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1. Pain and Frailty in Hospitalized Older Adults

Author

Ilaria Ardoino, Carlotta Franchi, Alessandro Nobili, Pier Mannuccio Mannucci, Oscar Corli, and REPOSI Investigators

Subjects
Chronic pain, Internal medicine and geriatric wards, Musculoskeletal diseases, Anesthesiology, RD78.3-87.3
Abstract

Abstract Introduction Pain and frailty are prevalent conditions in the older population. Many chronic diseases are likely involved in their origin, and both have a negative impact on quality of life. However, few studies have analysed their association. Methods In light of this knowledge gap, 3577 acutely hospitalized patients 65 years or older enrolled in the REPOSI register, an Italian network of internal medicine and geriatric hospital wards, were assessed to calculate the frailty index (FI). The impact of pain and some of its characteristics on the degree of frailty was evaluated using an ordinal logistic regression model after adjusting for age and gender. Results The prevalence of pain was 24.7%, and among patients with pain, 42.9% was regarded as chronic pain. Chronic pain was associated with severe frailty (OR = 1.69, 95% CI 1.38–2.07). Somatic pain (OR = 1.59, 95% CI 1.23–2.07) and widespread pain (OR = 1.60, 95% CI 0.93–2.78) were associated with frailty. Osteoarthritis was the most common cause of chronic pain, diagnosed in 157 patients (33.5%). Polymyalgia, rheumatoid arthritis and other musculoskeletal diseases causing chronic pain were associated with a lower degree of frailty than osteoarthritis (OR = 0.49, 95%CI 0.28–0.85). Conclusions Chronic and somatic pain negatively affect the degree of frailty. The duration and type of pain, as well as the underlying diseases associated with chronic pain, should be evaluated to improve the hospital management of frail older people.

Published
2020
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2. Kidney Disease Management in the Hospital Setting: A Focus on Inappropriate Drug Prescriptions in Older Patients

Author

Vincenzo Arcoraci, Maria Antonietta Barbieri, Michelangelo Rottura, Alessandro Nobili, Giuseppe Natoli, Christiano Argano, Giovanni Squadrito, Francesco Squadrito, Salvatore Corrao, and on behalf of the REPOSI investigators

Subjects
chronic kidney disease, appropriateness of prescriptions, prescribing patterns, real-world data, hospital setting, older patients, Therapeutics. Pharmacology, RM1-950
Abstract

Aging with multimorbidity and polytherapy are the most significant factors that could led to inappropriate prescribing of contraindicated medications in patients with chronic kidney disease (CKD). The aim of this study was to evaluate the prescriptions of contraindicated drugs in older adults in CKD and to identify their associated factors in a hospital context. An observational retrospective study was carried out considering all patients ≥65 years with at least one serum creatinine value recorded into the REPOSI register into 2010–2016 period. The estimated glomerular filtration rate (eGFR) was applied to identify CKD. A descriptive analysis was performed to compare demographic and clinical characteristics; logistic regression models were used to estimate factors of inappropriate and percentage changes of drug use during hospitalization. A total of 4,713 hospitalized patients were recorded, of which 49.8% had an eGFR

Published
2021
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4. Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Author

Ernesto, Crisafulli, · Giulia, Sartori, Alice, Vianello, Fabiana, Busti, Alessandro, Nobili, Pier Mannuccio, Mannucci, Domenico, Girelli, Reposi, Investigators, Colangelo, Luciano, Cilli, Mirella, Minisola, Salvatore, and Giancarlo, Labbabia

Subjects
hospital cure, multimorbidity, heart failure, prognosis, mortality, chronic obstructive pulmonary disease
Published
2023

5. Prescription appropriateness of anti-diabetes drugs in elderly patients hospitalized in a clinical setting: evidence from the REPOSI Register

Author

Succurro, Elena, Novella, Alessio, Nobili, Alessandro, Giofrè, Federica, Arturi, Franco, Sciacqua, Angela, Andreozzi, Francesco, Pietrangelo, Antonello, Sesti, Giorgio, Reposi, Investigators, Mecocci, Patrizia, Ruggiero, Carmelinda, and Boccardi, Virginia

Subjects
Anti-diabetes drugs, Diabetes, Elderly people, Hospitalized patients, Prescription appropriateness
Published
2023

7. Prevalence and Determinants of the Use of Lipid-Lowering Agents in a Population of Older Hospitalized Patients: the Findings from the REPOSI (REgistro POliterapie Società Italiana di Medicina Interna) Study

Author

Bertolotti, Marco, Franchi, Carlotta, Rocchi, Marco B. L., Miceli, Andrea, Libbra, M. Vittoria, Nobili, Alessandro, Lancellotti, Giulia, Carulli, Lucia, Mussi, Chiara, Mannucci, Pier Mannuccio, Nobili, Alessandro, Tettamanti, Mauro, Pasina, Luca, Franchi, Carlotta, Perticone, Francesco, Salerno, Francesco, Corrao, Salvatore, Marengoni, Alessandra, Licata, Giuseppe, Violi, Francesco, Corazza, Gino Roberto, Marcucci, Maura, Eldin, Tarek Kamal, Di Blanca, Maria Pia Donatella, Lanzo, Giovanna, Astuto, Sarah, Tettamanti, Mauro, Ardoino, Ilaria, Cortesi, Laura, Prisco, Domenico, Silvestri, Elena, Cenci, Caterina, Emmi, Giacomo, Biolo, Gianni, Guarnieri, Gianfranco, Zanetti, Michela, Fernandes, Giovanni, Chiuch, Massimiliano, Vanoli, Massimo, Grignani, Giulia, Casella, Gianluca, Pulixi, Edoardo Alessandro, Bernardi, Mauro, Bassi, Silvia Li, Santi, Luca, Zaccherini, Giacomo, Mannarino, Elmo, Lupattelli, Graziana, Bianconi, Vanessa, Paciullo, Francesco, Nuti, Ranuccio, Valenti, Roberto, Ruvio, Martina, Cappelli, Silvia, Palazzuoli, Alberto, Salvatore, Teresa, Sasso, Ferdinando Carlo, Girelli, Domenico, Olivieri, Oliviero, Matteazzi, Thomas, Barbagallo, Mario, Plances, Lidia, Alcamo, Roberta, Licata, Giuseppe, Calvo, Luigi, Valenti, Maria, Pasini, Franco Laghi, Capecchi, Pier Leopoldo, Bicchi, Maurizio, Palasciano, Giuseppe, Modeo, Maria Ester, Peragine, Maria, Pappagallo, Fabrizio, Pugliese, Stefania, Di Gennaro, Carla, Postiglione, Alfredo, Barbella, Maria Rosaria, De Stefano, Francesco, Cappellini, Maria Domenica, Fabio, Giovanna, Seghezzi, Sonia, De Amicis, Margherita Migone, Mancarella, Marta, Mari, Daniela, Rossi, Paolo Dionigi, Damanti, Sarah, Ottolini, Barbara Brignolo, Bonini, Giulia, Corazza, Gino Roberto, Miceli, Emanuela, Lenti, Marco Vincenzo, Padula, Donatella, Murialdo, Giovanni, Marra, Alessio, Cattaneo, Federico, Secchi, Maria Beatrice, Ghelfi, Davide, Anastasio, Luigi, Sofia, Lucia, Carbone, Maria, Davì, Giovanni, Guagnano, Maria Teresa, Sestili, Simona, Mancuso, Gerardo, Calipari, Daniela, Bartone, Mosè, Meroni, Maria Rachele, Perin, Paolo Cavallo, Lorenzati, Bartolomeo, Gruden, Gabriella, Bruno, Graziella, Amione, Cristina, Fornengo, Paolo, Tassara, Rodolfo, Melis, Deborah, Rebella, Lara, Delitala, Giuseppe, Pretti, Vincenzo, Masala, Maristella Salvatora, Pes, Chiara, Bolondi, Luigi, Rasciti, Leonardo, Serio, Ilaria, Fanelli, Filippo Rossi, Amoroso, Antonio, Molfino, Alessio, Petrillo, Enrico, Zuccalà, Giuseppe, Franceschi, Francesco, De Marco, Guido, Chiara, Cordischi, Marta, Sabbatini, D’Aurizio, Gabriella, Romanelli, Giuseppe, Amolini, Claudia, Chiesa, Deborah, Marengoni, Alessandra, Picardi, Antonio, Gentilucci, Umberto Vespasiani, Gallo, Paolo, Annoni, Giorgio, Corsi, Maurizio, Zazzetta, Sara, Bellelli, Giuseppe, Szabo, Hajnalka, Arturi, Franco, Succurro, Elena, Rubino, Mariangela, Sesti, Giorgio, Loria, Paola, Becchi, Maria Angela, Martucci, Gianfranco, Fantuzzi, Alessandra, Maurantonio, Mauro, Serra, Maria Grazia, Bleve, Maria Antonietta, Gasbarrone, Laura, Sajeva, Maria Rosaria, Brucato, Antonio, Ghidoni, Silvia, Di Corato, Paola, Agnelli, Giancarlo, Marchesini, Emanuela, Fabris, Fabrizio, Carlon, Michela, Turatto, Francesca, Baritusso, Aldo, Turatto, Francesca, Amabile, Annalisa, Omenetto, Elisabetta, Scarinzi, Paolo, Manfredini, Roberto, Molino, Christian, Pala, Marco, Fabbian, Fabio, Boari, Benedetta, De Giorgi, Alfredo, Paolisso, Giuseppe, Rizzo, Maria Rosaria, Laieta, Maria Teresa, Rini, Giovanbattista, Mansueto, Pasquale, Pepe, Ilenia, Borghi, Claudio, Strocchi, Enrico, De Sando, Valeria, Pareo, Ilaria, Sabbà, Carlo, Vella, Francesco Saverio, Suppressa, Patrizia, Valerio, Raffaella, Agosti, Pasquale, Fontana, Flavia, Loparco, Francesca, Pugliese, Stefania, Capobianco, Caterina, Fenoglio, Luigi, Bracco, Christian, Giraudo, Alessia Valentina, Testa, Elisa, Serraino, Cristina, Fargion, Silvia, Bonara, Paola, Periti, Giulia, Porzio, Marianna, Tiraboschi, Slivia, Peyvandi, Flora, Tedeschi, Alberto, Rossio, Raffaella, Ferrari, Barbara, Monzani, Valter, Savojardo, Valeria, Folli, Christian, Salerno, Maria Magnini Francesco, Conca, Alessio, Gobbo, Giulia, Conca, Alessio, Pallini, Giada, Valenti, Miriam, Balduini, Carlo L., Bertolino, Giampiera, Provini, Stella, Quaglia, Federica, Dallegri, Franco, Ottonello, Luciano, Liberale, Luca, Chin, Wu Sheng, Carassale, Laura, Caporotundo, Silvia, Traisci, Giancarlo, De Feudis, Lucrezia, Di Carlo, Silvia, Liberato, Nicola Lucio, Buratti, Alberto, Tognin, Tiziana, Bianchi, Giovanni Battista, Giaquinto, Sabrina, Purrello, Francesco, Di Pino, Antonino, Piro, Salvatore, Rozzini, Renzo, Falanga, Lina, Spazzini, Elena, Montrucchio, Giuseppe, Greco, Elisabetta, Tizzani, Pietro, Petitti, Paolo, Perciccante, Antonio, Coralli, Alessia, Salmi, Raffaella, Gaudenzi, Piergiorgio, Gamberini, Susanna, Semplicini, Andrea, Gottardo, Lucia, Vendemiale, Gianluigi, Serviddio, Gaetano, Forlano, Roberta, Masala, Cesare, Mammarella, Antonio, Raparelli, Valeria, Violi, Francesco, Basili, Stefania, Perri, Ludovica, Landolfi, Raffaele, Montalto, Massimo, Mirijello, Antonio, Vallone, Carla, Bellusci, Martino, Setti, Donatella, Pedrazzoli, Filippo, Guasti, Luigina, Castiglioni, Luana, Maresca, Andrea, Squizzato, Alessandro, Molaro, Marta, Bertolotti, Marco, Mussi, Chiara, Libbra, Maria Vittoria, Miceli, Andrea, Pellegrini, Elisa, Carulli, Lucia, Veltri, Francesca, Perticone, Francesco, Sciacqua, Angela, Quero, Michele, Bagnato, Chiara, Colangelo, Lidia, Falbo, Tania, De Giorgio, Roberto, Serra, Mauro, Grasso, Valentina, Ruggeri, Eugenio, Ilaria, Benzoni, Salvi, Andrea, Leonardi, Roberto, Grassini, Chiara, Mascherona, Ilenia, Minelli, Giorgio, Maltese, Francesca, Damiani, Giampaolo, Capeci, William, Mattioli, Massimo, Martino, Giuseppe Pio, Biondi, Lorenzo, Ormas, Monica, Pettinari, Pietro, Romiti, Roberto, Corrao, Salvatore, Messina, Silvia, Cavallaro, Federica, Ghio, Riccardi, Favorini, Serena, Col, Anna Dal, Minisola, Salvatore, Colangelo, Luciano, Afeltra, Antonella, Alemanno, Pamela, Marigliano, Benedetta, Pipita, Maria Elena, Castellino, Pietro, Blanco, Julien, Zanoli, Luca, Cattaneo, Marco, Fracasso, Paola, Amoruso, Maria Valentina, Saracco, Valter, Fogliati, Marisa, Bussolino, Carlo, Durante, Vittorio, Eusebi, Giovanna, Tirotta, Daniela, Mete, Francesca, Gino, Miriam, Cittadini, Antonio, Vigorito, Carlo, Arcopinto, Michele, Salzano, Andrea, Bobbio, Emanuele, Marra, Alberto Maria, Sirico, Domenico, Moreo, Guido, Scopelliti, Francesco, Gasparini, Francesca, Cocca, Melissa, Ballestrero, Alberto, Ferrando, Fabio, Berra, Sergio, Dassi, Simonetta, Nava, Maria Cristina, Graziella, Bruno, Ghidoni, Silvia, Amione, Cristina, Baldassarre, Stefano, Fragapani, Salvatore, Gruden, Gabriella, Galanti, Giorgio, Mascherini, Gabriele, Petri, Cristian, Stefani, Laura, Girino, Margherita, Piccinelli, Valeria, Nasso, Francesco, Gioffrè, Vincenza, Pasquale, Maria, Scattolin, Giuseppe, Martinelli, Sergio, Turrin, Mauro, Sechi, Leonardo, Catena, Cristina, Colussi, Gianluca, Nieves, Ramirez Duque, Alberto, Muela Molinero, Pedro, Abad Requejo, Vanessa, Lopez Pelaez, Lara, Tamargo, Xavier, Corbella Viros, Francesc, Formiga, Jesus, Diez Manglano, Esperanza, Bejarano Tello, Esther, Del Corral Behamonte, Maria, Sevil Puras, Romero, Manuel, Blanca, Pinilla Llorente, Cristina, Lopez Gonzalez-Cobos, Victoria, Villalba Garcia M., Saez, Lopez, Bosco, Juan, Susana, Sanz Baena, Marta, Arroyo Gallego, Concepcion, Gonzalez Becerra, Antonio, Fernandez Moyano, Hernandez, Mercedes Gomez, Borrego, Manuel Poyato, Raquel, Pacheco Cuadros, Florencia, Perez Rojas, Beatriz, Garcia Olid, Sara, Carrascosa Garcia, Alfonso, Gonzalez-Cruz Cervellera, Marta, Peinado Martinez, Garcia, Sara Carrascosa, Alberto, Ruiz Cantero, Antonio, Albarracín Arraigosa, Montserrat, Godoy Guerrero, Ángel, Barón Ramos Miguel, Manuel, Machin Jose, Ignacio, Novo Veleiro, Lucía, Alvela Suarez, Alfonso, Lopez, David, Rubal Bran, Iria, Iñiguez Vazquez, Monica, Rios Prego, and On behalf of REPOSI Investigators

Published
2017
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13. The 'Diabetes Comorbidome': A Different Way for Health Professionals to Approach the Comorbidity Burden of Diabetes

Author

Corrao, Salvatore, Natoli, Giuseppe, Nobili, Alessandro, Mannucci Pier Mannuccio, Perticone, Francesco, Arcoraci, Vincenzo, Argano, Christiano, Reposi, Investigators, Mecocci, Patrizia, Ruggiero, Carmelinda, Boccardi, Virginia, Corrao S., Natoli G., Nobili A., Mannucci P.M., Perticone F., Arcoraci V., and Argano C.

Subjects
“Diabetes Comorbidome”, Health Information Management, Leadership and Management, Health Policy, comorbidities, dementia, cancer, in-hospital mortality, 3-month mortality, 1-year mortality, Health Informatics, 1-year mortality, 3-month mortality, cancer, comorbidities, dementia, in-hospital mortality, “Diabetes Comorbidome”
Abstract

(1) Background: The disease burden related to diabetes is increasing greatly, particularly in older subjects. A more comprehensive approach towards the assessment and management of diabetes’ comorbidities is necessary. The aim of this study was to implement our previous data identifying and representing the prevalence of the comorbidities, their association with mortality, and the strength of their relationship in hospitalized elderly patients with diabetes, developing, at the same time, a new graphic representation model of the comorbidome called “Diabetes Comorbidome”. (2) Methods: Data were collected from the RePoSi register. Comorbidities, socio-demographic data, severity and comorbidity indexes (Cumulative Illness rating Scale CIRS-SI and CIRS-CI), and functional status (Barthel Index), were recorded. Mortality rates were assessed in hospital and 3 and 12 months after discharge. (3) Results: Of the 4714 hospitalized elderly patients, 1378 had diabetes. The comorbidities distribution showed that arterial hypertension (57.1%), ischemic heart disease (31.4%), chronic renal failure (28.8%), atrial fibrillation (25.6%), and COPD (22.7%), were the more frequent in subjects with diabetes. The graphic comorbidome showed that the strongest predictors of death at in hospital and at the 3-month follow-up were dementia and cancer. At the 1-year follow-up, cancer was the first comorbidity independently associated with mortality. (4) Conclusions: The “Diabetes Comorbidome” represents the perfect instrument for determining the prevalence of comorbidities and the strength of their relationship with risk of death, as well as the need for an effective treatment for improving clinical outcomes.

Published
2022

14. Beta-Blocker Use in Older Hospitalized Patients Affected by Heart Failure and Chronic Obstructive Pulmonary Disease: An Italian Survey From the REPOSI Register

Author

Arcoraci, V, Squadrito, F, Rottura, M, Barbieri, Ma, Pallio, G, Irrera, N, Nobili, A, Natoli, G, Argano, C, Squadrito, G, Corrao, S, on behalf of the REPOSI investigators, Mecocci, P, Ruggiero, C, Boccardi, V., Arcoraci V., Squadrito F., Rottura M., Barbieri M.A., Pallio G., Irrera N., Nobili A., Natoli G., Argano C., Squadrito G., and Corrao S.

Subjects
beta-blockers, REPOSI register, COPD, heart failure, beta-blockers, clinical practice, COPD, heart failure, REPOSI register, Cardiology and Cardiovascular Medicine, clinical practice
Abstract

Beta (β)-blockers (BB) are useful in reducing morbidity and mortality in patients with heart failure (HF) and concomitant chronic obstructive pulmonary disease (COPD). Nevertheless, the use of BBs could induce bronchoconstriction due to β2-blockade. For this reason, both the ESC and GOLD guidelines strongly suggest the use of selective β1-BB in patients with HF and COPD. However, low adherence to guidelines was observed in multiple clinical settings. The aim of the study was to investigate the BBs use in older patients affected by HF and COPD, recorded in the REPOSI register. Of 942 patients affected by HF, 47.1% were treated with BBs. The use of BBs was significantly lower in patients with HF and COPD than in patients affected by HF alone, both at admission and at discharge (admission, 36.9% vs. 51.3%; discharge, 38.0% vs. 51.7%). In addition, no further BB users were found at discharge. The probability to being treated with a BB was significantly lower in patients with HF also affected by COPD (adj. OR, 95% CI: 0.50, 0.37–0.67), while the diagnosis of COPD was not associated with the choice of selective β1-BB (adj. OR, 95% CI: 1.33, 0.76–2.34). Despite clear recommendations by clinical guidelines, a significant underuse of BBs was also observed after hospital discharge. In COPD affected patients, physicians unreasonably reject BBs use, rather than choosing a β1-BB. The expected improvement of the BB prescriptions after hospitalization was not observed. A multidisciplinary approach among hospital physicians, general practitioners, and pharmacologists should be carried out for better drug management and adherence to guideline recommendations.

Published
2022

16. Correction to: Hyperglycemia at admission, comorbidities, and in-hospital mortality in elderly patients hospitalized in internal medicine wards: data from the RePoSI Registry

Author

Corrao S, Nobili A, Natoli G, Mannucci PM, Perticone F, Pietrangelo A, Argano C, REPOSI Investigators, Borghi C, Corrao S, Nobili A, Natoli G, Mannucci PM, Perticone F, Pietrangelo A, Argano C, REPOSI Investigator, and Borghi C

Subjects
Aged, 80 and over, Male, Endocrinology, Diabetes and Metabolism, Correction, Comorbidity, General Medicine, Hospitals, Hospitalization, Endocrinology, Hyperglycemia, Internal Medicine, Humans, Female, Hospital Mortality, Registries, Aged
Abstract

The association between hyperglycemia at hospital admission and relevant short- and long-term outcomes in elderly population is known. We assessed the effects on mortality of hyperglycemia, disability, and multimorbidity at admission in internal medicine ward in patients aged ≥ 65 years.Data were collected from an active register of 102 internal medicine and geriatric wards in Italy (RePoSi project). Patients were recruited during four index weeks of a year. Socio-demographic data, reason for hospitalization, diagnoses, treatment, severity and comorbidity indexes (Cumulative Illness rating Scale CIRS-SI and CIRS-CI), renal function, functional (Barthel Index), and cognitive status (Short Blessed Test) and mood disorders (Geriatric Depression Scale) were recorded. Mortality rates were assessed in hospital 3 and 12 months after discharge.Of the 4714 elderly patients hospitalized, 361 had a glycemia level ≥ 250 mg/dL at admission. Compared to subjects with lower glycemia level, patients with glycemia ≥ 250 mg/dL showed higher rates of male sex, smoke and class III obesity. These patients had a significantly lower Barthel Index (p = 0.0249), higher CIRS-SI and CIRS-CI scores (p = 0.0025 and p = 0.0013, respectively), and took more drugs. In-hospital mortality rate was 9.2% and 5.1% in subjects with glycemia ≥ 250 and 250 mg/dL, respectively (p = 0.0010). Regression analysis showed a strong association between in-hospital death and glycemia ≥ 250 mg/dL (OR 2.07; [95% CI 1.34-3.19]), Barthel Index ≤ 40 (3.28[2.44-4.42]), CIRS-SI (1.87[1.27-2.77]), and male sex (1.54[1.16-2.03]).The stronger predictors of in-hospital mortality for older patients admitted in general wards were glycemia level ≥ 250 mg/dL, Barthel Index ≤ 40, CIRS-SI, and male sex.

Published
2021

17. P2635Prevalence of appropriate treatment in elderly heart failure patients and impact on clinical outcomes: a subgroup analysis from REPOSI registry

Author

Marco Proietti, Andrea Salzano, Antonio Cittadini, Giulio Francesco Romiti, Reposi Investigators, Alessandro Nobili, Alberto M. Marra, and P. M. Mannucci

Subjects
Polypharmacy, medicine.medical_specialty, business.industry, Treatment outcome, Subgroup analysis, medicine.disease, Comorbidity, Pharmacotherapy, Chronic disease, Heart failure, Emergency medicine, Hospital admission, medicine, Cardiology and Cardiovascular Medicine, business
Abstract

Introduction Therapeutic appropriateness in chronic diseases is a key factor in obtaining better clinical outcomes over clinical follow-up, in particular in elderly patients. Data about therapeutic appropriateness in elderly patients with heart failure (HF) are scarce. Purpose To describe the prevalence of appropriate treatment in elderly HF patients and its impact on clinical outcomes. Methods REgistro POliterapie SIMI (REPOSI) cohort was used to assess study aims. REPOSI is an Italian Nationwide Registry of elderly (≥65 years) hospitalized patients in Internal Medicine and Geriatric wards. HF diagnosis was assessed at hospital admission according to ICD-9 code 428.XX. Therapeutic appropriateness was defined according to International Guidelines. Results Among the 7003 patients originally enrolled, a total of 1095 (15.6%) patients reported a diagnosis of HF at hospital admission. At admission, 230 (21.0%) patients were considered as treated appropriately, with 245 (22.4%) treated appropriately during hospitalization and 249 (22.7%) at discharge (p=0.0.248). Focusing on patients aged ≥80 years, prevalence of appropriate treatment was respectively: 18.9% at admission, 20.3% during hospitalization and 21.0% at discharge (p=0.266). Among the 1095 patients with HF, 815 (74.4%) had available follow-up data. Patients appropriately treated at discharge, compared to those not treated appropriately, had a lower rate of CV death (5.1% vs. 11.9%, p=0.006) and all-cause death (7.2% vs. 26.1%, p Logistic Regression Analysis All Patients ≥80 years OR (95% CI) OR (95% CI) CV Death 0.46 (0.23–0.94) 0.59 (0.26–1.36) All-Cause Death 0.26 (0.14–0.46) 0.27 (0.14–0.53) CI = Confidence Interval; CV = Cardiovascular; OR = Odds Ratio. Conclusions In elderly hospitalized HF patients, prevalence of therapeutic appropriateness was consistently low at admission, during hospitalization and at discharge, particularly in patients ≥80 years. Appropriate HF therapy was inversely associated with the risk of CV death and all-cause death in all patients and with the risk of all-cause death in patients ≥80 years. Acknowledgement/Funding None

Published
2019

18. Hyperglycemia at admission, comorbidities, and in-hospital mortality in elderly patients hospitalized in internal medicine wards: data from the RePoSI Registry.

Author

Corrao, Salvatore, Nobili, Alessandro, Natoli, Giuseppe, Mannucci, Pier Mannuccio, Perticone, Francesco, Pietrangelo, Antonello, Argano, Christiano, on behalf of the REPOSI Investigators, Licata, Giuseppe, Violi, Francesco, Corazza, Gino Roberto, Marengoni, Alessandra, Salerno, Francesco, Cesari, Matteo, Tettamanti, Mauro, Pasina, Luca, Franchi, Carlotta, Cortesi, Laura, Miglio, Gabriella, and Ardoino, Ilaria

Subjects
HOSPITAL mortality, OLDER patients, HYPERGLYCEMIA, INTERNAL medicine, COMORBIDITY, GERIATRIC Depression Scale, HOSPITAL patients
Abstract

Aims: The association between hyperglycemia at hospital admission and relevant short- and long-term outcomes in elderly population is known. We assessed the effects on mortality of hyperglycemia, disability, and multimorbidity at admission in internal medicine ward in patients aged ≥ 65 years. Methods: Data were collected from an active register of 102 internal medicine and geriatric wards in Italy (RePoSi project). Patients were recruited during four index weeks of a year. Socio-demographic data, reason for hospitalization, diagnoses, treatment, severity and comorbidity indexes (Cumulative Illness rating Scale CIRS-SI and CIRS-CI), renal function, functional (Barthel Index), and cognitive status (Short Blessed Test) and mood disorders (Geriatric Depression Scale) were recorded. Mortality rates were assessed in hospital 3 and 12 months after discharge. Results: Of the 4714 elderly patients hospitalized, 361 had a glycemia level ≥ 250 mg/dL at admission. Compared to subjects with lower glycemia level, patients with glycemia ≥ 250 mg/dL showed higher rates of male sex, smoke and class III obesity. These patients had a significantly lower Barthel Index (p = 0.0249), higher CIRS-SI and CIRS-CI scores (p = 0.0025 and p = 0.0013, respectively), and took more drugs. In-hospital mortality rate was 9.2% and 5.1% in subjects with glycemia ≥ 250 and < 250 mg/dL, respectively (p = 0.0010). Regression analysis showed a strong association between in-hospital death and glycemia ≥ 250 mg/dL (OR 2.07; [95% CI 1.34–3.19]), Barthel Index ≤ 40 (3.28[2.44–4.42]), CIRS-SI (1.87[1.27–2.77]), and male sex (1.54[1.16–2.03]). Conclusions: The stronger predictors of in-hospital mortality for older patients admitted in general wards were glycemia level ≥ 250 mg/dL, Barthel Index ≤ 40, CIRS-SI, and male sex. [ABSTRACT FROM AUTHOR]

Published
2021
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19. Prevalence and Determinants of the Use of Lipid-Lowering Agents in a Population of Older Hospitalized Patients: the Findings from the REPOSI (REgistro POliterapie Società Italiana di Medicina Interna) Study

Author

Bertolotti, M, Franchi, C, Rocchi, Mb, Miceli, A, Libbra, Mv, Nobili, A, Lancellotti, G, Carulli, L, Mussi, C, Reposi, Investigators, Mannucci, Pm, Tettamanti, M, Pasina, L, Perticone, F, Salerno, F, Corrao, S, Marengoni, A, Licata, G, Violi, F, Corazza, Gr, Marcucci, M, Eldin, Tk, Di Blanca MP, Lanzo, G, Astuto, S, Ardoino, I, Cortesi, L, Prisco, D, Silvestri, E, Cenci, C, Emmi, G, Biolo, G, Guarnieri, G, Zanetti, M, Fernandes, G, Chiuch, M, Vanoli, M, Grignani, G, Casella, G, Pulixi, Ea, Bernardi, M, Bassi, Sl, Santi, L, Zaccherini, G, Mannarino, E, Lupattelli, G, Bianconi, V, Paciullo, F, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Palazzuoli, A, Salvatore, T, Sasso, Fc, Girelli, Domenico, Olivieri, Oliviero, Matteazzi, T, Barbagallo, M, Plances, L, Alcamo, R, Calvo, L, Valenti, M, Pasini, Fl, Capecchi, Pl, Bicchi, M, Palasciano, G, Modeo, Me, Peragine, M, Pappagallo, F, Pugliese, S, Di Gennaro, C, Postiglione, A, Barbella, Mr, De Stefano, F, Cappellini, Md, Fabio, G, Seghezzi, S, De Amicis MM, Mancarella, M, Mari, D, Rossi, Pd, Damanti, S, Ottolini, Bb, Bonini, G, Miceli, E, Lenti, Mv, Padula, D, Murialdo, G, Marra, A, Cattaneo, F, Secchi, Mb, Ghelfi, D, Anastasio, L, Sofia, L, Carbone, M, Davì, G, Guagnano, Mt, Sestili, S, Mancuso, G, Calipari, D, Bartone, M, Meroni, Mr, Perin, Pc, Lorenzati, B, Gruden, G, Bruno, G, Amione, C, Fornengo, P, Tassara, R, Melis, D, Rebella, L, Delitala, G, Pretti, V, Masala, Ms, Pes, C, Bolondi, L, Rasciti, L, Serio, I, Fanelli, Fr, Amoroso, A, Molfino, A, Petrillo, E, Zuccalà, G, Franceschi, F, De Marco, G, Chiara, C, Marta, S, D'Aurizio, G, Romanelli, G, Amolini, C, Chiesa, D, Picardi, A, Gentilucci, Uv, Gallo, P, Annoni, G, Corsi, M, Zazzetta, S, Bellelli, G, Szabo, H, Arturi, F, Succurro, E, Rubino, M, Sesti, G, Loria, P, Becchi, Ma, Martucci, G, Fantuzzi, A, Maurantonio, M, Serra, Mg, Bleve, Ma, Gasbarrone, L, Sajeva, Mr, Brucato, A, Ghidoni, S, Di Corato, P, Agnelli, G, Marchesini, E, Fabris, F, Carlon, M, Turatto, F, Baritusso, A, Amabile, A, Omenetto, E, Scarinzi, P, Manfredini, R, Molino, C, Pala, M, Fabbian, F, Boari, B, De Giorgi, A, Paolisso, G, Rizzo, Mr, Laieta, Mt, Rini, G, Mansueto, P, Pepe, I, Borghi, C, Strocchi, E, De Sando, V, Pareo, I, Sabbà, C, Vella, Fs, Suppressa, P, Valerio, R, Agosti, P, Fontana, F, Loparco, F, Capobianco, C, Fenoglio, L, Bracco, C, Giraudo, Av, Testa, E, Serraino, C, Fargion, S, Bonara, P, Periti, G, Porzio, M, Tiraboschi, S, Peyvandi, F, Tedeschi, A, Rossio, R, Ferrari, B, Monzani, V, Savojardo, V, Folli, C, Salerno, Mm, Conca, A, Gobbo, G, Pallini, G, Balduini, Cl, Bertolino, G, Provini, S, Quaglia, F, Dallegri, F, Ottonello, L, Liberale, L, Chin, Ws, Carassale, L, Caporotundo, S, Traisci, G, De Feudis, L, Di Carlo, S, Liberato, Nl, Buratti, A, Tognin, T, Bianchi, Gb, Giaquinto, S, Purrello, F, Di Pino, A, Piro, S, Rozzini, R, Falanga, L, Spazzini, E, Montrucchio, G, Greco, E, Tizzani, P, Petitti, P, Perciccante, A, Coralli, A, Salmi, R, Gaudenzi, P, Gamberini, S, Semplicini, A, Gottardo, L, Vendemiale, G, Serviddio, G, Forlano, R, Masala, C, Mammarella, A, Raparelli, V, Basili, S, Perri, L, Landolfi, R, Montalto, M, Mirijello, A, Vallone, C, Bellusci, M, Setti, D, Pedrazzoli, F, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Molaro, M, Pellegrini, E, Veltri, F, Sciacqua, A, Quero, M, Bagnato, C, Colangelo, L, Falbo, T, De Giorgio, R, Serra, M, Grasso, V, Ruggeri, E, Ilaria, B, Salvi, A, Leonardi, R, Grassini, C, Mascherona, I, Minelli, G, Maltese, F, Damiani, G, Capeci, W, Mattioli, M, Martino, Gp, Biondi, L, Ormas, M, Pettinari, P, Romiti, R, Messina, S, Cavallaro, F, Ghio, R, Favorini, S, Col, Ad, Minisola, S, Afeltra, A, Alemanno, P, Marigliano, B, Pipita, Me, Castellino, P, Blanco, J, Zanoli, L, Cattaneo, M, Fracasso, P, Amoruso, Mv, Saracco, V, Fogliati, M, Bussolino, C, Durante, V, Eusebi, G, Tirotta, D, Mete, F, Gino, M, Cittadini, A, Vigorito, C, Arcopinto, M, Salzano, A, Bobbio, E, Marra, Am, Sirico, D, Moreo, G, Scopelliti, F, Gasparini, F, Cocca, M, Ballestrero, A, Ferrando, F, Berra, S, Dassi, S, Nava, Mc, Graziella, B, Baldassarre, S, Fragapani, S, Galanti, G, Mascherini, G, Petri, C, Stefani, L, Girino, M, Piccinelli, V, Nasso, F, Gioffrè, V, Pasquale, M, Scattolin, G, Martinelli, S, Turrin, M, Sechi, L, Catena, C, Colussi, G, Nieves, Rd, Alberto, Mm, Pedro, Ar, Vanessa, Lp, Lara, T, Xavier, Cv, Francesc, F, Jesus, Dm, Esperanza, Bt, Esther, Dc, Maria, Sp, Romero, M, Blanca, Pl, Cristina, Lg, Victoria, Vg, Saez, L, Bosco, J, Susana, Sb, Marta, Ag, Concepcion, Gb, Antonio, Fm, Hernandez, Mg, Borrego, Mp, Raquel, Pc, Florencia, Pr, Beatriz, Go, Sara, Cg, Alfonso, Gc, Marta, Pm, Garcia, Sc, Alberto, Rc, Antonio, Aa, Montserrat, Gg, Ángel, Br, Manuel, Mj, Ignacio, Nv, Lucía, As, Alfonso, L, David, Rb, Iria, Iv, Monica, R. P., Bertolotti, Marco, Franchi, Carlotta, Rocchi, Marco B. L., Miceli, Andrea, Libbra, M. Vittoria, Nobili, Alessandro, Lancellotti, Giulia, Carulli, Lucia, Mussi, Chiara, On behalf of REPOSI Investigators [.., Mannucci, Pier Mannuccio, Tettamanti, Mauro, Pasina, Luca, Perticone, Francesco, Salerno, Francesco, Corrao, Salvatore, Marengoni, Alessandra, Licata, Giuseppe, Violi, Francesco, Corazza, Gino Roberto, Marcucci, Maura, Eldin, Tarek Kamal, Di Blanca, Maria Pia Donatella, Lanzo, Giovanna, Astuto, Sarah, Ardoino, Ilaria, Cortesi, Laura, Prisco, Domenico, Silvestri, Elena, Cenci, Caterina, Emmi, Giacomo, Biolo, Gianni, Guarnieri, Gianfranco, Zanetti, Michela, Fernandes, Giovanni, Chiuch, Massimiliano, Vanoli, Massimo, Grignani, Giulia, Casella, Gianluca, Pulixi, Edoardo Alessandro, Bernardi, Mauro, Bassi, Silvia Li, Santi, Luca, Zaccherini, Giacomo, Mannarino, Elmo, Lupattelli, Graziana, Bianconi, Vanessa, Paciullo, Francesco, Nuti, Ranuccio, Valenti, Roberto, Ruvio, Martina, Cappelli, Silvia, Palazzuoli, Alberto, Salvatore, Teresa, Sasso, Ferdinando Carlo, Girelli, Domenico, Olivieri, Oliviero, Matteazzi, Thoma, Barbagallo, Mario, Plances, Lidia, Alcamo, Roberta, Calvo, Luigi, Valenti, Maria, Pasini, Franco Laghi, Capecchi, Pier Leopoldo, Bicchi, Maurizio, Palasciano, Giuseppe, Modeo, Maria Ester, Peragine, Maria, Pappagallo, Fabrizio, Pugliese, Stefania, Di Gennaro, Carla, Postiglione, Alfredo, Barbella, Maria Rosaria, De Stefano, Francesco, Cappellini, Maria Domenica, Fabio, Giovanna, Seghezzi, Sonia, De Amicis, Margherita Migone, Mancarella, Marta, Mari, Daniela, Rossi, Paolo Dionigi, Damanti, Sarah, Ottolini, Barbara Brignolo, Bonini, Giulia, Miceli, Emanuela, Lenti, Marco Vincenzo, Padula, Donatella, Murialdo, Giovanni, Marra, Alessio, Cattaneo, Federico, Secchi, Maria Beatrice, Ghelfi, Davide, Anastasio, Luigi, Sofia, Lucia, Carbone, Maria, Davì, Giovanni, Guagnano, Maria Teresa, Sestili, Simona, Mancuso, Gerardo, Calipari, Daniela, Bartone, Mosè, Meroni, Maria Rachele, Perin, Paolo Cavallo, Lorenzati, Bartolomeo, Gruden, Gabriella, Bruno, Graziella, Amione, Cristina, Fornengo, Paolo, Tassara, Rodolfo, Melis, Deborah, Rebella, Lara, Delitala, Giuseppe, Pretti, Vincenzo, Masala, Maristella Salvatora, Pes, Chiara, Bolondi, Luigi, Rasciti, Leonardo, Serio, Ilaria, Fanelli, Filippo Rossi, Amoroso, Antonio, Molfino, Alessio, Petrillo, Enrico, Zuccalà, Giuseppe, Franceschi, Francesco, De Marco, Guido, Chiara, Cordischi, Marta, Sabbatini, D’Aurizio, Gabriella, Romanelli, Giuseppe, Amolini, Claudia, Chiesa, Deborah, Picardi, Antonio, Gentilucci, Umberto Vespasiani, Gallo, Paolo, Annoni, Giorgio, Corsi, Maurizio, Zazzetta, Sara, Bellelli, Giuseppe, Szabo, Hajnalka, Arturi, Franco, Succurro, Elena, Rubino, Mariangela, Sesti, Giorgio, Loria, Paola, Becchi, Maria Angela, Martucci, Gianfranco, Fantuzzi, Alessandra, Maurantonio, Mauro, Serra, Maria Grazia, Bleve, Maria Antonietta, Gasbarrone, Laura, Sajeva, Maria Rosaria, Brucato, Antonio, Ghidoni, Silvia, Di Corato, Paola, Agnelli, Giancarlo, Marchesini, Emanuela, Fabris, Fabrizio, Carlon, Michela, Turatto, Francesca, Baritusso, Aldo, Amabile, Annalisa, Omenetto, Elisabetta, Scarinzi, Paolo, Manfredini, Roberto, Molino, Christian, Pala, Marco, Fabbian, Fabio, Boari, Benedetta, De Giorgi, Alfredo, Paolisso, Giuseppe, Rizzo, Maria Rosaria, Laieta, Maria Teresa, Rini, Giovanbattista, Mansueto, Pasquale, Pepe, Ilenia, Borghi, Claudio, Strocchi, Enrico, De Sando, Valeria, Pareo, Ilaria, Sabbà, Carlo, Vella, Francesco Saverio, Suppressa, Patrizia, Valerio, Raffaella, Agosti, Pasquale, Fontana, Flavia, Loparco, Francesca, Capobianco, Caterina, Fenoglio, Luigi, Bracco, Christian, Giraudo, Alessia Valentina, Testa, Elisa, Serraino, Cristina, Fargion, Silvia, Bonara, Paola, Periti, Giulia, Porzio, Marianna, Tiraboschi, Slivia, Peyvandi, Flora, Tedeschi, Alberto, Rossio, Raffaella, Ferrari, Barbara, Monzani, Valter, Savojardo, Valeria, Folli, Christian, Salerno, Maria Magnini Francesco, Conca, Alessio, Gobbo, Giulia, Pallini, Giada, Valenti, Miriam, Balduini, Carlo L., Bertolino, Giampiera, Provini, Stella, Quaglia, Federica, Dallegri, Franco, Ottonello, Luciano, Liberale, Luca, Chin, Wu Sheng, Carassale, Laura, Caporotundo, Silvia, Traisci, Giancarlo, De Feudis, Lucrezia, Di Carlo, Silvia, Liberato, Nicola Lucio, Buratti, Alberto, Tognin, Tiziana, Bianchi, Giovanni Battista, Giaquinto, Sabrina, Purrello, Francesco, Di Pino, Antonino, Piro, Salvatore, Rozzini, Renzo, Falanga, Lina, Spazzini, Elena, Montrucchio, Giuseppe, Greco, Elisabetta, Tizzani, Pietro, Petitti, Paolo, Perciccante, Antonio, Coralli, Alessia, Salmi, Raffaella, Gaudenzi, Piergiorgio, Gamberini, Susanna, Semplicini, Andrea, Gottardo, Lucia, Vendemiale, Gianluigi, Serviddio, Gaetano, Forlano, Roberta, Masala, Cesare, Mammarella, Antonio, Raparelli, Valeria, Basili, Stefania, Perri, Ludovica, Landolfi, Raffaele, Montalto, Massimo, Mirijello, Antonio, Vallone, Carla, Bellusci, Martino, Setti, Donatella, Pedrazzoli, Filippo, Guasti, Luigina, Castiglioni, Luana, Maresca, Andrea, Squizzato, Alessandro, Molaro, Marta, Libbra, Maria Vittoria, Pellegrini, Elisa, Veltri, Francesca, Sciacqua, Angela, Quero, Michele, Bagnato, Chiara, Colangelo, Lidia, Falbo, Tania, De Giorgio, Roberto, Serra, Mauro, Grasso, Valentina, Ruggeri, Eugenio, Ilaria, Benzoni, Salvi, Andrea, Leonardi, Roberto, Grassini, Chiara, Mascherona, Ilenia, Minelli, Giorgio, Maltese, Francesca, Damiani, Giampaolo, Capeci, William, Mattioli, Massimo, Martino, Giuseppe Pio, Biondi, Lorenzo, Ormas, Monica, Pettinari, Pietro, Romiti, Roberto, Messina, Silvia, Cavallaro, Federica, Ghio, Riccardi, Favorini, Serena, Col, Anna Dal, Minisola, Salvatore, Colangelo, Luciano, Afeltra, Antonella, Alemanno, Pamela, Marigliano, Benedetta, Pipita, Maria Elena, Castellino, Pietro, Blanco, Julien, Zanoli, Luca, Cattaneo, Marco, Fracasso, Paola, Amoruso, Maria Valentina, Saracco, Valter, Fogliati, Marisa, Bussolino, Carlo, Durante, Vittorio, Eusebi, Giovanna, Tirotta, Daniela, Mete, Francesca, Gino, Miriam, Cittadini, Antonio, Vigorito, Carlo, Arcopinto, Michele, Salzano, Andrea, Bobbio, Emanuele, Marra, Alberto Maria, Sirico, Domenico, Moreo, Guido, Scopelliti, Francesco, Gasparini, Francesca, Cocca, Melissa, Ballestrero, Alberto, Ferrando, Fabio, Berra, Sergio, Dassi, Simonetta, Nava, Maria Cristina, Graziella, Bruno, Baldassarre, Stefano, Fragapani, Salvatore, Galanti, Giorgio, Mascherini, Gabriele, Petri, Cristian, Stefani, Laura, Girino, Margherita, Piccinelli, Valeria, Nasso, Francesco, Gioffrè, Vincenza, Pasquale, Maria, Scattolin, Giuseppe, Martinelli, Sergio, Turrin, Mauro, Sechi, Leonardo, Catena, Cristina, Colussi, Gianluca, Nieves, Ramirez Duque, Alberto, Muela Molinero, Pedro, Abad Requejo, Vanessa, Lopez Pelaez, Lara, Tamargo, Xavier, Corbella Viro, Francesc, Formiga, Jesus, Diez Manglano, Esperanza, Bejarano Tello, Esther, Del Corral Behamonte, Maria, Sevil Pura, Romero, Manuel, Blanca, Pinilla Llorente, Cristina, Lopez Gonzalez-Cobo, Victoria, Villalba Garcia M., Saez, Lopez, Bosco, Juan, Susana, Sanz Baena, Marta, Arroyo Gallego, Concepcion, Gonzalez Becerra, Antonio, Fernandez Moyano, Hernandez, Mercedes Gomez, Borrego, Manuel Poyato, Raquel, Pacheco Cuadro, Florencia, Perez Roja, Beatriz, Garcia Olid, Sara, Carrascosa Garcia, Alfonso, Gonzalez-Cruz Cervellera, Marta, Peinado Martinez, Garcia, Sara Carrascosa, Alberto, Ruiz Cantero, Antonio, Albarracín Arraigosa, Montserrat, Godoy Guerrero, Ángel, Barón Ramos Miguel, Manuel, Machin Jose, Ignacio, Novo Veleiro, Lucía, Alvela Suarez, Alfonso, Lopez, David, Rubal Bran, Iria, Iñiguez Vazquez, Monica, Rios Prego.., ], Bertolotti, M, Franchi, C, Rocchi, M, Miceli, A, Libbra, M, Nobili, A, Lancellotti, G, Carulli, L, Mussi, C, Annoni, G, Monica, Rios Prego, Reposi, Investigator, Bertolotti, M., Franchi, C., Rocchi, M. B. L., Miceli, A., Libbra, M. V., Nobili, A., Lancellotti, G., Carulli, L., Mussi, C., Mannucci, P. M., Tettamanti, M., Pasina, L., Perticone, F., Salerno, F., Corrao, S., Marengoni, A., Licata, G., Violi, F., Corazza, G. R., Marcucci, M., Eldin, T. K., Di Blanca, M. P. D., Lanzo, G., Astuto, S., Ardoino, I., Cortesi, L., Prisco, D., Silvestri, E., Cenci, C., Emmi, G., Biolo, G., Guarnieri, G., Zanetti, M., Fernandes, G., Chiuch, M., Vanoli, M., Grignani, G., Casella, G., Pulixi, E. A., Bernardi, M., Bassi, S. L., Santi, L., Zaccherini, G., Mannarino, E., Lupattelli, G., Bianconi, V., Paciullo, F., Nuti, R., Valenti, R., Ruvio, M., Cappelli, S., Palazzuoli, A., Salvatore, T., Sasso, F. C., Girelli, D., Olivieri, O., Matteazzi, T., Barbagallo, M., Plances, L., Alcamo, R., Calvo, L., Valenti, M., Pasini, F. L., Capecchi, P. L., Bicchi, M., Palasciano, G., Modeo, M. E., Peragine, M., Pappagallo, F., Pugliese, S., Di Gennaro, C., Postiglione, A., Barbella, M. R., De Stefano, F., Cappellini, M. D., Fabio, G., Seghezzi, S., De Amicis, M. M., Mancarella, M., Mari, D., Rossi, P. D., Damanti, S., Ottolini, B. B., Bonini, G., Miceli, E., Lenti, M. V., Padula, D., Murialdo, G., Marra, A., Cattaneo, F., Secchi, M. B., Ghelfi, D., Anastasio, L., Sofia, L., Carbone, M., Davi, G., Guagnano, M. T., Sestili, S., Mancuso, G., Calipari, D., Bartone, M., Meroni, M. R., Perin, P. C., Lorenzati, B., Gruden, G., Bruno, G., Amione, C., Fornengo, P., Tassara, R., Melis, D., Rebella, L., Delitala, G., Pretti, V., Masala, M. S., Pes, C., Bolondi, L., Rasciti, L., Serio, I., Fanelli, F. R., Amoroso, A., Molfino, A., Petrillo, E., Zuccala, G., Franceschi, F., De Marco, G., Chiara, C., Marta, S., D'Aurizio, G., Romanelli, G., Amolini, C., Chiesa, D., Picardi, A., Gentilucci, U. V., Gallo, P., Annoni, G., Corsi, M., Zazzetta, S., Bellelli, G., Szabo, H., Arturi, F., Succurro, E., Rubino, M., Sesti, G., Loria, P., Becchi, M. A., Martucci, G., Fantuzzi, A., Maurantonio, M., Serra, M. G., Bleve, M. A., Gasbarrone, L., Sajeva, M. R., Brucato, A., Ghidoni, S., Di Corato, P., Agnelli, G., Marchesini, E., Fabris, F., Carlon, M., Turatto, F., Baritusso, A., Amabile, A., Omenetto, E., Scarinzi, P., Manfredini, R., Molino, C., Pala, M., Fabbian, F., Boari, B., De Giorgi, A., Paolisso, G., Rizzo, M. R., Laieta, M. T., Rini, G., Mansueto, P., Pepe, I., Borghi, C., Strocchi, E., De Sando, V., Pareo, I., Sabba, C., Vella, F. S., Suppressa, P., Valerio, R., Agosti, P., Fontana, F., Loparco, F., Capobianco, C., Fenoglio, L., Bracco, C., Giraudo, A. V., Testa, E., Serraino, C., Fargion, S., Bonara, P., Periti, G., Porzio, M., Tiraboschi, S., Peyvandi, F., Tedeschi, A., Rossio, R., Ferrari, B., Monzani, V., Savojardo, V., Folli, C., Salerno, M. M. F., Conca, A., Gobbo, G., Pallini, G., Balduini, C. L., Bertolino, G., Provini, S., Quaglia, F., Dallegri, F., Ottonello, L., Liberale, L., Chin, W. S., Carassale, L., Caporotundo, S., Traisci, G., De Feudis, L., Di Carlo, S., Liberato, N. L., Buratti, A., Tognin, T., Bianchi, G. B., Giaquinto, S., Purrello, F., Di Pino, A., Piro, S., Rozzini, R., Falanga, L., Spazzini, E., Montrucchio, G., Greco, E., Tizzani, P., Petitti, P., Perciccante, A., Coralli, A., Salmi, R., Gaudenzi, P., Gamberini, S., Semplicini, A., Gottardo, L., Vendemiale, G., Serviddio, G., Forlano, R., Masala, C., Mammarella, A., Raparelli, V., Basili, S., Perri, L., Landolfi, R., Montalto, M., Mirijello, A., Vallone, C., Bellusci, M., Setti, D., Pedrazzoli, F., Guasti, L., Castiglioni, L., Maresca, A., Squizzato, A., Molaro, M., Pellegrini, E., Veltri, F., Sciacqua, A., Quero, M., Bagnato, C., Colangelo, L., Falbo, T., De Giorgio, R., Serra, M., Grasso, V., Ruggeri, E., Ilaria, B., Salvi, A., Leonardi, R., Grassini, C., Mascherona, I., Minelli, G., Maltese, F., Damiani, G., Capeci, W., Mattioli, M., Martino, G. P., Biondi, L., Ormas, M., Pettinari, P., Romiti, R., Messina, S., Cavallaro, F., Ghio, R., Favorini, S., Col, A. D., Minisola, S., Afeltra, A., Alemanno, P., Marigliano, B., Pipita, M. E., Castellino, P., Blanco, J., Zanoli, L., Cattaneo, M., Fracasso, P., Amoruso, M. V., Saracco, V., Fogliati, M., Bussolino, C., Durante, V., Eusebi, G., Tirotta, D., Mete, F., Gino, M., Cittadini, A., Vigorito, C., Arcopinto, M., Salzano, A., Bobbio, E., Marra, A. M., Sirico, D., Moreo, G., Scopelliti, F., Gasparini, F., Cocca, M., Ballestrero, A., Ferrando, F., Berra, S., Dassi, S., Nava, M. C., Graziella, B., Baldassarre, S., Fragapani, S., Galanti, G., Mascherini, G., Petri, C., Stefani, L., Girino, M., Piccinelli, V., Nasso, F., Gioffre, V., Pasquale, M., Scattolin, G., Martinelli, S., Turrin, M., Sechi, L., Catena, C., Colussi, G., Nieves, R. D., Alberto, M. M., Pedro, A. R., Vanessa, L. P., Lara, T., Xavier, C. V., Francesc, F., Jesus, D. M., Esperanza, B. T., Esther, D. C. B., Maria, S. P., Romero, M., Blanca, P. L., Cristina, L. G. -C., Victoria, V. G. M., Saez, L., Bosco, J., Susana, S. B., Marta, A. G., Concepcion, G. B., Antonio, F. M., Hernandez, M. G., Borrego, M. P., Raquel, P. C., Florencia, P. R., Beatriz, G. O., Sara, C. G., Alfonso, G. -C. C., Marta, P. M., Garcia, S. C., Alberto, R. C., Antonio, A. A., Montserrat, G. G., Angel, B. R. M., Manuel, M. J., Ignacio, N. V., Lucia, A. S., Alfonso, L., David, R. B., Iria, I. V., and Monica, R. P.

Subjects
Male, medicine.medical_specialty, Logistic Model, Lipid-Lowering Agents, Population, Socio-culturale, Older Hospitalized Patients, 030204 cardiovascular system & hematology, Geriatrics and Gerontology, Pharmacology (medical), 03 medical and health sciences, 0302 clinical medicine, Internal medicine, 80 and over, Prevalence, medicine, Humans, 030212 general & internal medicine, Medical prescription, Intensive care medicine, Omega 3 fatty acid, education, Adverse effect, Aged, Hypolipidemic Agents, Aged, 80 and over, Polypharmacy, Geriatrics, education.field_of_study, Hypolipidemic Agent, business.industry, Geriatrics and Gerontology, Pharmacology (medical), Hospitalization, Logistic Models, Cohort, Female, business, Human, Cohort study
Abstract

BACKGROUND: Older patients are prone to multimorbidity and polypharmacy, with an inherent risk of adverse events and drug interactions. To the best of our knowledge, available information on the appropriateness of lipid-lowering treatment is extremely limited. AIM: The aim of the present study was to quantify and characterize lipid-lowering drug use in a population of complex in-hospital older patients. METHODS: We analyzed data from 87 units of internal medicine or geriatric medicine in the REPOSI (Registro Politerapie della Società Italiana di Medicina Interna) study, with reference to the 2010 and 2012 patient cohorts. Lipid-lowering drug use was closely correlated with the clinical profiles, including multimorbidity markers and polypharmacy. RESULTS: 2171 patients aged >65 years were enrolled (1057 males, 1114 females, mean age 78.6 years). The patients treated with lipid-lowering drugs amounted to 508 subjects (23.4%), with no gender difference. Atorvastatin (39.3%) and simvastatin (34.0%) were the most widely used statin drugs. Likelihood of treatment was associated with polypharmacy (≥5 drugs) and with higher Cumulative Illness Rating Scale (CIRS) score. At logistic regression analysis, the presence of coronary heart disease, peripheral vascular disease, and hypertension were significantly correlated with lipid-lowering drug use, whereas age showed an inverse correlation. Diabetes was not associated with drug treatment. CONCLUSIONS: In this in-hospital cohort, the use of lipid-lowering agents was mainly driven by patients' clinical history, most notably the presence of clinically overt manifestations of atherosclerosis. Increasing age seems to be associated with lower prescription rates. This might be indicative of cautious behavior towards a potentially toxic treatment regimen

Published
2017

20. Risk factors for hospital readmission of elderly patients

Author

Franchi, C, Nobili, A, Mari, D, Tettamanti, M, Djade, Cd, Pasina, L, Salerno, F, Corrao, S, Marengoni, A, Iorio, A, Marcucci, M, Mannucci, Pm, Reposi, Investigators, Pier, Mm, Alessandro, N, Salvatore, C, Spirito, V, Noce, D, Bonazzi, J, Lombardo, R, Sparacio, E, Alborghetti, S, De Vittorio, L, Paolisso, G, Rizzo, Mr, Laieta, Mt, Brignone, C, Roberto, T, Persico, Marcello, Salvatore, T, Sasso, Fc, Utili, R, Durante Mangoni, E, Pinto, D, Fenoglio, L, Bracco, C, Gasbarrone, L, Porcari, P, Famularo, G, Sajeva, Mr, Maniscalco, G, Gunelli, M, Tirotta, D, Realdi, G, Baritussio, A, Frassoni, F, Delsignore, R, Baroni, Mc, Zardo, M, Volpato, S, Fotini, S, Manfredini, R, Longhini, C, Molino, C, Incasa, E, Guarnieri, G, Zanetti, M, Spalluti, A, Rini, G, Mansueto, P, Pepe, I, Licata, G, Calvo, L, Valenti, M, Tuttolomondo, A, Di Sciacca, R, Antonaci, S, Vella, F, Marseglia, A, Centonze, V, Modeo, Me, Palasciano, G, Pugliese, S, Capobianco, C, Murialdo, G, Bovio, M, Laghi Pasini, F, Capecchi, Pl, Bicchi, M, Nuti, R, Valenti, R, Capodarca, C, Auteri, A, Pasqui, Al, Puccetti, L, Olivieri, O, Stanzial, Am, Agnelli, G, Macura, A, Mannarino, E, Lupattelli, G, Rondelli, P, Serra, Mg, Musca, G, Cuccurullo, O, Cappellini, Md, Fabio, G, Motta, I, Cantoni, F, Fargion, S, Bonara, P, Bulgheroni, M, Magrini, F, Massari, F, Tonella, T, Peyvandi, F, Tedeschi, A, Rossio, R, Moreo, G, Ferrari, B, Monzani, V, Savojardo, V, Folli, C, Dionigi Rossi, P, Ziglioli, E, Lilleri, Ms, Selmi, C, Meda, F, Cazzaniga, M, Monti, V, Balduini, Cl, Bertolino, G, Dezzani, L, Cavallo, P, Corazza, Gr, Miceli, E, Secchi, Mb, Wu, Sc, Sofia, L, Anastasio, L, Carbone, M, Bertucci, L, De Feudis, L, Traisci, G, Bergami, E, Rizzioli, E, Cagnoni, C, Bertone, L, Manucra, A, Ronchi, E, Buratti, A, Tognin, T, Bertolini, D, Liberato, Nl, Bernasconi, G, Nardo, B, Venco, A, Guasti, L, Maroni, L, Castiglioni, L, Casella, G, Vanoli, M, Grignani, G, Mancuso, G, Tavella, R, Persico, R, Cicardi, M, Sandrone, G, Magenta, M, Perego, F, Meroni, Mr, Rozzini, R, Falanga, L, Giordano, A, Menardo, G, Bottone, S, Sferrazzo, E, Tassara, R, Melis, D, Rebella, L, Ferri, C, Striuli, R, Scipioni, R, Salmi, R, Gaudenzi, P, Di Todaro, F, Nielsen, I, Giusto, L, Semplicini, A, Gottardo, L, Delitala, G, Carta, S, Atzori, S, Rosei, Ea, Rizzoni, D, Castoldi, L, Altomare, E, Serviddio, G, Salvatore, S, Fera, G, Di Luca ML, Renna, D, Picardi, A, Mazzarelli, C, Vespasiani Gentilucci, U, De Vincentis, A, Hila, D, Bernardi, M, Li Bassi, S, Santi, L, Masala, C, Mammarella, A, Raparelli, V, Rossi Fanelli, F, Delfino, M, Amoroso, A, Serra, P, Fontana, V, Falcone, M, Violi, F, Basili, S, Perri, L, Silveri, Ng, De Marco, G, Giupponi, B, Landolfi, R, Grieco, A, Gallo, A, Perticone, F, Sciacqua, A, Quero, M, Bagnato, C, Bonometti, F, Loria, P, Ballestri, S, Becchi, Ma, Bolondi, L, Rasciti, L, Serio, I, Gualandi, S, Romanelli, G, Carulli, N, Rondinella, S, Giannico, I, Dallegri, F, Ottonello, L, Quercioli, A, Barreca, A, Sacco, A, Bonelli, A, Dentamaro, G, Micale, G, Delitalia, G, Deidda, S, Cuccuru, Lm, Benetti, G, Quagliolo, M, Centenaro, Gr, Macchini, L, Perciccante, A, Coralli, A, Realdi, A, Cricco, L, Morabito, C, Fava, R, Fiorentini, A, Tofi, C., Franchi C, Nobili A, Mari D, Tettamanti M, Djade CD, Pasina L, Salerno F, Corrao S, Marengoni A, Iorio A, Marcucci M, Mannucci PM, REPOSI Investigators [.., Bernardi M, Bolondi L, ], Franchi, C, Nobili, A, Mari, D, Tettamanti, M, Djade, CD, Pasina, L, Salerno, F, Corrao, S, Marengoni, A, Iorio, A, Marcucci, M, Mannucci, PM, Tuttolomondo, A, Mansueto, P, Franchi, Carlotta, Nobili, Alessandro, Mari, Daniela, Tettamanti, Mauro, Djade, Codjo D., Pasina, Luca, Salerno, Francesco, Corrao, Salvatore, Marengoni, Alessandra, Iorio, Alfonso, Marcucci, Maura, Mannucci, Pier Mannuccio, Rizzo, Maria Rosaria, Carlotta, Franchi, Alessandro, Nobili, Daniela, Mari, Mauro, Tettamanti, Codjo D., Djade, Luca, Pasina, Francesco, Salerno, Salvatore, Corrao, Alessandra, Marengoni, Alfonso, Iorio, Maura, Marcucci, Pier Mannuccio, Mannucci, and Zanetti, Michela

Subjects
Male, Settore MED/09 - Medicina Interna, Time Factors, Risk factors, internal medicine, Geriatric patient, hospital admission, Logistic regression, Elderly, Hospital readmission, Internal medicine and geriatric wards, 80 and over, Aged, Aged, 80 and over, Female, Geriatrics, Hospital Departments, Humans, Internal Medicine, Patient Readmission, Risk Factors, Medical diagnosis, Aged, Aged, 80 and over, Female, Geriatrics, Hospital Departments, Humans, Internal Medicine, Male, Patient Readmission, statistics /&/ numerical data, Risk Factors, Time Factors, Univariate analysis, vascular disease, Settore MED/45 - Scienze Infermieristiche Generali, Cliniche E Pediatriche, Ageing, readmission, statistics /&/ numerical data, Hospital Department, liver disease, Human, medicine.medical_specialty, Time Factor, MEDLINE, Hospital readmission, Internal medicine and geriatric wards, Risk factors, Elderly, elderly patients, NO, medicine, Registry Politerapie SIMI (REPOSI), Adverse effect, business.industry, Risk Factor, Univariate, medicine.disease, Comorbidity, elderly, hospital readmission, risk factors, internal medicine and geriatric wards, Internal medicine and geriatric ward, Emergency medicine, business, Geriatric
Abstract

Background: The aim of this study was to identify which factors were associated with a risk of hospital readmission within 3 months after discharge of a sample of elderly patients admitted to internal medicine and geriatric wards. Methods: Of the 1178 patients aged 65 years or more and discharged from one of the 66 wards of the 'Registry Politerapie SIMI (REPOSI)' during 2010, 766 were followed up by phone interview 3 months after discharge and were included in this analysis. Univariate and multivariate logistic regression models were used to evaluate the association of several variables with rehospitalization within 3 months from discharge. Results: Nineteen percent of patients were readmitted at least once within 3 months after discharge. By univariate analysis in-hospital clinical adverse events (AEs), a previous hospital admission, number of diagnoses and drugs, comorbidity and severity index (according to Cumulative Illness Rating Scale-CIRS), vascular and liver diseases with a level of impairment at discharge of 3 or more at CIRS were significantly associated with risk of readmission. Multivariate logistic regression analysis showed that only AEs during hospitalization, previous hospital admission, and vascular and liver diseases were significantly associated with the likelihood of readmission. Conclusions: The results demonstrate the need for increased medical attention towards elderly patients discharged from hospital with characteristics such as AEs during the hospitalization, previous admission, vascular and liver diseases. © 2012 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Published
2013

21. Pattern of comorbidities and 1-year mortality in elderly patients with COPD hospitalized in internal medicine wards: data from the RePoSI Registry.

Author

Argano, Christiano, Scichilone, Nicola, Natoli, Giuseppe, Nobili, Alessandro, Corazza, Gino Roberto, Mannucci, Pier Mannuccio, Perticone, Francesco, Corrao, Salvatore, on behalf of the REPOSI Investigators, Pietrangelo, Antonello, Licata, Giuseppe, Violi, Francesco, Marengoni, Alessandra, Salerno, Francesco, Cesari, Matteo, Tettamanti, Mauro, Pasina, Luca, Franchi, Carlotta, Miglio, Gabriella, and Cortesi, Laura

Abstract

Currently, chronic obstructive pulmonary disease (COPD) represents the fourth cause of death worldwide with significant economic burden. Comorbidities increase in number and severity with age and are identified as important determinants that influence the prognosis. In this observational study, we retrospectively analyzed data collected from the RePoSI register. We aimed to investigate comorbidities and outcomes in a cohort of hospitalized elderly patients with the clinical diagnosis of COPD. Socio-demographic, clinical characteristics and laboratory findings were considered. The association between variables and in-hospital, 3-month and 1-year follow-up were analyzed. Among 4696 in-patients, 932 (19.8%) had a diagnosis of COPD. Patients with COPD had more hospitalization, a significant overt cognitive impairment, a clinically significant disability and more depression in comparison with non-COPD subjects. COPD patients took more drugs, both at admission, in-hospital stay, discharge and 3-month and 1-year follow-up. 14 comorbidities were more frequent in COPD patients. Cerebrovascular disease was an independent predictor of in-hospital mortality. At 3-month follow-up, male sex and hepatic cirrhosis were independently associated with mortality. ICS-LABA therapy was predictor of mortality at in-hospital, 3-month and 1-year follow-up. This analysis showed the severity of impact of COPD and its comorbidities in the real life of internal medicine and geriatric wards. [ABSTRACT FROM AUTHOR]

Published
2021
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22. Underdiagnosis and undertreatment of osteoporotic patients admitted in internal medicine wards in Italy between 2010 and 2016 (the REPOSI Register).

Author

Pepe, Jessica, Agosti, Pasquale, Cipriani, Cristiana, Tettamanti, Mauro, Nobili, Alessandro, Colangelo, Luciano, Santori, Rachele, Cilli, Mirella, Minisola, Salvatore, Reposi investigators, Mannucci, Pier Mannuccio, Pietrangelo, Antonello, Perticone, Francesco, Violi, Francesco, Corazza, Gino Roberto, Corrao, Salvatore, Marengoni, Alessandra, Salerno, Francesco, Cesari, Matteo, and Pasina, Luca

Abstract

Purpose: To evaluate clinical features, treatments, and outcomes of osteoporotic patients admitted to internal medicine and geriatric wards compared with non-osteoporotic patients (REPOSI registry). Methods: We studied 4714 patients hospitalized between 2010 and 2016. We reported age, sex, educational level, living status, comorbidities and drugs taken, Cumulative Illness Rating Scale (CIRS), Barthel Index, Short-Blessed Test, 4-item Geriatric Depression Scale, serum hemoglobin, creatinine, and clinical outcomes. Osteoporosis was defined based on the diagnoses recorded at admission, according to the following ICD9: 733, 805–813, 820–823. Results: Twelve percent of the patients had a preadmission diagnosis of osteoporosis. Only 20% of these had been prescribed oral bisphosphonates; 34% were taking vitamin D supplements. Osteoporotic patients were significantly older, with lower BMI, higher CIRS, and taking more drugs. They were significantly more depressed, less independent, with a higher severity of cognitive impairment compared with non-osteoporotic patients. At discharge, the number of patients receiving treatment for osteoporosis did not change. Length of stay and inhospital mortality did not differ between groups. Osteoporotic patients were more frequently nonhome discharged compared with those without osteoporosis (14.8 vs. 7.9%, p = 0.0007), mostly discharged to physical therapy or rehabilitation (8.8 vs. 2.5% of patients, p < 0.0001). Among osteoporotic patients deceased 3 months after discharge, the number of those treated with vitamin D, with or without calcium supplements, was significantly lower compared with survivors (12 vs. 32%, p = 0.0168). Conclusions: The diagnosis of osteoporosis is poorly considered both during hospital stay and at discharge; osteoporotic patients are frailer compared to non-osteoporotic patients. [ABSTRACT FROM AUTHOR]

Published
2021
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23. Pain and Frailty in Hospitalized Older Adults.

Author

Ardoino, Ilaria, Franchi, Carlotta, Nobili, Alessandro, Mannucci, Pier Mannuccio, Corli, Oscar, REPOSI Investigators, Pietrangelo, Antonello, Perticone, Francesco, Licata, Giuseppe, Violi, Francesco, Corazza, Gino Roberto, Corrao, Salvatore, Marengoni, Alessandra, Salerno, Francesco, Cesari, Matteo, Tettamanti, Mauro, Pasina, Luca, Cortesi, Laura, Miglio, Gabriella, and Novella, Alessio

Published
2020
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24. Prevalence of older in-patients at risk of clopidogrel resistance according to the STIB score. Results from REPOSI registry

Author

Gallotta, Anna, Marengoni, Alessandra, Pasina, Luca, Cortesi, Laura, Nobili Alessandro, REPOSI investigators, Barbagallo, Mario, Dominguez Rodríguez, Ligia Juliana, Gallotta, Anna, Marengoni, Alessandra, Pasina, Luca, Cortesi, Laura, Nobili, Alessandro, REPOSI, investigator, Barbagallo, Mario, and Dominguez Rodríguez, Ligia Juliana

Subjects
Blood Platelets, medicine.medical_specialty, Ticlopidine, Settore MED/09 - Medicina Interna, HPR, Treatment outcome, MEDLINE, Clopidogrel resistance, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Prevalence, Internal Medicine, medicine, Clopidogrel resistance, HPR, STIB score, REPOSI, Humans, In patient, Platelet, Registries, STIB score, 030212 general & internal medicine, REPOSI, business.industry, Surgery, Treatment Outcome, Platelet aggregation inhibitor, business, Platelet Aggregation Inhibitors, medicine.drug
Abstract

The phenomenon of resistance to copidogrel catches the attention of a growing number of clinicians because of its frequency and the severity of adverse events related to it. The identification of patients with high platelet reactivity (HPR may help to improve their therapy applying the concept of personalized medicine, most important in the older people treated with polypharmacy. The existece of such a simple clinical method as the STIB score, that allows to predict the possible resistace to clopidogrel at the bedside without using expensive laboratory investigations, provides an attractive approach to the problem.

Published
2017

25. Comorbidity does not mean clinical complexity: evidence from the RePoSI register.

Author

Corrao, Salvatore, Natoli, Giuseppe, Nobili, Alessandro, Mannucci, Pier Mannuccio, Pietrangelo, Antonello, Perticone, Francesco, Argano, Christiano, and RePoSI Investigators

Subjects
LENGTH of stay in hospitals, CAUSES of death, RESEARCH, INTERNAL medicine, RESEARCH methodology, GERIATRIC assessment, ACQUISITION of data, RETROSPECTIVE studies, EVALUATION research, MEDICAL cooperation, SEVERITY of illness index, HOSPITAL mortality, COMPARATIVE studies, COMORBIDITY
Abstract

In the last 2-3 decades internists have confronted dramatic changes in the pattern of patients acutely admitted to hospital wards. Internists observed a shift from younger subjects affected by a single organ disease to more complex patients, usually older, with multiple chronic conditions, attended by different specialists, with poor integration and treated with multiple drugs. In this regard, the concept of complex patients is addressed daily in clinical practice even if there is no agreed definition of patient complexity. To try to evaluate clinical complexity different instruments have been proposed. Among these, the number of comorbidities (NoC) was considered a marker of clinical complexity. However, this instrument would not give information about the clinical relevance of each condition. On the contrary, cumulative illness rating scale (CIRS) addresses the problem calculating both CIRS severity index (CIRS-SI) and CIRS comorbidity index (CIRS-CI). In light of this, 4714 patients from the RePoSI register were retrospectively analyzed to show if CIRS assessment of comorbidity burden is different from the simple count of comorbidities in predicting the length of hospital stay (LOS) and all-cause of mortality in hospitalized elderly patients and if NoC could be a valid tool to measure patient's complexity. CIRS-SI resulted the best predictor of all-cause in-hospital mortality [OR: 2.66 (1.88-3.77)] in comparison with NoC that did not result statistically significant (p = 0.551). CIRS-SI was also the best predictor of all-cause of post-discharge mortality corrected for age and sex [OR: 2.12 (1.53-2.95)]. CIRS-SI (coefficient ± standard error: 1.23 ± 0.59; p < 0.0381) and CIRS-CI (coefficient ± standard error: 0.27 ± 0.10; p < 0.011) were strong predictors of LOS in comparison with NoC that did not result statistically significant (coefficient ± standard error: 0.04 ± 0.06 p < 0.0561). In conclusion, CIRS assessment of comorbidity burden is a better clinical tool in comparison with the simple count of comorbidities especially considering the length of hospital stay and all-cause mortality in hospitalized elderly patients. [ABSTRACT FROM AUTHOR]

Published
2020
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26. Association of Anticholinergic Burden with Cognitive and Functional Status in a Cohort of Hospitalized Elderly: Comparison of the Anticholinergic Cognitive Burden Scale and Anticholinergic Risk Scale

Author

Pasina, L, Djade, Cd, Lucca, U, Nobili, A, Tettamanti, M, Franchi, C, Salerno, F, Corrao, S, Marengoni, A, Iorio, A, Marcucci, M, Violi, F, Mannucci, Pm, Reposi, Investigators, Volpato, Stefano, and Manfredini, Roberto

Subjects
Male, medicine.medical_specialty, Activities of daily living, Elderly. Anticholinergic drugs, Cross-sectional study, medicine.drug_class, Cholinergic Antagonists, Cognition, Internal medicine, Activities of Daily Living, 80 and over, medicine, Anticholinergic, Activities of Daily Living, Aged, Aged, 80 and over, Cholinergic Antagonists, adverse effects, Cognition Disorders, chemically induced/epidemiology, Cognition, drug effects, Cross-Sectional Studies, Female, Hospitalization, Humans, Male, Prospective Studies, Humans, Pharmacology (medical), Prospective Studies, Cognitive decline, Psychiatry, Prospective cohort study, Stroke, cognitive function, Aged, Aged, 80 and over, business.industry, medicine.disease, Hospitalization, Cross-Sectional Studies, drug effects, Cohort, adverse effects, chemically induced/epidemiology, Delirium, Female, Geriatrics and Gerontology, medicine.symptom, Cognition Disorders, business
Abstract

Drugs with anticholinergic effects are associated with adverse events such as delirium and falls as well as cognitive decline and loss of independence. The aim of the study was to evaluate the association between anticholinergic burden and both cognitive and functional status, according to the hypothesis that the cumulative anticholinergic burden, as measured by the Anticholinergic Cognitive Burden (ACB) Scale and Anticholinergic Risk Scale (ARS), increases the risk of cognitive decline and impairs activities of daily living. This cross-sectional, prospective study (3-month telephone follow-up) was conducted in 66 Italian internal medicine and geriatric wards participating in the Registry of Polytherapies SIMI (Societa Italiana di Medicina Interna) (REPOSI) study during 2010. The sample included 1,380 inpatients aged 65 years or older. Cognitive status was rated with the Short Blessed Test (SBT) and physical function with the Barthel Index. Each patient’s anticholinergic burden was evaluated using the ACB and ARS scores. The mean SBT score for patients treated with anticholinergic drugs was higher than that for patients receiving no anticholinergic medications as also indicated by the ACB scale, even after adjustment for age, sex, education, stroke and transient ischaemic attack [9.2 (95 % CI 8.6–9.9) vs. 8.5 (95 % CI 7.8–9.2); p = 0.05]. There was a dose–response relationship between total ACB score and cognitive impairment. Patients identified by the ARS had more severe cognitive and physical impairment than patients identified by the ACB scale, and the dose–response relationship between this score and ability to perform activities of daily living was clear. No correlation was found with length of hospital stay. Drugs with anticholinergic properties identified by the ACB scale and ARS are associated with worse cognitive and functional performance in elderly patients. The ACB scale might permit a rapid identification of drugs potentially associated with cognitive impairment in a dose–response pattern, but the ARS is better at rating activities of daily living.

Published
2012

28. Predictors of clinical events occurring during hospital stay among elderly patients admitted to medical wards in Italy

Author

Rossi, PD, Bilotta, C, Consonni, D, Nobili, A, Damanti, S, Marcucci, M, Mannucci, PM, Mari, D, REPOSI, Investigators, BARBAGALLO, Mario, DOMINGUEZ RODRIGUEZ, Ligia Juliana, Rossi, PD, Bilotta, C, Consonni, D, Nobili, A, Damanti, S, Marcucci, M, Mannucci, PM, Mari, D, REPOSI, Investigator, Barbagallo, M, and Dominguez Rodríguez, LJ

Subjects
Male, Pediatrics, medicine.medical_specialty, Settore MED/09 - Medicina Interna, Fever, medicine.medical_treatment, Water-Electrolyte Imbalance, Risk Assessment, Urinary catheterization, Body Temperature, 03 medical and health sciences, symbols.namesake, 0302 clinical medicine, Risk Factors, Internal Medicine, medicine, Odds Ratio, Humans, 030212 general & internal medicine, Poisson regression, Poisson Distribution, Prospective Studies, Prospective cohort study, Aged, Geriatrics, Aged, 80 and over, business.industry, 030503 health policy & services, Anemia, Arrhythmias, Cardiac, Proton Pump Inhibitors, Odds ratio, Pneumonia, medicine.disease, Comorbidity, Hospitalization, Italy, Relative risk, Emergency medicine, Multivariate Analysis, Urinary Tract Infections, symbols, Elderly, Intercurrent clinical events, Adverse events, REPOSI, Hospitalization, Observational study, Female, 0305 other medical science, business, Urinary Catheterization, Immunosuppressive Agents
Abstract

Background Clinical events occurring during hospital stay are independent predictors of prolonged hospitalization, in-hospital mortality and readmission among elderly patients admitted to medical wards. Purpose To identify predictors of intercurrent clinical events (ICE) during hospital stay among the main demographic, functional and clinical characteristics assessed at hospital admission in a multicenter sample of elderly inpatients in Italy. Methods This observational prospective cohort study was conducted in 66 internal and geriatric medicine hospital wards in 2010. It enrolled 1267 inpatients aged 65 years or older living at home before hospitalization. Multivariable Poisson regression analyses were employed to identify the most common ICEs as well as their independent predictors. Results During the hospital stay 427 patients (33.7%) experienced at least one ICE. The most common ICEs were urinary tract infections, pneumonia, anemia, arrhythmias and fluid electrolyte disorders. After correction for age, sex, comorbidity, cognitive impairment and functional dependence, independent predictors of any ICE were: being a bladder catheter holder (RR [risk ratio] 1.86, 95% CI 1.52–2.27), being on treatment at home with a proton pump inhibitor (PPI) (RR 1.25, 95% CI 1.03–1.53), with immunosuppressant therapy (RR 2.10, 95% CI 1.24–3.56), and body temperature at admission (RR 1.19, 95% CI 1.06–1.33). Conclusion Four clinical characteristics, easily assessable at admission, may be useful to identify elderly inpatients at a higher risk for developing ICEs during hospital stay. Furthermore three of these predictors are modifiable factors, thus interventions reducing the use of catheter, PPI and immunosuppressants may result in reduction of ICEs.

Published
2015

29. Comparison of Disease Clusters in Two Elderly Populations Hospitalized in 2008 and 2010

Author

Marengoni, A, Nobili, A, Pirali, C, Tettamanti, M, Pasina, L, Salerno, F, Corrao, S, Iorio, A, Marcucci, M, Franchi, C, Mannucci, Pm, Reposi, Investigators, Pier Mannucci, M, Spirito, V, Noce, D, Bonazzi, J, Lombardo, R, Sparacio, E, Alborghetti, S, De Vittorio, L, Djade, Cd, Paolisso, G, Rizzo, Mr, Laieta, Mt, Roberto, T, Persico, Marcello, Salvatore, T, Sasso, Fc, Utili, R, Durante Mangoni, E, Pinto, D, Fenoglio, L, Brignone, C, Bracco, C, Gasbarrone, L, Porcari, P, Famularo, G, Sajeva, Mr, Maniscalco, G, Gunelli, M, Tirotta, D, Realdi, G, Baritussio, A, Frassoni, F, Delsignore, R, Baroni, Mc, Zardo, M, Volpato, S, Fotini, S, Manfredini, R, Longhini, C, Molino, C, Incasa, E, Guarnieri, G, Zanetti, M, Spalluti, A, Rini, G, Mansueto, P, Pepe, I, Licata, G, Calvo, L, Valenti, M, Tuttolomondo, A, Di Sciacca, R, Antonaci, S, Vella, F, Marseglia, A, Centonze, V, Modeo, Me, Palasciano, G, Pugliese, S, Capobianco, C, Murialdo, G, Bovio, M, Pasini, Fl, Capecchi, Pl, Bicchi, M, Nuti, R, Valenti, R, Capodarca, C, Auteri, A, Pasqui, Al, Puccetti, L, Olivieri, O, Stanzial, Am, Agnelli, G, Macura, A, Mannarino, E, Lupattelli, G, Rondelli, P, Serra, Mg, Musca, G, Cuccurullo, O, Cappellini, Md, Fabio, G, Motta, I, Cantoni, F, Fargion, S, Bonara, P, Bulgheroni, M, Magrini, F, Massari, F, Tonella, T, Peyvandi, F, Tedeschi, A, Rossio, R, Moreo, G, Ferrari, B, Roncari, L, Monzani, V, Savojardo, V, Folli, C, Mari, D, Rossi, Pd, Ziglioli, E, Vergani, C, Lilleri, Ms, Podda, M, Selmi, C, Meda, F, Cazzaniga, M, Monti, V, Balduini, Cl, Bertolino, G, Dezzani, L, Cavallo, P, Corazza, Gr, Miceli, E, Secchi, Mb, Wu, Sc, Balsamo, C, Anastasio, L, Sofia, L, Carbone, M, Bertucci, L, Valentia, V, Traisci, G, De Feudis, L, Bergami, E, Rizzioli, E, Cagnoni, C, Bertone, L, Manucra, A, Ronchi, E, Buratti, A, Tognin, T, Bertolini, D, Liberato, Nl, Bernasconi, G, Nardo, B, Venco, A, Guasti, L, Maroni, L, Castiglioni, L, Vanoli, M, Grignani, G, Casella, G, Mancuso, G, Tavella, R, Persico, R, Cicardi, M, Sandrone, G, Cortellaro, M, Magenta, M, Perego, F, Meroni, Mr, Rozzini, R, Falanga, L, Giordano, A, Menardo, G, Bottone, S, Sferrazzo, E, Tassara, R, Melis, D, Rebella, L, Ferri, C, Striuli, R, Scipioni, R, Salmi, R, Gaudenzi, P, Di Todaro, F, Nielsen, I, Giusto, L, Semplicini, A, Gottardo, L, Delitala, G, Carta, S, Atzori, S, Rosei, Ea, Rizzoni, D, Castoldi, L, Altomare, E, Serviddio, G, Salvatore, S, Fera, G, Di Luca ML, Renna, D, Picardi, A, Mazzarelli, C, Gentilucci, Uv, De Vincentis, A, Hila, D, Bernardi, M, Li Bassi, S, Santi, L, Masala, C, Mammarella, A, Raparelli, V, Rossi Fanelli, F, Delfino, M, Amoroso, A, Serra, P, Fontana, V, Falcone, M, Violi, F, Basili, S, Perri, L, Silveri, Ng, De Marco, G, Giupponi, B, Landolfi, R, Grieco, A, Gallo, A, Perticone, F, Sciacqua, A, Quero, M, Bagnato, C, Loria, P, Ballestri, S, Becchi, Ma, Bellettini, E, Bolondi, L, Rasciti, L, Serio, I, Gualandi, S, Romanelli, G, Bonometti, F, Carulli, N, Rondinella, S, Giannico, I, Dallegri, F, Ottonello, L, Quercioli, A, Barreca, A, Sacco, A, Bonelli, A, Dentamaro, G, Micale, G, Delitalia, G, Deidda, S, Cuccuru, Lm, Benetti, G, Quagliolo, M, Centenaro, Gr, Perciccante, A, Coralli, A, Morabito, C, Fava, R, Macchini, L, Realdi, A, Cricco, L, Fiorentini, A, Tofi, C., Marengoni A, Nobili A, Pirali, C, Tettamanti, M, Pasina, L, Salerno, F, Corrao, S, Iorio, A, Marcucci, M, Franchi, C, Mannucci, Pm, Investigators, Reposi, Zanetti, Michela, Marengoni, A., Nobili, A., Pirali, C., Tettamanti, M., Pasina, L., Salerno, F., Corrao, S., Iorio, A., Marcucci, M., Franchi, C., Mannucci, P. M, Rizzo, Mr, Marengoni A, Nobili A, Pirali C, Tettamanti M, Pasina L, Salerno F, Corrao S, Iorio A, Marcucci M, Franchi C, Mannucci PM, REPOSI Investigators [.., Bernardi M, Bolondi L, ], Mannucci, P., and Mansueto, P.

Subjects
Registrie, Male, Aging, Cirrhosis, Settore MED/09 - Medicina Interna, Time Factors, hispitalization, Gerontology, aging populations, atterns of multimorbidity, diseases in the elderly population, Health care, 80 and over, Prevalence, Chronic diseases, Cluster analysis, Hospitalized elderly, Registries, aging population, Aged, 80 and over, education.field_of_study, Settore MED/45 - Scienze Infermieristiche Generali, Cliniche E Pediatriche, Hospitalization, Italy, elderly, disease clusters, Female, hospitalized, Human, medicine.medical_specialty, Time Factor, Anemia, MULTIMORBIDITY, Population, MEDLINE, Malignancy, Diabetes mellitus, Internal medicine, medicine, Multimorbidity, Humans, education, Aged, Chronic Disease, Cluster Analysis, Geriatrics and Gerontology, Cluster Analysi, business.industry, medicine.disease, Physical therapy, disease cluster, business
Abstract

Background: As chronicity represents one of the major challenges in the healthcare of aging populations, the understanding of how chronic diseases distribute and co-occur in this part of the population is needed. Objectives: The aims of this study were to evaluate and compare patterns of diseases identified with cluster analysis in two samples of hospitalized elderly. Methods: Data were obtained from the multicenter ‘Registry Politerapie SIMI (REPOSI)' that included people aged 65 or older hospitalized in internal medicine and geriatric wards in Italy during 2008 and 2010. The study sample from the first wave included 1,411 subjects enrolled in 38 hospitals wards, whereas the second wave included 1,380 subjects in 66 wards located in different regions of Italy. To analyze patterns of multimorbidity, a cluster analysis was performed including the same diseases (19 chronic conditions with a prevalence >5%) collected at hospital discharge during the two waves of the registry. Results: Eight clusters of diseases were identified in the first wave of the REPOSI registry and six in the second wave. Several diseases were included in similar clusters in the two waves, such as malignancy and liver cirrhosis; anemia, gastric and intestinal diseases; diabetes and coronary heart disease; chronic obstructive pulmonary disease and prostate hypertrophy. Conclusion: These findings strengthened the idea of an association other than by chance of diseases in the elderly population.

Published
2013

31. Patterns of infections in older patients acutely admitted to medical wards: data from the REPOSI register.

Author

Rossio, Raffaella, Ardoino, Ilaria, Franchi, Carlotta, Nobili, Alessandro, Mannuccio Mannucci, Pier, Peyvandi, Flora, REPOSI Investigators, Prisco, Domenico, Silvestri, Elena, Emmi, Giacomo, Bettiol, Alessandra, Caterina, Cenci, Biolo, Gianni, Zanetti, Michela, Guadagni, Martina, Zaccari, Michele, Chiuch, Massimiliano, Vanoli, Massimo, Grignani, Giulia, and Pulixi, Edoardo Alessandro

Published
2019
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32. Need for Deprescribing in Hospital Elderly Patients Discharged with a Limited Life Expectancy: The REPOSI Study.

Author

Pasina, Luca, Brignolo Ottolini, Barbara, Cortesi, Laura, Tettamanti, Mauro, Franchi, Carlotta, Marengoni, Alessandra, Mannucci, Pier Mannuccio, Nobili, Alessandro, Brignolo Ottolini, Barbara, Mannucci, Pier Mannuccio, and REPOSI Investigators

Subjects
LIFE expectancy, HOSPITAL admission & discharge, DRUG side effects, HOSPITAL patients, OLDER patients
Abstract

Objective: Older people approaching the end of life are at a high risk for adverse drug reactions. Approaching the end of life should change the therapeutic aims, triggering a reduction in the number of drugs.The main aim of this study is to describe the preventive and symptomatic drug treatments prescribed to patients discharged with a limited life expectancy from internal medicine and geriatric wards. The secondary aim was to describe the potentially severe drug-drug interactions (DDI).Materials and Methods: We analyzed Registry of Polytherapies Societa Italiana di Medicina Interna (REPOSI), a network of internal medicine and geriatric wards, to describe the drug therapy of patients discharged with a limited life expectancy.Results: The study sample comprised 55 patients discharged with a limited life expectancy. Patients with at least 1 preventive medication that could be considered for deprescription at the end of life were significantly fewer from admission to discharge (n = 30; 54.5% vs. n = 21; 38.2%; p = 0.02). Angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, lipid-lowering drugs, and clonidine were the most frequent potentially avoidable medications prescribed at discharge, followed by xanthine oxidase inhibitors and drugs to prevent fractures. Thirty-seven (67.3%) patients were also exposed to at least 1 potentially severe DDI at discharge.Conclusion: Hospital discharge is associated with a small reduction in the use of commonly prescribed preventive medications in patients discharged with a limited life expectancy. Cardiovascular drugs are the most frequent potentially avoidable preventive medications. A consensus framework or shared criteria for potentially inappropriate medication in elderly patients with limited life expectancy could be useful to further improve drug prescription. [ABSTRACT FROM AUTHOR]

Published
2019
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33. Adherence to antithrombotic therapy guidelines improves mortality among elderly patients with atrial fibrillation: insights from the REPOSI study

Author

Proietti, M., Nobili, A., Raparelli, V., Napoleone, L., Mannucci, P. M., Lip, G. Y. H., Pasina, L., Franchi, C., Tettamanti, M., Eldin, T. K., Di Blanca, M. P. D., Djade, C. D., Ardoino, I., Cortesi, L., Marengoni, A., Licata, G., Violi, F., Corazza, G. R., Biolo, G., Guarnieri, G., Zanetti, M., Fernandes, G., Vanoli, M., Grignani, G., Casella, G., Bernardi, M., Bassi, S. L., Santi, L., Zaccherini, G., Mannarino, E., Lupattelli, G., Bianconi, V., Paciullo, F., Nuti, R., Valenti, R., Ruvio, M., Cappelli, S., Palazzuoli, A., Salvatore, T., Sasso, F. C., Girelli, D., Olivieri, O., Matteazzi, T., Barbagallo, M., Plances, L., Alcamo, R., Calvo, L., Valenti, M., Zoli, M., Arno, R., Pasini, F. L., Capecchi, P. L., Bicchi, M., Palasciano, G., Modeo, M. E., Peragine, M., Pappagallo, F., Di Gennaro, C., Postiglione, A., Barbella, M. R., De Stefano, F., Cappellini, M. D., Fabio, G., Seghezzi, S., De Amicis, M. M., Mari, D., Rossi, P. D., Ottolini, B. B., Miceli, E., Lenti, M. V., Padula, D., Murialdo, G., Marra, A., Cattaneo, F., Secchi, M. B., Ghelfi, D., Anastasio, L., Sofia, L., Carbone, M., Damanti, S., Guagnano, M. T., Sestili, S., Mancuso, G., Calipari, D., Bartone, M., Meroni, M. R., Perin, P. C., Lorenzati, B., Gruden, G., Bruno, G., Amione, C., Fornengo, P., Tassara, R., Melis, D., Rebella, L., Pretti, V., Masala, M. S., Bolondi, L., Rasciti, L., Serio, I., Fanelli, F. R., Amoroso, A., Molfino, A., Petrillo, E., Zuccala', Giuseppe, Franceschi, Francesco, De Marco, G., Chiara, C., Marta, S., Romanelli, G., Amolini, C., Chiesa, D., Picardi, A., Gentilucci, U. V., Gallo, P., Annoni, G., Corsi, M., Zazzetta, S., Bellelli, G., Arturi, F., Succurro, E., Rubino, M., Sesti, G., Loria, P., Becchi, M. A., Martucci, G., Fantuzzi, A., Maurantonio, M., Carta, S., Atzori, S., Serra, M. G., Bleve, M. A., Gasbarrone, L., Sajeva, M. R., Brucato, A., Ghidoni, S., Di Corato, P., Agnelli, G., Marchesini, E., Fabris, F., Carlon, M., Baritusso, A., Manfredini, R., Molino, C., Pala, M., Fabbian, F., Boari, B., De Giorgi, A., Paolisso, G., Rizzo, M. R., Laieta, M. T., Rini, G., Mansueto, P., Pepe, I., Borghi, C., Strocchi, E., De Sando, V., Sabba, C., Vella, F. S., Turatto, F., Valerio, R., Capobianco, C., Fenoglio, L., Bracco, C., Giraudo, A. V., Testa, E., Serraino, C., Fargion, S., Bonara, P., Periti, G., Porzio, M., Peyvandi, F., Tedeschi, A., Rossio, R., Monzani, V., Savojardo, V., Folli, C., Magnini, M., Gobbo, G., Balduini, C. L., Bertolino, G., Provini, S., Quaglia, F., Dallegri, F., Ottonello, L., Liberale, L., Chin, W. S., Carassale, L., Caporotundo, S., Traisci, G., De Feudis, L., Di Carlo, S., Liberato, N. L., Buratti, A., Tognin, T., Bianchi, G. B., Giaquinto, S., Purrello, F., Di Pino, Antonella, Piro, S., Conca, A., Falanga, L., Montrucchio, G., Greco, E., Tizzani, P., Petitti, P., Perciccante, A., Coralli, A., Salmi, R., Gaudenzi, P., Gamberini, S., Semplicini, A., Gottardo, L., Vendemiale, G., Serviddio, G., Forlano, R., Masala, C., Mammarella, A., Basili, S., Perri, L., Landolfi, Raffaele, Montalto, Massimo, Mirijello, A., Vallone, C., Bellusci, M., Setti, D., Pedrazzoli, F., Guasti, L., Castiglioni, L., Maresca, A., Squizzato, A., Molaro, M., Bertolotti, M., Mussi, C., Libbra, M. V., Miceli, A., Pellegrini, E., Carulli, L., Sciacqua, A., Quero, M., Bagnato, C., Corinaldesi, R., De Giorgio, R., Serra, M., Grasso, V., Ruggeri, E., Salvi, A., Leonardi, R., Grassini, C., Mascherona, I., Minelli, G., Maltese, F., Gabrielli, A., Mattioli, M., Capeci, W., Martino, G. P., Messina, S., Ghio, R., Favorini, S., Col, A. D., Minisola, S., Colangelo, L., Afeltra, A., Alemanno, P., Marigliano, B., Castellino, P., Blanco, J., Zanoli, L., Cattaneo, M., Fracasso, P., Amoruso, M. V., Saracco, V., Fogliati, M., Bussolino, C., Durante, V., Eusebi, G., Tirotta, D., Mete, F., Gino, M., Cittadini, A., Arcopinto, M., Salzano, A., Bobbio, E., Marra, A. M., Sirico, D., Moreo, G., Scopelliti, F., Gasparini, F., Cocca, M., Nieves, R. D., Alberto, M. M., Pedro, A. R., Vanessa, L. P., Lara, T., Xavier, C. V., Francesc, F., Jesus, D. M., Esperanza, B. T., Behamonte Esther, D. C., Maria, S. P., Romero, M., Blanca, P. L., Cristina, L. G. -C., Victoria, V. G. M., Saez, L., Bosco, J., Susana, S. B., Marta, A. G., Concepcion, G. B., Antonio, F. M., Hernandez, M. G., Borrego, M. P., Raquel, P. C., Florencia, P. R., Beatriz, G. O., Sara, C. G., Cervellera Alfonso, G. -C., Marta, P. M., Alberto, R. C., Antonio, A. A., Montserrat, G. G., Miguel Angel, B. R., Manuel, M. J., Ignacio, N. V., Lucia, A. S., Alfonso, L., David, R. B., Iria, I. V., Monica, R. P., On behalf of REPOSI, Investigators, Zuccala G. (ORCID:0000-0002-2567-2220), Franceschi F. (ORCID:0000-0001-6266-445X), Di Pino A., Landolfi R. (ORCID:0000-0002-7913-8576), Montalto M. (ORCID:0000-0001-8819-3684), Proietti, M., Nobili, A., Raparelli, V., Napoleone, L., Mannucci, P. M., Lip, G. Y. H., Pasina, L., Franchi, C., Tettamanti, M., Eldin, T. K., Di Blanca, M. P. D., Djade, C. D., Ardoino, I., Cortesi, L., Marengoni, A., Licata, G., Violi, F., Corazza, G. R., Biolo, G., Guarnieri, G., Zanetti, M., Fernandes, G., Vanoli, M., Grignani, G., Casella, G., Bernardi, M., Bassi, S. L., Santi, L., Zaccherini, G., Mannarino, E., Lupattelli, G., Bianconi, V., Paciullo, F., Nuti, R., Valenti, R., Ruvio, M., Cappelli, S., Palazzuoli, A., Salvatore, T., Sasso, F. C., Girelli, D., Olivieri, O., Matteazzi, T., Barbagallo, M., Plances, L., Alcamo, R., Calvo, L., Valenti, M., Zoli, M., Arno, R., Pasini, F. L., Capecchi, P. L., Bicchi, M., Palasciano, G., Modeo, M. E., Peragine, M., Pappagallo, F., Di Gennaro, C., Postiglione, A., Barbella, M. R., De Stefano, F., Cappellini, M. D., Fabio, G., Seghezzi, S., De Amicis, M. M., Mari, D., Rossi, P. D., Ottolini, B. B., Miceli, E., Lenti, M. V., Padula, D., Murialdo, G., Marra, A., Cattaneo, F., Secchi, M. B., Ghelfi, D., Anastasio, L., Sofia, L., Carbone, M., Damanti, S., Guagnano, M. T., Sestili, S., Mancuso, G., Calipari, D., Bartone, M., Meroni, M. R., Perin, P. C., Lorenzati, B., Gruden, G., Bruno, G., Amione, C., Fornengo, P., Tassara, R., Melis, D., Rebella, L., Pretti, V., Masala, M. S., Bolondi, L., Rasciti, L., Serio, I., Fanelli, F. R., Amoroso, A., Molfino, A., Petrillo, E., Zuccala', Giuseppe, Franceschi, Francesco, De Marco, G., Chiara, C., Marta, S., Romanelli, G., Amolini, C., Chiesa, D., Picardi, A., Gentilucci, U. V., Gallo, P., Annoni, G., Corsi, M., Zazzetta, S., Bellelli, G., Arturi, F., Succurro, E., Rubino, M., Sesti, G., Loria, P., Becchi, M. A., Martucci, G., Fantuzzi, A., Maurantonio, M., Carta, S., Atzori, S., Serra, M. G., Bleve, M. A., Gasbarrone, L., Sajeva, M. R., Brucato, A., Ghidoni, S., Di Corato, P., Agnelli, G., Marchesini, E., Fabris, F., Carlon, M., Baritusso, A., Manfredini, R., Molino, C., Pala, M., Fabbian, F., Boari, B., De Giorgi, A., Paolisso, G., Rizzo, M. R., Laieta, M. T., Rini, G., Mansueto, P., Pepe, I., Borghi, C., Strocchi, E., De Sando, V., Sabba, C., Vella, F. S., Turatto, F., Valerio, R., Capobianco, C., Fenoglio, L., Bracco, C., Giraudo, A. V., Testa, E., Serraino, C., Fargion, S., Bonara, P., Periti, G., Porzio, M., Peyvandi, F., Tedeschi, A., Rossio, R., Monzani, V., Savojardo, V., Folli, C., Magnini, M., Gobbo, G., Balduini, C. L., Bertolino, G., Provini, S., Quaglia, F., Dallegri, F., Ottonello, L., Liberale, L., Chin, W. S., Carassale, L., Caporotundo, S., Traisci, G., De Feudis, L., Di Carlo, S., Liberato, N. L., Buratti, A., Tognin, T., Bianchi, G. B., Giaquinto, S., Purrello, F., Di Pino, Antonella, Piro, S., Conca, A., Falanga, L., Montrucchio, G., Greco, E., Tizzani, P., Petitti, P., Perciccante, A., Coralli, A., Salmi, R., Gaudenzi, P., Gamberini, S., Semplicini, A., Gottardo, L., Vendemiale, G., Serviddio, G., Forlano, R., Masala, C., Mammarella, A., Basili, S., Perri, L., Landolfi, Raffaele, Montalto, Massimo, Mirijello, A., Vallone, C., Bellusci, M., Setti, D., Pedrazzoli, F., Guasti, L., Castiglioni, L., Maresca, A., Squizzato, A., Molaro, M., Bertolotti, M., Mussi, C., Libbra, M. V., Miceli, A., Pellegrini, E., Carulli, L., Sciacqua, A., Quero, M., Bagnato, C., Corinaldesi, R., De Giorgio, R., Serra, M., Grasso, V., Ruggeri, E., Salvi, A., Leonardi, R., Grassini, C., Mascherona, I., Minelli, G., Maltese, F., Gabrielli, A., Mattioli, M., Capeci, W., Martino, G. P., Messina, S., Ghio, R., Favorini, S., Col, A. D., Minisola, S., Colangelo, L., Afeltra, A., Alemanno, P., Marigliano, B., Castellino, P., Blanco, J., Zanoli, L., Cattaneo, M., Fracasso, P., Amoruso, M. V., Saracco, V., Fogliati, M., Bussolino, C., Durante, V., Eusebi, G., Tirotta, D., Mete, F., Gino, M., Cittadini, A., Arcopinto, M., Salzano, A., Bobbio, E., Marra, A. M., Sirico, D., Moreo, G., Scopelliti, F., Gasparini, F., Cocca, M., Nieves, R. D., Alberto, M. M., Pedro, A. R., Vanessa, L. P., Lara, T., Xavier, C. V., Francesc, F., Jesus, D. M., Esperanza, B. T., Behamonte Esther, D. C., Maria, S. P., Romero, M., Blanca, P. L., Cristina, L. G. -C., Victoria, V. G. M., Saez, L., Bosco, J., Susana, S. B., Marta, A. G., Concepcion, G. B., Antonio, F. M., Hernandez, M. G., Borrego, M. P., Raquel, P. C., Florencia, P. R., Beatriz, G. O., Sara, C. G., Cervellera Alfonso, G. -C., Marta, P. M., Alberto, R. C., Antonio, A. A., Montserrat, G. G., Miguel Angel, B. R., Manuel, M. J., Ignacio, N. V., Lucia, A. S., Alfonso, L., David, R. B., Iria, I. V., Monica, R. P., On behalf of REPOSI, Investigators, Zuccala G. (ORCID:0000-0002-2567-2220), Franceschi F. (ORCID:0000-0001-6266-445X), Di Pino A., Landolfi R. (ORCID:0000-0002-7913-8576), and Montalto M. (ORCID:0000-0001-8819-3684)

Abstract

Background: Atrial fibrillation (AF) is associated with a substantial risk of thromboembolism and mortality, significantly reduced by oral anticoagulation. Adherence to guidelines may lower the risks for both all cause and cardiovascular (CV) deaths. Methods: Our objective was to evaluate if antithrombotic prophylaxis according to the 2012 European Society of Cardiology (ESC) guidelines is associated to a lower rate of adverse outcomes. Data were obtained from REPOSI; a prospective observational study enrolling inpatients aged ≥65 years. Patients enrolled in 2012 and 2014 discharged with an AF diagnosis were analysed. Results: Among 2535 patients, 558 (22.0 %) were discharged with a diagnosis of AF. Based on ESC guidelines, 40.9 % of patients were on guideline-adherent thromboprophylaxis, 6.8 % were overtreated, and 52.3 % were undertreated. Logistic analysis showed that increasing age (p = 0.01), heart failure (p = 0.04), coronary artery disease (p = 0.013), peripheral arterial disease (p = 0.03) and concomitant cancer (p = 0.003) were associated with non-adherence to guidelines. Specifically, undertreatment was significantly associated with increasing age (p = 0.001) and cancer (p < 0.001), and inversely associated with HF (p = 0.023). AF patients who were guideline adherent had a lower rate of both all-cause death (p = 0.007) and CV death (p = 0.024) compared to those non-adherent. Kaplan–Meier analysis showed that guideline-adherent patients had a lower cumulative risk for both all-cause (p = 0.002) and CV deaths (p = 0.011). On Cox regression analysis, guideline adherence was independently associated with a lower risk of all-cause and CV deaths (p = 0.019 and p = 0.006). Conclusions: Non-adherence to guidelines is highly prevalent among elderly AF patients, despite guideline-adherent treatment be

Published
2016

34. Prevalence of potentially inappropriate medications and risk of adverse clinical outcome in a cohort of hospitalized elderly patients: results from the REPOSI Study

Author

Pasina, L, Djade, Cd, Tettamanti, M, Franchi, C, Salerno, F, Corrao, S, Marengoni, A, Marcucci, M, Mannucci, Pm, Nobili, A, Reposi, Investigators, Manfredini, Roberto, Fabbian, Fabio, and Volpato, Stefano

Subjects
Male, medicine.medical_specialty, Multivariate analysis, pharmacoepidemiology, Health Services for the Aged, Beers Criteria, Patient Discharge Summaries, Inappropriate Prescribing, elderly, Cohort Studies, Beers' criteria, Aged, Aged, 80 and over, Cross-Sectional Studies, Female, Humans, Italy, Polypharmacy, Prevalence, Pharmacology (medical), Pharmacology, Medicine (all), Health care, Beer's criteria, 80 and over, medicine, Dementia, Medical prescription, Psychiatry, Adverse effect, business.industry, Pharmacoepidemiology, medicine.disease, Cohort, Emergency medicine, business
Abstract

SummaryWhat is known and objective Inappropriate prescribing is highly prevalent for older people and has become a global healthcare concern because of its association with negative health outcomes including ADEs, hospitalization and resource utilization. Beers' criteria are widely utilized for evaluating the appropriateness of medications, and an up-to-date version has recently been published. To assess the prevalence of patients exposed to PIMs at hospital discharge according to the 2003 and 2012 versions of Beers' criteria and to evaluate the risk of adverse clinical events, re-hospitalization and all-cause mortality at 3-month follow-up. Methods This cross-sectional study was held in 66 Italian internal medicine and geriatric wards. The sample included 1380 inpatients aged 65 years or older. Prescriptions of PIM were analysed at hospital discharge. We considered all patients with complete 3-month follow-up. Results and discussion The prevalence of patients receiving at least one PIM was 20·1% and 23·5% according to the 2003 and 2012 versions of the Beers' criteria, respectively. The 2012 Beers' criteria identified more patients with at least one PIM than the 2003 version, although a high percentage of those patients (72·2%) were also identified by the criteria updated in 2003. The main difference in the prevalence of patients receiving a PIM according to the two versions of Beers' criteria involved prescriptions of benzodiazepines for insomnia or agitation, chronic use of non-benzodiazepine hypnotics, prescription of antipsychotics in people with dementia and oral iron at dosage higher than 325 mg/day. Prescription of PIMs was not associated with a higher risk of adverse clinical events, re-hospitalization and all-cause mortality at 3-month follow-up in both univariate and multivariate analysis, after adjusting for age, sex and CIRS comorbidity index. What is New and Conclusions This study found no significant effect of inappropriate drug use according to Beers' criteria on health outcomes among older adults 3 month after discharge. Even though these criteria have been suggested as helpful in promoting appropriate prescribing, reducing drug-related adverse events and associated healthcare costs, to date there is no clear evidence that their application can achieve objective and quantifiable improvements in clinical outcomes. A possible explanation is that both versions of the Beers' criteria have several recognized limitations, one of the main ones being the restricted availability of some drugs in Europe or their limited prescription in everyday clinical practice.

Published
2014

35. Gout, allopurinol intake and clinical outcomes in the hospitalized multimorbid elderly

Author

Franchi, C, Salerno, F, Conca, A, Djade, Cd, Tettamanti, M, Pasina, L, Corrao, S, Marengoni, A, Marcucci, M, Mannucci, Pm, Nobili, A, Reposi, Investigators, Sparacio, E, Alborghetti, S, Di Costanzo, R, Prisco, D, Silvestri, E, Cenci, C, Barnini, T, Delitala, G, Carta, S, Atzori, S, Guarnieri, G, Zanetti, M, Spalluti, A, Serra, Mg, Bleve, Ma, Vanoli, M, Grignani, G, Casella, G, Gasbarrone, L, Maniscalco, G, Gunelli, M, Tirotta, D, Brucato, A, Ghidoni, S, Di Corato, P, Bernardi, M, Li Bassi, S, Santi, L, Agnelli, G, Iorio, A, Marchesini, E, Mannarino, E, Lupattelli, G, Rondelli, P, Paciullo, F, Fabris, F, Carlon, M, Turatto, F, Baroni, Mc, Zardo, M, Manfredini, R, Molino, C, Pala, M, Fabbian, F, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Paolisso, G, Rizzo, Mr, Laieta, Mt, Salvatore, T, Sasso, Fc, Utili, R, Durante Mangoni, E, Pinto, D, Olivieri, O, Stanzial, Am, Fellin, R, Volpato, S, Fotini, S, Barbagallo, M, Dominguez, L, Plances, L, D'Angelo, D, Rini, G, Mansueto, P, Pepe, I, Licata, G, Calvo, L, Valenti, M, Borghi, C, Strocchi, E, Rinaldi, Er, Zoli, M, Fabbri, E, Magalotti, D, Auteri, A, Pasqui, Al, Puccetti, L, Pasini, Fl, Capecchi, Pl, Bicchi, M, Sabbà, C, Vella, Fs, Marseglia, A, Luglio, Cv, Palasciano, G, Modeo, Me, Aquilino, A, Raffaele, P, Pugliese, S, Capobianco, C, Postiglione, A, Barbella, Mr, De Stefano, F, Fenoglio, L, Brignone, C, Bracco, C, Giraudo, A, Musca, G, Cuccurullo, O, Cricco, L, Fiorentini, A, Cappellini, Md, Fabio, G, Seghezzi, S, De Amicis MM, Fargion, S, Bonara, P, Bulgheroni, M, Lombardi, R, Magrini, F, Massari, F, Tonella, T, Peyvandi, F, Tedeschi, A, Rossio, R, Moreo, G, Ferrari, B, Roncari, L, Monzani, V, Savojardo, V, Folli, C, Magnini, M, Mari, D, Rossi, Pd, Damanti, S, Prolo, S, Lilleri, Ms, Micale, G, Podda, M, Selmi, C, Meda, F, Accordino, S, Monti, V, Corazza, Gr, Miceli, E, Lenti, Mv, Padula, D, Balduini, Cl, Bertolino, G, Provini, S, Quaglia, F, Murialdo, G, Bovio, M, Dallegri, F, Ottonello, L, Quercioli, A, Barreca, A, Secchi, Mb, Ghelfi, D, Chin, Ws, Carassale, L, Caporotundo, S, Anastasio, L, Sofia, L, Carbone, M, Traisci, G, De Feudis, L, Di Carlo, S, Davì, G, Guagnano, Mt, Sestili, S, Bergami, E, Rizzioli, E, Cagnoni, C, Bertone, L, Manucra, A, Buratti, A, Tognin, T, Liberato, Nl, Bernasconi, G, Nardo, B, Bianchi, Gb, Giaquinto, S, Benetti, G, Quagliolo, M, Centenaro, Gr, Purrello, Francesco, Di Pino, A, Piro, Salvatore, Mancuso, G, Calipari, D, Bartone, M, Gullo, F, Cortellaro, M, Magenta, M, Perego, F, Meroni, Mr, Cicardi, M, Marina Magenta AG, Sacco, A, Bonelli, A, Dentamaro, G, Rozzini, R, Falanga, L, Giordano, A, Perin, Pc, Lorenzati, B, Gruden, G, Bruno, G, Montrucchio, G, Greco, E, Tizzani, P, Fera, G, Di Luca ML, Renna, D, Perciccante, A, Coralli, A, Tassara, R, Melis, D, Rebella, L, Menardo, G, Bottone, S, Sferrazzo, E, Ferri, C, Striuli, R, Scipioni, R, Salmi, R, Gaudenzi, P, Gamberini, S, Ricci, F, Morabito, C, Fava, R, Semplicini, A, Gottardo, L, Vendemiale, G, Serviddio, G, Forlano, R, Bolondi, L, Rasciti, L, Serio, I, Masala, C, Mammarella, A, Raparelli, V, Rossi Fanelli, F, Delfino, M, Amoroso, A, Violi, F, Basili, S, Perri, L, Serra, P, Fontana, V, Falcone, M, Landolfi, R, Grieco, A, Gallo, A, Zuccalà, G, Franceschi, F, De Marco, G, Chiara, C, Marta, S, Bellusci, M, Setti, D, Pedrazzoli, F, Romanelli, G, Pirali, C, Amolini, C, Rosei, Ea, Rizzoni, D, Castoldi, L, Picardi, A, Gentilucci, Uv, Mazzarelli, C, Gallo, P, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Contini, S, Molaro, M, Annoni, G, Corsi, M, Zazzetta, S, Bertolotti, M, Mussi, C, Scotto, R, Ferri, Ma, Veltri, F, Arturi, F, Succurro, E, Sesti, G, Gualtieri, U, Perticone, F, Sciacqua, A, Quero, M, Bagnato, C, Loria, P, Becchi, Ma, Martucci, G, Fantuzzi, A, Maurantonio, M, Corinaldesi, R, De Giorgio, R, Serra, M, Grasso, V, Ruggeri, E, Carozza, Lm, Pignatti, F., 337. Franchi C, Salerno F, Conca A, Djade CD, Tettamanti M, Pasina L, Corrao S, Marengoni A, Marcucci M, Mannucci PM, Nobili A. REPOSI Investigator, Bernardi M, Borghi C, Strocchi E, Zoli M, Bolondi L, Corinaldesi R, De Giorgio R, Franchi C, Salerno F, Conca, A, Djade, Cd, Tettamanti, M, Pasina, L, Corrao, S, Marengoni, A, Marcucci, M, Mannucci, Pm, Nobili, A, Zanetti, Michela, Franchi, Carlotta, Salerno, Francesco, Conca, Alessio, Djade, Codjo D., Tettamanti, Mauro, Pasina, Luca, Corrao, Salvatore, Marengoni, Alessandra, Marcucci, Maura, Mannucci, Pier Mannuccio, Nobili, Alessandro, Sparacio, Eleonora, Alborghetti, Stefania, Di Costanzo, Rosa, Prisco, Domenico, Silvestri, Elena, Cenci, Caterina, Barnini, Tommaso, Delitala, Giuseppe, Carta, Stefano, Atzori, Sebastiana, Guarnieri, Gianfranco, Spalluti, Annalisa, Serra, Maria Grazia, Bleve, Maria Antonietta, Vanoli, Massimo, Grignani, Giulia, Casella, Gianluca, Gasbarrone, Laura, Maniscalco, Giorgio, Gunelli, Massimo, Tirotta, Daniela, Brucato, Antonio, Ghidoni, Silvia, Di Corato, Paola, Bernardi, Mauro, Li Bassi, Silvia, Santi, Luca, Agnelli, Giancarlo, Iorio, Alfonso, Marchesini, Emanuela, Mannarino, Elmo, Lupattelli, Graziana, Rondelli, Pamela, Paciullo, Francesco, Fabris, Fabrizio, Carlon, Michela, Turatto, Francesca, Baroni, Maria Cristina, Zardo, Marianna, Manfredini, Roberto, Molino, Christian, Pala, Marco, Fabbian, Fabio, Nuti, Ranuccio, Valenti, Roberto, Ruvio, Martina, Cappelli, Silvia, Paolisso, Giuseppe, Rizzo, Mr, Laieta, Maria Teresa, Salvatore, Teresa, Sasso, Ferdinando Carlo, Utili, Riccardo, Mangoni, Emanuele Durante, Pinto, Daniela, Olivieri, Oliviero, Stanzial, Anna Maria, Fellin, Renato, Volpato, Stefano, Fotini, Siouli, Barbagallo, Mario, Dominguez, Ligia, Plances, Lidia, D'Angelo, Daniela, Rini, Giovanbattista, Mansueto, Pasquale, Pepe, Ilenia, Licata, Giuseppe, Calvo, Luigi, Valenti, Maria, Borghi, Claudio, Strocchi, Enrico, Rinaldi, Elisa Rebecca, Zoli, Marco, Fabbri, Elisa, Magalotti, Donatella, Auteri, Alberto, Pasqui, Anna Laura, Puccetti, Luca, Pasini, Franco Laghi, Capecchi, Pier Leopoldo, Bicchi, Maurizio, SabbÃ&nbsp, Carlo, Vella, Francesco Saverio, Marseglia, Alessandro, Luglio, Chiara Valentina, Palasciano, Giuseppe, Modeo, Maria Ester, Aquilino, Annamaria, Raffaele, Pallante, Pugliese, Stefania, Capobianco, Caterina, Postiglione, Alfredo, Barbella, Maria Rosaria, De Stefano, Francesco, Fenoglio, Luigi, Brignone, Chiara, Bracco, Christian, Giraudo, Alessia, Musca, Giuseppe, Cuccurullo, Olga, Cricco, Luigi, Fiorentini, Alessandra, Cappellini, Maria Domenica, Fabio, Giovanna, Seghezzi, Sonia, De Amicis, Margherita Migone, Fargion, Silvia, Bonara, Paola, Bulgheroni, Mara, Lombardi, Rosa, Magrini, Fabio, Massari, Ferdinando, Tonella, Tatiana, Peyvandi, Flora, Tedeschi, Alberto, Rossio, Raffaella, Moreo, Guido, Ferrari, Barbara, Roncari, Luisa, Monzani, Valter, Savojardo, Valeria, Folli, Christian, Magnini, Maria, Mari, Daniela, Rossi, Paolo Dionigi, Damanti, Sarah, Prolo, Silvia, Lilleri, Maria Sole, Micale, Giuliana, Podda, Mauro, Selmi, Carlo, Meda, Francesca, Accordino, Silvia, Monti, Valentina, Corazza, Gino Roberto, Miceli, Emanuela, Lenti, Marco Vincenzo, Padula, Donatella, Balduini, Carlo L., Bertolino, Giampiera, Provini, Stella, Quaglia, Federica, Murialdo, Giovanni, Bovio, Marta, Dallegri, Franco, Ottonello, Luciano, Quercioli, Alessandra, Barreca, Alessandra, Secchi, Maria Beatrice, Ghelfi, Davide, Chin, Wu Sheng, Carassale, Laura, Caporotundo, Silvia, Anastasio, Luigi, Sofia, Lucia, Carbone, Maria, Traisci, Giancarlo, De Feudis, Lucrezia, Di Carlo, Silvia, Davã¬, Giovanni, Guagnano, Maria Teresa, Sestili, Simona, Bergami, Elisabetta, Rizzioli, Emanuela, Cagnoni, Carlo, Bertone, Luca, Manucra, Antonio, Buratti, Alberto, Tognin, Tiziana, Liberato, Nicola Lucio, Bernasconi, Giordano, Nardo, Barbara, Bianchi, Giovanni Battista, Benetti, Giampiero, Quagliolo, Michela, Centenaro, Giuseppe Riccardo, Purrello, Francesco, Di Pino, Antonino, Piro, Salvatore, Mancuso, Gerardo, Calipari, Daniela, Bartone, Mosã, Gullo, Francesco, Cortellaro, Michele, Magenta, Marina, Perego, Francesca, Meroni, Maria Rachele, Cicardi, Marco, Magenta, Antonio Gidaro Marina, Sacco, Andrea, Bonelli, Antonio, Dentamaro, Gaetano, Rozzini, Renzo, Falanga, Lina, Giordano, Alessandro, Perin, Paolo Cavallo, Lorenzati, Bartolomeo, Gruden, Gabriella, Bruno, Graziella, Montrucchio, Giuseppe, Greco, Elisabetta, Tizzani, Pietro, Fera, Giacomo, Di Luca, Maria Loreta, Renna, Donatella, Perciccante, Antonio, Coralli, Alessia, Tassara, Rodolfo, Melis, Deborah, Rebella, Lara, Menardo, Giorgio, Bottone, Stefania, Sferrazzo, Elsa, Ferri, Claudio, Striuli, Rinaldo, Scipioni, Rosa, Salmi, Raffaella, Gaudenzi, Piergiorgio, Gamberini, Susanna, Ricci, Franco, Morabito, Cosimo, Fava, Roberto, Semplicini, Andrea, Gottardo, Lucia, Vendemiale, Gianluigi, Serviddio, Gaetano, Forlano, Roberta, Bolondi, Luigi, Rasciti, Leonardo, Serio, Ilaria, Masala, Cesare, Mammarella, Antonio, Raparelli, Valeria, Fanelli, Filippo Rossi, Delfino, Massimo, Amoroso, Antonio, Violi, Francesco, Basili, Stefania, Perri, Ludovica, Serra, Pietro, Fontana, Vincenzo, Falcone, Marco, Landolfi, Raffaele, Grieco, Antonio, Gallo, Antonella, ZuccalÃ&nbsp, Giuseppe, Franceschi, Francesco, De Marco, Guido, Chiara, Cordischi, Marta, Sabbatini, Bellusci, Martino, Setti, Donatella, Pedrazzoli, Filippo, Romanelli, Giuseppe, Pirali, Caterina, Amolini, Claudia, Rosei, Enrico Agabiti, Rizzoni, Damiano, Castoldi, Luana, Picardi, Antonio, Gentilucci, Umberto Vespasiani, Mazzarelli, Chiara, Gallo, Paolo, Guasti, Luigina, Castiglioni, Luana, Maresca, Andrea, Squizzato, Alessandro, Contini, Sara, Molaro, Marta, Annoni, Giorgio, Corsi, Maurizio, Zazzetta, Sara, Bertolotti, Marco, Mussi, Chiara, Scotto, Roberto, Ferri, Maria Alice, Veltri, Francesca, Arturi, Franco, Succurro, Elena, Sesti, Giorgio, Gualtieri, Umberto, Perticone, Francesco, Sciacqua, Angela, Quero, Michele, Bagnato, Chiara, Loria, Paola, Becchi, Maria Angela, Martucci, Gianfranco, Fantuzzi, Alessandra, Maurantonio, Mauro, Corinaldesi, Roberto, De Giorgio, Roberto, Serra, Mauro, Grasso, Valentina, Ruggeri, Eugenio, Carozza, Lorenzo Mauro, Pignatti, Fabio, Franchi, C, Salerno, F, Djade, C, Mannucci, P, Prisco, D, Silvestri, E, Cenci, C, Barnini, T, Delitala, G, Carta, S, Attori, S, Guarnieri, G, Zanetti, M, Spallati, A, Serra, M, Bleve, M, Vanoli, M, Grignani, G, Casella, G, Gasbarrone, L, Maniscalco, G, Gunelli, M, Tirotta, D, Brucato, A, Ghidoni, S, Di Corato, P, Bernardi, M, Li Bassi, S, Santi, L, Agnelli, G, Iorio, A, Marchesini, E, Mannarino, E, Lupattelli, G, Rondelli, P, Maciullo, F, Fabris, F, Carlon, M, Turatto, F, Baroni, M, Zardo, M, Manfredini, R, Molino, C, Pala, M, Fabbian, F, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Paolisso, G, Rizzo, M, Laieta, M, Salvatore, T, Sasso, F, Utili, R, Durante Mangoni, E, Pinto, D, Olivieri, O, Stanzial, A, Fellin, R, Volpato, S, Fotini, S, Barbagallo, M, Dominguez, L, Plances, L, D'Angelo, D, Rini, G, Mansueto, P, Pepe, I, Licata, G, Calvo, L, Valenti, M, Borghi, C, Strocchi, E, Rinaldi, E, Zoli, M, Fabbri, E, Magalotti, D, Auteri, A, Pasqui, A, Puccetti, L, Laghi Pasini, F, Capecchi, P, Bicchi, M, Sabbà, C, Vella, F, Marseglia, A, Luglio, C, Palasciano, G, Modeo, M, Aquilino, A, Raffaele, P, Pugliese, S, Capobianco, C, Postiglione, A, Barbella, M, De Stefano, F, Fenoglio, L, Brignone, C, Bracco, C, Girando, A, Musca, G, Cuccurullo, O, Cricco, L, Fiorentini, A, Cappellini, M, Fabio, G, Seghezzi, S, Migone De Amicis, M, Fargion, S, Bonara, P, Bulgheroni, M, Lombardi, R, Magrini, F, Massari, F, Tonella, T, Peyvandi, F, Tedeschi, A, Rossio, R, Moreo, G, Ferrari, B, Roncari, L, Monzani, V, Savojardo, V, Folli, C, Magnini, M, Mari, D, Rossi, P, Damanti, S, Prolo, S, Lilleri, M, Micale, G, Podda, M, Selmi, C, Meda, F, Accordino, S, Monti, A, Corazza, G, Miceli, E, Lenti, M, Padula, D, Balduini, C, Bertolino, G, Provini, S, Quaglia, F, Murialdo, G, Bovio, M, Dallegri, F, Ottonello, L, Quercioli, A, Barreca, A, Secchi, M, Guelfi, D, Chin, W, Carassale, L, Caporotundo, S, Anastasio, L, Sofia, L, Carbone, M, Traisci, G, De Feudis, L, Di Carlo, S, Davì, G, Guagnano, M, Sestili, S, Bergami, E, Rizzioli, E, Cagnoni, C, Bertone, L, Manucra, A, Buratti, A, Tognin, T, Liberato, N, Bernasconi, G, Nardo, B, Bianchi, G, Giaquinto, S, Benetti, G, Quagliolo, M, Centenaro, G, Purrello, F, Di Pino, A, Piro, S, Mancuso, G, Calipari, D, Bartone, M, Gullo, F, Cortellaro, M, Magenta, M, Perego, F, Meroni, M, Cicardi, M, Gigaro, A, Sacco, A, Bonelli, A, Dentamaro, G, Rozzini, R, Falanga, L, Giordano, A, Cavallo Perin, P, Lorenzati, B, Gruden, G, Bruno, G, Montrucchio, G, Greco, E, Tizzoni, P, Fera, G, Di Luca, M, Renna, D, Perciccante, A, Coralli, A, Tassara, R, Melis, D, Rebella, L, Menardo, G, Bottone, S, Sferruzzo, E, Ferri, C, Striuli, R, Scipioni, R, Salmi, R, Gaudenzi, P, Gamberini, S, Ricci, R, Morabito, C, Fava, R, Semplicini, A, Gottardo, L, Vendemiale, G, Serviddio, G, Forlano, R, Bolondi, L, Rasciti, L, Serio, I, Masala, C, Mammarella, A, Raparelli, V, Rossi Fanelli, F, Delfino, M, Amoroso, A, Violi, F, Basili, S, Perri, L, Serra, P, Fontana, V, Falcone, M, Landolfi, R, Grieco, A, Gallo, A, Zuccalà, G, Franceschi, F, De Marco, G, Chiara, C, Marta, S, Bellusci, M, Setti, D, Pedrazzoli, F, Romanelli, G, Pirali, C, Amolini, C, Agabiti Rosei, E, Rizzoni, D, Castoldi, L, Picardi, A, Vespasiani Gentilucci, U, Mazzarelli, C, Gallo, P, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Contini, S, Molaro, M, Annoni, G, Corsi, M, Zazzetta, S, Bertolotti, M, Mussi, C, Scotto, R, Ferri, M, Veltri, F, Arturi, F, Succurro, E, Sesti, G, Gualtieri, U, Perticone, F, Sciacqua, A, Quero, M, Bagnato, C, Loria, P, Becchi, M, Martucci, G, Fantuzzi, A, Maurantonio, M, Corinaldesi, R, De Giorgio, R, Grasso, V, Ruggeri, E, Carozza, L, Pignatti, F, Franchi, C., Salerno, F., Conca, A., Djade, C., Tettamanti, M., Pasina, L., Corrao, S., Marengoni, A., Marcucci, M., Mannucci, P., Nobili, A., and Mansueto, P.

Subjects
Male, Kidney Disease, Settore MED/09 - Medicina Interna, hyperuricemia, Comorbidities, chemistry.chemical_compound, Cardiovascular Disease, gout, elderly, Allopurinol, Elderly, Gout, Hyperuricemia, Outcomes, Age Factors, Aged, Aged, 80 and over, Cardiovascular Diseases, Chronic Disease, Comorbidity, Female, Hospital Mortality, Hospitalization, Humans, Kidney Diseases, Length of Stay, Treatment Outcome, Uric Acid, Internal Medicine, Medicine (all), 80 and over, Medicine, Age Factor, Outcome, OUTCOMES, comorbidity, Cohort, Comorbiditie, Human, medicine.drug, musculoskeletal diseases, medicine.medical_specialty, congenital, hereditary, and neonatal diseases and abnormalities, allopurinol, NO, gout, Gout, allopurinol, hyperuricemia, comorbidities, outcomes, elderly, Internal medicine, Risk factor, Intensive care medicine, Adverse effect, ELDERLY, gout, allopurinol, hyperuricemia, comorbidities, outcomes, elderly, business.industry, nutritional and metabolic diseases, medicine.disease, chemistry, Uric acid, business
Abstract

Background: Increased serum uric acid has been considered a cardiovascular risk factor but no study has assessed its relation with hospital mortality or length of stay. On the basis of data obtained from a prospective registry, the prevalence of gout/hyperuricemia and its association with these and other clinical parameters was evaluated in an Italian cohort of elderly patients acutely admitted to internal medicine or geriatric wards. Methods: While the prevalence of gout was calculated by counting patients with this diagnosis hyperuricemia was inferred in patients taking allopurinol at hospital admission or discharge, on the assumption that this drug was only prescribed owing to the finding of high serum levels of uric acid. A series of clinical and demographic variables were evaluated for their association with gout/hyperuricemia. Results: Of 1380 patients, 139 (10%) had a diagnosis of gout or were prescribed allopurinol. They had more co-morbidities (7.0 vs 5.6; P < 0.0001) and consumed more drugs (6.8 vs 5.0; < b 0.0001). The CIRS (co-morbidity index) was worse in these patients (OR 1.28 95% CI 1.15-1.41). Multivariable regression analysis showed that only renal and heart failures were independently associated with gout/allopurinol intake. Moreover, this combined event was associated with an increased risk of adverse events during hospitalization (OR 1.66, 95% CI 1.16-2.36), but not with the risk of re-hospitalization, length of hospital stay or death. Conclusions: Gout/allopurinol intake has a high prevalence in elderly patients acutely admitted to hospital and are associated with renal and cardiovascular diseases, an increased rate of adverse events and a high degree of drug consumption. In contrast, this finding did not affect the length of hospitalization nor hospital mortality.

Published
2014

36. 7. INAPPROPRIATE PRESCRIPTION OF ALLOPURINOL AND FEBUXOSTAT AND RISK OF ADVERSE EVENTS IN THE ELDERLY: RESULTS FROM THE REPOSI REGISTRY

Author

Pasina, L, Brucato, AL, Djade, CD, Di Corato, P, Ghidoni, S, Tettamanti, M, Franchi, C, Salerno, F, CORRAO, Salvatore, Marengoni, A, Marcucci, M, Mannucci, PM, Nobili, A, REPOSI, Investigators, BARBAGALLO, Mario, DOMINGUEZ RODRIGUEZ, Ligia Juliana, Pasina, L, Brucato, AL, Djade, CD, Di Corato, P, Ghidoni, S, Tettamanti, M, Franchi, C, Salerno, F, Corrao, S, Marengoni, A, Marcucci, M, Mannucci, PM, Nobili, A, REPOSI, Investigator, Barbagallo, M, and Dominguez Rodriguez, LJ

Subjects
Settore MED/09 - Medicina Interna, Aged . Pharmacoepidemiology . Allopurinol
Abstract

Purpose To investigate the prevalence of xanthine oxidase (XO) inhibitors prescription at admission and discharge in elderly hospital in-patients, to analyze the appropriateness of their use in relation to evidence-based indications, to evaluate the predictors of inappropriate prescription at discharge and the association with adverse events 3 months after hospital discharge. Methods This cross-sectional study, based upon a prospective registry, was held in 95 Italian internal medicine and geriatric hospital wards. The sample included 4035 patients aged 65 years or older at admission and 3502 at discharge. The prescription of XO inhibitors was considered appropriate in patients with diagnosis of gout, gout nephropathy, uric acid nephrolithiasis, tophi, and chemotherapy-induced hyperurice-mia. In order to evaluate the predictors of inappropriate pre-scription of XO inhibitors, we compared the characteristics of patients considered inappropriately treated with those appro-priately not treated. Results Among the 4035 patients eligible for the analysis, 467 (11.6 %) were treated with allopurinol or febuxostat at hospital admission and 461 (13.2 %) among 3502 patients discharged. At admission, 39 (8.6 %) of patients receiving XO inhibitors and 43 (9.4 %) at discharge were appropriately treated. Among those inappropriately treated, hyperuricemia, polytherapy, chronic renal failure, diabetes, obesity, ischemic cardiomyopathy, heart failure, and cardiac dysrhythmias were associated with greater prescription of XO inhibitors. Pre-scription of XO inhibitors was associated with a higher risk of adverse clinical events in univariate and multivariate analysis. Conclusions Prevalence of inappropriate prescription of XO inhibitors remained almost the same at admission and dis-charge. Inappropriate use of these drugs is principally related to treatment of asymptomatic hyperuricemia and various car-diovascular diseases.

Published
2014

37. Prognostic value of estimated glomerular filtration rate in hospitalized elderly patients

Author

De La Higuera, L, Riva, E, Djade, Cd, Mandelli, S, Franchi, C, Marengoni, A, Salerno, F, Corrao, S, Pasina, L, Tettamanti, M, Marcucci, M, Mannucci, Pm, Nobili, A, Reposi, Investigators, Manfredini, Roberto, Volpato, Stefano, and Fabbian, Fabio

Subjects
multicenter study, in-hospital elderly patients, comorbidity, polypharmacy, eGFR
Published
2014

38. Brain and kidney, victims of atrial microembolism in elderly hospitalized patients? Data from the REPOSI study

Author

Corrao, S, Argano, C, Nobili, A, Marcucci, M, Djade, CD, Tettamanti, M, Pasina, L, Franchi, C, Marengoni, A, Salerno, F, Violi, F, REPOSI Investigators, GRIECO, ANTONIO, Mannucci, PM, Perticone, F, Corrao, S, Argano, C, Nobili, A, Marcucci, M, Djade, CD, Tettamanti, M, Pasina, L, Franchi, C, Marengoni, A, Salerno, F, Violi, F, REPOSI Investigators, GRIECO, ANTONIO, Mannucci, PM, and Perticone, F

Published
2015

39. PROGNOSTIC VALUE OF ESTIMATED GLOMERULAR FILTRATION RATE IN HOSPITALIZED ELDERLY PATIENTS

Author

De La Higuera, L, Riva, E, Djade, CD, Mandelli, S, Franchi, C, Marengoni, A, Salerno, F, CORRAO, Salvatore, Pasina, L, Tettamanti, M, Marcucci, M, Mannucci, PM, Nobili, A, REPOSI, investigators, BARBAGALLO, Mario, DOMINGUEZ RODRIGUEZ, Ligia Juliana, De La Higuera, L, Riva, E, Djade, CD, Mandelli, S, Franchi, C, Marengoni, A, Salerno, F, Corrao, S, Pasina, L, Tettamanti, M, Marcucci, M, Mannucci, PM, Nobili, A, REPOSI, investigator, Barbagallo, M, and Dominguez Rodriguez, LJ

Subjects
Settore MED/09 - Medicina Interna, Multicenter study, in-hospital elderly patients, comorbidity, polypharmacy, eGFR
Abstract

A multicenter observational study, REPOSI (REgustri POliterapie Società Italiana di Medicina Interna), was conducted to assess the prognostic value of glomerular filtration rate (eGFR) on in-hospital mortality, hospital readmission and death within 3 months, in a sample of elderly patients (n=1,363) admitted to 66 internal medicine and geriatric wards. Bases on eGFR, calculated by the new Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula, subjects at hostpital admission were classified into three groups: group 1 with normal eGFR (60 ml/min/1.73m2, reference group), group 2 with moderately reduced eGFR (30-59 ml/min/1.73 m2) and group 3 with severely reduced eGFR (

Published
2013

40. Joint use of cardio-embolic and bleeding risk scores in elderly patients with atrial fibrillation

Author

Marcucci, M, Nobili, A, Tettamanti, M, Iorio, A, Pasina, L, Djade, Cd, Franchi, C, Marengoni, A, Salerno, F, Corrao, S, Violi, F, Mannucci, Pm, Reposi, Investigators, Pier, Mm, Spirito, V, Noce, D, Bonazzi, J, Lombardo, R, Sparacio, E, Alborghetti, S, De Vittorio, L, Prisco, D, Silvestri, E, Cenci, C, Barnini, T, Delitala, G, Carta, S, Atzori, S, Guarnieri, G, Zanetti, M, Spalluti, A, Serra, Mg, Bleve, Ma, Vanoli, M, Grignani, G, Casella, G, Gasbarrone, L, Maniscalco, G, Gunelli, M, Tirotta, D, Brucato, A, Ghidoni, S, Di Corato, P, Bernardi, M, Li Bassi, S, Santi, L, Agnelli, G, Marchesini, E, Mannarino, E, Lupattelli, G, Rondelli, P, Paciullo, F, Fabris, F, Carlon, M, Turatto, F, Baroni, Mc, Zardo, M, Manfredini, R, Molino, C, Pala, M, Fabbian, F, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Paolisso, G, Rizzo, Mr, Laieta, Mt, Salvatore, T, Sasso, Fc, Utili, R, Durante Mangoni, E, Pinto, D, Olivieri, O, Stanzial, Am, Fellin, R, Volpato, S, Fotini, S, Barbagallo, M, Dominguez, L, Plances, L, D'Angelo, D, Rini, G, Mansueto, P, Pepe, I, Licata, G, Calvo, L, Valenti, M, Borghi, C, Strocchi, E, Rinaldi, Er, Zoli, M, Fabbri, E, Magalotti, D, Auteri, A, Pasqui, Al, Puccetti, L, Pasini, Fl, Capecchi, Pl, Bicchi, M, Sabbà, C, Vella, Fs, Marseglia, A, Luglio, Cv, Palasciano, G, Modeo, Me, Aquilino, A, Raffaele, P, Pugliese, S, Capobianco, C, Postiglione, A, Barbella, Mr, De Stefano, F, Fenoglio, L, Brignone, C, Bracco, C, Giraudo, A, Musca, G, Cuccurullo, O, Cricco, L, Fiorentini, A, Cappellini, Md, Fabio, G, Seghezzi, S, De Amicis MM, Fargion, S, Bonara, P, Bulgheroni, M, Lombardi, R, Magrini, F, Massari, F, Tonella, T, Peyvandi, F, Tedeschi, A, Rossio, R, Moreo, G, Ferrari, B, Roncari, L, Monzani, V, Savojardo, V, Folli, C, Magnini, M, Mari, D, Dionigi Rossi, P, Damanti, S, Prolo, S, Lilleri, Ms, Micale, G, Podda, M, Selmi, C, Meda, F, Accordino, S, Conca, A, Monti, V, Corazza, Gr, Miceli, E, Lenti, Mv, Padula, D, Balduini, Cl, Bertolino, G, Provini, S, Quaglia, F, Murialdo, G, Bovio, M, Dallegri, F, Ottonello, L, Quercioli, A, Barreca, A, Secchi, Mb, Ghelfi, D, Chin, Ws, Carassale, L, Caporotundo, S, Sofia, L, Anastasio, L, Carbone, M, Traisci, G, De Feudis, L, Di Carlo, S, Guagnano, Mt, Sestili, S, Bergami, E, Rizzioli, E, Cagnoni, C, Bertone, L, Manucra, A, Buratti, A, Tognin, T, Liberato, Nl, Bernasconi, G, Nardo, B, Bianchi, Gb, Giaquinto, S, Benetti, G, Quagliolo, M, Centenaro, Gr, Purrello, Francesco, Di Pino, A, Piro, Salvatore, Mancuso, G, Calipari, D, Bartone, M, Gullo, F, Cortellaro, M, Magenta, M, Perego, F, Meroni, Mr, Cicardi, M, Magenta, Ag, Sacco, A, Bonelli, A, Dentamaro, G, Rozzini, R, Falanga, L, Giordano, A, Perin, Pc, Lorenzati, B, Gruden, G, Bruno, G, Montrucchio, G, Greco, E, Tizzani, P, Fera, G, Di Luca ML, Renna, D, Perciccante, A, Coralli, A, Tassara, R, Melis, D, Rebella, L, Menardo, G, Bottone, S, Sferrazzo, E, Ferri, C, Striuli, R, Scipioni, R, Salmi, R, Gaudenzi, P, Gamberini, S, Ricci, F, Morabito, C, Fava, R, Semplicini, A, Gottardo, L, Vendemiale, G, Serviddio, G, Forlano, R, Bolondi, L, Rasciti, L, Serio, I, Masala, C, Mammarella, A, Raparelli, V, Rossi Fanelli, F, Delfino, M, Amoroso, A, Basili, S, Perri, L, Serra, P, Fontana, V, Falcone, M, Landolfi, R, Grieco, A, Gallo, A, Zuccalà, G, Franceschi, F, De Marco, G, Chiara, C, Marta, S, Bellusci, M, Setti, D, Pedrazzoli, F, Romanelli, G, Pirali, C, Amolini, C, Rosei, Ea, Rizzoni, D, Castoldi, L, Picardi, A, Gentilucci, Uv, Mazzarelli, C, Gallo, P, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Contini, S, Molaro, M, Annoni, G, Zazzetta, Mc, Bertolotti, M, Scotto, Cm, Ferri, Ma, Veltri, F, Arturi, F, Succurro, E, Sesti, G, Gualtieri, U, Perticone, F, Sciacqua, A, Quero, M, Bagnato, C, Loria, P, Becchi, Ma, Martucci, G, Fantuzzi, A, Maurantonio, M, Corinaldesi, R, De Giorgio, R, Serra, M, Grasso, V, Ruggeri, E, Carozza, Lm, Pignatti, F., Maura Marcuccia, Alessandro Nobili, Mauro Tettamanti, Alfonso Iorio, Luca Pasina, Codjo D. Djade, Carlotta Franchi, Alessandra Marengoni, Francesco Salerno, Salvatore Corrao, Francesco Violi, Pier Mannuccio Mannucci, REPOSI Investigators1 […, Corinaldesi Roberto, Strocchi Enrico, Borghi Claudio, Bolondi Luigi, Zoli Marco, De Giorgio Roberto, Bernardi Mauro, …], Marcucci, Maura, Nobili, Alessandro, Tettamanti, Mauro, Iorio, Alfonso, Pasina, Luca, Djade, Codjo D., Franchi, Carlotta, Marengoni, Alessandra, Salerno, Francesco, Corrao, Salvatore, Violi, Francesco, Mannucci, Pier o, Zanetti, Michela, Investigators, Reposi, Marcucci, M, Nobili, A, Tettamanti, M, Iorio, A, Pasina, L, Djade, Cd, Franchi, C, Marengoni, A, Salerno, F, Corrao, S, Violi, F, Mannucci, Pm, Reposi, Investigator, Postiglione, Alfredo, PAGANO LEONETTI GIANNI MANNUCCI, Paolo, Pier, Mannuccio, Rizzo, Mr, Djade, C, Mannucci, P, and Annoni, G

Subjects
Registrie, Male, Embolism, Atrial fibrillation, Bleeding risk, Cardioembolic risk, Elderly, Prediction guides, Thromboprophylaxis, Aged, 80 and over, Anticoagulants, Atrial Fibrillation, Female, Hemorrhage, Humans, Logistic Models, Platelet Aggregation Inhibitors, Retrospective Studies, Stroke, Warfarin, Registries, Risk Assessment, Internal Medicine, Retrospective Studie, aritmia, bleeding risk score, atrial fibrillation, Aged, 80 and over, Aspirin, education.field_of_study, Elderly, Atrial fibrillation, Prediction guides, Bleeding risk, Cardioembolic risk, Thromboprophylaxis, Cardiovascular disease, cardio-embolic score, Platelet aggregation inhibitor, cardio-embolic scores, bleeding risk scores, elderly, Risk assessment, medicine.drug, Human, medicine.medical_specialty, Logistic Model, Population, CARDIOEMBOLIC RISK, NO, BLEEDING RISK, Internal medicine, medicine, Prediction guide, education, ELDERLY, business.industry, Platelet Aggregation Inhibitor, Settore MED/09 - MEDICINA INTERNA, Anticoagulant, Retrospective cohort study, medicine.disease, Surgery, Thromboprophylaxi, business
Abstract

Background Scores for cardio-embolic and bleeding risk in patients with atrial fibrillation are described in the literature. However, it is not clear how they co-classify elderly patients with multimorbidity, nor whether and how they affect the physician's decision on thromboprophylaxis. Methods Four scores for cardio-embolic and bleeding risks were retrospectively calculated for ≥ 65 year old patients with atrial fibrillation enrolled in the REPOSI registry. The co-classification of patients according to risk categories based on different score combinations was described and the relationship between risk categories tested. The association between the antithrombotic therapy received and the scores was investigated by logistic regressions and CART analyses. Results At admission, among 543 patients the median scores (range) were: CHADS22 (0-6), CHA2DS2-VASc 4 (1-9), HEMORR2HAGES 3 (0-7), HAS-BLED 2 (1-6). Most of the patients were at high cardio-embolic/high-intermediate bleeding risk (70.5% combining CHADS2and HEMORR2HAGES, 98.3% combining CHA2DS2-VASc and HAS-BLED). 50-60% of patients were classified in a cardio-embolic risk category higher than the bleeding risk category. In univariate and multivariable analyses, a higher bleeding score was negatively associated with warfarin prescription, and positively associated with aspirin prescription. The cardio-embolic scores were associated with the therapeutic choice only after adjusting for bleeding score or age. Conclusion REPOSI patients represented a population at high cardio-embolic and bleeding risks, but most of them were classified by the scores as having a higher cardio-embolic than bleeding risk. Yet, prescription and type of antithrombotic therapy appeared to be primarily dictated by the bleeding risk. © 2013 European Federation of Internal Medicine.

Published
2013

41. Prophylaxis of venous thromboembolism in elderly patients with multimorbidity

Author

Marcucci, M., Iorio, A., Nobili, A., Tettamanti, M., Pasina, L., Djade, Cd, Marengoni, A., Salerno, F., Corrao, S., Mannucci, Pm, Reposi, Investigators, Mannucci, M., Franchi, C., Sparacio, E., Alborghetti, S., Di Costanzo, R., Prisco, D., Silvestri, E., Cenci, C., Barnini, T., Delitala, G., Carta, S., Atzori, S., Guarnieri, G., Zanetti, M., Spalluti, A., Serra, Mg, Bleve, Ma, Di Corato, P., Vanoli, M., Grignani, G., Casella, G., Gasbarrone, L., Maniscalco, G., Gunelli, M., Tirotta, D., Brucato, A., Ghidoni, S., Bernardi, M., Li Bassi, S., Santi, L., Agnelli, G., Marchesini, E., Mannarino, E., Lupattelli, G., Rondelli, P., Paciullo, F., Fabris, F., Carlon, M., Turatto, F., Baroni, Mc, Zardo, M., Manfredini, R., Molino, C., Pala, M., Fabbian, F., Nuti, R., Valenti, R., Ruvio, M., Cappelli, S., Paolisso, G., Rizzo, MR, Laieta, Mt, Salvatore Piro, Sasso, Fc, Utili, R., Durante Mangoni, E., Pinto, D., Olivieri, O., Stanzial, Am, Fellin, R., Volpato, S., Fotini, S., Barbagallo, M., Dominguez, L., Plances, L., Dangelo, D., Rini, G., Mansueto, P., Pepe, I., Licata, G., Calvo, L., Valenti, M., Borghi, C., Strocchi, E., Rinaldi, Er, Zoli, M., Fabbri, E., Magalotti, D., Auteri, A., Pasqui, Al, Puccetti, L., Pasini, Fl, Capecchi, Pl, Bicchi, M., Sabbà, C., Vella, Fs, Marseglia, A., Luglio, Cv, Palasciano, G., Modeo, Me, Aquilino, A., Raffaele, P., Pugliese, S., Capobianco, C., Postiglione, A., Barbella, MR, Stefano, F., Fenoglio, L., Brignone, C., Bracco, C., Giraudo, A., Musca, G., Cuccurullo, O., Cricco, L., Fiorentini, A., Cappellini, Md, Fabio, G., Seghezzi, S., De Amicis MM, Fargion, S., Bonara, P., Bulgheroni, M., Lombardi, R., Magrini, F., Massari, F., Tonella, T., Peyvandi, F., Tedeschi, A., Rossio, R., Moreo, G., Ferrari, B., Roncari, L., Monzani, V., Savojardo, V., Folli, C., Magnini, M., Mari, D., Rossi, Pd, Damanti, S., Prolo, S., Lilleri, Ms, Micale, G., Podda, M., Selmi, C., Meda, F., Accordino, S., Conca, A., Monti, V., Corazza, Gr, Miceli, E., Lenti, Mv, Padula, D., Balduini, Cl, Bertolino, G., Provini, S., Quaglia, F., Murialdo, G., Bovio, M., Dallegri, F., Ottonello, L., Quercioli, A., Barreca, A., Secchi, Mb, Ghelfi, D., Chin, Ws, Carassale, L., Caporotundo, S., Sofia, L., Anastasio, L., Carbone, M., Di Carlo, S., Traisci, G., Feudis, L., Davì, G., Guagnano, Mt, Sestili, S., Bergami, E., Rizzioli, E., Cagnoni, C., Bertone, L., Manucra, A., Buratti, A., Tognin, T., Liberato, Nl, Bernasconi, G., Nardo, B., Bianchi, Gb, Benetti, G., Quagliolo, M., Centenaro, Gr, Purrello, Francesco Salvatore, Antonino Di Pino, Piro S., Mancuso, G., Calipari, D., Bartone, M., Gullo, F., Cortellaro, M., Magenta, M., Perego, F., Meroni, MR, Cicardi, M., Magenta, Ag, Sacco, A., Bonelli, A., Dentamaro, G., Rozzini, R., Falanga, L., Giordano, A., Perin, Pc, Lorenzati, B., Gruden, G., Bruno, G., Montrucchio, G., Greco, E., Tizzani, P., Fera, G., Di Luca ML, Renna, D., Perciccante, A., Coralli, A., Tassara, R., Melis, D., Rebella, L., Menardo, G., Bottone, S., Sferrazzo, E., Ferri, C., Striuli, R., Scipioni, R., Salmi, R., Gaudenzi, P., Gamberini, S., Ricci, F., Morabito, C., Fava, R., Semplicini, A., Gottardo, L., Vendemiale, G., Serviddio, G., Forlano, R., Bolondi, L., Rasciti, L., Serio, I., Masala, C., Mammarella, A., Raparelli, V., Rossi Fanelli, F., Delfino, M., Amoroso, A., Violi, F., Basili, S., Perri, L., Serra, P., Fontana, V., Falcone, M., Landolfi, R., Grieco, A., Gallo, A., Zuccalà, G., Franceschi, F., Marco, G., Chiara, C., Marta, S., Bellusci, M., Setti, D., Pedrazzoli, F., Romanelli, G., Pirali, C., Amolini, C., Rosei, Ea, Rizzoni, D., Castoldi, L., Picardi, A., Gentilucci, Uv, Mazzarelli, C., Gallo, P., Guasti, L., Castiglioni, L., Maresca, A., Squizzato, A., Contini, S., Molaro, M., Annoni, G., Zazzetta, Mc, Bertolotti, M., Scotto, Cm, Ferri, Ma, Veltri, F., Arturi, F., Succurro, E., Sesti, G., Gualtieri, U., Perticone, F., Sciacqua, A., Quero, M., Bagnato, C., Loria, P., Becchi, Ma, Martucci, G., Fantuzzi, A., Maurantonio, M., Corinaldesi, R., Giorgio, R., Serra, M., Grasso, V., Ruggeri, E., Carozza, Lm, Pignatti, F., Maura, Marcucci, Alfonso, Iorio, Alessandro, Nobili, Mauro, Tettamanti, Luca, Pasina, Codjo Djignefa, Djade, Alessandra, Marengoni, Francesco, Salerno, Salvatore, Corrao, Pier Mannuccio, Mannucci, Zanetti, Michela, DIPARTIMENTO DI SCIENZE MEDICHE E CHIRURGICHE, Facolta' di MEDICINA e CHIRURGIA, Da definire, AREA MIN. 06 - Scienze mediche, Mannucci, M, Nobili, A, Tettamanti, M, Pasina, L, Franchi, C, Salerno, F, Corrao, S, Marengoni, A, Iorio, A, Marcucci, M, Sparacio, E, Alborghetti, S, Di Costanzo, R, Djade, C, Prisco, D, Silvestri, E, Cenci, C, Barnini, T, Delitala, G, Carta, S, Atzori, S, Guarnieri, G, Zanetti, M, Spalluti, A, Serra, M, Bleve, M, Di Corato, P, Vanoli, M, Grignani, G, Casella, G, Gasbarrone, L, Maniscalco, G, Gunelli, M, Tirotta, D, Brucato, A, Ghidoni, S, Bernardi, M, Li Bassi, S, Santi, L, Agnelli, G, Marchesini, E, Mannarino, E, Lupattelli, G, Rondelli, P, Paciullo, F, Fabris, F, Carlon, M, Turatto, F, Baroni, M, Zardo, M, Manfredini, R, Molino, C, Pala, M, Fabbian, F, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Paolisso, G, Rizzo, M, Laieta, M, Salvatore, T, Sasso, F, Utili, R, Durante Mangoni, E, Pinto, D, Olivieri, O, Stanzial, A, Fellin, R, Volpato, S, Fotini, S, Barbagallo, M, Dominguez, L, Plances, L, Dangelo, D, Rini, G, Mansueto, P, Pepe, I, Licata, G, Calvo, L, Valenti, M, Borghi, C, Strocchi, E, Rinaldi, E, Zoli, M, Fabbri, E, Magalotti, D, Auteri, A, Pasqui, A, Puccetti, L, Pasini, F, Capecchi, P, Bicchi, M, Sabbà, C, Vella, F, Marseglia, A, Luglio, C, Palasciano, G, Modeo, M, Aquilino, A, Raffaele, P, Pugliese, S, Capobianco, C, Postiglione, A, Barbella, M, De Stefano, F, Fenoglio, L, Brignone, C, Bracco, C, Giraudo, A, Musca, G, Cuccurullo, O, Cricco, L, Fiorentini, A, Cappellini, M, Fabio, G, Seghezzi, S, De Amicis, M, Fargion, S, Bonara, P, Bulgheroni, M, Lombardi, R, Magrini, F, Massari, F, Tonella, T, Peyvandi, F, Tedeschi, A, Rossio, R, Moreo, G, Ferrari, B, Roncari, L, Monzani, V, Savojardo, V, Folli, C, Magnini, M, Mari, D, Rossi, P, Damanti, S, Prolo, S, Lilleri, M, Micale, G, Podda, M, Selmi, C, Meda, F, Accordino, S, Conca, A, Monti, V, Corazza, G, Miceli, E, Lenti, M, Padula, D, Balduini, C, Bertolino, G, Provini, S, Quaglia, F, Murialdo, G, Bovio, M, Dallegri, F, Ottonello, L, Quercioli, A, Barreca, A, Secchi, M, Ghelfi, D, Chin, W, Carassale, L, Caporotundo, S, Sofia, L, Anastasio, L, Carbone, M, Di Carlo, S, Traisci, G, De Feudis, L, Davì, G, Guagnano, M, Sestili, S, Bergami, E, Rizzioli, E, Cagnoni, C, Bertone, L, Manucra, A, Buratti, A, Tognin, T, Liberato, N, Bernasconi, G, Nardo, B, Bianchi, G, Benetti, G, Quagliolo, M, Centenaro, G, Purrello, F, Di Pino, A, Piro, S, Mancuso, G, Calipari, D, Bartone, M, Gullo, F, Cortellaro, M, Magenta, M, Perego, F, Meroni, M, Cicardi, M, Magenta, A, Sacco, A, Bonelli, A, Dentamaro, G, Rozzini, R, Falanga, L, Giordano, A, Perin, P, Lorenzati, B, Gruden, G, Bruno, G, Montrucchio, G, Greco, E, Tizzani, P, Fera, G, Di Luca, M, Renna, D, Perciccante, A, Coralli, A, Tassara, R, Melis, D, Rebella, L, Menardo, G, Bottone, S, Sferrazzo, E, Ferri, C, Striuli, R, Scipioni, R, Salmi, R, Gaudenzi, P, Gamberini, S, Ricci, F, Morabito, C, Fava, R, Semplicini, A, Gottardo, L, Vendemiale, G, Serviddio, G, Forlano, R, Bolondi, L, Rasciti, L, Serio, I, Masala, C, Mammarella, A, Raparelli, V, Rossi Fanelli, F, Delfino, M, Amoroso, A, Violi, F, Basili, S, Perri, L, Serra, P, Fontana, V, Falcone, M, Landolfi, R, Grieco, A, Gallo, A, Zuccalà, G, Franceschi, F, De Marco, G, Chiara, C, Marta, S, Bellusci, M, Setti, D, Pedrazzoli, F, Romanelli, G, Pirali, C, Amolini, C, Rosei, E, Rizzoni, D, Castoldi, L, Picardi, A, Gentilucci, U, Mazzarelli, C, Gallo, P, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Contini, S, Molaro, M, Annoni, G, Zazzetta, S, Bertolotti, M, Scotto, C, Ferri, M, Veltri, F, Arturi, F, Succurro, E, Sesti, G, Gualtieri, U, Perticone, F, Sciacqua, A, Quero, M, Bagnato, C, Loria, P, Becchi, M, Martucci, G, Fantuzzi, A, Maurantonio, M, Corinaldesi, R, De Giorgio, R, Grasso, V, Ruggeri, E, Carozza, L, Pignatti, F, Marcucci, M., Iorio, A., Nobili, A., Tettamanti, M., Pasina, L., Djade, C., Marengoni, A., Salerno, F., Corrao, S., Mannucci, P., Mansueto, P., Djade, Cd, Mannucci, Pm, Reposi, Investigator, Postiglione, Alfredo, Marcucci M, Iorio A, Nobili A, Tettamanti M, Pasina L, Djade CD, Marengoni A, Salerno F, Corrao S, Mannucci PM, Mannucci M, Franchi C, Sparacio E, Alborghetti S, Di Costanzo R, Prisco D, Silvestri E, Cenci C, Barnini T, Delitala G, Carta S, Atzori S, Guarnieri G, Zanetti M, Spalluti A, Serra MG, Bleve MA, Di Corato P, Vanoli M, Grignani G, Casella G, Gasbarrone L, Maniscalco G, Gunelli M, Tirotta D, Brucato A, Ghidoni S, Bernardi M, Li Bassi S, Santi L, Agnelli G, Marchesini E, Mannarino E, Lupattelli G, Rondelli P, Paciullo F, Fabris F, Carlon M, Turatto F, Baroni MC, Zardo M, Manfredini R, Molino C, Pala M, Fabbian F, Nuti R, Valenti R, Ruvio M, Cappelli S, Paolisso G, Rizzo MR, Laieta MT, Salvatore T, Sasso FC, Utili R, Durante Mangoni E, Pinto D, Olivieri O, Stanzial AM, Fellin R, Volpato S, Fotini S, Barbagallo M, Dominguez L, Plances L, DAngelo D, Rini G, Mansueto P, Pepe I, Licata G, Calvo L, Valenti M, Borghi C, Strocchi E, Rinaldi ER, Zoli M, Fabbri E, Magalotti D, Auteri A, Pasqui AL, Puccetti L, Pasini FL, Capecchi PL, Bicchi M, Sabbà C, Vella FS, Marseglia A, Luglio CV, Palasciano G, Modeo ME, Aquilino A, Raffaele P, Pugliese S, Capobianco C, Postiglione A, Barbella MR, De Stefano F, Fenoglio L, Brignone C, Bracco C, Giraudo A, Musca G, Cuccurullo O, Cricco L, Fiorentini A, Cappellini MD, Fabio G, Seghezzi S, De Amicis MM, Fargion S, Bonara P, Bulgheroni M, Lombardi R, Magrini F, Massari F, Tonella T, Peyvandi F, Tedeschi A, Rossio R, Moreo G, Ferrari B, Roncari L, Monzani V, Savojardo V, Folli C, Magnini M, Mari D, Rossi PD, Damanti S, Prolo S, Lilleri MS, Micale G, Podda M, Selmi C, Meda F, Accordino S, Conca A, Monti V, Corazza GR, Miceli E, Lenti MV, Padula D, Balduini CL, Bertolino G, Provini S, Quaglia F, Murialdo G, Bovio M, Dallegri F, Ottonello L, Quercioli A, Barreca A, Secchi MB, Ghelfi D, Chin WS, Carassale L, Caporotundo S, Sofia L, Anastasio L, Carbone M, Di Carlo S, Traisci G, De Feudis L, Davì G, Guagnano MT, Sestili S, Bergami E, Rizzioli E, Cagnoni C, Bertone L, Manucra A, Buratti A, Tognin T, Liberato NL, Bernasconi G, Nardo B, Bianchi GB, Benetti G, Quagliolo M, Centenaro GR, Purrello F, Di Pino A, Piro S, Mancuso G, Calipari D, Bartone M, Gullo F, Cortellaro M, Magenta M, Perego F, Meroni MR, Cicardi M, Magenta AG, Sacco A, Bonelli A, Dentamaro G, Rozzini R, Falanga L, Giordano A, Perin PC, Lorenzati B, Gruden G, Bruno G, Montrucchio G, Greco E, Tizzani P, Fera G, Di Luca ML, Renna D, Perciccante A, Coralli A, Tassara R, Melis D, Rebella L, Menardo G, Bottone S, Sferrazzo E, Ferri C, Striuli R, Scipioni R, Salmi R, Gaudenzi P, Gamberini S, Ricci F, Morabito C, Fava R, Semplicini A, Gottardo L, Vendemiale G, Serviddio G, Forlano R, Bolondi L, Rasciti L, Serio I, Masala C, Mammarella A, Raparelli V, Rossi Fanelli F, Delfino M, Amoroso A, Violi F, Basili S, Perri L, Serra P, Fontana V, Falcone M, Landolfi R, Grieco A, Gallo A, Zuccalà G, Franceschi F, De Marco G, Chiara C, Marta S, Bellusci M, Setti D, Pedrazzoli F, Romanelli G, Pirali C, Amolini C, Rosei EA, Rizzoni D, Castoldi L, Picardi A, Gentilucci UV, Mazzarelli C, Gallo P, Guasti L, Castiglioni L, Maresca A, Squizzato A, Contini S, Molaro M, Annoni G, Zazzetta MC, Bertolotti M, Scotto CM, Ferri MA, Veltri F, Arturi F, Succurro E, Sesti G, Gualtieri U, Perticone F, Sciacqua A, Quero M, Bagnato C, Loria P, Becchi MA, Martucci G, Fantuzzi A, Maurantonio M, Corinaldesi R, De Giorgio R, Serra M, Grasso V, Ruggeri E, Carozza LM, and Pignatti F

Subjects
Male, TVP, Settore MED/09 - Medicina Interna, Comorbidity, Logistic regression, Fondaparinux, VENOUS THROMBOEMBOLISM, THROMBOPROPHYLAXIS, Medical Patients, Medical patients, Thromboprophylaxis, Venous thromboembolism, Aged, Aged, 80 and over, Area Under Curve, Female, Hospital Mortality, Hospitalization, Humans, Logistic Models, Propensity Score, Venous Thromboembolism, Internal Medicine, Emergency Medicine, Thromboprophylaxis, Venous thromboembolism, Medical patients, 80 and over, Settore MED/45 - Scienze Infermieristiche Generali, Cliniche E Pediatriche, prophylaxis, venous thromboembolism, elderly, medicine.drug, medicine.medical_specialty, multimorbidity, Barthel index, MEDLINE, elderly patients, Internal medicine, medicine, Medical prescription, Intensive care medicine, business.industry, prophylaxi, Elderly, medical patients, thromboprophylaxis, medicine.disease, Propensity score matching, business
Abstract

none 327 si Pharmacological thromboprophylaxis (TP) is known to reduce venous thromboembolism (VTE) in medical inpatients, but the criteria for risk-driven prescription, safety and impact on mortality are still debated. We analyze data on elderly patients with multimorbidities admitted in the year 2010 to the Italian internal medicine wards participating in the REPOSI registry to investigate the rate of TP during the hospital stay, and analyze the factors that are related to its prescription. Multivariate logistic regression, area under the ROC curve and CART analysis were performed to look for independent predictors of TP prescription. Association between TP and VTE, bleeding and death in hospital and during the 3-month post-discharge follow-up were explored by logistic regression and propensity score analysis. Among the 1,380 patients enrolled, 171 (15.2 %) were on TP during the hospital stay (162 on low molecular weight heparins, 9 on fondaparinux). The disability Barthel index was the main independent predictor of TP prescription. Rate of fatal and non-fatal VTE and bleeding during and after hospitalization did not differ between TP and non-TP patients. In-hospital and post-discharge mortality was significantly higher in patients on TP, that however was not an independent predictor of mortality. Among elderly medical patients there was a relatively low rate of TP, that was more frequently prescribed to patients with a higher degree of disability and who had an overall higher mortality. mixed Marcucci M; Iorio A; Nobili A; Tettamanti M; Pasina L; Djade CD; Marengoni A; Salerno F; Corrao S; Mannucci PM; Mannucci M; Nobili A; Tettamanti M; Pasina L; Franchi C; Salerno F; Corrao S; Marengoni A; Iorio A; Marcucci M; Sparacio E; Alborghetti S; Di Costanzo R; Tettamanti M; Djade CD; Prisco D; Silvestri E; Cenci C; Barnini T; Delitala G; Carta S; Atzori S; Guarnieri G; Zanetti M; Spalluti A; Serra MG; Bleve MA; Di Corato P; Vanoli M; Grignani G; Casella G; Gasbarrone L; Maniscalco G; Gunelli M; Tirotta D; Brucato A; Ghidoni S; Bernardi M; Li Bassi S; Santi L; Agnelli G; Iorio A; Marcucci M; Marchesini E; Mannarino E; Lupattelli G; Rondelli P; Paciullo F; Fabris F; Carlon M; Turatto F; Baroni MC; Zardo M; Manfredini R; Molino C; Pala M; Fabbian F; Nuti R; Valenti R; Ruvio M; Cappelli S; Paolisso G; Rizzo MR; Laieta MT; Salvatore T; Sasso FC; Utili R; Durante Mangoni E; Pinto D; Olivieri O; Stanzial AM; Fellin R; Volpato S; Fotini S; Barbagallo M; Dominguez L; Plances L; DAngelo D; Rini G; Mansueto P; Pepe I; Licata G; Calvo L; Valenti M; Borghi C; Strocchi E; Rinaldi ER; Zoli M; Fabbri E; Magalotti D; Auteri A; Pasqui AL; Puccetti L; Pasini FL; Capecchi PL; Bicchi M; Sabbà C; Vella FS; Marseglia A; Luglio CV; Palasciano G; Modeo ME; Aquilino A; Raffaele P; Pugliese S; Capobianco C; Postiglione A; Barbella MR; De Stefano F; Fenoglio L; Brignone C; Bracco C; Giraudo A; Musca G; Cuccurullo O; Cricco L; Fiorentini A; Cappellini MD; Fabio G; Seghezzi S; De Amicis MM; Fargion S; Bonara P; Bulgheroni M; Lombardi R; Magrini F; Massari F; Tonella T; Peyvandi F; Tedeschi A; Rossio R; Moreo G; Ferrari B; Roncari L; Monzani V; Savojardo V; Folli C; Magnini M; Mari D; Rossi PD; Damanti S; Prolo S; Lilleri MS; Cricco L; Fiorentini A; Micale G; Podda M; Selmi C; Meda F; Salerno F; Accordino S; Conca A; Monti V; Corazza GR; Miceli E; Lenti MV; Padula D; Balduini CL; Bertolino G; Provini S; Quaglia F; Murialdo G; Bovio M; Dallegri F; Ottonello L; Quercioli A; Barreca A; Secchi MB; Ghelfi D; Chin WS; Carassale L; Caporotundo S; Sofia L; Anastasio L; Carbone M; Di Carlo S; Traisci G; De Feudis L; Davì G; Guagnano MT; Sestili S; Bergami E; Rizzioli E; Cagnoni C; Bertone L; Manucra A; Buratti A; Tognin T; Liberato NL; Bernasconi G; Nardo B; Bianchi GB; Benetti G; Quagliolo M; Centenaro GR; Purrello F; Di Pino A; Piro S; Mancuso G; Calipari D; Bartone M; Gullo F; Cortellaro M; Magenta M; Perego F; Meroni MR; Cicardi M; Magenta AG; Sacco A; Bonelli A; Dentamaro G; Rozzini R; Falanga L; Giordano A; Perin PC; Lorenzati B; Gruden G; Bruno G; Montrucchio G; Greco E; Tizzani P; Fera G; Di Luca ML; Renna D; Perciccante A; Coralli A; Tassara R; Melis D; Rebella L; Menardo G; Bottone S; Sferrazzo E; Ferri C; Striuli R; Scipioni R; Salmi R; Gaudenzi P; Gamberini S; Ricci F; Morabito C; Fava R; Semplicini A; Gottardo L; Delitala G; Carta S; Atzori S; Vendemiale G; Serviddio G; Forlano R; Bolondi L; Rasciti L; Serio I; Masala C; Mammarella A; Raparelli V; Rossi Fanelli F; Delfino M; Amoroso A; Violi F; Basili S; Perri L; Serra P; Fontana V; Falcone M; Landolfi R; Grieco A; Gallo A; Zuccalà G; Franceschi F; De Marco G; Chiara C; Marta S; Bellusci M; Setti D; Pedrazzoli F; Romanelli G; Pirali C; Amolini C; Rosei EA; Rizzoni D; Castoldi L; Picardi A; Gentilucci UV; Mazzarelli C; Gallo P; Guasti L; Castiglioni L; Maresca A; Squizzato A; Contini S; Molaro M; Annoni G; Zazzetta MC; Bertolotti M; Scotto CM; Ferri MA; Veltri F; Arturi F; Succurro E; Sesti G; Gualtieri U; Perticone F; Sciacqua A; Quero M; Bagnato C; Loria P; Becchi MA; Martucci G; Fantuzzi A; Maurantonio M; Corinaldesi R; De Giorgio R; Serra M; Grasso V; Ruggeri E; Carozza LM; Pignatti F Marcucci M; Iorio A; Nobili A; Tettamanti M; Pasina L; Djade CD; Marengoni A; Salerno F; Corrao S; Mannucci PM; Mannucci M; Nobili A; Tettamanti M; Pasina L; Franchi C; Salerno F; Corrao S; Marengoni A; Iorio A; Marcucci M; Sparacio E; Alborghetti S; Di Costanzo R; Tettamanti M; Djade CD; Prisco D; Silvestri E; Cenci C; Barnini T; Delitala G; Carta S; Atzori S; Guarnieri G; Zanetti M; Spalluti A; Serra MG; Bleve MA; Di Corato P; Vanoli M; Grignani G; Casella G; Gasbarrone L; Maniscalco G; Gunelli M; Tirotta D; Brucato A; Ghidoni S; Bernardi M; Li Bassi S; Santi L; Agnelli G; Iorio A; Marcucci M; Marchesini E; Mannarino E; Lupattelli G; Rondelli P; Paciullo F; Fabris F; Carlon M; Turatto F; Baroni MC; Zardo M; Manfredini R; Molino C; Pala M; Fabbian F; Nuti R; Valenti R; Ruvio M; Cappelli S; Paolisso G; Rizzo MR; Laieta MT; Salvatore T; Sasso FC; Utili R; Durante Mangoni E; Pinto D; Olivieri O; Stanzial AM; Fellin R; Volpato S; Fotini S; Barbagallo M; Dominguez L; Plances L; DAngelo D; Rini G; Mansueto P; Pepe I; Licata G; Calvo L; Valenti M; Borghi C; Strocchi E; Rinaldi ER; Zoli M; Fabbri E; Magalotti D; Auteri A; Pasqui AL; Puccetti L; Pasini FL; Capecchi PL; Bicchi M; Sabbà C; Vella FS; Marseglia A; Luglio CV; Palasciano G; Modeo ME; Aquilino A; Raffaele P; Pugliese S; Capobianco C; Postiglione A; Barbella MR; De Stefano F; Fenoglio L; Brignone C; Bracco C; Giraudo A; Musca G; Cuccurullo O; Cricco L; Fiorentini A; Cappellini MD; Fabio G; Seghezzi S; De Amicis MM; Fargion S; Bonara P; Bulgheroni M; Lombardi R; Magrini F; Massari F; Tonella T; Peyvandi F; Tedeschi A; Rossio R; Moreo G; Ferrari B; Roncari L; Monzani V; Savojardo V; Folli C; Magnini M; Mari D; Rossi PD; Damanti S; Prolo S; Lilleri MS; Cricco L; Fiorentini A; Micale G; Podda M; Selmi C; Meda F; Salerno F; Accordino S; Conca A; Monti V; Corazza GR; Miceli E; Lenti MV; Padula D; Balduini CL; Bertolino G; Provini S; Quaglia F; Murialdo G; Bovio M; Dallegri F; Ottonello L; Quercioli A; Barreca A; Secchi MB; Ghelfi D; Chin WS; Carassale L; Caporotundo S; Sofia L; Anastasio L; Carbone M; Di Carlo S; Traisci G; De Feudis L; Davì G; Guagnano MT; Sestili S; Bergami E; Rizzioli E; Cagnoni C; Bertone L; Manucra A; Buratti A; Tognin T; Liberato NL; Bernasconi G; Nardo B; Bianchi GB; Benetti G; Quagliolo M; Centenaro GR; Purrello F; Di Pino A; Piro S; Mancuso G; Calipari D; Bartone M; Gullo F; Cortellaro M; Magenta M; Perego F; Meroni MR; Cicardi M; Magenta AG; Sacco A; Bonelli A; Dentamaro G; Rozzini R; Falanga L; Giordano A; Perin PC; Lorenzati B; Gruden G; Bruno G; Montrucchio G; Greco E; Tizzani P; Fera G; Di Luca ML; Renna D; Perciccante A; Coralli A; Tassara R; Melis D; Rebella L; Menardo G; Bottone S; Sferrazzo E; Ferri C; Striuli R; Scipioni R; Salmi R; Gaudenzi P; Gamberini S; Ricci F; Morabito C; Fava R; Semplicini A; Gottardo L; Delitala G; Carta S; Atzori S; Vendemiale G; Serviddio G; Forlano R; Bolondi L; Rasciti L; Serio I; Masala C; Mammarella A; Raparelli V; Rossi Fanelli F; Delfino M; Amoroso A; Violi F; Basili S; Perri L; Serra P; Fontana V; Falcone M; Landolfi R; Grieco A; Gallo A; Zuccalà G; Franceschi F; De Marco G; Chiara C; Marta S; Bellusci M; Setti D; Pedrazzoli F; Romanelli G; Pirali C; Amolini C; Rosei EA; Rizzoni D; Castoldi L; Picardi A; Gentilucci UV; Mazzarelli C; Gallo P; Guasti L; Castiglioni L; Maresca A; Squizzato A; Contini S; Molaro M; Annoni G; Zazzetta MC; Bertolotti M; Scotto CM; Ferri MA; Veltri F; Arturi F; Succurro E; Sesti G; Gualtieri U; Perticone F; Sciacqua A; Quero M; Bagnato C; Loria P; Becchi MA; Martucci G; Fantuzzi A; Maurantonio M; Corinaldesi R; De Giorgio R; Serra M; Grasso V; Ruggeri E; Carozza LM; Pignatti F

Published
2013

42. Drug–drug interactions in a cohort of hospitalized elderly patients

Author

Pasina, L., Djade, C. D., Nobili, A., Tettamanti, M., Franchi, C., Salerno, F., Corrao, S., Marengoni, A., Iorio, A., Marcucci, M., Mannucci, P. M., Reposi, Investigators, Volpato, Stefano, and Manfredini, Roberto

Subjects
ELDERLY, drug interactions, hospitalization
Published
2013

44. Factors affecting adherence to guidelines for antithrombotic therapy in elderly patients with atrial fibrillation admitted to internal medicine wards

Author

Marcucci, M, Iorio, A, Nobili, A, Tettamanti, M, Pasina, L, Marengoni, A, Salerno, F, Corrao, S, Mannucci, Pm, Tedeschi A, REPOSI Investigators., Rossio, R, Moreo, G, Ferrari, B, Mammarella, A, Raparelli, V, Rondinella, S, Giannico, I, Rasciti, L, Gualandi, S, Monzani, V, Savojardo, V, Fabio, G, Colombo, S, Quercioli, A, Barreca, A, Durante-Mangoni, E, Pinto, D, Incasa, E, Rizzoli, E, Vanoli, M, Casella, G, Musca, G, Cuccurullo, O, Famularo, G, Sajeva, Mr, Picardi, A, Hila, D, Rozzini, R, Giordano, A, Bonelli, A, Dentamaro, G, Gobbo, G, Cazzaniga, M, Gaudenzi, P, Giusto, L, Rizzoni, D, Castoldi, L, Mari, D, Micale, G, Altomare, E, Serviddio, G, Longhini, C, Molino, C, Deidda, S, Cuccuru, Lm, Quagliolo, M, Centenaro, Gr, Pasqui, Al, Puccetti, L, Bertolino, G, Cavallo, P, Bertolini, D, Liberato, Nl, Perciccante, A, Coralli, A, Anastasio, L, Bertucci, L, Macura, A, Matino, D, Morabito, C, Fava, R, Tuttolomondo, A, Di Sciacca, R, Semplicini, A, Magagnotti, G, Fiorentini, A, Tofi, C, Cagnoni, C, Manucra, A, Romanelli, G, Cortellaro, M, Meroni, Mr, Rossi, Dp, Vergani, C., Marcucci, M, Iorio, A, Nobili, A, Tettamanti, M, Pasina, L, Marengoni, A, Salerno, F, Corrao, S, Mannucci, PM, Tedeschi, A, Rossio, R, Moreo, G, Ferrari, B, Mammarella, A, Raparelli, V, Rondinella, S, Giannico, I, Rasciti, L, Gualandi, S, Monzani, V, Savojardo, V, Fabio, G, Colombo, S, Quercioli, A, Barreca, A, Durante-Mangoni, E, Pinto, D, Incasa, E, Rizzoli, E, Vanoli, M, Casella, G, Musca, G, Cuccurullo, O, Famularo, G, Sajeva, MR, Picardi, A, Hila, D, Rozzini, R, Giordano, A, Bonelli, A, Dentamaro, G, Gobbo, G, Cazzaniga, M, Gaudenzi, P, Giusto, L, Rizzoni, D, Castoldi, L, Mari, D, Micale, G, Altomare, E, Serviddio, G, Longhini, C, Molino, C, Deidda, S, Cuccuru, LM, Quagliolo, M, Centenaro, GR, Pasqui, AL, Puccetti, L, Bertolino, G, Cavallo, P, Bertolini, D, Liberato, NL, Perciccante, A, Coralli, A, Anastasio, L, Bertucci, L, Macura, A, Matino, D, Morabito, C, Fava, R, Tuttolomondo, A, Di Sciacca, R, Semplicini, A, Magagnotti, G, Fiorentini, A, Tofi, C, Cagnoni, C, Manucra, A, Romanelli, G, Cortellaro, M, Meroni, MR, Rossi, DP, and Vergani, C

Subjects
Male, medicine.medical_specialty, Settore MED/09 - Medicina Interna, Vitamin K, antithrombotic therapy, NO, Antithrombotic prophylaxis, Atrial fibrillation, Platelet agents, Vitamin K antagonists, Fibrinolytic Agents, Risk Factors, Internal medicine, Antithrombotic, Internal Medicine, medicine, Humans, atrial fibrillation, Registries, Medical prescription, Stroke, Aged, Retrospective Studies, Aged, 80 and over, Antithrombotic prophylaxis, Atrial fibrillation, Platelet agents, Vitamin K antagonists, guidelines, Aspirin, business.industry, antithrombotic prophylaxis, platelet agents, vitamin k antagonists, Retrospective cohort study, medicine.disease, Intracranial Embolism, Italy, Platelet aggregation inhibitor, Female, Guideline Adherence, business, guideline, Platelet Aggregation Inhibitors, Fibrinolytic agent, medicine.drug
Abstract

Introduction Current guidelines for ischemic stroke prevention in atrial fibrillation or flutter (AFF) recommend Vitamin K antagonists (VKAs) for patients at high-intermediate risk and aspirin for those at intermediate-low risk. The cost-effectiveness of these treatments was demonstrated also in elderly patients. However, there are several reports that emphasize the underuse of pharmacological prophylaxis of cardio-embolism in patients with AFF in different health care settings. Aims To evaluate the adherence to current guidelines on cardio-embolic prophylaxis in elderly (> 65 years old) patients admitted with an established diagnosis of AFF to the Italian internal medicine wards participating in REPOSI registry, a project on polypathologies/polytherapies stemming from the collaboration between the Italian Society of Internal Medicine and the Mario Negri Institute of Pharmacological Research; to investigate whether or not hospitalization had an impact on guidelines adherence; to test the role of possible modifiers of VKAs prescription. Methods We retrospectively analyzed registry data collected from January to December 2008 and assessed the prevalence of patients with AFF at admission and the prevalence of risk factors for cardio-embolism. After stratifying the patients according to their CHADS 2 score the percentage of appropriateness of antithrombotic therapy prescription was evaluated both at admission and at discharge. Univariable and multivariable logistic regression models were employed to verify whether or not socio-demographic (age > 80 years, living alone) and clinical features (previous or recent bleeding, cranio-facial trauma, cancer, dementia) modified the frequency and modalities of antithrombotic drugs prescription at admission and discharge. Results Among the 1332 REPOSI patients, 247 were admitted with AFF. At admission, CHADS 2 score was ≥ 2 in 68.4% of patients, at discharge in 75.9%. Among patients with AFF 26.5% at admission and 32.8% at discharge were not on any antithrombotic therapy, and 43.7% at admission and 40.9% at discharge were not taking an appropriate therapy according to the CHADS 2 score. The higher the level of cardio-embolic risk the higher was the percentage of antiplatelet- but not of VKAs-treated patients. At admission or at discharge, both at univariable and at multivariable logistic regression, only an age > 80 years and a diagnosis of cancer, previous or active, had a statistically significant negative effect on VKAs prescription. Moreover, only a positive history of bleeding events (past or present) was independently associated to no VKA prescription at discharge in patients who were on VKA therapy at admission. If heparin was considered as an appropriate therapy for patients with indication for VKAs, the percentage of patients admitted or discharged on appropriate therapy became respectively 43.7% and 53.4%. Conclusion Among elderly patients admitted with a diagnosis of AFF to internal medicine wards, an appropriate antithrombotic prophylaxis was taken by less than 50%, with an underuse of VKAs prescription independently of the level of cardio-embolic risk. Hospitalization did not improve the adherence to guidelines.

Published
2010

45. Multimorbidity and polypharmacy in the elderly: lessons from REPOSI

Author

Mannucci, Pm, Nobili, A, Grieco, Antonio, Reposi, Investigators, Grieco, Antonio (ORCID:0000-0002-0544-8993), Mannucci, Pm, Nobili, A, Grieco, Antonio, Reposi, Investigators, and Grieco, Antonio (ORCID:0000-0002-0544-8993)

Abstract

The dramatic demographic changes that are occurring in the third millennium are modifying the mission of generalist professionals such as primary care physicians and internists. Multiple chronic diseases and the related prescription of multiple medications are becoming typical problems and present many challenges. Unfortunately, the available evidence regarding the efficacy of medications has been generated by clinical trials involving patients completely different from those currently admitted to internal medicine: much younger, affected by a single disease and managed in a highly controlled research environment. Because only registries can provide information on drug effectiveness in real-life conditions, REPOSI started in 2008 with the goal of acquiring data on elderly people acutely admitted to medical or geriatric hospital wards in Italy. The main goals of the registry were to evaluate drug prescription appropriateness, the relationship between multimorbidity/polypharmacy and such cogent outcomes as hospital mortality and re-hospitalization, and the identification of disease clusters that most often concomitantly occur in the elderly. The findings of 3-yearly REPOSI runs (2008, 2010, 2012) suggest the following pertinent tasks for the internist in order to optimally handle their elderly patients: the management of multiple medications, the need to become acquainted with geriatric multidimensional tools, the promotion and implementation of a multidisciplinary team approach to patient health and care and the corresponding involvement of patients and their relatives and caregivers. There is also a need for more research, tailored to the peculiar features of the multimorbid elderly patient.

Published
2014

46. Defining Aging Phenotypes and Related Outcomes: Clues to Recognize Frailty in Hospitalized Older Patients.

Author

Marcucci, Maura, Franchi, Carlotta, Nobili, Alessandro, Mannucci, Pier Mannuccio, Ardoino, Ilaria, and REPOSI Investigators

Subjects
FRAIL elderly, AGING, HUMAN phenotype, HEALTH of older people, OLDER patients, GERIATRICS, INTERNAL medicine, CLUSTER analysis (Statistics), MEDICAL care, GERIATRIC assessment, HOSPITAL care, LONGITUDINAL method, PHENOTYPES, HOSPITAL mortality
Abstract

Background: Because frailty is a complex phenomenon associated with poor outcomes, the identification of patient profiles with different care needs might be of greater practical help than to look for a unifying definition. This study aimed at identifying aging phenotypes and their related outcomes in order to recognize frailty in hospitalized older patients.Methods: Patients aged 65 or older enrolled in internal medicine and geriatric wards participating in the REPOSI registry. Relationships among variables associated to sociodemographic, physical, cognitive, functional, and medical status were explored using a multiple correspondence analysis. The hierarchical cluster analysis was then performed to identify possible patient profiles. Multivariable logistic regression was used to verify the association between clusters and outcomes (in-hospital mortality and 3-month postdischarge mortality and rehospitalization).Results: 2,841 patients were included in the statistical analyses. Four clusters were identified: the healthiest (I); those with multimorbidity (II); the functionally independent women with osteoporosis and arthritis (III); and the functionally dependent oldest old patients with cognitive impairment (IV). There was a significantly higher in-hospital mortality in Cluster II (odds ratio [OR] = 2.27, 95% confidence interval [CI] = 1.15-4.46) and Cluster IV (OR = 5.15, 95% CI = 2.58-10.26) and a higher 3-month mortality in Cluster II (OR = 1.66, 95% CI = 1.13-2.44) and Cluster IV (OR = 1.86, 95% CI = 1.15-3.00) than in Cluster I.Conclusions: Using alternative analytical techniques among hospitalized older patients, we could distinguish different frailty phenotypes, differently associated with adverse events. The identification of different patient profiles can help defining the best care strategy according to specific patient needs. [ABSTRACT FROM AUTHOR]

Published
2017
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47. Adherence to antibiotic treatment guidelines and outcomes in the hospitalized elderly with different types of pneumonia

Author

Rossio, R, Franchi, C, Ardoino, I, Djade, Cd, Tettamanti, M, Pasina, L, Salerno, F, Marengoni, A, Corrao, S, Marcucci, M, Peyvandi, F, Biganzoli, Em, Nobili, A, Mannucci, Pm, Mannucci, M, Sparacio, E, Alborghetti, S, Di Costanzo, R, Eldin, Tk, Prisco, D, Silvestri, E, Cenci, C, Barnini, T, Delitala, G, Carta, S, Atzori, S, Guarnieri, G, Zanetti, M, Spalluti, A, Serra, Mg, Bleve, Ma, Vanoli, M, Grignani, G, Casella, G, Gasbarrone, L, Maniscalco, G, Gunelli, M, Tirotta, D, Brucato, A, Ghidoni, S, Di Corato, P, Bernardi, M, Li Bassi, S, Santi, L, Agnelli, G, Iorio, A, Marchesini, E, Mannarino, E, Lupattelli, G, Rondelli, P, Paciullo, F, Fabris, F, Carlon, M, Turatto, F, Baroni, Mc, Zardo, M, Manfredini, R, Molino, C, Pala, M, Fabbian, F, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Paolisso, G, Rizzo, Mr, Laieta, Mt, Salvatore, T, Sasso, Fc, Utili, R, Durante Mangoni, E, Pinto, D, Olivieri, O, Stanzial, Am, Fellin, R, Volpato, S, Fotini, S, Barbagallo, M, Dominguez, L, Plances, L, D'Angelo, D, Rini, G, Mansueto, P, Pepe, I, Licata, G, Calvo, L, Valenti, M, Borghi, C, Strocchi, E, Rinaldi, Er, Zoli, M, Fabbri, E, Magalotti, D, Auteri, A, Pasqui, Al, Puccetti, L, Laghi Pasini, F, Capecchi, Pl, Bicchi, M, Sabbà, C, Vella, Fs, Marseglia, A, Luglio, Cv, Palasciano, G, Modeo, Me, Aquilino, A, Pugliese, S, Capobianco, C, Postiglione, A, Barbella, Mr, De Stefano, F, Fenoglio, L, Brignone, C, Bracco, C, Giraudo, A, Musca, G, Cuccurullo, O, Cricco, L, Fiorentini, A, Cappellini, Md, Fabio, G, Seghezzi, S, De Amicis, Mm, Fargion, S, Bonara, P, Bulgheroni, M, Lombardi, R, Magrini, F, Massari, F, Tonella, T, Tedeschi, A, Moreo, G, Ferrari, B, Roncari, L, Monzani, V, Savojardo, V, Folli, C, Magnini, M, Mari, D, Rossi, Pd, Damanti, S, Prolo, S, Lilleri, Ms, Micale, G, Podda, M, Selmi, C, Meda, F, Accordino, S, Conca, A, Monti, V, Corazza, Gr, Miceli, E, Lenti, Mv, Padula, D, Balduini, Cl, Bertolino, G, Provini, S, Quaglia, F, Murialdo, G, Bovio, M, Dallegri, F, Ottonello, L, Quercioli, A, Barreca, A, Secchi, Mb, Ghelfi, D, Chin, Ws, Carassale, L, Caporotundo, S, Anastasio, L, Sofia, L, Carbone, M, Di Carlo, S, Traisci, G, De Feudis, L, Davì, G, Guagnano, Mt, Sestili, S, Bergami, E, Rizzioli, E, Cagnoni, C, Bertone, L, Manucra, A, Buratti, A, Tognin, T, Liberato, Nl, Bernasconi, G, Nardo, B, Bianchi, Gb, Giaquinto, S, Benetti, G, Quagliolo, M, Centenaro, Gr, Purrello, F, Di Pino, A, Piro, S, Mancuso, G, Calipari, D, Bartone, M, Gullo, F, Cortellaro, M, Magenta, M, Perego, F, Meroni, Mr, Cicardi, M, Gidaro, A, Sacco, A, Bonelli, A, Dentamaro, G, Rozzini, R, Falanga, L, Giordano, A, Perin, Pc, Lorenzati, B, Gruden, G, Bruno, G, Montrucchio, G, Greco, E, Tizzani, P, Fera, G, Di Luca, Ml, Renna, D, Perciccante, A, Coralli, A, Tassara, R, Melis, D, Rebella, L, Menardo, G, Bottone, S, Sferrazzo, E, Ferri, C, Striuli, R, Scipioni, R, Salmi, R, Gaudenzi, P, Gamberini, S, Ricci, F, Morabito, C, Fava, R, Semplicini, A, Gottardo, L, Vendemiale, G, Serviddio, G, Forlano, R, Bolondi, L, Rasciti, L, Serio, I, Masala, C, Mammarella, A, Raparelli, V, Rossi Fanelli, F, Delfino, M, Amoroso, A, Violi, F, Basili, S, Perri, L, Serra, P, Fontana, V, Falcone, M, Landolfi, R, Grieco, A, Gallo, A, Zuccalà, G, Franceschi, F, De Marco, G, Chiara, C, Marta, S, Bellusci, M, Setti, D, Pedrazzoli, F, Romanelli, G, Pirali, C, Amolini, C, Rosei, Ea, Rizzoni, D, Castoldi, L, Picardi, A, Gentilucci, Uv, Mazzarelli, C, Gallo, P, Guasti, Luigina, Castiglioni, Luana, Maresca, ANDREA MARIA, Squizzato, Alessandro, Contini, Sara, Molaro, Marta, Annoni, G, Corsi, M, Zazzetta, S, Bertolotti, M, Mussi, C, Scotto, R, Ferri, Ma, Veltri, F, Arturi, F, Succurro, E, Sesti, G, Gualtieri, U, Perticone, F, Sciacqua, A, Quero, M, Bagnato, C, Loria, P, Becchi, Ma, Martucci, G, Fantuzzi, A, Maurantonio, M, Corinaldesi, R, De Giorgio, R, Serra, M, Grasso, V, Ruggeri, E, Carozza, Lm, Pignatti, F., Rossio, Raffaella, Franchi, Carlotta, Ardoino, Ilaria, Djade, Codjo D., Tettamanti, Mauro, Pasina, Luca, Salerno, Francesco, Marengoni, Alessandra, Corrao, Salvatore, Marcucci, Maura, Peyvandi, Flora, Biganzoli, Elia M., Nobili, Alessandro, Mannucci, Pier Mannuccio, Sparacio, Eleonora, Alborghetti, Stefania, Di Costanzo, Rosa, Prisco, Domenico, Silvestri, Elena, Cenci, Caterina, Barnini, Tommaso, Delitala, Giuseppe, Carta, Stefano, Atzori, Sebastiana, Guarnieri, Gianfranco, Zanetti, Michela, Spalluti, Annalisa, Serra, Maria Grazia, Bleve, Maria Antonietta, Vanoli, Massimo, Grignani, Giulia, Casella, Gianluca, Gasbarrone, Laura, Maniscalco, Giorgio, Gunelli, Massimo, Tirotta, Daniela, Brucato, Antonio, Ghidoni, Silvia, Di Corato, Paola, Bernardi, Mauro, Li Bassi, Silvia, Santi, Luca, Agnelli, Giancarlo, Iorio, Alfonso, Marchesini, Emanuela, Mannarino, Elmo, Lupattelli, Graziana, Rondelli, Pamela, Paciullo, Francesco, Fabris, Fabrizio, Carlon, Michela, Turatto, Francesca, Baroni, Maria Cristina, Zardo, Marianna, Manfredini, Roberto, Molino, Christian, Pala, Marco, Fabbian, Fabio, Nuti, Ranuccio, Valenti, Roberto, Ruvio, Martina, Cappelli, Silvia, Paolisso, Giuseppe, Rizzo, Maria Rosaria, Laieta, Maria Teresa, Salvatore, Teresa, Sasso, Ferdinando Carlo, Utili, Riccardo, Mangoni, Emanuele Durante, Pinto, Daniela, Olivieri, Oliviero, Stanzial, Anna Maria, Fellin, Renato, Volpato, Stefano, Fotini, Siouli, Barbagallo, Mario, Dominguez, Ligia, Plances, Lidia, D'Angelo, Daniela, Rini, Giovanbattista, Mansueto, Pasquale, Pepe, Ilenia, Licata, Giuseppe, Calvo, Luigi, Valenti, Maria, Borghi, Claudio, Strocchi, Enrico, Rinaldi, Elisa Rebecca, Zoli, Marco, Fabbri, Elisa, Magalotti, Donatella, Auteri, Alberto, Pasqui, Anna Laura, Puccetti, Luca, Pasini, Franco Laghi, Capecchi, Pier Leopoldo, Bicchi, Maurizio, Sabbà, Carlo, Vella, Francesco Saverio, Marseglia, Alessandro, Luglio, Chiara Valentina, Palasciano, Giuseppe, Modeo, Maria Ester, Aquilino, Annamaria, Raffaele, Pallante, Pugliese, Stefania, Capobianco, Caterina, Postiglione, Alfredo, Barbella, Maria Rosaria, De Stefano, Francesco, Fenoglio, Luigi, Brignone, Chiara, Bracco, Christian, Giraudo, Alessia, Musca, Giuseppe, Cuccurullo, Olga, Cricco, Luigi, Fiorentini, Alessandra, Cappellini, Maria Domenica, Fabio, Giovanna, Seghezzi, Sonia, De Amicis, Margherita Migone, Fargion, Silvia, Bonara, Paola, Bulgheroni, Mara, Lombardi, Rosa, Magrini, Fabio, Massari, Ferdinando, Tonella, Tatiana, Tedeschi, Alberto, Moreo, Guido, Ferrari, Barbara, Roncari, Luisa, Monzani, Valter, Savojardo, Valeria, Folli, Christian, Magnini, Maria, Mari, Daniela, Rossi, Paolo Dionigi, Damanti, Sarah, Prolo, Silvia, Lilleri, Maria Sole, Micale, Giuliana, Podda, Mauro, Selmi, Carlo, Meda, Francesca, Accordino, Silvia, Conca, Alessio, Monti, Valentina, Corazza, Gino Roberto, Miceli, Emanuela, Lenti, Marco Vincenzo, Padula, Donatella, Balduini, Carlo L., Bertolino, Giampiera, Provini, Stella, Quaglia, Federica, Murialdo, Giovanni, Bovio, Marta, Dallegri, Franco, Ottonello, Luciano, Quercioli, Alessandra, Barreca, Alessandra, Secchi, Maria Beatrice, Ghelfi, Davide, Chin, Wu Sheng, Carassale, Laura, Caporotundo, Silvia, Anastasio, Luigi, Sofia, Lucia, Carbone, Maria, Traisci, Giancarlo, De Feudis, Lucrezia, Di Carlo, Silvia, Davì, Giovanni, Guagnano, Maria Teresa, Sestili, Simona, Bergami, Elisabetta, Rizzioli, Emanuela, Cagnoni, Carlo, Bertone, Luca, Manucra, Antonio, Buratti, Alberto, Tognin, Tiziana, Liberato, Nicola Lucio, Bernasconi, Giordano, Nardo, Barbara, Bianchi, Giovanni Battista, Benetti, Giampiero, Quagliolo, Michela, Centenaro, Giuseppe Riccardo, Purrello, Francesco, Di Pino, Antonino, Piro, Salvatore, Mancuso, Gerardo, Calipari, Daniela, Bartone, Mosè, Gullo, Francesco, Cortellaro, Michele, Magenta, Marina, Perego, Francesca, Meroni, Maria Rachele, Cicardi, Marco, Magenta, Antonio Gidaro Marina, Sacco, Andrea, Bonelli, Antonio, Dentamaro, Gaetano, Rozzini, Renzo, Falanga, Lina, Giordano, Alessandro, Perin, Paolo Cavallo, Lorenzati, Bartolomeo, Gruden, Gabriella, Bruno, Graziella, Montrucchio, Giuseppe, Greco, Elisabetta, Tizzani, Pietro, Fera, Giacomo, Di Luca, Maria Loreta, Renna, Donatella, Perciccante, Antonio, Coralli, Alessia, Tassara, Rodolfo, Melis, Deborah, Rebella, Lara, Menardo, Giorgio, Bottone, Stefania, Sferrazzo, Elsa, Ferri, Claudio, Striuli, Rinaldo, Scipioni, Rosa, Salmi, Raffaella, Gaudenzi, Piergiorgio, Gamberini, Susanna, Ricci, Franco, Morabito, Cosimo, Fava, Roberto, Semplicini, Andrea, Gottardo, Lucia, Vendemiale, Gianluigi, Serviddio, Gaetano, Forlano, Roberta, Bolondi, Luigi, Rasciti, Leonardo, Serio, Ilaria, Masala, Cesare, Mammarella, Antonio, Raparelli, Valeria, Fanelli, Filippo Rossi, Delfino, Massimo, Amoroso, Antonio, Violi, Francesco, Basili, Stefania, Perri, Ludovica, Serra, Pietro, Fontana, Vincenzo, Falcone, Marco, Landolfi, Raffaele, Grieco, Antonio, Gallo, Antonella, Zuccalà, Giuseppe, Franceschi, Francesco, De Marco, Guido, Chiara, Cordischi, Marta, Sabbatini, Bellusci, Martino, Setti, Donatella, Pedrazzoli, Filippo, Romanelli, Giuseppe, Pirali, Caterina, Amolini, Claudia, Rosei, Enrico Agabiti, Rizzoni, Damiano, Castoldi, Luana, Picardi, Antonio, Gentilucci, Umberto Vespasiani, Mazzarelli, Chiara, Gallo, Paolo, Guasti, Luigina, Castiglioni, Luana, Maresca, Andrea, Squizzato, Alessandro, Contini, Sara, Molaro, Marta, Annoni, Giorgio, Corsi, Maurizio, Zazzetta, Sara, Bertolotti, Marco, Mussi, Chiara, Scotto, Roberto, Ferri, Maria Alice, Veltri, Francesca, Arturi, Franco, Succurro, Elena, Sesti, Giorgio, Gualtieri, Umberto, Perticone, Francesco, Sciacqua, Angela, Quero, Michele, Bagnato, Chiara, Loria, Paola, Becchi, Maria Angela, Martucci, Gianfranco, Fantuzzi, Alessandra, Maurantonio, Mauro, Corinaldesi, Roberto, De Giorgio, Roberto, Serra, Mauro, Grasso, Valentina, Ruggeri, Eugenio, Carozza, Lorenzo Mauro, Pignatti, Fabio, Raffaella Rossio, Carlotta Franchi, Ilaria Ardoino, Codjo D. Djade, Mauro Tettamanti, Luca Pasina, Francesco Salerno, Alessandra Marengoni, Salvatore Corrao, Maura Marcucci, Flora Peyvandi, Elia M. Biganzoli, Alessandro Nobili, Pier Mannuccio Mannucci, REPOSI Investigators [.., Mauro Bernardi, Claudio Borghi, Marco Zoli, Luigi Bolondi, Roberto Corinaldesi, Roberto De Giorgio, ], Rossio, R, Franchi, C, Ardoino, I, Djade, C, Tettamanti, M, Pasina, L, Salerno, F, Marengoni, A, Corrao, S, Marcucci, M, Peyvandi, F, Biganzoli, E, Nobili, A, Mannucci, P, Mannucci, M, Sparacio, E, Alborghetti, S, Di Costanzo, R, Eldin, T, Prisco, D, Silvestri, E, Cenci, C, Barnini, T, Delitala, G, Carta, S, Atzori, S, Guarnieri, G, Zanetti, M, Spalluti, A, Serra, M, Bleve, M, Vanoli, M, Grignani, G, Casella, G, Gasbarrone, L, Maniscalco, G, Gunelli, M, Tirotta, D, Brucato, A, Ghidoni, S, Di Corato, P, Bernardi, M, Li Bassi, S, Santi, L, Agnelli, G, Iorio, A, Marchesini, E, Mannarino, E, Lupattelli, G, Rondelli, P, Paciullo, F, Fabris, F, Carlon, M, Turatto, F, Baroni, M, Zardo, M, Manfredini, R, Molino, C, Pala, M, Fabbian, F, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Paolisso, G, Rizzo, M, Laieta, M, Salvatore, T, Sasso, F, Utili, R, Durante Mangoni, E, Pinto, D, Olivieri, O, Stanzial, A, Fellin, R, Volpato, S, Fotini, S, Barbagallo, M, Dominguez, L, Plances, L, D’Angelo, D, Rini, G, Mansueto, P, Pepe, I, Licata, G, Calvo, L, Valenti, M, Borghi, C, Strocchi, E, Rinaldi, E, Zoli, M, Fabbri, E, Magalotti, D, Auteri, A, Pasqui, A, Puccetti, L, Laghi Pasini, F, Capecchi, P, Bicchi, M, Sabbà, C, Vella, F, Marseglia, A, Luglio, C, Palasciano, G, Modeo, M, Aquilino, A, Pugliese, S, Capobianco, C, Postiglione, A, Barbella, M, De Stefano, F, Fenoglio, L, Brignone, C, Bracco, C, Giraudo, A, Musca, G, Cuccurullo, O, Cricco, L, Fiorentini, A, Cappellini, M, Fabio, G, Seghezzi, S, De Amicis, M, Fargion, S, Bonara, P, Bulgheroni, M, Lombardi, R, Magrini, F, Massari, F, Tonella, T, Tedeschi, A, Moreo, G, Ferrari, B, Roncari, L, Monzani, V, Savojardo, V, Folli, C, Magnini, M, Mari, D, Rossi, P, Damanti, S, Prolo, S, Lilleri, M, Micale, G, Podda, M, Selmi, C, Meda, F, Accordino, S, Conca, A, Monti, V, Corazza, G, Miceli, E, Lenti, M, Padula, D, Balduini, C, Bertolino, G, Provini, S, Quaglia, F, Murialdo, G, Bovio, M, Dallegri, F, Ottonello, L, Quercioli, A, Barreca, A, Secchi, M, Ghelfi, D, Chin, W, Carassale, L, Caporotundo, S, Anastasio, L, Sofia, L, Carbone, M, Di Carlo, S, Traisci, G, De Feudis, L, Davì, G, Guagnano, M, Sestili, S, Bergami, E, Rizzioli, E, Cagnoni, C, Bertone, L, Manucra, A, Buratti, A, Tognin, T, Liberato, N, Bernasconi, G, Nardo, B, Bianchi, G, Giaquinto, S, Benetti, G, Quagliolo, M, Centenaro, G, Purrello, F, Di Pino, A, Piro, S, Mancuso, G, Calipari, D, Bartone, M, Gullo, F, Cortellaro, M, Magenta, M, Perego, F, Meroni, M, Cicardi, M, Gidaro, A, Sacco, A, Bonelli, A, Dentamaro, G, Rozzini, R, Falanga, L, Giordano, A, Perin, P, Lorenzati, B, Gruden, G, Bruno, G, Montrucchio, G, Greco, E, Tizzani, P, Fera, G, Di Luca, M, Renna, D, Perciccante, A, Coralli, A, Tassara, R, Melis, D, Rebella, L, Menardo, G, Bottone, S, Sferrazzo, E, Ferri, C, Striuli, R, Scipioni, R, Salmi, R, Gaudenzi, P, Gamberini, S, Ricci, F, Morabito, C, Fava, R, Semplicini, A, Gottardo, L, Vendemiale, G, Serviddio, G, Forlano, R, Bolondi, L, Rasciti, L, Serio, I, Masala, C, Mammarella, A, Raparelli, V, Rossi Fanelli, F, Delfino, M, Amoroso, A, Violi, F, Basili, S, Perri, L, Serra, P, Fontana, V, Falcone, M, Landolfi, R, Grieco, A, Gallo, A, Zuccalà, G, Franceschi, F, De Marco, G, Chiara, C, Marta, S, Bellusci, M, Setti, D, Pedrazzoli, F, Romanelli, G, Pirali, C, Amolini, C, Rosei, E, Rizzoni, D, Castoldi, L, Picardi, A, Gentilucci, U, Mazzarelli, C, Gallo, P, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Contini, S, Molaro, M, Annoni, G, Corsi, M, Zazzetta, S, Bertolotti, M, Mussi, C, Scotto, R, Ferri, M, Veltri, F, Arturi, F, Succurro, E, Sesti, G, Gualtieri, U, Perticone, F, Sciacqua, A, Quero, M, Bagnato, C, Loria, P, Becchi, M, Martucci, G, Fantuzzi, A, Maurantonio, M, Corinaldesi, R, De Giorgio, R, Grasso, V, Ruggeri, E, Carozza, L, Pignatti, F, DIPARTIMENTO DI SCIENZE MEDICHE E CHIRURGICHE, Facolta' di MEDICINA e CHIRURGIA, Da definire, AREA MIN. 06 - Scienze mediche, DOMINGUEZ RODRIGUEZ, Ligia Juliana, and Reposi, Investigators

Subjects
Male, Antibiotic regimen, Guidelines adherence, Settore MED/09 - Medicina Interna, Antibiotics, Logistic regression, Elderly, Community-acquired pneumonia, 80 and over, Elderly people, Age Factor, Hospital Mortality, Aged, 80 and over, Treatment regimen, Medicine (all), Age Factors, Optimal management, Mortality, Pneumonia, Re-hospitalization, Aged, Anti-Bacterial Agents, Female, Humans, Logistic Models, Practice Guidelines as Topic, Treatment Outcome, Guideline Adherence, Hospitalization, Internal Medicine, Human, medicine.medical_specialty, Logistic Model, medicine.drug_class, Socio-culturale, antibiotic treatment, guidelines, pneumonia, elderly, Internal medicine, Anti-Bacterial Agent, medicine, elderly, pmeumonia, antibiotics, guidelines adherence, mortality, re-hospitalization, pmeumonia, Intensive care medicine, business.industry, Settore MED/09 - MEDICINA INTERNA, Antibiotic, medicine.disease, business
Abstract

none 22 no Background: Few studies evaluated the clinical outcomes of Community Acquired Pneumonia (CAP), Hospital-Acquired Pneumonia (HAP) and Health Care-Associated Pneumonia (HCAP) in relation to the adherence of antibiotic treatment to the guidelines of the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS) in hospitalized elderly people (65 years or older). Methods: Data were obtained from REPOSI, a prospective registry held in 87 Italian internal medicine and geriatric wards. Patients with a diagnosis of pneumonia (ICD-9 480-487) or prescribed with an antibiotic for pneumonia as indication were selected. The empirical antibiotic regimen was defined to be adherent to guidelines if concordant with the treatment regimens recommended by IDSA/ATS for CAP, HAP, and HCAP. Outcomes were assessed by logistic regression models. Results: A diagnosis of pneumonia was made in 317 patients. Only 38.8% of them received an empirical antibiotic regimen that was adherent to guidelines. However, no significant association was found between adherence to guidelines and outcomes. Having HAP, older age, and higher CIRS severity index were the main factors associated with in-hospital mortality. Conclusions: The adherence to antibiotic treatment guidelines was poor, particularly for HAP and HCAP, suggesting the need for more adherence to the optimal management of antibiotics in the elderly with pneumonia. none Raffaella Rossio; Carlotta Franchi; Ilaria Ardoino; Codjo D. Djade; Mauro Tettamanti; Luca Pasina; Francesco Salerno; Alessandra Marengoni; Salvatore Corrao; Maura Marcucci; Flora Peyvandi; Elia M. Biganzoli; Alessandro Nobili; Pier Mannuccio Mannucci; REPOSI Investigators [...; Mauro Bernardi; Claudio Borghi; Marco Zoli; Luigi Bolondi; Roberto Corinaldesi; Roberto De Giorgio;...] Raffaella Rossio; Carlotta Franchi; Ilaria Ardoino; Codjo D. Djade; Mauro Tettamanti; Luca Pasina; Francesco Salerno; Alessandra Marengoni; Salvatore Corrao; Maura Marcucci; Flora Peyvandi; Elia M. Biganzoli; Alessandro Nobili; Pier Mannuccio Mannucci; REPOSI Investigators [..; Mauro Bernardi; Claudio Borghi; Marco Zoli; Luigi Bolondi; Roberto Corinaldesi; Roberto De Giorgio;..]

Published
2015

48. Antihypertensive treatment changes and related clinical outcomes in older hospitalized patients

Author

Sebastiano, Cicco, D'Abbondanza, Marco, Proietti, Marco, Vincenzo, Zaccone, Chiara, Pes, Federica, Caradio, Mattioli, Massimo, Salvatore, Piano, Alberto Maria Marra, Alessandro, Nobili, Pier Mannuccio Mannucci, Antonello, Pietrangelo, Giorgio, Sesti, Elena, Buzzetti, Andrea, Salzano, Antonio, Cimellaro, Francesco, Perticone, Francesco, Violi, Gino Roberto Corazza, Salvatore, Corrao, Alessandra, Marengoni, Francesco, Salerno, Matteo, Cesari, Mauro, Tettamanti, Luca, Pasina, Carlotta, Franchi, Alessio, Novella, Gabriella, Miglio, Alessia Antonella Galbussera, Ilaria, Ardoino, Prisco, Domenico, Elena, Silvestri, Giacomo, Emmi, Alessandra, Bettiol, Irene, Mattioli, Gianni, Biolo, Michela, Zanetti, Giacomo, Bartelloni, Michele, Zaccari, Massimiliano, Chiuch, Massimo, Vanoli, Giulia, Grignani, Edoardo Alessandro Pulixi, Pirro, Matteo, Lupattelli, Graziana, Bianconi, Vanessa, Alcidi, Riccardo, Giotta, Alessia, Massimo, R Mannarino, Domenico, Girelli, Fabiana, Busti, Giacomo, Marchi, Mario, Barbagallo, Ligia, Dominguez, Vincenza, Beneduce, Federica, Cacioppo, Giuseppe, Natoli, Salvatore, Mularo, Massimo, Raspanti, Christiano, Argano, Federica, Cavallaro, Marco, Zoli, Maria Laura Matacena, Giuseppe, Orio, Eleonora, Magnolfi, Serafini, Giovanni, Angelo, Simili, Mattia, Brunori, Ilaria, Lazzari, Cappellini, MARIA DOMENICA, Giovanna, Fabio, Margherita Migone De Amicis, Giacomo De Luca, Natalia, Scaramellini, Valeria Di Stefano, Simona, Leoni, Sonia, Seghezzi, Alessandra Danuto Di Mauro, Diletta, Maira, Marta, Mancarella, Tiziano, Lucchi, Paolo Dionigi Rossi, Marta, Clerici, Alessandra Danuta Di Mauro, Giulia, Bonini, Conti, Federica, Silvia, Prolo, Maddalena, Fabrizi, Miriana, Martelengo, Giulia, Vigani, Antonio Di Sabatino, Emanuela, Miceli, Marco Vincenzo Lenti, Martina, Pisati, Lavinia, Pitotti, Donatella, Padula, Valentina, Antoci, Ginevra, Cambiè, Roberto, Pontremoli, Valentina, Beccati, Giulia, Nobili, Giovanna, Leoncini, Jacopo, Alberto, Federico, Cattaneo, Luigi, Anastasio, Lucia, Sofia, Carbone, LUIGI MARIA, Francesco, Cipollone, Maria Teresa Guagnano, Ilaria, Rossi, Emanuele, Valeriani, Damiani, D'Ardes, Lucia, Esposito, Simona, Sestili, Ermanno, Angelucci, Gerardo, Mancuso, Daniela, Calipari, Mosè, Bartone, Giuseppe, Delitala, Maria, Berria, Alessandro, Delitala, Maurizio, Muscaritoli, Alessio, Molfino, Enrico, Petrillo, Antonella, Giorgi, Christian, Gracin, Giovanni, Imbimbo, Giuseppe, Zuccalà, Gabriella, D'Aurizio, Giuseppe, Romanelli, Andrea, Volpini, Daniela, Lucente, Francesca, Manzoni, Annalisa, Pirozzi, Alberto, Zucchelli, Antonio, Picardi, Umberto Vespasiani Gentilucci, Paolo, Gallo, Chiara, Dell'Unto, Giuseppe, Bellelli, Maurizio, Corsi, Cesare, Antonucci, Chiara, Sidoli, Giulia, Principato, Alessandra, Bonfanti, Hajnalka, Szabo, Mazzola, Paolo, Piazzoli, Andrea, Franco, Arturi, Elena, Succurro, Bruno, Tassone, Federica, Giofrè, Maria Grazia Serra, Maria Antonietta Bleve, Antonio, Brucato, Teresa De Falco, Enrica, Negro, Martino, Brenna, Lucia, Trotta, Giovanni Lorenzo Squintani, Maria Luisa Randi, Fabrizio, Fabris, Irene, Bertozzi, Giulia, Bogoni, Maria Victoria Rabuini, Tancredi, Prandini, Francesco, Ratti, Chiara, Zurlo, Lorenzo, Cerruti, Elisabetta, Cosi, Roberto, Manfredini, Fabio, Fabbian, Benedetta, Boari, Alfredo De Giorgi, Ruana, Tiseo, Giuseppe, Paolisso, Maria Rosaria Rizzo, Claudia, Catalano, Irene Di Meo, Claudio, Borghi, Enrico, Strocchi, Eugenia, Ianniello, Mario, Soldati, Silvia, Schiavone, Alessio, Bragagni, Francesca Giulia Leoni, Valeria De Sando, Sara, Scarduelli, Michela, Cammarosano, Ilenia, Pareo, Carlo, Sabbà, Francesco Saverio Vella, Patrizia, Suppressa, Giovanni Michele De Vincenzo, Alessio, Comitangelo, Emanuele, Amoruso, Carlo, Custodero, Giuseppe, Re, Andrea, Schilardi, Francesca, Loparco, Luigi, Fenoglio, Andrea, Falcetta, Alessia Valentina Giraudo, Salvatore, D'Aniano, Anna, L Fracanzani, Silvia, Tiraboschi, Annalisa, Cespiati, Giovanna, Oberti, Giordano, Sigon, Felice, Cinque, Flora, Peyvandi, Raffaella, Rossio, Giulia, Colombo, Pasquale, Agosti, Erica, Pagliaro, Eleonora, Semproni, Canetta, Ciro, Valter, Monzani, Valeria, Savojardo, Giuliana, Ceriani, Christian, Folli, Giada, Pallini, Fabrizio, Montecucco, Luciano, Ottonello, Lara, Caserza, Giulia, Vischi, Salam, Kassem, Luca, Liberale, Nicola Lucio Liberato, Tiziana, Tognin, Francesco, Purrello, Antonino Di Pino, Salvatore, Piro, Renzo, Rozzini, Lina, Falanga, Maria Stella Pisciotta, Francesco Baffa Bellucci, Stefano, Buffelli, Camillo, Ferrandina, Francesca, Mazzeo, Elena, Spazzini, Giulia, Cono, Giulia, Cesaroni, Giuseppe, Montrucchio, Paolo, Peasso, Edoardo, Favale, Cesare, Poletto, Carl, Margaria, Maura, Sanino, Ludovica, Perri, Luigina, Guasti, Francesca, Rotunno, Luana, Castiglioni, Andrea, Maresca, Alessandro, Squizzato, Leonardo, Campiotti, Alessandra, Grossi, Roberto Davide Diprizio, Francesco, Dentali, Bertolotti, Marco, Chiara, Mussi, Giulia, Lancellotti, Maria Vittoria Libbra, Matteo, Galassi, Yasmine, Grassi, Alessio, Greco, Elena, Bigi, Pellegrini, Elisa, Laura, Orlandi, Giulia, Dondi, Lucia, Carulli, Angela, Sciacqua, Maria, Perticone, Rosa, Battaglia, Raffaele, Maio, Aleandra, Scozzafava, Valentino, Condoleo, Tania, Falbo, Lidia, Colangelo, Marco, Filice, Elvira, Clausi, Vincenzo, Stanghellini, Eugenio, Ruggeri, Sara Del Vecchio, Ilaria, Benzoni, Andrea, Salvi, Leonardi, Roberto, Giampaolo, Damiani, Gianluca, Moroncini, William, Capeci, Giuseppe Pio Martino, Biondi, Lorenzo, Pietro, Pettinari, Monica, Ormas, Emanuele, Filippini, Devis, Benfaremo, Roberto, Romiti, Riccardo, Ghio, Anna Dal Col, Salvatore, Minisola, Luciano, Colangelo, Mirella, Cilli, Giancarlo, Labbadia, Antonella, Afeltra, Benedetta, Marigliano, Maria Elena Pipita, Pietro, Castellino, Luca, Zanoli, Alfio, Gennaro, Agostino, Gaudio, Samuele, Pignataro, Francesca, Mete, Miriam, Gino, Guido, Moreo, Gloria, Pina, Alberto, Ballestrero, Fabio, Ferrando, Roberta, Gonella, Domenico, Cerminara, Paolo, Setti, Chiara, Traversa, Camilla, Scarsi, Bruno, Graziella, Stefano, Baldassarre, Salvatore, Fragapani, Gabriella, Gruden, Franco, Berti, Giuseppe, Famularo, Patrizia, Tarsitani, Roberto, Castello, Michela, Pasino, Marcello Giuseppe Maggio Gian Paolo Ceda, Simonetta, Morganti, Andrea, Artoni, Margherita, Grossi, Stefano Del Giacco, Davide, Firinu, Giulia, Costanzo, Giacomo, Argiolas, Giovanni, Paoletti, Francesca, Losa, Montalto, GIUSEPPE ALBERT, Anna, Licata, Filippo Alessandro Montalto, Francesco, Corica, Giorgio, Basile, Antonino, Catalano, Federica, Bellone, Concetto, Principato, Lorenzo, Malatino, Benedetta, Stancanelli, Valentina, Terranova, Salvatore Di Marca, Rosario Di Quattro, Lara La Malfa, Rossella, Caruso, Mecocci, Patrizia, Ruggiero, Carmelinda, Boccardi, Virginia, Tiziana, Meschi, Andrea, Ticinesi, Antonio, Nouvenne, Pietro, Minuz, Luigi, Fondrieschi, Giandomenico Nigro Imperiale, Sarah, Morellini, Mario, Pirisi, Gian Paolo Fra, Daniele, Sola, Mattia, Bellan, Roberto, Quadri, Erica, Larovere, Marco, Novelli, Emilio, Simeone, Rosa, Scurti, Fabio, Tolloso, Tarquini, Roberto, Alice, Valoriani, Silvia, Dolenti, Giulia, Vannini, Volpi, Riccardo, Pietro, Bocchi, Alessandro, Vignali, Sergio, Harari, Chiara, Lonati, Federico, Napoli, Italia, Aiello, Teresa, Salvatore, Lucio, Monaco, Carmen, Ricozzi, Alberto, Pilotto, Ilaria, Indiano, Federica, Gandolfo, Franco Laghi Pasini, Pier Leopoldo Capecchi, Ranuccio, Nuti, Roberto, Valenti, Martina, Ruvio, Silvia, Cappelli, Alberto, Palazzuoli, Mauro, Bernardi, Silvia Li Bassi, Luca, Santi, Giacomo, Zaccherini, Vittorio, Durante, Daniela, Tirotta, Giovanna, Eusebi, Cattaneo, Marco Natale, Amoruso, MARIA VALENTINA, Paola, Fracasso, Cristina, Fasolino, Moreno, Tresoldi, Enrica, Bozzolo, Sarah, Damanti, Massimo, Porta, Giuseppe, Armentaro, Maria Immacolata Arnone, Milena, Barone, Lorenzo, Bertolino, Sara, Bianco, Nicolò, Binello, Simona, Brancati, Agostino, Buonauro, William, Cordeddu, Curcio, Rosa, Andrea, Dalbeni, Salvatore, D'Agnano, Damiano, D'Ardes, Martina De Feo, Emilia, Donnarumma, Marco, Fei, Carmine Gabriele Gambino, Paolo, Giorgini, Lombardi, Rosa, Giuseppe, Miceli, Paola, Naccarato, Silvia, Noviello, Gaia, Olivieri, Roberta, Parente, Francesca Serena Pignataro, Sonia, Poma, Enrica, Porceddu, Pucci, Giacomo, Marco, Ricchio, Anna, Sabena, Marco, Salice, Claudia, Santarossa, Ambra, Savona, Caterina, Savrié, Roberto, Scicali, Mario, Stabile, Giovanni, Talerico, Michela, Talia, Eliezer Joseph Tassone, Thomas, Teatini, Elisabetta, Tombolini, Matteo, Traversa, Elia, Vettore, Alessandro, Vignal, Luca, Vilardi, Rosanna, Villani, Francesco, Vitale, Cicco, Sebastiano, D Abbondanza, Marco, Proietti, Marco, Zaccone, Vincenzo, Pes, Chiara, Caradio, Federica, Mattioli, Massimo, Piano, Salvatore, Marra, Alberto Maria, Nobili, Alessandro, Mannucci, Pier Mannuccio, Pietrangelo, Antonello, Sesti, Giorgio, Buzzetti, Elena, Salzano, Andrea, Cimellaro, Antonio, Antonio Cimellaro, Salvatore, Corrao, Mario, Barbagallo, Anna, Licata, Giuseppe, Montalto, Paolisso, Giuseppe, Rizzo, Maria Rosaria, and Cimellaro, Antonio - Giovani Internisti Società Italiana di Medicina Interna (GIS-SIMI) and of the REPOSI Investigators

Subjects
cardiovascular events, older patient, hypertension, antihypertensive drugs, older patients, survival, Clinical Biochemistry, antihypertensive drug, General Medicine, Biochemistry, cardiovascular event
Abstract

Background: Hypertension management in older patients represents a challenge, particularly when hospitalized. Objective: The objective of this study is to investigate the determinants and related outcomes of antihypertensive drug prescription in a cohort of older hospitalized patients. Methods: A total of 5671 patients from REPOSI (a prospective multicentre observational register of older Italian in-patients from internal medicine or geriatric wards) were considered; 4377 (77.2%) were hypertensive. Minimum treatment (MT) for hypertension was defined according to the 2018 ESC guidelines [an angiotensin-converting-enzyme-inhibitor (ACE-I) or an angiotensin-receptor-blocker (ARB) with a calcium-channel-blocker (CCB) and/or a thiazide diuretic; if >80 years old, an ACE-I or ARB or CCB or thiazide diuretic]. Determinants of MT discontinuation at discharge were assessed. Study outcomes were any cause rehospitalization/all cause death, all-cause death, cardiovascular (CV) hospitalization/death, CV death, non-CV death, evaluated according to the presence of MT at discharge. Results: Hypertensive patients were older than normotensives, with a more impaired functional status, higher burden of comorbidity and polypharmacy. A total of 2233 patients were on MT at admission, 1766 were on MT at discharge. Discontinuation of MT was associated with the presence of comorbidities (lower odds for diabetes, higher odds for chronic kidney disease and dementia). An adjusted multivariable logistic regression analysis showed that MT for hypertension at discharge was associated with lower risk of all-cause death, all-cause death/hospitalization, CV death, CV death/hospitalization and non-CV death. Conclusions: Guidelines-suggested MT for hypertension at discharge is associated with a lower risk of adverse clinical outcomes. Nevertheless, changes in antihypertensive treatment still occur in a significant proportion of older hospitalized patients.

Published
2023

49. Hospital Care of Older Patients With COPD: Adherence to International Guidelines for Use of Inhaled Bronchodilators and Corticosteroids

Author

Marco Proietti, Pasquale Agosti, Chiara Lonati, Salvatore Corrao, Francesco Perticone, Pier Mannuccio Mannucci, Alessandro Nobili, Sergio Harari, Mauro Tettamanti, Luca Pasina, Carlotta Franchi, Alessandra Marengoni, Francesco Salerno, Matteo Cesari, Giuseppe Licata, Francesco Violi, Gino Roberto Corazza, Laura Cortesi, Ilaria Ardoino, Domenico Prisco, Elena Silvestri, Caterina Cenci, Giacomo Emmi, Gianni Biolo, Michela Zanetti, Martina Guadagni, Michele Zaccari, Massimo Vanoli, Giulia Grignani, Edoardo Alessandro Pulixi, Mauro Bernardi, Silvia Li Bassi, Luca Santi, Giacomo Zaccherini, Elmo Mannarino, Graziana Lupattelli, Vanessa Bianconi, Francesco Paciullo, Ranuccio Nuti, Roberto Valenti, Martina Ruvio, Silvia Cappelli, Alberto Palazzuoli, Oliviero Olivieri, Domenico Girelli, Thomas Matteazzi, Mario Barbagallo, Ligia Dominguez, Floriana Cocita, Vincenza Beneduce, Lidia Plances, Marco Zoli, Ilaria Lazzari, Mattia Brunori, Franco Laghi Pasini, Pier Leopoldo Capecchi, Giuseppe Palasciano, Maria Ester Modeo, Carla Di Gennaro, Maria Domenica Cappellini, Diletta Maira, Valeria Di Stefano, Giovanna Fabio, Sonia Seghezzi, Marta Mancarella, Paolo Dionigi Rossi, Sarah Damanti, Marta Clerici, Federica Conti, Emanuela Miceli, Marco Vincenzo Lenti, Martina Pisati, Costanza Caccia Dominioni, Giovanni Murialdo, Alessio Marra, Federico Cattaneo, Roberto Pontremoli, Maria Beatrice Secchi, Davide Ghelfi, Luigi Anastasio, Lucia Sofia, Maria Carbone, Francesco Cipollone, Maria Teresa Guagnano, Ermanno Angelucci, Emanuele Valeriani, Gerardo Mancuso, Daniela Calipari, Mosè Bartone, Giuseppe Delitala, Maria Berria, Maurizio Muscaritoli, Alessio Molfino, Enrico Petrillo, Giuseppe Zuccalà, Gabriella D’Aurizio, Giuseppe Romanelli, Alberto Zucchelli, Antonio Picardi, Umberto Vespasiani Gentilucci, Paolo Gallo, Chiara Dell’Unto, Giorgio Annoni, Maurizio Corsi, Giuseppe Bellelli, Sara Zazzetta, Paolo Mazzola, Hajnalka Szabo, Alessandra Bonfanti, Franco Arturi, Elena Succurro, Mariangela Rubino, Maria Grazia Serra, Maria Antonietta Bleve, Laura Gasbarrone, Maria Rosaria Sajeva, Antonio Brucato, Silvia Ghidoni, Fabrizio Fabris, Irene Bertozzi, Giulia Bogoni, Maria Victoria Rabuini, Elisabetta Cosi, Roberto Manfredini, Fabio Fabbian, Benedetta Boari, Alfredo De Giorgi, Ruana Tiseo, Giuseppe Paolisso, Maria Rosaria Rizzo, Claudio Borghi, Enrico Strocchi, Valeria De Sando, Ilenia Pareo, Carlo Sabbà, Francesco Saverio Vella, Patrizia Suppressa, Andrea Schilardi, Francesca Loparco, Luigi Fenoglio, Christian Bracco, Alessia Valentina Giraudo, Silvia Fargion, Giulia Periti, Marianna Porzio, Slivia Tiraboschi, Flora Peyvandi, Raffaella Rossio, Barbara Ferrari, Giulia Colombo, Valter Monzani, Valeria Savojardo, Christian Folli, Giuliana Ceriani, Giada Pallini, Franco Dallegri, Luciano Ottonello, Luca Liberale, Lara Caserza, Kassem Salam, Nicola Lucio Liberato, Tiziana Tognin, Giovanni Battista Bianchi, Sabrina Giaquinto, Francesco Purrello, Antonino Di Pino, Salvatore Piro, Renzo Rozzini, Lina Falanga, Elena Spazzini, Camillo Ferrandina, Giuseppe Montrucchio, Paolo Petitti, Raffaella Salmi, Piergiorgio Gaudenzi, Ludovica Perri, Raffaele Landolfi, Massimo Montalto, Antonio Mirijello, Luigina Guasti, Luana Castiglioni, Andrea Maresca, Alessandro Squizzato, Marta Molaro, Alessandra Grossi, Marco Bertolotti, Chiara Mussi, Maria Vittoria Libbra, Giulia Dondi, Elisa Pellegrini, Lucia Carulli, Lidia Colangelo, Tania Falbo, Vincenzo Stanghellini, Roberto De Giorgio, Eugenio Ruggeri, Sara del Vecchio, Andrea Salvi, Roberto Leonardi, Giampaolo Damiani, Armando Gabrielli, William Capeci, Massimo Mattioli, Giuseppe Pio Martino, Lorenzo Biondi, Pietro Pettinari, Riccardo Ghio, Anna Dal Col, Salvatore Minisola, Luciano Colangelo, Antonella Afeltra, Benedetta Marigliano, Maria Elena Pipita, Pietro Castellino, Julien Blanco, Luca Zanoli, Samuele Pignataro, Valter Saracco, Marisa Fogliati, Carlo Bussolino, Francesca Mete, Miriam Gino, Antonio Cittadini, Carlo Vigorito, Michele Arcopinto, Andrea Salzano, Emanuele Bobbio, Alberto Maria Marra, Domenico Sirico, Guido Moreo, Francesca Gasparini, Silvia Prolo, Gloria Pina, Alberto Ballestrero, Fabio Ferrando, Sergio Berra, Simonetta Dassi, Maria Cristina Nava, Bruno Graziella, Stefano Baldassarre, Salvatore Fragapani, Gabriella Gruden, Giorgio Galanti, Gabriele Mascherini, Cristian Petri, Laura Stefani, Margherita Girino, Valeria Piccinelli, Francesco Nasso, Vincenza Gioffrè, Maria Pasquale, Giuseppe Scattolin, Sergio Martinelli, Mauro Turrin, Leonardo Sechi, Cristina Catena, Gianluca Colussi, Nicola Passariello, Luca Rinaldi, Franco Berti, Giuseppe Famularo, Tarsitani Patrizia, Roberto Castello, Michela Pasino, Gian Paolo Ceda, Marcello Giuseppe Maggio, Simonetta Morganti, Andrea Artoni, Stefano Del Giacco, Davide Firinu, Francesca Losa, Giovanni Paoletti, Giuseppe Montalto, Anna Licata, Valentina Malerba, Lasco Antonino, Giorgio Basile, Catalano Antonino, Lorenzo Malatino, Benedetta Stancanelli, Valentina Terranova, Salvatore Di Marca, Patrizia Mecocci, Carmelinda Ruggiero, Virginia Boccardi, Tiziana Meschi, Fulvio Lauretani, Andrea Ticinesi, Pietro Minuz, Luigi Fondrieschi, Mario Pirisi, Gian Paolo Fra, Daniele Sola, Massimo Porta, Piero Riva, Roberto Quadri, Giorgio Scanzi, Caterina Mengoli, Stella Provini, Laura Ricevuti, Emilio Simeone, Rosa Scurti, Fabio Tolloso, Roberto Tarquini, Alice Valoriani, Silvia Dolenti, Giulia Vannini, Alberto Tedeschi, Lucia Trotta, Riccardo Volpi, Pietro Bocchi, Alessandro Vignali, Mara Cattaneo, Mannucci PM, Nobili A, Tettamanti M, Pasina L, Franchi C, Corrao S, Marengoni A, Salerno F, Cesari M, Perticone F, Licata G, Violi F, Corazza GR, Franchi C, Cortesi L, Tettamanti M, Cortesi L, Ardoino I, Prisco D, Silvestri E, Cenci C, Emmi G, Biolo G, Zanetti M, Guadagni M, Zaccari M, Vanoli M, Grignani G, Pulixi EA, Bernardi M, Bassi SL, Santi L, Zaccherini G, Mannarino E, Lupattelli G, Bianconi V, Paciullo F, Nuti R, Valenti R, Ruvio M, Cappelli S, Palazzuoli A, Olivieri O, Girelli D, Matteazzi T, Barbagallo M, Dominguez L, Cocita F, Beneduce V, Plances L, Zoli M, Lazzari I, Brunori M, Pasini FL, Capecchi PL, Palasciano G, Modeo ME, Di Gennaro C, Cappellini MD, Maira D, Di Stefano V, Fabio G, Seghezzi S, Mancarella M, Cesari M, Rossi PD, Damanti S, Clerici M, Conti F, Corazza GR, Miceli E, Lenti MV, Pisati M, Dominioni CC, Murialdo G, Marra A, Cattaneo F, Pontremoli R, Secchi MB, Ghelfi D, Anastasio L, Sofia L, Carbone M, Cipollone F, Guagnano MT, Angelucci E, Valeriani E, Mancuso G, Calipari D, Bartone M, Delitala G, Berria M, Muscaritoli M, Molfino A, Petrillo E, Zuccalà G, D'Aurizio G, Romanelli G, Marengoni A, Zucchelli A, Picardi A, Gentilucci UV, Gallo P, Dell'Unto C, Annoni G, Corsi M, Bellelli G, Zazzetta S, Mazzola P, Szabo H, Bonfanti A, Arturi F, Succurro E, Rubino M, Serra MG, Bleve MA, Gasbarrone L, Sajeva MR, Brucato A, Ghidoni S, Fabris F, Bertozzi I, Bogoni G, Rabuini MV, Cosi E, Manfredini R, Fabbian F, Boari B, De Giorgi A, Tiseo R, Paolisso G, Rizzo MR, Borghi C, Strocchi E, De Sando V, Pareo I, Sabbà C, Vella FS, Suppressa P, Agosti P, Schilardi A, Loparco F, Fenoglio L, Bracco C, Giraudo AV, Fargion S, Periti G, Porzio M, Tiraboschi S, Peyvandi F, Rossio R, Ferrari B, Colombo G, Monzani V, Savojardo V, Folli C, Ceriani G, Salerno F, Pallini G, Dallegri F, Ottonello L, Liberale L, Caserza L, Salam K, Liberato NL, Tognin T, Bianchi GB, Giaquinto S, Purrello F, Di Pino A, Piro S, Rozzini R, Falanga L, Spazzini E, Ferrandina C, Montrucchio G, Petitti P, Salmi R, Gaudenzi P, Violi F, Perri L, Landolfi R, Montalto M, Mirijello A, Guasti L, Castiglioni L, Maresca A, Squizzato A, Molaro M, Grossi A, Bertolotti M, Mussi C, Libbra MV, Dondi G, Pellegrini E, Carulli L, Perticone F, Colangelo L, Falbo T, Stanghellini V, De Giorgio R, Ruggeri E, Vecchio SD, Salvi A, Leonardi R, Damiani G, Gabrielli A, Capeci W, Mattioli M, Martino GP, Biondi L, Pettinari P, Ghio R, Col AD, Minisola S, Colangelo L, Afeltra A, Marigliano B, Pipita ME, Castellino P, Blanco J, Zanoli L, Pignataro S, Saracco V, Fogliati M, Bussolino C, Mete F, Gino M, Cittadini A, Vigorito C, Arcopinto M, Salzano A, Bobbio E, Marra AM, Sirico D, Moreo G, Gasparini F, Prolo S, Pina G, Ballestrero A, Ferrando F, Berra S, Dassi S, Nava MC, Graziella B, Baldassarre S, Fragapani S, Gruden G, Galanti G, Mascherini G, Petri C, Stefani L, Girino M, Piccinelli V, Nasso F, Gioffrè V, Pasquale M, Scattolin G, Martinelli S, Turrin M, Sechi L, Catena C, Colussi G, Passariello N, Rinaldi L, Berti F, Famularo G, Patrizia T, Castello R, Pasino M, Ceda GP, Maggio MG, Morganti S, Artoni A, Del Giacco S, Firinu D, Losa F, Paoletti G, Montalto G, Licata A, Malerba V, Antonino L, Basile G, Antonino C, Malatino L, Stancanelli B, Terranova V, Di Marca S, Mecocci P, Ruggiero C, Boccardi V, Meschi T, Lauretani F, Ticinesi A, Minuz P, Fondrieschi L, Pirisi M, Fra GP, Sola D, Porta M, Riva P, Quadri R, Scanzi G, Mengoli C, Provini S, Ricevuti L, Simeone E, Scurti R, Tolloso F, Tarquini R, Valoriani A, Dolenti S, Vannini G, Tedeschi A, Trotta L, Volpi R, Bocchi P, Vignali A, Harari S, Lonati C, Cattaneo M., Proietti M., Agosti P., Lonati C., Corrao S., Perticone F., Mannucci P.M., Nobili A., Harari S., Tettamanti M., Pasina L., Franchi C., Marengoni A., Salerno F., Cesari M., Licata G., Violi F., Corazza G.R., Cortesi L., Ardoino I., Prisco D., Silvestri E., Cenci C., Emmi G., Biolo G., Zanetti M., Guadagni M., Zaccari M., Vanoli M., Grignani G., Pulixi E.A., Bernardi M., Bassi S.L., Santi L., Zaccherini G., Mannarino E., Lupattelli G., Bianconi V., Paciullo F., Nuti R., Valenti R., Ruvio M., Cappelli S., Palazzuoli A., Olivieri O., Girelli D., Matteazzi T., Barbagallo M., Dominguez L., Cocita F., Beneduce V., Plances L., Zoli M., Lazzari I., Brunori M., Pasini F.L., Capecchi P.L., Palasciano G., Modeo M.E., Di Gennaro C., Cappellini M.D., Maira D., Di Stefano V., Fabio G., Seghezzi S., Mancarella M., Rossi P.D., Damanti S., Clerici M., Conti F., Miceli E., Lenti M.V., Pisati M., Dominioni C.C., Murialdo G., Marra A., Cattaneo F., Pontremoli R., Secchi M.B., Ghelfi D., Anastasio L., Sofia L., Carbone M., Cipollone F., Guagnano M.T., Angelucci E., Valeriani E., Mancuso G., Calipari D., Bartone M., Delitala G., Berria M., Muscaritoli M., Molfino A., Petrillo E., Zuccala G., D'Aurizio G., Romanelli G., Zucchelli A., Picardi A., Gentilucci U.V., Gallo P., Dell'Unto C., Annoni G., Corsi M., Bellelli G., Zazzetta S., Mazzola P., Szabo H., Bonfanti A., Arturi F., Succurro E., Rubino M., Serra M.G., Bleve M.A., Gasbarrone L., Sajeva M.R., Brucato A., Ghidoni S., Fabris F., Bertozzi I., Bogoni G., Rabuini M.V., Cosi E., Manfredini R., Fabbian F., Boari B., De Giorgi A., Tiseo R., Paolisso G., Rizzo M.R., Borghi C., Strocchi E., De Sando V., Pareo I., Sabba C., Vella F.S., Suppressa P., Schilardi A., Loparco F., Fenoglio L., Bracco C., Giraudo A.V., Fargion S., Periti G., Porzio M., Tiraboschi S., Peyvandi F., Rossio R., Ferrari B., Colombo G., Monzani V., Savojardo V., Folli C., Ceriani G., Pallini G., Dallegri F., Ottonello L., Liberale L., Caserza L., Salam K., Liberato N.L., Tognin T., Bianchi G.B., Giaquinto S., Purrello F., Di Pino A., Piro S., Rozzini R., Falanga L., Spazzini E., Ferrandina C., Montrucchio G., Petitti P., Salmi R., Gaudenzi P., Perri L., Landolfi R., Montalto M., Mirijello A., Guasti L., Castiglioni L., Maresca A., Squizzato A., Molaro M., Grossi A., Bertolotti M., Mussi C., Libbra M.V., Dondi G., Pellegrini E., Carulli L., Colangelo L., Falbo T., Stanghellini V., De Giorgio R., Ruggeri E., Vecchio S.D., Salvi A., Leonardi R., Damiani G., Gabrielli A., Capeci W., Mattioli M., Martino G.P., Biondi L., Pettinari P., Ghio R., Col A.D., Minisola S., Afeltra A., Marigliano B., Pipita M.E., Castellino P., Blanco J., Zanoli L., Pignataro S., Saracco V., Fogliati M., Bussolino C., Mete F., Gino M., Cittadini A., Vigorito C., Arcopinto M., Salzano A., Bobbio E., Marra A.M., Sirico D., Moreo G., Gasparini F., Prolo S., Pina G., Ballestrero A., Ferrando F., Berra S., Dassi S., Nava M.C., Graziella B., Baldassarre S., Fragapani S., Gruden G., Galanti G., Mascherini G., Petri C., Stefani L., Girino M., Piccinelli V., Nasso F., Gioffre V., Pasquale M., Scattolin G., Martinelli S., Turrin M., Sechi L., Catena C., Colussi G., Passariello N., Rinaldi L., Berti F., Famularo G., Patrizia T., Castello R., Pasino M., Ceda G.P., Maggio M.G., Morganti S., Artoni A., Del Giacco S., Firinu D., Losa F., Paoletti G., Montalto G., Licata A., Malerba V., Antonino L., Basile G., Antonino C., Malatino L., Stancanelli B., Terranova V., Di Marca S., Mecocci P., Ruggiero C., Boccardi V., Meschi T., Lauretani F., Ticinesi A., Minuz P., Fondrieschi L., Pirisi M., Fra G.P., Sola D., Porta M., Riva P., Quadri R., Scanzi G., Mengoli C., Provini S., Ricevuti L., Simeone E., Scurti R., Tolloso F., Tarquini R., Valoriani A., Dolenti S., Vannini G., Tedeschi A., Trotta L., Volpi R., Bocchi P., Vignali A., Cattaneo M., Proietti, M., Agosti, P., Lonati, C., Corrao, S., Perticone, F., Mannucci, P. M., Nobili, A., Harari, S., Tettamanti, M., Pasina, L., Franchi, C., Marengoni, A., Salerno, F., Cesari, M., Licata, G., Violi, F., Corazza, G. R., Cortesi, L., Ardoino, I., Prisco, D., Silvestri, E., Cenci, C., Emmi, G., Biolo, G., Zanetti, M., Guadagni, M., Zaccari, M., Vanoli, M., Grignani, G., Pulixi, E. A., Bernardi, M., Bassi, S. L., Santi, L., Zaccherini, G., Mannarino, E., Lupattelli, G., Bianconi, V., Paciullo, F., Nuti, R., Valenti, R., Ruvio, M., Cappelli, S., Palazzuoli, A., Olivieri, O., Girelli, D., Matteazzi, T., Barbagallo, M., Dominguez, L., Cocita, F., Beneduce, V., Plances, L., Zoli, M., Lazzari, I., Brunori, M., Pasini, F. L., Capecchi, P. L., Palasciano, G., Modeo, M. E., Di Gennaro, C., Cappellini, M. D., Maira, D., Di Stefano, V., Fabio, G., Seghezzi, S., Mancarella, M., Rossi, P. D., Damanti, S., Clerici, M., Conti, F., Miceli, E., Lenti, M. V., Pisati, M., Dominioni, C. C., Murialdo, G., Marra, A., Cattaneo, F., Pontremoli, R., Secchi, M. B., Ghelfi, D., Anastasio, L., Sofia, L., Carbone, M., Cipollone, F., Guagnano, M. T., Angelucci, E., Valeriani, E., Mancuso, G., Calipari, D., Bartone, M., Delitala, G., Berria, M., Muscaritoli, M., Molfino, A., Petrillo, E., Zuccala, G., D'Aurizio, G., Romanelli, G., Zucchelli, A., Picardi, A., Gentilucci, U. V., Gallo, P., Dell'Unto, C., Annoni, G., Corsi, M., Bellelli, G., Zazzetta, S., Mazzola, P., Szabo, H., Bonfanti, A., Arturi, F., Succurro, E., Rubino, M., Serra, M. G., Bleve, M. A., Gasbarrone, L., Sajeva, M. R., Brucato, A., Ghidoni, S., Fabris, F., Bertozzi, I., Bogoni, G., Rabuini, M. V., Cosi, E., Manfredini, R., Fabbian, F., Boari, B., De Giorgi, A., Tiseo, R., Paolisso, G., Rizzo, M. R., Borghi, C., Strocchi, E., De Sando, V., Pareo, I., Sabba, C., Vella, F. S., Suppressa, P., Schilardi, A., Loparco, F., Fenoglio, L., Bracco, C., Giraudo, A. V., Fargion, S., Periti, G., Porzio, M., Tiraboschi, S., Peyvandi, F., Rossio, R., Ferrari, B., Colombo, G., Monzani, V., Savojardo, V., Folli, C., Ceriani, G., Pallini, G., Dallegri, F., Ottonello, L., Liberale, L., Caserza, L., Salam, K., Liberato, N. L., Tognin, T., Bianchi, G. B., Giaquinto, S., Purrello, F., Di Pino, A., Piro, S., Rozzini, R., Falanga, L., Spazzini, E., Ferrandina, C., Montrucchio, G., Petitti, P., Salmi, R., Gaudenzi, P., Perri, L., Landolfi, R., Montalto, M., Mirijello, A., Guasti, L., Castiglioni, L., Maresca, A., Squizzato, A., Molaro, M., Grossi, A., Bertolotti, M., Mussi, C., Libbra, M. V., Dondi, G., Pellegrini, E., Carulli, L., Colangelo, L., Falbo, T., Stanghellini, V., De Giorgio, R., Ruggeri, E., Vecchio, S. D., Salvi, A., Leonardi, R., Damiani, G., Gabrielli, A., Capeci, W., Mattioli, M., Martino, G. P., Biondi, L., Pettinari, P., Ghio, R., Col, A. D., Minisola, S., Afeltra, A., Marigliano, B., Pipita, M. E., Castellino, P., Blanco, J., Zanoli, L., Pignataro, S., Saracco, V., Fogliati, M., Bussolino, C., Mete, F., Gino, M., Cittadini, A., Vigorito, C., Arcopinto, M., Salzano, A., Bobbio, E., Marra, A. M., Sirico, D., Moreo, G., Gasparini, F., Prolo, S., Pina, G., Ballestrero, A., Ferrando, F., Berra, S., Dassi, S., Nava, M. C., Graziella, B., Baldassarre, S., Fragapani, S., Gruden, G., Galanti, G., Mascherini, G., Petri, C., Stefani, L., Girino, M., Piccinelli, V., Nasso, F., Gioffre, V., Pasquale, M., Scattolin, G., Martinelli, S., Turrin, M., Sechi, L., Catena, C., Colussi, G., Passariello, N., Rinaldi, L., Berti, F., Famularo, G., Patrizia, T., Castello, R., Pasino, M., Ceda, G. P., Maggio, M. G., Morganti, S., Artoni, A., Del Giacco, S., Firinu, D., Losa, F., Paoletti, G., Montalto, G., Licata, A., Malerba, V., Antonino, L., Basile, G., Antonino, C., Malatino, L., Stancanelli, B., Terranova, V., Di Marca, S., Mecocci, P., Ruggiero, C., Boccardi, V., Meschi, T., Lauretani, F., Ticinesi, A., Minuz, P., Fondrieschi, L., Pirisi, M., Fra, G. P., Sola, D., Porta, M., Riva, P., Quadri, R., Scanzi, G., Mengoli, C., Provini, S., Ricevuti, L., Simeone, E., Scurti, R., Tolloso, F., Tarquini, R., Valoriani, A., Dolenti, S., Vannini, G., Tedeschi, A., Trotta, L., Volpi, R., Bocchi, P., Vignali, A., Cattaneo, M., Proietti, Marco, Agosti, Pasquale, Lonati, Chiara, Corrao, Salvatore, Perticone, Francesco, Mannucci, Pier Mannuccio, Nobili, Alessandro, Harari, Sergio, Tettamanti, Mauro, Pasina, Luca, Franchi, Carlotta, Marengoni, Alessandra, Salerno, Francesco, Cesari, Matteo, Licata, Giuseppe, Violi, Francesco, Corazza, Gino Roberto, Cortesi, Laura, Ardoino, Ilaria, Prisco, Domenico, Silvestri, Elena, Cenci, Caterina, Emmi, Giacomo, Biolo, Gianni, Zanetti, Michela, Guadagni, Martina, Zaccari, Michele, Vanoli, Massimo, Grignani, Giulia, Pulixi, Edoardo Alessandro, Bernardi, Mauro, Bassi, Silvia Li, Santi, Luca, Zaccherini, Giacomo, Mannarino, Elmo, Lupattelli, Graziana, Bianconi, Vanessa, Paciullo, Francesco, Nuti, Ranuccio, Valenti, Roberto, Ruvio, Martina, Cappelli, Silvia, Palazzuoli, Alberto, Olivieri, Oliviero, Girelli, Domenico, Matteazzi, Thoma, Barbagallo, Mario, Dominguez, Ligia, Cocita, Floriana, Beneduce, Vincenza, Plances, Lidia, Zoli, Marco, Lazzari, Ilaria, Brunori, Mattia, Pasini, Franco Laghi, Capecchi, Pier Leopoldo, Palasciano, Giuseppe, Modeo, Maria Ester, Di Gennaro, Carla, Cappellini, Maria Domenica, Maira, Diletta, Di Stefano, Valeria, Fabio, Giovanna, Seghezzi, Sonia, Mancarella, Marta, Rossi, Paolo Dionigi, Damanti, Sarah, Clerici, Marta, Conti, Federica, Miceli, Emanuela, Lenti, Marco Vincenzo, Pisati, Martina, Dominioni, Costanza Caccia, Murialdo, Giovanni, Marra, Alessio, Cattaneo, Federico, Pontremoli, Roberto, Secchi, Maria Beatrice, Ghelfi, Davide, Anastasio, Luigi, Sofia, Lucia, Carbone, Maria, Cipollone, Francesco, Guagnano, Maria Teresa, Angelucci, Ermanno, Valeriani, Emanuele, Mancuso, Gerardo, Calipari, Daniela, Bartone, Mosè, Delitala, Giuseppe, Berria, Maria, Muscaritoli, Maurizio, Molfino, Alessio, Petrillo, Enrico, Zuccalà, Giuseppe, D'Aurizio, Gabriella, Romanelli, Giuseppe, Zucchelli, Alberto, Picardi, Antonio, Gentilucci, Umberto Vespasiani, Gallo, Paolo, Dell'Unto, Chiara, Annoni, Giorgio, Corsi, Maurizio, Bellelli, Giuseppe, Zazzetta, Sara, Mazzola, Paolo, Szabo, Hajnalka, Bonfanti, Alessandra, Arturi, Franco, Succurro, Elena, Rubino, Mariangela, Serra, Maria Grazia, Bleve, Maria Antonietta, Gasbarrone, Laura, Sajeva, Maria Rosaria, Brucato, Antonio, Ghidoni, Silvia, Fabris, Fabrizio, Bertozzi, Irene, Bogoni, Giulia, Rabuini, Maria Victoria, Cosi, Elisabetta, Manfredini, Roberto, Fabbian, Fabio, Boari, Benedetta, De Giorgi, Alfredo, Tiseo, Ruana, Paolisso, Giuseppe, Rizzo, Maria Rosaria, Borghi, Claudio, Strocchi, Enrico, De Sando, Valeria, Pareo, Ilenia, Sabbà, Carlo, Vella, Francesco Saverio, Suppressa, Patrizia, Schilardi, Andrea, Loparco, Francesca, Fenoglio, Luigi, Bracco, Christian, Giraudo, Alessia Valentina, Fargion, Silvia, Periti, Giulia, Porzio, Marianna, Tiraboschi, Slivia, Peyvandi, Flora, Rossio, Raffaella, Ferrari, Barbara, Colombo, Giulia, Monzani, Valter, Savojardo, Valeria, Folli, Christian, Ceriani, Giuliana, Pallini, Giada, Dallegri, Franco, Ottonello, Luciano, Liberale, Luca, Caserza, Lara, Salam, Kassem, Liberato, Nicola Lucio, Tognin, Tiziana, Bianchi, Giovanni Battista, Giaquinto, Sabrina, Purrello, Francesco, Di Pino, Antonino, Piro, Salvatore, Rozzini, Renzo, Falanga, Lina, Spazzini, Elena, Ferrandina, Camillo, Montrucchio, Giuseppe, Petitti, Paolo, Salmi, Raffaella, Gaudenzi, Piergiorgio, Perri, Ludovica, Landolfi, Raffaele, Montalto, Massimo, Mirijello, Antonio, Guasti, Luigina, Castiglioni, Luana, Maresca, Andrea, Squizzato, Alessandro, Molaro, Marta, Grossi, Alessandra, Bertolotti, Marco, Mussi, Chiara, Libbra, Maria Vittoria, Dondi, Giulia, Pellegrini, Elisa, Carulli, Lucia, Colangelo, Lidia, Falbo, Tania, Stanghellini, Vincenzo, De Giorgio, Roberto, Ruggeri, Eugenio, Vecchio, Sara del, Salvi, Andrea, Leonardi, Roberto, Damiani, Giampaolo, Gabrielli, Armando, Capeci, William, Mattioli, Massimo, Martino, Giuseppe Pio, Biondi, Lorenzo, Pettinari, Pietro, Ghio, Riccardo, Col, Anna Dal, Minisola, Salvatore, Colangelo, Luciano, Afeltra, Antonella, Marigliano, Benedetta, Pipita, Maria Elena, Castellino, Pietro, Blanco, Julien, Zanoli, Luca, Pignataro, Samuele, Saracco, Valter, Fogliati, Marisa, Bussolino, Carlo, Mete, Francesca, Gino, Miriam, Cittadini, Antonio, Vigorito, Carlo, Arcopinto, Michele, Salzano, Andrea, Bobbio, Emanuele, Marra, Alberto Maria, Sirico, Domenico, Moreo, Guido, Gasparini, Francesca, Prolo, Silvia, Pina, Gloria, Ballestrero, Alberto, Ferrando, Fabio, Berra, Sergio, Dassi, Simonetta, Nava, Maria Cristina, Graziella, Bruno, Baldassarre, Stefano, Fragapani, Salvatore, Gruden, Gabriella, Galanti, Giorgio, Mascherini, Gabriele, Petri, Cristian, Stefani, Laura, Girino, Margherita, Piccinelli, Valeria, Nasso, Francesco, Gioffrè, Vincenza, Pasquale, Maria, Scattolin, Giuseppe, Martinelli, Sergio, Turrin, Mauro, Sechi, Leonardo, Catena, Cristina, Colussi, Gianluca, Passariello, Nicola, Rinaldi, Luca, Berti, Franco, Famularo, Giuseppe, Patrizia, Tarsitani, Castello, Roberto, Pasino, Michela, Ceda, Gian Paolo, Maggio, Marcello Giuseppe, Morganti, Simonetta, Artoni, Andrea, Del Giacco, Stefano, Firinu, Davide, Losa, Francesca, Paoletti, Giovanni, Montalto, Giuseppe, Licata, Anna, Malerba, Valentina, Antonino, Lasco, Basile, Giorgio, Antonino, Catalano, Malatino, Lorenzo, Stancanelli, Benedetta, Terranova, Valentina, Di Marca, Salvatore, Mecocci, Patrizia, Ruggiero, Carmelinda, Boccardi, Virginia, Meschi, Tiziana, Lauretani, Fulvio, Ticinesi, Andrea, Minuz, Pietro, Fondrieschi, Luigi, Pirisi, Mario, Fra, Gian Paolo, Sola, Daniele, Porta, Massimo, Riva, Piero, Quadri, Roberto, Scanzi, Giorgio, Mengoli, Caterina, Provini, Stella, Ricevuti, Laura, Simeone, Emilio, Scurti, Rosa, Tolloso, Fabio, Tarquini, Roberto, Valoriani, Alice, Dolenti, Silvia, Vannini, Giulia, Tedeschi, Alberto, Trotta, Lucia, Volpi, Riccardo, Bocchi, Pietro, Vignali, Alessandro, Cattaneo, Mara, Proietti, M, Agosti, P, Lonati, C, Corrao, S, Perticone, F, Mannucci, Pm, Nobili, A, Harari, S, Rizzo, Mr, Paolisso, G, Reposi, Investigators., Mannucci, P, Tettamanti, M, Pasina, L, Franchi, C, Marengoni, A, Salerno, F, Cesari, M, Licata, G, Violi, F, Corazza, G, Cortesi, L, Ardoino, I, Prisco, D, Silvestri, E, Cenci, C, Emmi, G, Biolo, G, Zanetti, M, Guadagni, M, Zaccari, M, Vanoli, M, Grignani, G, Pulixi, E, Bernardi, M, Bassi, S, Santi, L, Zaccherini, G, Mannarino, E, Lupattelli, G, Bianconi, V, Paciullo, F, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Palazzuoli, A, Olivieri, O, Girelli, D, Matteazzi, T, Barbagallo, M, Dominguez, L, Cocita, F, Beneduce, V, Plances, L, Zoli, M, Lazzari, I, Brunori, M, Pasini, F, Capecchi, P, Palasciano, G, Modeo, M, Di Gennaro, C, Cappellini, M, Maira, D, Di Stefano, V, Fabio, G, Seghezzi, S, Mancarella, M, Rossi, P, Damanti, S, Clerici, M, Conti, F, Miceli, E, Lenti, M, Pisati, M, Dominioni, C, Murialdo, G, Marra, A, Cattaneo, F, Pontremoli, R, Secchi, M, Ghelfi, D, Anastasio, L, Sofia, L, Carbone, M, Cipollone, F, Guagnano, M, Angelucci, E, Valeriani, E, Mancuso, G, Calipari, D, Bartone, M, Delitala, G, Berria, M, Muscaritoli, M, Molfino, A, Petrillo, E, Zuccala, G, D'Aurizio, G, Romanelli, G, Zucchelli, A, Picardi, A, Gentilucci, U, Gallo, P, Dell'Unto, C, Annoni, G, Corsi, M, Bellelli, G, Zazzetta, S, Mazzola, P, Szabo, H, Bonfanti, A, Arturi, F, Succurro, E, Rubino, M, Serra, M, Bleve, M, Gasbarrone, L, Sajeva, M, Brucato, A, Ghidoni, S, Fabris, F, Bertozzi, I, Bogoni, G, Rabuini, M, Cosi, E, Manfredini, R, Fabbian, F, Boari, B, De Giorgi, A, Tiseo, R, Rizzo, M, Borghi, C, Strocchi, E, De Sando, V, Pareo, I, Sabba, C, Vella, F, Suppressa, P, Schilardi, A, Loparco, F, Fenoglio, L, Bracco, C, Giraudo, A, Fargion, S, Periti, G, Porzio, M, Tiraboschi, S, Peyvandi, F, Rossio, R, Ferrari, B, Colombo, G, Monzani, V, Savojardo, V, Folli, C, Ceriani, G, Pallini, G, Dallegri, F, Ottonello, L, Liberale, L, Caserza, L, Salam, K, Liberato, N, Tognin, T, Bianchi, G, Giaquinto, S, Purrello, F, Di Pino, A, Piro, S, Rozzini, R, Falanga, L, Spazzini, E, Ferrandina, C, Montrucchio, G, Petitti, P, Salmi, R, Gaudenzi, P, Perri, L, Landolfi, R, Montalto, M, Mirijello, A, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Molaro, M, Grossi, A, Bertolotti, M, Mussi, C, Libbra, M, Dondi, G, Pellegrini, E, Carulli, L, Colangelo, L, Falbo, T, Stanghellini, V, De Giorgio, R, Ruggeri, E, Vecchio, S, Salvi, A, Leonardi, R, Damiani, G, Gabrielli, A, Capeci, W, Mattioli, M, Martino, G, Biondi, L, Pettinari, P, Ghio, R, Col, A, Minisola, S, Afeltra, A, Marigliano, B, Pipita, M, Castellino, P, Blanco, J, Zanoli, L, Pignataro, S, Saracco, V, Fogliati, M, Bussolino, C, Mete, F, Gino, M, Cittadini, A, Vigorito, C, Arcopinto, M, Salzano, A, Bobbio, E, Sirico, D, Moreo, G, Gasparini, F, Prolo, S, Pina, G, Ballestrero, A, Ferrando, F, Berra, S, Dassi, S, Nava, M, Graziella, B, Baldassarre, S, Fragapani, S, Gruden, G, Galanti, G, Mascherini, G, Petri, C, Stefani, L, Girino, M, Piccinelli, V, Nasso, F, Gioffre, V, Pasquale, M, Scattolin, G, Martinelli, S, Turrin, M, Sechi, L, Catena, C, Colussi, G, Passariello, N, Rinaldi, L, Berti, F, Famularo, G, Patrizia, T, Castello, R, Pasino, M, Ceda, G, Maggio, M, Morganti, S, Artoni, A, Del Giacco, S, Firinu, D, Losa, F, Paoletti, G, Montalto, G, Licata, A, Malerba, V, Antonino, L, Basile, G, Antonino, C, Malatino, L, Stancanelli, B, Terranova, V, Di Marca, S, Mecocci, P, Ruggiero, C, Boccardi, V, Meschi, T, Lauretani, F, Ticinesi, A, Minuz, P, Fondrieschi, L, Pirisi, M, Fra, G, Sola, D, Porta, M, Riva, P, Quadri, R, Scanzi, G, Mengoli, C, Provini, S, Ricevuti, L, Simeone, E, Scurti, R, Tolloso, F, Tarquini, R, Valoriani, A, Dolenti, S, Vannini, G, Tedeschi, A, Trotta, L, Volpi, R, Bocchi, P, Vignali, A, and Cattaneo, M

Subjects
Male, major clinical event, major clinical events, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Older patients, Adrenal Cortex Hormones, 80 and over, 030212 general & internal medicine, LS4_4, adherence, Prospective Studies, General Nursing, Nursing (all)2901 Nursing (miscellaneous), Aged, 80 and over, COPD, Health Policy, General Medicine, COPD guidelines, adherence, major clinical events, older patients, older patients, Obstructive lung disease, Bronchodilator Agents, guidelines adherence, Hospitalization, Inhalation, Administration, Inhalation, Aged, Female, Humans, Guideline Adherence, Administration, COPD guidelines, Geriatrics and Gerontology, Chronic Obstructive, medicine.medical_specialty, Socio-culturale, Pulmonary Disease, 03 medical and health sciences, older patient, Internal medicine, medicine, Medical prescription, Polypharmacy, business.industry, Settore MED/09 - MEDICINA INTERNA, Odds ratio, medicine.disease, Confidence interval, respiratory tract diseases, Observational study, business, 030217 neurology & neurosurgery
Abstract

Objectives We aimed to analyze the prevalence and impact of COPD in older patients hospitalized in internal medicine or geriatric wards, and to investigate adherence to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, associated clinical factors, and outcomes. Design Data were obtained from REgistro POliterapie SIMI (REPOSI), a prospective multicenter observational registry that enrolls inpatients aged ≥65 years. Setting and Participants Older hospitalized patients enrolled from 2008 to 2016 with a diagnosis of COPD. Measures We evaluated adherence to the 2018 GOLD guidelines at admission and discharge, by examining the prescription of inhaled bronchodilators and corticosteroids in COPD patients. We also evaluated the occurrence of outcomes and its association with COPD and guideline adherence. Results At hospital admission, COPD was diagnosed in 1302 (21.5%) of 6046 registered patients. COPD patients were older, with more impaired clinical and functional status and multiple comorbidities. Overall, 34.3% of COPD patients at admission and 35.6% at discharge were adherent to the GOLD guidelines. Polypharmacy (≥5 drugs) at admission [odds ratio (OR): 3.28, 95% confidence interval (CI): 2.24-4.81], a history of acute COPD exacerbation (OR: 2.65, 95% CI: 1.44-4.88) at admission, smoking habit (OR: 1.45, 95% CI: 1.08-1.94), and polypharmacy at discharge (OR: 6.76, 95% CI: 4.15-11.0) were associated with adherence to guidelines. COPD was independently associated with the risk of cardiovascular and respiratory death and rehospitalization occurrence compared to patients without COPD during follow-up. Adherence to guidelines was inversely associated with the occurrence of death from all causes (OR: 0.12, 95% CI: 0.02-0.90). Conclusions/Implications COPD was common in older patients acutely hospitalized, showing an impaired functional and clinical status. Prescriptions for older COPD patients were often not adherent to GOLD guidelines. Poor adherence to guidelines was associated with a worse clinical status. There is a need to improve adherence to guidelines in treating COPD patients, with the ultimate goal of reducing clinical events.

Published
2019

50. Pattern of in-hospital changes in drug use in the older people from 2010 to 2016

Author

Carlotta, Franchi, Ilaria, Ardoino, Alessandro, Nobili, Luca, Pasina, Pier Mannuccio Mannucci, Alessandra, Marengoni, Francesco, Perticone, Mauro, Tettamanti, Francesco, Salerno, Salvatore, Corrao, Giuseppe, Licata, Francesco, Violi, Gino Roberto Corazza, Marcucci, Maura, Tarek Kamal Eldin, Maria Pia Donatella Di Blanca, Giovanna, Lanzo, Sarah, Astuto, Laura, Cortesi, Prisco, Domenico, Elena, Silvestri, Caterina, Cenci, Giacomo, Emmi, Gianni, Biolo, Gianfranco, Guarnieri, Michela, Zanetti, Giovanni, Fernandes, Massimiliano, Chiuch, Massimo, Vanoli, Giulia, Grignani, Gianluca, Casella, Edoardo Alessandro Pulixi, Mauro, Bernardi, Silvia Li Bassi, Luca, Santi, Giacomo, Zaccherini, Mannarino, Elmo, Lupattelli, Graziana, Bianconi, Vanessa, Paciullo, Francesco, Ranuccio, Nuti, Roberto, Valenti, Martina, Ruvio, Silvia, Cappelli, Alberto, Palazzuoli, Teresa, Salvatore, Ferdinando Carlo Sasso, Domenico, Girelli, Oliviero, Olivieri, Thomas, Matteazzi, Mario, Barbagallo, Lidia, Plances, Roberta, Alcamo, Luigi, Calvo, Maria, Valenti, Marco, Zoli, Raffaella, Arnò, Franco Laghi Pasini, Pier Leopoldo Capecchi, Maurizio, Bicchi, Giuseppe, Palasciano, Maria Ester Modeo, Maria, Peragine, Fabrizio, Pappagallo, Stefania, Pugliese, Carla Di Gennaro, Alfredo, Postiglione, Maria Rosaria Barbella, Francesco De Stefano, Cappellini, MARIA DOMENICA, Giovanna, Fabio, Sonia, Seghezzi, Margherita Migone De Amicis, Marta, Mancarella, Daniela, Mari, Paolo Dionigi Rossi, Sarah, Damanti, Barbara Brignolo Ottolini, Giulia, Bonini, Emanuela, Miceli, Marco Vincenzo Lenti, Donatella, Padula, Giovanni, Murialdo, Alessio, Marra, Federico, Cattaneo, Maria Beatrice Secchi, Davide, Ghelfi, Luigi, Anastasio, Lucia, Sofia, Carbone, LUIGI MARIA, Giovanni, Davì, Maria Teresa Guagnano, Simona, Sestili, Gerardo, Mancuso, Daniela, Calipari, Mosè, Bartone, Maria Rachele Meroni, Paolo Cavallo Perin, Bartolomeo, Lorenzati, Gabriella, Gruden, Graziella, Bruno, Cristina, Amione, Paolo, Fornengo, Rodolfo, Tassara, Deborah, Melis, Lara, Rebella, Giuseppe, Delitala, Vincenzo, Pretti, Maristella Salvatora Masala, Chiara, Pes, Luigi, Bolondi, Leonardo, Rasciti, Ilaria, Serio, Filippo Rossi Fanelli, Antonio, Amoroso, Alessio, Molfino, Enrico, Petrillo, Giuseppe, Zuccalà, Francesco, Franceschi, Guido De Marco, Cordischi, Chiara, Sabbatini, Marta, Gabriella, D’Aurizio, Giuseppe, Romanelli, Claudia, Amolini, Deborah, Chiesa, Antonio, Picardi, Umberto Vespasiani Gentilucci, Paolo, Gallo, Giorgio, Annoni, Maurizio, Corsi, Sara, Zazzetta, Giuseppe, Bellelli, Hajnalka, Szabo, Franco, Arturi, Elena, Succurro, Mariangela, Rubino, Giorgio, Sesti, Paola, Loria, Maria Angela Becchi, Gianfranco, Martucci, Alessandra, Fantuzzi, Mauro, Maurantonio, Maria Grazia Serra, Maria Antonietta Bleve, Laura, Gasbarrone, Maria Rosaria Sajeva, Antonio, Brucato, Silvia, Ghidoni, Paola Di Corato, Agnelli, Giancarlo, Marchesini, Emanuela, Fabrizio, Fabris, Michela, Carlon, Francesca, Turatto, Aldo, Baritusso, Annalisa, Amabile, Elisabetta, Omenetto, Paolo, Scarinzi, Roberto, Manfredini, Christian, Molino, Marco, Pala, Fabio, Fabbian, Benedetta, Boari, Alfredo De Giorgi, Giuseppe, Paolisso, Maria Rosaria Rizzo, Maria Teresa Laieta, Giovanbattista, Rini, Pasquale, Mansueto, Ilenia, Pepe, Claudio, Borghi, Enrico, Strocchi, Valeria De Sando, Ilaria, Pareo, Carlo, Sabbà, Francesco Saverio Vella, Patrizia, Suppressa, Raffaella, Valerio, Pasquale, Agosti, Flavia, Fontana, Francesca, Loparco, Caterina, Capobianco, Luigi, Fenoglio, Christian, Bracco, Alessia Valentina Giraudo, Elisa, Testa, Cristina, Serraino, Silvia, Fargion, Paola, Bonara, Giulia, Periti, Marianna, Porzio, Slivia, Tiraboschi, Flora, Peyvandi, Alberto, Tedeschi, Raffaella, Rossio, Valter, Monzani, Valeria, Savojardo, Christian, Folli, Maria, Magnini, Alessio, Conca, Giulia, Gobbo, Giada, Pallini, Miriam, Valenti, Balduini, Carlo L., Giampiera, Bertolino, Stella, Provini, Federica, Quaglia, Franco, Dallegri, Luciano, Ottonello, Luca, Liberale, Wu Sheng Chin, Laura, Carassale, Silvia, Caporotundo, Giancarlo, Traisci, Lucrezia De Feudis, Silvia Di Carlo, Nicola Lucio Liberato, Alberto, Buratti, Tiziana, Tognin, Giovanni Battista Bianchi, Sabrina, Giaquinto, Francesco, Purrello, Antonino Di Pino, Salvatore, Piro, Renzo, Rozzini, Lina, Falanga, Elena, Spazzini, Giuseppe, Montrucchio, Elisabetta, Greco, Pietro, Tizzani, Paolo, Petitti, Antonio, Perciccante, Alessia, Coralli, Raffaella, Salmi, Piergiorgio, Gaudenzi, Susanna, Gamberini, Andrea, Semplicini, Lucia, Gottardo, Gianluigi, Vendemiale, Gaetano, Serviddio, Roberta, Forlano, Cesare, Masala, Antonio, Mammarella, Valeria, Raparelli, Stefania, Basili, Ludovica, Perri, Raffaele, Landolfi, Massimo, Montalto, Antonio, Mirijello, Carla, Vallone, Martino, Bellusci, Donatella, Setti, Filippo, Pedrazzoli, Luigina, Guasti, Luana, Castiglioni, Andrea, Maresca, Alessandro, Squizzato, Marta, Molaro, Bertolotti, Marco, Chiara, Mussi, Maria Vittoria Libbra, DI MICELI, Andrea, Pellegrini, Elisa, Lucia, Carulli, Francesca, Veltri, Angela, Sciacqua, Michele, Quero, Chiara, Bagnato, Lidia, Colangelo, Tania, Falbo, Roberto De Giorgio, DALLA SERRA, Mauro, Valentina, Grasso, Eugenio, Ruggeri, Benzoni, Ilaria, Andrea, Salvi, Leonardi, Roberto, Chiara, Grassini, Ilenia, Mascherona, Minelli, Giorgio, Francesca, Maltese, Giampaolo, Damiani, William, Capeci, Mattioli, Massimo, Giuseppe Pio Martino, Biondi, Lorenzo, Monica, Ormas, Pietro, Pettinari, Roberto, Romiti, Silvia, Messina, Federica, Cavallaro, Riccardi, Ghio, Serena, Favorini, Anna Dal Col, Salvatore, Minisola, Luciano, Colangelo, Antonella, Afeltra, Pamela, Alemanno, Benedetta, Marigliano, Maria Elena Pipita, Pietro, Castellino, Julien, Blanco, Luca, Zanoli, Cattaneo, Marco Natale, Paola, Fracasso, Amoruso, MARIA VALENTINA, Valter, Saracco, Marisa, Fogliati, Carlo, Bussolino, Vittorio, Durante, Giovanna, Eusebi, Daniela, Tirotta, Francesca, Mete, Miriam, Gino, Antonio, Cittadini, Carlo, Vigorito, Michele, Arcopinto, Andrea, Salzano, Emanuele, Bobbio, Alberto Maria Marra, Domenico, Sirico, Guido, Moreo, Francesco, Scopelliti, Francesca, Gasparini, Melissa, Cocca, Alberto, Ballestrero, Fabio, Ferrando, Sergio, Berra, Simonetta, Dassi, Maria Cristina Nava, Bruno, Graziella, Stefano, Baldassarre, Salvatore, Fragapani, Giorgio, Galanti, Gabriele, Mascherini, Cristian, Petri, Laura, Stefani, Margherita, Girino, Valeria, Piccinelli, Francesco, Nasso, Vincenza, Gioffrè, Maria, Pasquale, Giuseppe, Scattolin, Sergio, Martinelli, Mauro, Turrin, Leonardo, Sechi, Cristina, Catena, Gianluca, Colussi, Ramirez Duque Nieves, Muela Molinero Alberto, Abad Requejo Pedro, Lopez Pelaez Vanessa, Tamargo, Lara, Corbella Viros Xavier, Formiga, Francesc, Diez Manglano Jesus, Bejarano Tello Esperanza, Del Corral Behamonte Esther, Sevil Puras Maria, Manuel, Romero, Pinilla Llorente Blanca, Lopez Gonzalez-Cobos Cristina, Victoria, Villalba Garcia M., Lopez, Saez, Juan, Bosco, Sanz Baena Susana, Arroyo Gallego Marta, Gonzalez Becerra Concepcion, Fernandez Moyano Antonio, Mercedes Gomez Hernandez, Manuel Poyato Borrego, Pacheco Cuadros Raquel, Perez Rojas Florencia, Garcia Olid Beatriz, Carrascosa Garcia Sara, Gonzalez-Cruz Cervellera Alfonso, Peinado Martinez Marta, Sara Carrascosa Garcia, Ruiz Cantero Alberto, Albarracín Arraigosa Antonio, Godoy Guerrero Montserrat, Barón Ramos Miguel Ángel, Machin Jose Manuel, Novo Veleiro Ignacio, Alvela Suarez Lucía, Lopez, Alfonso, Rubal Bran David, Iñiguez Vazquez Iria, Rios Prego Monica, Franchi C., Ardoino I., Nobili A., Pasina L., Mannucci P.M., Marengoni A., Perticone F., REPOSI investigators., Barbagallo M., Dominguez Rodríguez L.J., Franchi, C., Ardoino, I., Nobili, A., Pasina, L., Mannucci, P. M., Marengoni, A., Perticone, F., Tettamanti, M., Salerno, F., Corrao, S., Licata, G., Violi, F., Corazza, G. R., Marcucci, M., Eldin, T. K., Donatella Di Blanca, M. P., Lanzo, G., Astuto, S., Cortesi, L., Prisco, D., Silvestri, E., Cenci, C., Emmi, G., Biolo, G., Guarnieri, G., Zanetti, M., Fernandes, G., Chiuch, M., Vanoli, M., Grignani, G., Casella, G., Pulixi, E. A., Bernardi, M., Li Bassi, S., Santi, L., Zaccherini, G., Mannarino, E., Lupattelli, G., Bianconi, V., Paciullo, F., Nuti, R., Valenti, R., Ruvio, M., Cappelli, S., Palazzuoli, A., Salvatore, T., Sasso, F. C., Girelli, D., Olivieri, O., Matteazzi, T., Barbagallo, M., Plances, L., Alcamo, R., Calvo, L., Valenti, M., Zoli, M., Arno, R., Pasini, F. L., Capecchi, P. L., Bicchi, M., Palasciano, G., Modeo, M. E., Peragine, M., Pappagallo, F., Pugliese, S., Di Gennaro, C., Postiglione, A., Barbella, M. R., De Stefano, F., Cappellini, M. D., Fabio, G., Seghezzi, S., De Amicis, M. M., Mancarella, M., Mari, D., Rossi, P. D., Damanti, S., Ottolini, B. B., Bonini, G., Miceli, E., Lenti, M. V., Padula, D., Murialdo, G., Marra, A., Cattaneo, F., Secchi, M. B., Ghelfi, D., Anastasio, L., Sofia, L., Carbone, M., Davi, G., Guagnano, M. T., Sestili, S., Mancuso, G., Calipari, D., Bartone, M., Meroni, M. R., Perin, P. C., Lorenzati, B., Gruden, G., Bruno, G., Amione, C., Fornengo, P., Tassara, R., Melis, D., Rebella, L., Delitala, G., Pretti, V., Masala, M. S., Pes, C., Bolondi, L., Rasciti, L., Serio, I., Fanelli, F. R., Amoroso, A., Molfino, A., Petrillo, E., Zuccala, G., Franceschi, F., De Marco, G., Chiara, C., Marta, S., D'Aurizio, G., Romanelli, G., Amolini, C., Chiesa, D., Picardi, A., Gentilucci, U. V., Gallo, P., Annoni, G., Corsi, M., Zazzetta, S., Bellelli, G., Szabo, H., Arturi, F., Succurro, E., Rubino, M., Sesti, G., Loria, P., Becchi, M. A., Martucci, G., Fantuzzi, A., Maurantonio, M., Serra, M. G., Bleve, M. A., Gasbarrone, L., Sajeva, M. R., Brucato, A., Ghidoni, S., Di Corato, P., Agnelli, G., Marchesini, E., Fabris, F., Carlon, M., Turatto, F., Baritusso, A., Amabile, A., Omenetto, E., Scarinzi, P., Manfredini, R., Molino, C., Pala, M., Fabbian, F., Boari, B., De Giorgi, A., Paolisso, G., Rizzo, M. R., Laieta, M. T., Rini, G., Mansueto, P., Pepe, I., Borghi, C., Strocchi, E., De Sando, V., Pareo, I., Sabba, C., Vella, F. S., Suppressa, P., Valerio, R., Agosti, P., Fontana, F., Loparco, F., Capobianco, C., Fenoglio, L., Bracco, C., Giraudo, A. V., Testa, E., Serraino, C., Fargion, S., Bonara, P., Periti, G., Porzio, M., Tiraboschi, S., Peyvandi, F., Tedeschi, A., Rossio, R., Monzani, V., Savojardo, V., Folli, C., Magnini, M., Conca, A., Gobbo, G., Pallini, G., Balduini, C. L., Bertolino, G., Provini, S., Quaglia, F., Dallegri, F., Ottonello, L., Liberale, L., Chin, W. S., Carassale, L., Caporotundo, S., Traisci, G., De Feudis, L., Di Carlo, S., Liberato, N. L., Buratti, A., Tognin, T., Bianchi, G. B., Giaquinto, S., Purrello, F., Di Pino, A., Piro, S., Rozzini, R., Falanga, L., Spazzini, E., Montrucchio, G., Greco, E., Tizzani, P., Petitti, P., Perciccante, A., Coralli, A., Salmi, R., Gaudenzi, P., Gamberini, S., Semplicini, A., Gottardo, L., Vendemiale, G., Serviddio, G., Forlano, R., Masala, C., Mammarella, A., Raparelli, V., Basili, S., Perri, L., Landolfi, R., Montalto, M., Mirijello, A., Vallone, C., Bellusci, M., Setti, D., Pedrazzoli, F., Guasti, L., Castiglioni, L., Maresca, A., Squizzato, A., Molaro, M., Bertolotti, M., Mussi, C., Libbra, M. V., Miceli, A., Pellegrini, E., Carulli, L., Veltri, F., Sciacqua, A., Quero, M., Bagnato, C., Colangelo, L., Falbo, T., De Giorgio, R., Serra, M., Grasso, V., Ruggeri, E., Ilaria, B., Salvi, A., Leonardi, R., Grassini, C., Mascherona, I., Minelli, G., Maltese, F., Damiani, G., Capeci, W., Mattioli, M., Martino, G. P., Biondi, L., Ormas, M., Pettinari, P., Romiti, R., Messina, S., Cavallaro, F., Ghio, R., Favorini, S., Dal Col, A., Minisola, S., Afeltra, A., Alemanno, P., Marigliano, B., Pipita, M. E., Castellino, P., Blanco, J., Zanoli, L., Cattaneo, M., Fracasso, P., Amoruso, M. V., Saracco, V., Fogliati, M., Bussolino, C., Durante, V., Eusebi, G., Tirotta, D., Mete, F., Gino, M., Cittadini, A., Vigorito, C., Arcopinto, M., Salzano, A., Bobbio, E., Marra, A. M., Sirico, D., Moreo, G., Scopelliti, F., Gasparini, F., Cocca, M., Ballestrero, A., Ferrando, F., Berra, S., Dassi, S., Nava, M. C., Graziella, B., Baldassarre, S., Fragapani, S., Galanti, G., Mascherini, G., Petri, C., Stefani, L., Girino, M., Piccinelli, V., Nasso, F., Gioffre, V., Pasquale, M., Scattolin, G., Martinelli, S., Turrin, M., Sechi, L., Catena, C., Colussi, G., Nieves, R. D., Alberto, M. M., Pedro, A. R., Vanessa, L. P., Lara, T., Xavier, C. V., Francesc, F., Jesus, D. M., Esperanza, B. T., Esther, D. C. B., Maria, S. P., Romero, M., Blanca, P. L., Cristina, L. G. -C., Victoria, V. G. M., Saez, L., Bosco, J., Susana, S. B., Marta, A. G., Concepcion, G. B., Antonio, F. M., Hernandez, M. G., Borrego, M. P., Raquel, P. C., Florencia, P. R., Beatriz, G. O., Sara, C. G., Alfonso, G. -C. C., Marta, P. M., Garcia, S. C., Alberto, R. C., Antonio, A. A., Montserrat, G. G., Angel, B. R. M., Manuel, M. J., Ignacio, N. V., Lucia, A. S., Alfonso, L., David, R. B., Iria, I. V., Monica, R. P., Franchi, C, Ardoino, I, Nobili, A, Pasina, L, Mannucci, P, Marengoni, A, Perticone, F, Tettamanti, M, Salerno, F, Corrao, S, Licata, G, Violi, F, Corazza, G, Marcucci, M, Eldin, T, Donatella Di Blanca, M, Lanzo, G, Astuto, S, Cortesi, L, Prisco, D, Silvestri, E, Cenci, C, Emmi, G, Biolo, G, Guarnieri, G, Zanetti, M, Fernandes, G, Chiuch, M, Vanoli, M, Grignani, G, Casella, G, Pulixi, E, Bernardi, M, Li Bassi, S, Santi, L, Zaccherini, G, Mannarino, E, Lupattelli, G, Bianconi, V, Paciullo, F, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Palazzuoli, A, Salvatore, T, Sasso, F, Girelli, D, Olivieri, O, Matteazzi, T, Barbagallo, M, Plances, L, Alcamo, R, Calvo, L, Valenti, M, Zoli, M, Arno, R, Pasini, F, Capecchi, P, Bicchi, M, Palasciano, G, Modeo, M, Peragine, M, Pappagallo, F, Pugliese, S, Di Gennaro, C, Postiglione, A, Barbella, M, De Stefano, F, Cappellini, M, Fabio, G, Seghezzi, S, De Amicis, M, Mancarella, M, Mari, D, Rossi, P, Damanti, S, Ottolini, B, Bonini, G, Miceli, E, Lenti, M, Padula, D, Murialdo, G, Marra, A, Cattaneo, F, Secchi, M, Ghelfi, D, Anastasio, L, Sofia, L, Carbone, M, Davi, G, Guagnano, M, Sestili, S, Mancuso, G, Calipari, D, Bartone, M, Meroni, M, Perin, P, Lorenzati, B, Gruden, G, Bruno, G, Amione, C, Fornengo, P, Tassara, R, Melis, D, Rebella, L, Delitala, G, Pretti, V, Masala, M, Pes, C, Bolondi, L, Rasciti, L, Serio, I, Fanelli, F, Amoroso, A, Molfino, A, Petrillo, E, Zuccala, G, Franceschi, F, De Marco, G, Chiara, C, Marta, S, D'Aurizio, G, Romanelli, G, Amolini, C, Chiesa, D, Picardi, A, Gentilucci, U, Gallo, P, Annoni, G, Corsi, M, Zazzetta, S, Bellelli, G, Szabo, H, Arturi, F, Succurro, E, Rubino, M, Sesti, G, Loria, P, Becchi, M, Martucci, G, Fantuzzi, A, Maurantonio, M, Serra, M, Bleve, M, Gasbarrone, L, Sajeva, M, Brucato, A, Ghidoni, S, Di Corato, P, Agnelli, G, Marchesini, E, Fabris, F, Carlon, M, Turatto, F, Baritusso, A, Amabile, A, Omenetto, E, Scarinzi, P, Manfredini, R, Molino, C, Pala, M, Fabbian, F, Boari, B, De Giorgi, A, Paolisso, G, Rizzo, M, Laieta, M, Rini, G, Mansueto, P, Pepe, I, Borghi, C, Strocchi, E, De Sando, V, Pareo, I, Sabba, C, Vella, F, Suppressa, P, Valerio, R, Agosti, P, Fontana, F, Loparco, F, Capobianco, C, Fenoglio, L, Bracco, C, Giraudo, A, Testa, E, Serraino, C, Fargion, S, Bonara, P, Periti, G, Porzio, M, Tiraboschi, S, Peyvandi, F, Tedeschi, A, Rossio, R, Monzani, V, Savojardo, V, Folli, C, Magnini, M, Conca, A, Gobbo, G, Pallini, G, Balduini, C, Bertolino, G, Provini, S, Quaglia, F, Dallegri, F, Ottonello, L, Liberale, L, Chin, W, Carassale, L, Caporotundo, S, Traisci, G, De Feudis, L, Di Carlo, S, Liberato, N, Buratti, A, Tognin, T, Bianchi, G, Giaquinto, S, Purrello, F, Di Pino, A, Piro, S, Rozzini, R, Falanga, L, Spazzini, E, Montrucchio, G, Greco, E, Tizzani, P, Petitti, P, Perciccante, A, Coralli, A, Salmi, R, Gaudenzi, P, Gamberini, S, Semplicini, A, Gottardo, L, Vendemiale, G, Serviddio, G, Forlano, R, Masala, C, Mammarella, A, Raparelli, V, Basili, S, Perri, L, Landolfi, R, Montalto, M, Mirijello, A, Vallone, C, Bellusci, M, Setti, D, Pedrazzoli, F, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Molaro, M, Bertolotti, M, Mussi, C, Libbra, M, Miceli, A, Pellegrini, E, Carulli, L, Veltri, F, Sciacqua, A, Quero, M, Bagnato, C, Colangelo, L, Falbo, T, De Giorgio, R, Grasso, V, Ruggeri, E, Ilaria, B, Salvi, A, Leonardi, R, Grassini, C, Mascherona, I, Minelli, G, Maltese, F, Damiani, G, Capeci, W, Mattioli, M, Martino, G, Biondi, L, Ormas, M, Pettinari, P, Romiti, R, Messina, S, Cavallaro, F, Ghio, R, Favorini, S, Dal Col, A, Minisola, S, Afeltra, A, Alemanno, P, Marigliano, B, Pipita, M, Castellino, P, Blanco, J, Zanoli, L, Cattaneo, M, Fracasso, P, Amoruso, M, Saracco, V, Fogliati, M, Bussolino, C, Durante, V, Eusebi, G, Tirotta, D, Mete, F, Gino, M, Cittadini, A, Vigorito, C, Arcopinto, M, Salzano, A, Bobbio, E, Sirico, D, Moreo, G, Scopelliti, F, Gasparini, F, Cocca, M, Ballestrero, A, Ferrando, F, Berra, S, Dassi, S, Nava, M, Graziella, B, Baldassarre, S, Fragapani, S, Galanti, G, Mascherini, G, Petri, C, Stefani, L, Girino, M, Piccinelli, V, Nasso, F, Gioffre, V, Pasquale, M, Scattolin, G, Martinelli, S, Turrin, M, Sechi, L, Catena, C, Colussi, G, Nieves, R, Alberto, M, Pedro, A, Vanessa, L, Lara, T, Xavier, C, Francesc, F, Jesus, D, Esperanza, B, Esther, D, Maria, S, Romero, M, Blanca, P, Cristina, L, Victoria, V, Saez, L, Bosco, J, Susana, S, Marta, A, Concepcion, G, Antonio, F, Hernandez, M, Borrego, M, Raquel, P, Florencia, P, Beatriz, G, Sara, C, Alfonso, G, Marta, P, Garcia, S, Alberto, R, Antonio, A, Montserrat, G, Angel, B, Manuel, M, Ignacio, N, Lucia, A, Alfonso, L, David, R, Iria, I, and Monica, R

Subjects
Registrie, Male, pharmacoepidemiology, Epidemiology, Discharged alive, 030204 cardiovascular system & hematology, internal medicine and geriatric ward, drug use, excessive polypharmacy, internal medicine and geriatric wards, older people, polypharmacy, 0302 clinical medicine, Drug Prescription, Risk Factors, 80 and over, Pharmacology (medical), 030212 general & internal medicine, Registries, At-Risk Population, media_common, Aged, 80 and over, Overtime, drug use, excessive polypharmacy, internal medicine and geriatric wards, older people, pharmacoepidemiology, polypharmacy, Pharmacoepidemiology, Hospitalization, Italy, Female, Medical emergency, Human, Drug, medicine.medical_specialty, media_common.quotation_subject, Socio-culturale, Drug Prescriptions, 03 medical and health sciences, Hospital discharge, medicine, Internal Medicine, Humans, Aged, Polypharmacy, Inpatients, business.industry, Risk Factor, medicine.disease, Emergency medicine, Older people, business
Abstract

Purpose: To assess the pattern of in-hospital changes in drug use in older patients from 2010 to 2016. Methods: People aged 65years or more acutely hospitalized in those internal medicine and geriatric wards that did continuously participate to the REgistro POliterapie Società Italiana di Medicina Interna register from 2010 to 2016 were selected. Drugs use were categorized as 0 to 1 drug (very low drug use), 2 to 4 drugs (low drug use), 5 to 9 drugs (polypharmacy), and 10 or more drugs (excessive polypharmacy). To assess whether or not prevalence of patients in relation to drug use distribution changed overtime, adjusted prevalence ratios (PRs) was estimated with log-binomial regression models. Results: Among 2120 patients recruited in 27 wards continuously participating to data collection, 1882 were discharged alive and included in this analysis. The proportion of patients with very low drug use (0-1 drug) at hospital discharge increased overtime, from 2.7% in 2010 to 9.2% in 2016. Results from a log-logistic adjusted model confirmed the increasing PR of these very low drug users overtime (particularly in 2014 vs 2012, PR 1.83 95% CI 1.14-2.95). Moreover, from 2010 to 2016, there was an increasing number of patients who, on polypharmacy at hospital admission, abandoned it at hospital discharge, switching to the very low drug use group. Conclusion: This study shows that in internal medicine and geriatric wards continuously participating to the REgistro POliterapie Società Italiana di Medicina Interna register, the proportion of patients with a very low drug use at hospital discharge increased overtime, thus reducing the therapeutic burden in this at risk population.

Published
2017

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