Swiss medical weekly最新文献

{"title":"Demographic distribution and injury patterns of ankle physeal fractures in children: a retrospective cohort study.","authors":"Silvia Valisena, Giacomo De Marco, Oscar Vazquez, Anne Tabard-Fougère, Nastassia Guanziroli-Pralong, Christina Steiger-Tuc, Romain Olivier Dayer, Dimitri Ceroni","doi":"10.57187/s.4265","DOIUrl":"10.57187/s.4265","url":null,"abstract":"<p><strong>Introduction: </strong>Ankle physeal fractures are a significant concern in paediatric populations due to their potential to cause growth disturbances, including premature physeal closure. The present study aimed to describe the epidemiology and injury patterns of ankle physeal fractures in children treated at a single university hospital centre in Switzerland over a 19-year period.</p><p><strong>Materials and methods: </strong>This retrospective cohort study included children aged 0 to 16 years who were admitted to our institution for an ankle physeal fracture between January 2004 and April 2023. Demographic and radiological data were collected, and fractures were classified according to the Salter-Harris and Dias-Tachdjian classifications. Statistical analyses, including Fisher's exact test, were performed for dichotomous outcomes, with significance set at p<0.05.</p><p><strong>Results: </strong>We included 259 patients with a mean age of 12.3 years old, mostly males (58.7%), with most fractures occurring among boys aged 14 and girls aged 12. Sports-related activities accounted for 51% of fractures, with the highest incidence in autumn. Isolated fractures of the distal tibia were most common (47.1%), and Salter-Harris type II fractures represented 51% of cases (p <0.05). The predominant mechanism of injury was supination-plantar flexion (33.6%).</p><p><strong>Conclusion: </strong>This study provided a comprehensive overview of the distribution and patterns of paediatric ankle physeal fractures. It underscored the need for future prospective multicentre studies to explore causative factors and outcomes related to growth disturbances. Targeted prevention and management strategies may help mitigate the incidence and consequences of these injuries.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4265"},"PeriodicalIF":2.1,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of intermediate airway management on ventilation parameters in simulated paediatric out-of-hospital cardiac arrest: a multicentre randomised crossover trial.","authors":"Loric Stuby, Laurent Bourgeois, Jean-Marie Tinembart, Elisa Mühlemann, David Thurre, Johan N Siebert, Laurent Suppan","doi":"10.57187/s.4079","DOIUrl":"10.57187/s.4079","url":null,"abstract":"<p><strong>Introduction: </strong>Paediatric out-of-hospital cardiac arrest survival rates remain low despite advancements in resuscitation science. Prompt restoration of oxygenation is crucial for achieving return of spontaneous circulation. Delays in airway management are associated with decreased survival rates. The primary objective of this study was to determine whether early i-gel® insertion, without prior bag-valve-mask, could enhance ventilation parameters in comparison with a bag-valve-mask-only approach.</p><p><strong>Methods: </strong>This multicentre, randomised crossover study used a simulated paediatric out-of-hospital cardiac arrest model to compare standard American Heart Association guidelines with an intermediate airway management approach using an i-gel® device. Paramedics and emergency medical technicians from eight participating emergency medical service centres were randomised into teams and performed two 10-minute simulations. Each team employed one of the airway management strategies. Data was automatically collected by a high-fidelity manikin. The primary outcome was alveolar ventilation per minute. Secondary outcomes included metrics for ventilation quality and timing, chest compression performance and timing of adrenaline administration. Statistical analysis involved paired tests suitable for the crossover design.</p><p><strong>Results: </strong>From 30 January 2023 to 13 June 2023, 68 participants formed 34 resuscitation teams. Minute alveolar ventilation was similar between intermediate airway management and bag-valve-mask strategies (difference: 36 ml [95% CI -28 to 99]). A sensitivity analysis showed comparable results. Intermediate airway management delivered more ventilations, but bag-valve-mask enabled quicker ventilation initiation and more ventilations within the target volume. Chest compression fraction was higher with intermediate airway management, although chest recoil was better with bag-valve-mask. Adrenaline administration rates and times were similar in both strategies. Minor protocol deviations were observed but did not introduce significant bias. The study was underpowered due to an error in the sample size calculation, limiting the robustness and generalisability of the findings.</p><p><strong>Conclusion: </strong>In a simulated paediatric out-of-hospital cardiac arrest model, immediate use of intermediate airway management did not show relevant differences compared to bag-valve-mask. Intermediate airway management devices cannot be recommended as first-line choice but may be considered when bag-valve-mask is challenging. Whichever device is used, the focus should remain on providing high-quality ventilations.</p><p><strong>Clinicaltrials: </strong>gov ID: NCT05498402.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4079"},"PeriodicalIF":2.1,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mediation effects of attitudes on the generational and gender influence on Swiss General Practitioners' home visits: a cross-sectional study.","authors":"Serena Petrocchi, Qianfeng Lu, Luca Gabutti, Sandro Bonetti, Mjriam Rodella Sapia, Franco Denti, Mario Bianchetti, Peter Schulz","doi":"10.57187/s.4039","DOIUrl":"10.57187/s.4039","url":null,"abstract":"<p><strong>Background: </strong>In family medicine, home visits are a tangible manifestation of patient-centred care, allowing physicians to comprehensively understand patients' circumstances and cater to their medical and psychosocial needs. However, a recent decline in general practitioner home visits has raised significant concerns about the potential impact on care quality, particularly for older patients. General practitioners' age, gender and attitudes may play a role. Attitudes refer to positive or negative thinking or feelings about something typically reflected in a person's behaviour.</p><p><strong>Aims: </strong>To study the effects of age and gender (i.e. predictors) on the number of home visits conducted during a typical week of work (i.e. outcome) by general practitioners in Canton Ticino, Switzerland. To investigate whether attitudes (i.e. mediators) mediate the relationship between age and home visits, controlling for gender.</p><p><strong>Methods: </strong>A cross-sectional study was conducted from June to October 2023 on 142 family doctors (28% women) with an average age of 56.42 years (standard deviation [SD] = 11.51, range 36-83). Correlations between variables and a t-test with gender were conducted. A mediation analysis was performed to examine the potential association in which the attitudes may mediate the relationship between age and home visits, controlling for gender.</p><p><strong>Results: </strong>Older physicians conducted more home visits in a typical week (r = 0.32, p <0.001) than younger physicians, while female doctors conducted fewer visits (M = 2.39±1.8) than males (M = 4.09±2.9), t(100.8) = 3.77, p <0.001. The mediation analysis suggested that younger general practitioners tend to have more negative attitudes towards home visits, which in turn leads to a decrease in the number of home visits they make in a typical week (indirect effect B = 0.02).</p><p><strong>Conclusion: </strong>There is a generational and gender effect on home visit practice in family medicine. Moreover, younger doctors hold more negative attitudes towards home visits.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4039"},"PeriodicalIF":2.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistent opioid use among patients who underwent intermediate-to-major elective surgery at a Swiss cantonal hospital: a prospective cohort study.","authors":"Flavia Breitenmoser, Aaron Rixecker, Rahel Naef, Pascal Probst, Nils Horn, Markus K Müller, Alexander Dullenkopf, JoEllen Welter","doi":"10.57187/s.4152","DOIUrl":"10.57187/s.4152","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study aim: &lt;/strong&gt;To investigate the extent of persistent opioid use among patients undergoing intermediate-to-major elective surgery at a Swiss cantonal hospital and as a secondary aim to identify factors potentially predictive of persistent opioid use (6 to 12 weeks after surgery).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;For this single-centre prospective cohort study, all consecutive patients undergoing elective primary hip arthroplasty, partial or complete prostatectomy, caesarean delivery, spinal surgery, intermediate-to-major visceral surgery or major hand surgery were screened for enrolment from June 2022 to May 2023. We collected basic demographic and medical data, perioperative opioid use (converted to morphine milligram equivalents), postoperative complications, and opioid prescriptions issued by the hospital or other healthcare providers. Telephone interviews about opioid use were conducted with patients 6 weeks after surgery. Only those patients who were still taking opioids at the 6-week interview were contacted 12 weeks after surgery. The primary endpoint was the rate of persistent opioid use 6 or 12 weeks after surgery, and the secondary endpoints were (a) the percentage of patients who received and reported filling prescriptions, and (b) the type and amount of opioids dispensed. With persistent opioid use as the dependent variable, bivariate (predictors: pain or preoperative morphine milligram equivalent) and multivariate logistic regression models were used to assess associations (predictors: age, sex, ASA [American Society of Anesthesiologists] score, preoperative pain).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 855 patients were included in the main analysis. Median age was 62 years (interquartile range [IQR] 45-73), 52% were male and postsurgical complications occurred in 51 patients (6%). Fifty-six patients (7%) were preoperative opioid users. At discharge, 40 patients (5%) received an opioid prescription. Of the 724 patients who completed the 6-week follow-up interview, 30 (4%) had filled an opioid prescription (17 hospital-issued, 9 from an external source and 4 from both). Of the 30 patients (4%) who took opioids, the median length of consumption was 7 days (IQR 3-18). Seventeen patients (2%, 9 preoperative users) were taking opioids after 6 weeks. Seven of these 724 patients (1%, 5 preoperative users) continued use at 12 weeks postoperatively. Bivariate logistic regression analyses showed preoperative pain levels (at rest and during movement) were associated with persistent opioid use (odds ratio [OR] 1.27, 95% confidence interval [CI]: 1.11-1.46, p = 0.001; OR 1.3, 95% CI: 1.12-1.5, p = 0.001, respectively), as were 6-week postoperative pain levels (OR 1.96, 95% CI: 1.61-2.39, p &lt;0.0001; OR 1.82, 95% CI: 1.52-2.18, p &lt;0.0001, respectively). The median preoperative morphine milligram equivalent of persistent opioid users was 60 (IQR 30-180) versus 22.5 (IQR 15-30) in non-persistent users (p = 0.0155). There was a sl","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4152"},"PeriodicalIF":2.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Did the COVID-19 pandemic impact paediatric health service utilisation in Switzerland? Interrupted time-series models of health insurance data.","authors":"Michelle Dey, Thomas Volken, Szilvia Altwicker-Hámori, Michael Von Rhein, Michelle Seiler, Ursula Laasner, Frank Wieber, Julia Dratva","doi":"10.57187/s.3899","DOIUrl":"10.57187/s.3899","url":null,"abstract":"<p><strong>Background: </strong>There is a scarcity of studies that examined the impact of the COVID-19 pandemic on different primary paediatric health services beyond the first pandemic year and with longitudinal analytical approaches. Concerning Switzerland, studies are also lacking that assessed the impact of the pandemic on primary paediatric health services with objective and representative data. The current study addresses these research gaps.</p><p><strong>Methods: </strong>Representative Swiss health insurance data (covering 96% of the population) of 0-18-year-olds, aggregated by month and by age groups 0-5, 6-10, 11-15 and 16-18 years were used for the analyses. The study period was from January 2018 to March 2022. Interrupted time-series models were applied to compare pandemic and pre-pandemic health care utilisation. The first lockdown served as the point of differentiation between these two periods. Regular visits, urgent visits, well-child visits and telephone consultations as well as routine vaccinations in the primary care setting were used as outcomes.</p><p><strong>Results: </strong>Among 0-5-year-olds, the average utilisation rates of regular, urgent and well-child visits were statistically significantly lower during the pandemic compared to the pre-pandemic period. This decrease in utilisation was primarily due to an initial marked drop after the lockdown, followed by a partial recovery during the pandemic phase. Additionally, the average vaccination rates for measles/mumps/rubella were statistically significantly lower during the pandemic for this age group, without indication of a catch-up over the pandemic phase. For 6-10-year-olds, a decreased average utilisation of regular and urgent visits was found without a statistically significant recovery over the pandemic period. No statistically significant changes were shown for older age groups regarding regular or urgent visits. However, telephone consultations showed statistically significantly higher average utilisation rates during the pandemic compared to the pre-pandemic phase across all age groups.</p><p><strong>Conclusions: </strong>Delayed or missed well-child visits, which might persist even after a certain recovery, pose the risk of delayed detection of clinical/developmental abnormalities. Furthermore, missed vaccinations for measles/mumps/rubella increase the likelihood of infections and outbreaks, which can be particularly dangerous for the youngest children. Therefore, promoting catch-up well-child visits and vaccinations is essential. Higher utilisation of telephone consultations during the pandemic may have partially compensated the underutilisation of face-to-face consultations/visits in young children. In adolescents, in whom no changes in the utilisation of face-to-face consultations were observed, the increased use of telephone consultations may indicate an increase in health concerns within this age group.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"3899"},"PeriodicalIF":2.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suplementum 285: Abstracts of the of the 9th Annual Spring Congress of the Swiss Society of General Internal Medicine (Basel, Switzerland, May 21-23, 2025).","authors":"Swiss Society Of General Internal Medicine","doi":"10.57187/s.4571","DOIUrl":"https://doi.org/10.57187/s.4571","url":null,"abstract":"","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4571"},"PeriodicalIF":2.1,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrapartum antibiotic prophylaxis for Streptococcal B colonisation: a cross-sectional study of hospital internal protocols in Switzerland.","authors":"Sylvie Anne Genier, Gessica Trivelli, Vera Ruth Mitter","doi":"10.57187/s.4297","DOIUrl":"10.57187/s.4297","url":null,"abstract":"<p><strong>Study aims: </strong>Streptococcus agalacticae is a pathogen associated with maternal and neonatal morbidity and mortality. The current gold standard for preventing neonatal sepsis is the intrapartum antibiotic prophylaxis (IAP) of Streptococcus agalacticae-positive mothers. Antimicrobial resistance is on the rise and increasingly threatens public health. Therefore, the responsible use of antibiotics is critical. Switzerland lacks unified IAP guidelines. IAP management varies by obstetric ward and is based on various national and international guidelines. This study aimed to gain an overview of the variability of existing internal protocols for IAP for Streptococcus agalacticae in Swiss obstetrics wards.</p><p><strong>Method: </strong>In March and April 2024, all identified obstetric wards in Switzerland were contacted and invited to submit their internal protocols so that they could be analysed for the choice of antibiotics for IAP, the referenced literature supporting their protocols and the professions involved in their development.</p><p><strong>Results: </strong>Of 87 departments contacted, 43 (49%) shared their protocols. Three β-lactam antibiotics were identified as the first choice: penicillin G (56%, n = 24), amoxicillin (28%, n = 12) and co-amoxicillin (9%, n = 4). In 19% of the protocols (n = 8), there was no distinction between mild or severe allergy to penicillin derivatives. In this group (n = 8), 75% (n = 6) administered clindamycin as the second choice, with 50% (n = 3 of 6) offering vancomycin as an alternative in cases of known clindamycin resistance or allergy. In the group with allergy severity classification (n = 35), first- and second-generation cephalosporins were preferred for mild penicillin allergy: 71% (n = 25) used cefazolin, 26% (n = 9) used cefuroxime and erythromycin was mentioned by n = 1. In 21 of the 33 received protocols with references, Expert Letter No. 19 from the Swiss Society of Gynaecology and Obstetrics (SGGG) was referenced, making up 64 % of the used literature. This was followed by other literature (58 %, n = 19) and the revised guidelines of the Swiss Society of Neonatology in collaboration with the Paediatric Infectious Disease Group Switzerland (PIGS) (30 %, n = 10). Mostly gynaecologists (90%; n = 28 of 31) were involved as authors of internal protocols. Neonatologists were not mentioned by any.</p><p><strong>Conclusion: </strong>Our study highlights that the management of intrapartum antibiotic prophylaxis is heterogeneous, and antimicrobial stewardship is lacking in most Swiss obstetric wards. In terms of literature, German-speaking wards in Switzerland are more orientated towards German-speaking neighbouring countries than French- and Italian-speaking wards. There is a need to enhance interdisciplinarity in the development of internal protocols and to create a joint national guideline among professional societies.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4297"},"PeriodicalIF":2.1,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technical comment on: Würnschimmel C, et al. Prostate cancer screening in Switzerland: a literature review and consensus statement from the Swiss Society of Urology.","authors":"Takeshi Takahashi","doi":"10.57187/s.4069","DOIUrl":"10.57187/s.4069","url":null,"abstract":"<p><p>No abstract available.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4069"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating growth references used in Switzerland: a comparative analysis in Zurich schoolchildren.","authors":"Lorenz M Leuenberger, Fabiën N Belle, Rebeca Mozun, Ben D Spycher, Maria C Mallet, Oskar G Jenni, Christoph Saner, Philipp Latzin, Alexander Moeller, Claudia E Kuehni","doi":"10.57187/s.3834","DOIUrl":"10.57187/s.3834","url":null,"abstract":"<p><strong>Introduction: </strong>The Swiss Society of Paediatrics currently recommends the growth references of the World Health Organization (WHO), while the Paediatric Endocrinology Centre Zurich (PEZZ) has proposed alternative growth references. Specialists and researchers also use International Obesity Task Force (IOTF) references to define overweight and obesity. We investigated the fit of anthropometric measurements from schoolchildren in the canton of Zurich to these three growth references and assessed the prevalence of overweight, obesity and short stature across the three references.</p><p><strong>Methods: </strong>We analysed data from 3755 children aged 6-17 years in the cross-sectional LuftiBus in the School (LUIS) study, collected in the period 2013-2016 in the canton of Zurich. We calculated z-scores of height, weight and body mass index (BMI) based on WHO, PEZZ and IOTF references. We compared the mean and distribution of z-scores to the expected standard normal distribution using the Anderson-Darling test. We classified overweight, obesity and severe obesity based on cutoff values given by the three references. We defined short stature as <3rd percentile of height for age.</p><p><strong>Results: </strong>The mean z-scores in LUIS were 0.56 for height, 0.28 for weight and 0.06 for BMI based on WHO references; 0.15 for height, 0.06 for weight and -0.01 for BMI based on PEZZ references; and 0.19 for BMI based on IOTF references. The Anderson-Darling test showed that children in LUIS fit worse to WHO and IOTF than to PEZZ references. The WHO classified fewer children as overweight than PEZZ and IOTF references (WHO: 8%; PEZZ: 15%; IOTF: 13%) but more children as obese or severely obese (6%; 4%; 3%). The WHO defined fewer children as being of short stature than PEZZ references (1% vs 3%).</p><p><strong>Conclusions: </strong>Our findings suggest that anthropometric data of schoolchildren in Zurich (LUIS) differ notably from WHO and IOTF references potentially leading to misclassification of overweight, obesity and short stature. Thus it would be timely to develop new nationally representative growth references for Switzerland.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"3834"},"PeriodicalIF":2.1,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of health-related quality of life in patients with acute dyspnoea: a cohort study.","authors":"Maria Belkin, Desiree N Wussler, Samyut Shrestha, Pedro Lopez-Ayala, Albina Nowak, Eleni Michou, Androniki Papachristou, Codruta Popescu, Ivo Strebel, Nikola Kozhuharov, Zaid Sabti, Isabelle Netzer, Tobias Zimmermann, Matthias Diebold, Tobias Breidthardt, Christian Mueller","doi":"10.57187/s.3785","DOIUrl":"10.57187/s.3785","url":null,"abstract":"<p><strong>Background: </strong>Self-reported health-related quality of life is an established prognostic tool in stable outpatients. However, its prognostic relevance in patients presenting with an acute onset of symptoms such as acute dyspnoea is largely unknown.</p><p><strong>Methods: </strong>This major unmet clinical need was addressed in a secondary analysis of a prospective study, enrolling patients presenting with acute dyspnoea to the emergency departments of two university hospitals in Switzerland. Self-reported health-related quality of life was obtained at presentation with the use of the generic EQ-5D tool and directly compared to the objective risk prediction marker N-terminal pro-B-type natriuretic peptide (NT-proBNP). The primary endpoint was all-cause mortality within 90 and 720 days. Cox proportional hazard regressions were performed with age, sex, history of heart failure, systolic blood pressure, haemoglobin, estimated glomerular filtration rate and NT-proBNP as predictors. Prognostic accuracies were calculated with the use of area under the receiver operating characteristics curve (AUC).</p><p><strong>Results: </strong>Among 1144 eligible patients (median age 74 years, 42% women, 52% acute heart failure), 7% died within 90 days and 28% within 720 days after presentation to the emergency department. The EQ-5D index was strongly associated with mortality. In adjusted Cox regression analyses, the hazard ratios of the EQ-5D index for 90- and 720-day mortality were 7.8 (95% confidence interval [CI] 3.4-17.9) and 5.0 (95% CI 3.3-7.6), respectively. Prognostic accuracies of the EQ-5D index for 90- and 720-day mortality were 0.68 and 0.65, and comparable to the prognostic accuracy of NT-proBNP (both AUCs: 0.69, p-value for comparison 0.915 and 0.121).</p><p><strong>Conclusions: </strong>Self-reported health-related quality of life assessed by the generic EQ-5D tool provides moderate-to-high prognostic accuracy in patients presenting with acute dyspnoea to the emergency department and may aid physicians in risk stratification.</p><p><strong>Trial registration: </strong>https://clinicaltrials.gov NCT01831115.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"3785"},"PeriodicalIF":2.1,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}