Lancet Regional Health-Europe最新文献

{"title":"Increased risk of cardiopulmonary mortality during hot weather: well-designed health impact assessments to inform heat adaptation strategies","authors":"Zhiwei Xu","doi":"10.1016/j.lanepe.2024.101065","DOIUrl":"10.1016/j.lanepe.2024.101065","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"46 ","pages":"Article 101065"},"PeriodicalIF":13.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142571598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why is alcohol so normalised in Europe?","authors":"The Lancet Regional Health – Europe","doi":"10.1016/j.lanepe.2024.101119","DOIUrl":"10.1016/j.lanepe.2024.101119","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"46 ","pages":"Article 101119"},"PeriodicalIF":13.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142571891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a prognostic model to predict 90-day mortality in hospitalised cancer patients (PROMISE tool): a prospective observational study","authors":"Oriol Mirallas ,&nbsp;Berta Martin-Cullell ,&nbsp;Víctor Navarro ,&nbsp;Kreina Sharela Vega ,&nbsp;Jordi Recuero-Borau ,&nbsp;Diego Gómez-Puerto ,&nbsp;Daniel López-Valbuena ,&nbsp;Clara Salva de Torres ,&nbsp;Laura Andurell ,&nbsp;Anna Pedrola ,&nbsp;Roger Berché ,&nbsp;Fiorella Palmas ,&nbsp;José María Ucha ,&nbsp;Guillermo Villacampa ,&nbsp;Alejandra Rezqallah ,&nbsp;Judit Sanz-Beltran ,&nbsp;Rafael Bach ,&nbsp;Sergio Bueno ,&nbsp;Cristina Viaplana ,&nbsp;Gaspar Molina ,&nbsp;Joan Carles","doi":"10.1016/j.lanepe.2024.101063","DOIUrl":"10.1016/j.lanepe.2024.101063","url":null,"abstract":"<div><h3>Background</h3><div>Prognostic factors for ambulatory oncology patients have been described, including Eastern Cooperative Oncology Group (ECOG), tumor stage and malnutrition. However, there is no firm evidence on which variables best predict mortality in hospitalized patients receiving active systemic treatment. Our main goal was to develop a predictive model for 90-day mortality upon admission.</div></div><div><h3>Methods</h3><div>Between 2020 and 2022, we prospectively collected data from three sites for cancer patients with hospitalizations. Those with metastatic disease receiving systemic therapy in the 6 months before unplanned admission were eligible to this study. The least absolute shrinkage and selection operator (LASSO) method was used to select the most relevant factors to predict 90-day mortality at admission. A multivariable logistic regression was fitted to create the PROgnostic Score for Hospitalized Cancer Patients (PROMISE) score. The score was developed in a single-center training cohort and externally validated.</div></div><div><h3>Findings</h3><div>Of 1658 hospitalized patients, 1009 met eligibility criteria. Baseline demographics, patient and disease characteristics were similar across cohorts. Lung cancer was the most common tumor type in both cohorts. Factors associated with higher 90-day mortality included worse ECOG, stable/progressive disease, low levels of albumin, increased absolute neutrophil count, and high lactate dehydrogenase. The c-index after bootstrap correction was 0.79 (95% CI, 0.75–0.82) and 0.74 (95% CI, 0.68–0.80) in the training and validation cohorts, respectively. A web tool (<span><span>https://promise.vhio.net/</span><svg><path></path></svg></span>) was developed to facilitate the clinical deployment of the model.</div></div><div><h3>Interpretation</h3><div>The PROMISE tool demonstrated high performance for identifying metastatic cancer patients who are alive 90 days after an unplanned hospitalization. This will facilitate healthcare providers with rational clinical decisions and care planning after discharge.</div></div><div><h3>Funding</h3><div><span>Merck S.L.U.</span>, Spain.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"46 ","pages":"Article 101063"},"PeriodicalIF":13.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142572318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liver transplantation for critically ill patients with acute on chronic liver failure: a prospective national programme of waitlist prioritisation","authors":"William Bernal ,&nbsp;Rhiannon Taylor ,&nbsp;Ian A. Rowe ,&nbsp;Abhishek Chauhan ,&nbsp;Matthew J. Armstrong ,&nbsp;Michael E.D. Allison ,&nbsp;Gwilym Webb ,&nbsp;Tasneem Pirani ,&nbsp;Joanna Moore ,&nbsp;Laura Burke ,&nbsp;Steven Masson ,&nbsp;David Cressy ,&nbsp;Brian J. Hogan ,&nbsp;Rachel Westbrook ,&nbsp;Rajiv Jalan ,&nbsp;Kenneth J. Simpson ,&nbsp;John Isaac ,&nbsp;Douglas Thorburn","doi":"10.1016/j.lanepe.2024.101067","DOIUrl":"10.1016/j.lanepe.2024.101067","url":null,"abstract":"<div><h3>Background</h3><div>Acute on Chronic Liver Failure (ACLF) complicates chronic liver disease (CLD) combining rapidly progressive hepatic with extra-hepatic multiple organ failure and high short-term mortality. Effective therapeutic options are very limited, and liver transplantation (LT) seldom utilised through concerns of high recipient mortality and resource use. Retrospective reports suggest recent outcomes may have improved, but use of LT for ACLF has not been prospectively assessed.</div></div><div><h3>Methods</h3><div>A prospective programme of prioritised liver graft allocation for selected recipients with ACLF through registration on a new national tier, initiated in May 2021 in all 7 United Kingdom LT centres. Candidates were selected by centre multidisciplinary teams, with inclusion criteria mandating cirrhotic CLD with ACLF requiring critical care (CC) organ support and expected 1-month mortality &gt;50%. Exclusion criteria included age ≥60 years, previous LT, comorbidity or substance misuse profile precluding elective LT. A pilot 50 registrations were planned, with pre-specified futility criteria of a 1-year post-LT survival of 60%.</div></div><div><h3>Findings</h3><div>Fifty-two patients were registered on the ACLF tier, median (IQR) age 46 (39–52) years, ACLF grade 3 (3–3) and Model for End-stage Liver Disease (MELD) 39 (35–40). At registration 32 (62%) required mechanical ventilation, 44 (85%) vasopressors and 46 (89%) renal replacement. Forty-two (81%) underwent LT 2 (2–5) days after registration: 10 (19%) did not. All non-transplanted died at median 7 (4–13) days after registration (p &lt; 0.0001 vs. LT). Post-LT follow-up was 212 (119–530) days and patient survival 81% (95% CI 66–91): 28-, 90-day and 1-year survival after registration 93%, 86% and 77%. Median length of CC and hospital stay in LT recipients was 16 (8–28) and 35 (23–54) days respectively.</div></div><div><h3>Interpretation</h3><div>We report the first prospective national series of prioritised liver transplantation for critically ill patients with ACLF. For selected recipients LT is a practical and highly effective treatment option where no other similarly effective interventions exist.</div></div><div><h3>Funding</h3><div>There was no funding for the study.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"46 ","pages":"Article 101067"},"PeriodicalIF":13.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142572319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutri-score and cardiovascular risk: new insights from the EPIC cohorts","authors":"Andrea Poli,&nbsp;Franca Marangoni","doi":"10.1016/j.lanepe.2024.101059","DOIUrl":"10.1016/j.lanepe.2024.101059","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"46 ","pages":"Article 101059"},"PeriodicalIF":13.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142571600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"European Society for Medical Oncology (ESMO) congress 2024","authors":"Daniela Marín-Hernández,&nbsp;Ivana Nedic","doi":"10.1016/j.lanepe.2024.101087","DOIUrl":"10.1016/j.lanepe.2024.101087","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"46 ","pages":"Article 101087"},"PeriodicalIF":13.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142571603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Solidarity and trust in European Union health governance: three ways forward","authors":"Anniek de Ruijter ,&nbsp;Tamara Hervey ,&nbsp;Barbara Prainsack","doi":"10.1016/j.lanepe.2024.101047","DOIUrl":"10.1016/j.lanepe.2024.101047","url":null,"abstract":"<div><div>Trust and solidarity are centrally important to the functioning of healthcare systems, and for societal resilience and stability more broadly. The European Union is increasingly shaping governance and norms that affect trust and solidarity in health—a process that has intensified with the announcement of the ‘European Health Union’ in response to the COVID-19 pandemic. In this context, how can the EU ensure solidarity in health while generating public trust as a pre-condition for solidaristic institutions? We propose three strategies to reach this goal. First, both at national and European levels, institutions and mechanisms of solidarity should be strengthened. Second, the Union should boost the resilience and stability of national healthcare systems through mechanisms of risk-sharing. Third, the Union should mandate or encourage its member countries to enhance prevention and other public health policies to strengthen pre-distribution, aimed to ensure a more equal baseline of public health before inequalities arise.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"46 ","pages":"Article 101047"},"PeriodicalIF":13.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142572320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Impact of COVID-19 on total excess mortality and geographic disparities in Europe, 2020–2023: a spatio-temporal analysis” The Lancet Regional Health – Europe, Vol 44, 100996","authors":"Margherita Pizzato ,&nbsp;Alberto Giovanni Gerli ,&nbsp;Carlo La Vecchia ,&nbsp;Gianfranco Alicandro","doi":"10.1016/j.lanepe.2024.101117","DOIUrl":"10.1016/j.lanepe.2024.101117","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"47 ","pages":"Article 101117"},"PeriodicalIF":13.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142537690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The importance of understanding pelvic inflammatory disease as a polymicrobial infection - authors’ reply","authors":"Zoïe W. Alexiou ,&nbsp;Bernice M. Hoenderboom ,&nbsp;Christian J.P.A. Hoebe ,&nbsp;Nicole H.T.M. Dukers-Muijrers ,&nbsp;Hannelore M. Götz ,&nbsp;Marianne A.B. van der Sande ,&nbsp;Henry J.C. de Vries ,&nbsp;Janneke E. den Hartog ,&nbsp;Servaas A. Morré ,&nbsp;Birgit H.B. van Benthem","doi":"10.1016/j.lanepe.2024.101116","DOIUrl":"10.1016/j.lanepe.2024.101116","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"47 ","pages":"Article 101116"},"PeriodicalIF":13.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142552519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The importance of understanding pelvic inflammatory disease as a polymicrobial infection","authors":"Kenyon Chris","doi":"10.1016/j.lanepe.2024.101115","DOIUrl":"10.1016/j.lanepe.2024.101115","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"47 ","pages":"Article 101115"},"PeriodicalIF":13.6,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}