Veloso, P, Bandin-Dieguez, M, Myers, J, Arena, R, Armstrong, P, Cujec, B, Paterson, I, Wood, D, Coats, A, Thompson, S, Suresh, V, Poole-Wilson, P, Sutton, G, Robles, J, Prieto, L, Munoa, M, Frades, E, Diaz-Castro, O, Almendral, J, Faggiano, P, Bertoli, D, Porcu, M, Opasich, C, Tavazzi, L, Kirk, V, Bay, M, Parner, J, Krogsgaard, K, Herzog, T, Boesgaard, S, Hassager, C, Nielsen, O, Aldershvile, J, Nielsen, H, Perna, E, Canella, J, Alvarenga, P, Pantich, R, Rios, N, Farias, E, Badaracco, J, Hansen, J, Stokholm, K, Brons, J, Husum, D, Mortensen, L, Vazquez, R, Puig, T, Fernandez-Palomeque, C, Bardaji, A, Pascual-Figal, D, Ordonez-Llanos, J, Valdes, M, Gabarrus, A, Pavon, R, Pastor, L, Fiol, M, Nieto, V, Macaya, C, Cinca, J, de Luna, A, Newton, J, Blackledge, H, Wright, S, Kerzner, R, Gage, B, Freedland, K, Huynh, B, Rovner, A, Carney, R, Teasdale, T, Bleyer, A, Kutka, N, Luchi, R, Rusinaru, D, Mahjoub, H, Souliere, V, Levy, F, Peltier, M, Tsuchihashi, M, Takeshita, A, Maccarthy, P, Nolan, J, Lee, A, Prescott, R, Shah, A, Brooksby, W, Fox, K, Basante, P, Trillo, R, Garcia-Seara, J, Martinez-Sande, J, Gude, F, Berry C, Doughty RN, Granger C, Kober L, Massie B, McAlister F, McMurray J, Pocock S, Poppe K, Swedberg K, Somaratne J, Whalley GA, Ahmed A, Andersson B, Bayes-Genis A, Cowie M, Cubbon R, Ezekowitz J, Gonzalez-Juanatey J, Gorini M, Gotsman I, Grigorian-Shamagian L, Guazzi M, Kearney M, Komajda M, di Lenarda A, Lenzen M, Lucci D, Macin S, Madsen B, Maggioni A, Martinez-Selles M, Oliva F, Rich M, Richards M, Senni M, Squire I, Taffet G, Tarantini L, Tribouilloy C, Troughton R, Tsutsui H, Earle N, Perera K, Dobson J, Whalley G, Hall C, Richards AM, Lainchbury J, Hogg K, Norrie J, Stevenson K, Brett M, Pfeffer MA, Granger CB, Held P, McMurray JJV, Michelson EL, Olofsson B, Ostergren J, Yusuf S, Torp-Pedersen C, Lenzen MJ, Reimer WJMS, Boersma E, Vantrimpont PJMJ, Follath F, Cleland J, Zwas D, Planer D, Azaz-Livshits T, Admon D, Lotan C, Keren A, Varela-Roman A, Mazon-Ramos P, Rigeiro-Veloso P, Bandin-Dieguez MA, Gonzalez-Juanatey JR, Myers J, Arena R, McAlister FA, Armstrong PW, Cujec B, Paterson I, Cowie MR, Wood DA, Coats AJS, Thompson SG, Suresh V, Poole-Wilson PA, Sutton GC, Robles JAG, Prieto L, Munoa MD, Frades E, Diaz-Castro O, Almendral J, Faggiano P, Bertoli D, Porcu M, Opasich C, Tavazzi L, Maggioni AP, Kirk V, Bay M, Parner J, Krogsgaard K, Herzog TM, Boesgaard S, Hassager C, Nielsen OW, Aldershvile J, Nielsen H, Macin SM, Perna ER, Canella JPC, Alvarenga P, Pantich R, Rios N, Farias EF, Badaracco JR, Madsen BK, Hansen JF, Stokholm KH, Brons J, Husum D, Mortensen LS, Vazquez R, Puig T, Fernandez-Palomeque C, Bardaji A, Pascual-Figal D, Ordonez-Llanos J, Valdes M, Gabarrus A, Pavon R, Pastor L, Fiol M, Nieto V, Macaya C, Cinca J, de Luna AB, Newton JD, Blackledge HM, Squire IB, Wright SP, Kerzner R, Gage BF, Freedland KE, Rich MW, Huynh BC, Rovner A, Carney RM, Taffet GE, Teasdale TA, Bleyer AJ, Kutka NJ, Luchi RJ, Rusinaru D, Mahjoub H, Souliere V, Levy F, Peltier M, Tsuchihashi M, Takeshita A, MacCarthy PA, Kearney MT, Nolan J, Lee AJ, Prescott RJ, Shah AM, Brooksby WP, Fox KAA, Basante P, Trillo R, Garcia-Seara J, Martinez-Sande JL, and Gude F

Abstract

Aims: A substantial proportion of patients with heart failure have preserved left ventricular ejection fraction (HF-PEF). Previous studies have reportedmixed resultswhether survival is similar to those patientswith heart failure and reduced EF (HF-REF). Methods and results: We compared survival in patients with HF-PEF with that in patients with HF-REF in a meta-analysis using individual patient data. Preserved EF was defined as an EF ≥ 50%. The 31 studies included 41 972 patients: 10 347 with HF-PEF and 31 625 with HF-REF. Compared with patients with HF-REF, those with HF-PEF were older (mean age 71 vs. 66 years), were more often women (50 vs. 28%), and have a history of hypertension (51 vs. 41%). Ischaemic aetiology was less common (43 vs. 59%) in patients with HF-PEF. There were 121 [95% confidence interval (CI): 117, 126] deaths per 1000 patient-years in those with HF-PEF and 141 (95% CI: 138, 144) deaths per 1000 patient-years in those with HF-REF. Patients with HF-PEF had lower mortality than those with HF-REF (adjusted for age, gender, aetiology, and history of hypertension, diabetes, and atrial fibrillation); hazard ratio 0.68 (95% CI: 0.64, 0.71). The risk of death did not increase notably until EF fell below 40%. Conclusion: Patients with HF-PEF have a lower risk of death than patients with HF-REF, and this difference is seen regardless of age, gender, and aetiology of HF. However, absolute mortality is still high in patients with HF-PEF highlighting the need for a treatment to improve prognosis.

Published
2012

40. Consensus and variations in opinions on delirium care: a survey of European delirium specialists

Author

Morandi, Alessandro, Davis, D., Taylor, J.K., Bellelli, Giuseppe, Olofsson, B., Kreisel, Stefan, Teodorczuk, Andrew, Kamholz, Barbara, Hasemann, Wolfgang, Young, John, Agar, M., de Rooij, Sophia E.J.A., Meagher, David, Trabucchi, Marco T., MacLullich, Alasdair M., Morandi, Alessandro, Davis, D., Taylor, J.K., Bellelli, Giuseppe, Olofsson, B., Kreisel, Stefan, Teodorczuk, Andrew, Kamholz, Barbara, Hasemann, Wolfgang, Young, John, Agar, M., de Rooij, Sophia E.J.A., Meagher, David, Trabucchi, Marco T., and MacLullich, Alasdair M.

Abstract

peer-reviewed, Background: There are still substantial uncertainties over best practice in delirium care. The European Delirium Association (EDA) conducted a survey of its members and other interested parties on various aspects of delirium care.Methods: The invitation to participate in the online survey was distributed among the EDA membership. The survey covered assessment, treatment of hyperactive and hypoactive delirium, and organizational management.Results: A total of 200 responses were collected (United Kingdom 28.6%, Netherlands 25.3%, Italy 15%, Switzerland 9.7%, Germany 7.1%, Spain 3.8%, Portugal 2.5%, Ireland 2.5%, Sweden 0.6%, Denmark 0.6%, Austria 0.6%, and others 3.2%). Most of the responders were doctors (80%), working in geriatrics (45%) or internal medicine (14%). Ninety-two per cent of the responders assessed patients for delirium daily. The most commonly used assessment tools were the Confusion Assessment Method (52%) and the Delirium Observation Screening Scale (30%). The first-line choice in the management of hyperactive delirium was a combination of non-pharmacological and pharmacological approaches (61%). Conversely, non-pharmacological management was the first-line choice in hypoactive delirium (67%). Delirium awareness (34%), knowledge (33%), and lack of education (13%) were the most commonly reported barriers to improving the detection of delirium. Interestingly, 63% of the responders referred patients after an episode of delirium to a follow-up clinic.Conclusions: This is the first systematic survey involving an international group of specialists in delirium. Several areas of lack of consensus were found. These results emphasise the importance of further research to improve care of this major unmet medical need., PUBLISHED, peer-reviewed

Published
2017

41. Consensus and variations in opinions on delirium care: a survey of European delirium specialists

Author

Morandi, A., Davis, D., Taylor, J. K., Bellelli, G., Olofsson, B., Kreisel, S., Teodorczuk, A., Kamholz, B., Hasemann, W., Young, J., Agar, M., de Rooij, S. E., Meagher, D., Trabucchi, M., MacLullich, A. M., Morandi, A., Davis, D., Taylor, J. K., Bellelli, G., Olofsson, B., Kreisel, S., Teodorczuk, A., Kamholz, B., Hasemann, W., Young, J., Agar, M., de Rooij, S. E., Meagher, D., Trabucchi, M., and MacLullich, A. M.

Abstract

Background: There are still substantial uncertainties over best practice in delirium care. The European Delirium Association (EDA) conducted a survey of its members and other interested parties on various aspects of delirium care. Methods: The invitation to participate in the online survey was distributed among the EDA membership. The survey covered assessment, treatment of hyperactive and hypoactive delirium, and organizational management. Results: A total of 200 responses were collected (United Kingdom 28.6%, Netherlands 25.3%, Italy 15%, Switzerland 9.7%, Germany 7.1%, Spain 3.8%, Portugal 2.5%, Ireland 2.5%, Sweden 0.6%, Denmark 0.6%, Austria 0.6%, and others 3.2%). Most of the responders were doctors (80%), working in geriatrics (45%) or internal medicine (14%). Ninety-two per cent of the responders assessed patients for delirium daily. The most commonly used assessment tools were the Confusion Assessment Method (52%) and the Delirium Observation Screening Scale (30%). The first-line choice in the management of hyperactive delirium was a combination of non-pharmacological and pharmacological approaches (61%). Conversely, non-pharmacological management was the first-line choice in hypoactive delirium (67%). Delirium awareness (34%), knowledge (33%), and lack of education (13%) were the most commonly reported barriers to improving the detection of delirium. Interestingly, 63% of the responders referred patients after an episode of delirium to a follow-up clinic. Conclusions: This is the first systematic survey involving an international group of specialists in delirium. Several areas of lack of consensus were found. These results emphasise the importance of further research to improve care of this major unmet medical need

Published
2017

42. The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction: an individual patient data meta-analysis

Author

Berry C, Doughty RN, Granger C, Kober L, Massie B, McAlister F, McMurray J, Pocock S, Poppe K, Swedberg K, Somaratne J, Whalley GA, Ahmed A, Andersson B, Bayes-Genis A, Cowie M, Cubbon R, Ezekowitz J, Gonzalez-Juanatey J, Gorini M, Gotsman I, Grigorian-Shamagian L, Guazzi M, Kearney M, Komajda M, di Lenarda A, Lenzen M, Lucci D, Macin S, Madsen B, Maggioni A, Martinez-Selles M, Oliva F, Rich M, Richards M, Senni M, Squire I, Taffet G, Tarantini L, Tribouilloy C, Troughton R, Tsutsui H, Earle N, Perera K, Dobson J, Whalley G, Hall C, Richards AM, Lainchbury J, Hogg K, Norrie J, Stevenson K, Brett M, Pfeffer MA, Granger CB, Held P, McMurray JJV, Michelson EL, Olofsson B, Ostergren J, Yusuf S, Torp-Pedersen C, Lenzen MJ, Reimer WJMS, Boersma E, Vantrimpont PJMJ, Follath F, Cleland J, Zwas D, Planer D, Azaz-Livshits T, Admon D, Lotan C, Keren A, Varela-Roman A, Mazon-Ramos P, Rigeiro-Veloso P, Bandin-Dieguez MA, Gonzalez-Juanatey JR, Myers J, Arena R, McAlister FA, Armstrong PW, Cujec B, Paterson I, Cowie MR, Wood DA, Coats AJS, Thompson SG, Suresh V, Poole-Wilson PA, Sutton GC, Robles JAG, Prieto L, Munoa MD, Frades E, Diaz-Castro O, Almendral J, Faggiano P, Bertoli D, Porcu M, Opasich C, Tavazzi L, Maggioni AP, Kirk V, Bay M, Parner J, Krogsgaard K, Herzog TM, Boesgaard S, Hassager C, Nielsen OW, Aldershvile J, Nielsen H, Macin SM, Perna ER, Canella JPC, Alvarenga P, Pantich R, Rios N, Farias EF, Badaracco JR, Madsen BK, Hansen JF, Stokholm KH, Brons J, Husum D, Mortensen LS, Vazquez R, Puig T, Fernandez-Palomeque C, Bardaji A, Pascual-Figal D, Ordonez-Llanos J, Valdes M, Gabarrus A, Pavon R, Pastor L, Fiol M, Nieto V, Macaya C, Cinca J, de Luna AB, Newton JD, Blackledge HM, Squire IB, Wright SP, Kerzner R, Gage BF, Freedland KE, Rich MW, Huynh BC, Rovner A, Carney RM, Taffet GE, Teasdale TA, Bleyer AJ, Kutka NJ, Luchi RJ, Rusinaru D, Mahjoub H, Souliere V, Levy F, Peltier M, Tsuchihashi M, Takeshita A, MacCarthy PA, Kearney MT, Nolan J, Lee AJ, Prescott RJ, Shah AM, Brooksby WP, Fox KAA, Basante P, Trillo R, Garcia-Seara J, Martinez-Sande JL, Gude F, Berry, C, Doughty, R, Granger, C, Kober, L, Massie, B, Mcalister, F, Mcmurray, J, Pocock, S, Poppe, K, Swedberg, K, Somaratne, J, Whalley, G, Ahmed, A, Andersson, B, Bayes-Genis, A, Cowie, M, Cubbon, R, Ezekowitz, J, Gonzalez-Juanatey, J, Gorini, M, Gotsman, I, Grigorian-Shamagian, L, Guazzi, M, Kearney, M, Komajda, M, di Lenarda, A, Lenzen, M, Lucci, D, Macin, S, Madsen, B, Maggioni, A, Martinez-Selles, M, Oliva, F, Rich, M, Richards, M, Senni, M, Squire, I, Taffet, G, Tarantini, L, Tribouilloy, C, Troughton, R, Tsutsui, H, Earle, N, Perera, K, Dobson, J, Hall, C, Richards, A, Lainchbury, J, Hogg, K, Norrie, J, Stevenson, K, Brett, M, Pfeffer, M, Held, P, Michelson, E, Olofsson, B, Ostergren, J, Yusuf, S, Torp-Pedersen, C, Reimer, W, Boersma, E, Vantrimpont, P, Follath, F, Cleland, J, Zwas, D, Planer, D, Azaz-Livshits, T, Admon, D, Lotan, C, Keren, A, Varela-Roman, A, Mazon-Ramos, P, Rigeiro-Veloso, P, Bandin-Dieguez, M, Myers, J, Arena, R, Armstrong, P, Cujec, B, Paterson, I, Wood, D, Coats, A, Thompson, S, Suresh, V, Poole-Wilson, P, Sutton, G, Robles, J, Prieto, L, Munoa, M, Frades, E, Diaz-Castro, O, Almendral, J, Faggiano, P, Bertoli, D, Porcu, M, Opasich, C, Tavazzi, L, Kirk, V, Bay, M, Parner, J, Krogsgaard, K, Herzog, T, Boesgaard, S, Hassager, C, Nielsen, O, Aldershvile, J, Nielsen, H, Perna, E, Canella, J, Alvarenga, P, Pantich, R, Rios, N, Farias, E, Badaracco, J, Hansen, J, Stokholm, K, Brons, J, Husum, D, Mortensen, L, Vazquez, R, Puig, T, Fernandez-Palomeque, C, Bardaji, A, Pascual-Figal, D, Ordonez-Llanos, J, Valdes, M, Gabarrus, A, Pavon, R, Pastor, L, Fiol, M, Nieto, V, Macaya, C, Cinca, J, de Luna, A, Newton, J, Blackledge, H, Wright, S, Kerzner, R, Gage, B, Freedland, K, Huynh, B, Rovner, A, Carney, R, Teasdale, T, Bleyer, A, Kutka, N, Luchi, R, Rusinaru, D, Mahjoub, H, Souliere, V, Levy, F, Peltier, M, Tsuchihashi, M, Takeshita, A, Maccarthy, P, Nolan, J, Lee, A, Prescott, R, Shah, A, Brooksby, W, Fox, K, Basante, P, Trillo, R, Garcia-Seara, J, Martinez-Sande, J, and Gude, F

Subjects
Male, medicine.medical_specialty, Prognosi, Heart failure, Lower risk, Risk Factors, Cause of Death, Internal medicine, medicine, Humans, Meta-analysi, Aged, Randomized Controlled Trials as Topic, Ejection fraction, business.industry, Hazard ratio, Stroke Volume, Atrial fibrillation, medicine.disease, Confidence interval, Meta-analysis, Cardiology, Etiology, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Aims A substantial proportion of patients with heart failure have preserved left ventricular ejection fraction (HF-PEF). Previous studies have reported mixed results whether survival is similar to those patients with heart failure and reduced EF (HF-REF). Methods and results We compared survival in patients with HF-PEF with that in patients with HF-REF in a meta-analysis using individual patient data. Preserved EF was defined as an EF ≥ 50%. The 31 studies included 41 972 patients: 10 347 with HF-PEF and 31 625 with HF-REF. Compared with patients with HF-REF, those with HF-PEF were older (mean age 71 vs. 66 years), were more often women (50 vs. 28%), and have a history of hypertension (51 vs. 41%). Ischaemic aetiology was less common (43 vs. 59%) in patients with HF-PEF. There were 121 [95% confidence interval (CI): 117, 126] deaths per 1000 patient-years in those with HF-PEF and 141 (95% CI: 138, 144) deaths per 1000 patient-years in those with HF-REF. Patients with HF-PEF had lower mortality than those with HF-REF (adjusted for age, gender, aetiology, and history of hypertension, diabetes, and atrial fibrillation); hazard ratio 0.68 (95% CI: 0.64, 0.71). The risk of death did not increase notably until EF fell below 40%. Conclusion Patients with HF-PEF have a lower risk of death than patients with HF-REF, and this difference is seen regardless of age, gender, and aetiology of HF. However, absolute mortality is still high in patients with HF-PEF highlighting the need for a treatment to improve prognosis.

Published
2012

44. The DSM-5 criteria, level of arousal and delirium diagnosis: Inclusiveness is safer

Author

Boustani, M, Rudolph, J, Shaughnessy, M, Gruber-Baldini, A, Alici, Y, Arora, RC, Campbell, N, Flaherty, J, Gordon, S, Kamholz, B, Maldonado, JR, Pandharipande, P, Parks, J, Waszynski, C, Khan, B, Neufeld, K, Olofsson, B, Thomas, C, Young, J, Davis, D, Laurila, J, Page, V, Teodorczuk, A, Agar, M, Meagher, D, Spiller, J, Schieveld, J, Milisen, K, de Rooij, S, van Munster, B, Kreisel, S, Cerejeira, J, Hasemann, W, Wilson, D, Cunningham, C, Morandi, A, Slooter, A, Detroyer, E, Caraceni, A, and MacLullich, A

Subjects
Diagnostic and Statistical Manual of Mental Disorders, General & Internal Medicine, mental disorders, Sleep Arousal Disorders, Humans, Delirium, behavioral disciplines and activities
Abstract

© 2014 European Delirium Association et al.; licensee BioMed Central Ltd. Background: Delirium is a common and serious problem among acutely unwell persons. Alhough linked to higher rates of mortality, institutionalisation and dementia, it remains underdiagnosed. Careful consideration of its phenomenology is warranted to improve detection and therefore mitigate some of its clinical impact. The publication of the fifth edition of the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-5) provides an opportunity to examine the constructs underlying delirium as a clinical entity.Discussion: Altered consciousness has been regarded as a core feature of delirium; the fact that consciousness itself should be physiologically disrupted due to acute illness attests to its clinical urgency. DSM-5 now operationalises 'consciousness' as 'changes in attention'. It should be recognised that attention relates to content of consciousness, but arousal corresponds to level of consciousness. Reduced arousal is also associated with adverse outcomes. Attention and arousal are hierarchically related; level of arousal must be sufficient before attention can be reasonably tested.Summary: Our conceptualisation of delirium must extend beyond what can be assessed through cognitive testing (attention) and accept that altered arousal is fundamental. Understanding the DSM-5 criteria explicitly in this way offers the most inclusive and clinically safe interpretation.

Published
2014

45. High morale and survival

Author

Niklasson, J., primary, Hörnsten, C., additional, Conradsson, M., additional, Nyqvist, F., additional, Olofsson, B., additional, Lövheim, H., additional, and Gustavsson, Y., additional

Published
2016
Full Text
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48. Purple fumes: The importance of iodine

Author

Küpper, F.C., Feiters, M.C., Olofsson, B., Kaiho, T., Yanagida, S., Zimmermann, M.B., Carpenter, L.J., III, G.W. Luther, Lu, Z., Jonsson, M., and Kloo, L.

Subjects
Synthetic Organic Chemistry, GeneralLiterature_REFERENCE(e.g.,dictionaries,encyclopedias,glossaries), Physical Organic Chemistry
Abstract

Contains fulltext : 123226.pdf (Publisher’s version ) (Open Access)

Published
2013

49. The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction: an individual patient data meta-analysis

Author

Granger, C, Massie, B, Somaratne, J, Ahmed, A, Cowie, M, Gonzalez-Juanatey, J, Gorini, M, Kearney, M, di Lenarda, A, Lenzen, M, Macin, S, Madsen, B, Maggioni, A, McAlister, F, Oliva, F, Rich, M, Richards, M, Squire, I, Taffet, G, Earle, N, Perera, K, Dobson, J, Pocock, S, Poppe, K, Whalley, G, Andersson, B, Hall, C, Richards, AM, Troughton, R, Lainchbury, J, Berry, C, Hogg, K, Norrie, J, Stevenson, K, Brett, M, McMurray, J, Pfeffer, MA, Granger, CB, Held, P, McMurray, JJV, Michelson, EL, Olofsson, B, Ostergren, J, Yusuf, S, Torp-Pedersen, C, Lenzen, MJ, Reimer, WJMS, Boersma, E, Vantrimpont, PJMJ, Follath, F, Swedberg, K, Cleland, J, Komajda, M, Gotsman, I, Zwas, D, Planer, D, Azaz-Livshits, T, Admon, D, Lotan, C, Keren, A, Grigorian-Shamagian, L, Mazon-Ramos, P, Rigeiro-Veloso, P, Bandin-Dieguez, MA, Guazzi, M, Myers, J, Arena, R, McAlister, FA, Ezekowitz, J, Armstrong, PW, Cujec, B, Paterson, I, Cowie, MR, Wood, DA, Coats, AJS, Thompson, SG, Suresh, V, Poole-Wilson, PA, Sutton, GC, Martinez-Selles, M, Robles, JAG, Prieto, L, Munoa, MD, Frades, E, Diaz-Castro, O, Tarantini, L, Faggiano, P, Senni, M, Lucci, D, Bertoli, D, Porcu, M, Opasich, C, Tavazzi, L, Maggioni, AP, Kirk, V, Bay, M, Parner, J, Krogsgaard, K, Herzog, TM, Boesgaard, S, Hassager, C, Nielsen, OW, Aldershvile, J, Nielsen, H, Kober, L, Macin, SM, Perna, ER, Canella, JPC, Alvarenga, P, Pantich, R, Rios, N, Farias, EF, Badaracco, JR, Madsen, BK, Hansen, JF, Stokholm, KH, Brons, J, Husum, D, Mortensen, LS, Bayes-Genis, A, Vazquez, R, Puig, T, Fernandez-Palomeque, C, Bardaji, A, Pascual-Figal, D, Ordonez-Llanos, J, Valdes, M, Gabarrus, A, Pavon, R, Pastor, L, Almendral, J, Fiol, M, Nieto, V, Macaya, C, Cinca, J, de Luna, AB, Newton, JD, Blackledge, HM, Squire, IB, Wright, SP, Whalley, GA, Doughty, RN, Kerzner, R, Gage, BF, Huynh, BC, Rovner, A, Freedland, KE, Carney, RM, Rich, MW, Taffet, GE, Teasdale, TA, Bleyer, AJ, Kutka, NJ, Luchi, RJ, Tribouilloy, C, Rusinaru, D, Mahjoub, H, Souliere, V, Levy, F, Peltier, M, Tsutsui, H, Tsuchihashi, M, Takeshita, A, MacCarthy, PA, Kearney, MT, Cubbon, R, Nolan, J, Lee, AJ, Prescott, RJ, Shah, AM, Brooksby, WP, Fox, KAA, Varela-Roman, A, Gonzalez-Juanatey, JR, Basante, P, Trillo, R, Garcia-Seara, J, Martinez-Sande, JL, and Gude, F

Subjects
Meta-analysis, Heart failure, Prognosis
Abstract

A substantial proportion of patients with heart failure have preserved left ventricular ejection fraction (HF-PEF). Previous studies have reported mixed results whether survival is similar to those patients with heart failure and reduced EF (HF-REF). We compared survival in patients with HF-PEF with that in patients with HF-REF in a meta-analysis using individual patient data. Preserved EF was defined as an EF epsilon 50. The 31 studies included 41 972 patients: 10 347 with HF-PEF and 31 625 with HF-REF. Compared with patients with HF-REF, those with HF-PEF were older (mean age 71 vs. 66 years), were more often women (50 vs. 28), and have a history of hypertension (51 vs. 41). Ischaemic aetiology was less common (43 vs. 59) in patients with HF-PEF. There were 121 [95 confidence interval (CI): 117, 126] deaths per 1000 patient-years in those with HF-PEF and 141 (95 CI: 138, 144) deaths per 1000 patient-years in those with HF-REF. Patients with HF-PEF had lower mortality than those with HF-REF (adjusted for age, gender, aetiology, and history of hypertension, diabetes, and atrial fibrillation); hazard ratio 0.68 (95 CI: 0.64, 0.71). The risk of death did not increase notably until EF fell below 40. Patients with HF-PEF have a lower risk of death than patients with HF-REF, and this difference is seen regardless of age, gender, and aetiology of HF. However, absolute mortality is still high in patients with HF-PEF highlighting the need for a treatment to improve prognosis.

Published
2012

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