Acta Clinica Belgica最新文献_第8页

Severe rhabdomyolysis due to idiopathic inflammatory myopathies, a wary manifestation of a heterogenous pathology. 严重的横纹肌溶解由于特发性炎性肌病，一个谨慎的表现异质病理。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2023-04-01 DOI: 10.1080/17843286.2022.2070974

Niels Schepens, Pauline H Herroelen, An-Sofie Decavele, An Vanacker

{"title":"Severe rhabdomyolysis due to idiopathic inflammatory myopathies, a wary manifestation of a heterogenous pathology.","authors":"Niels Schepens, Pauline H Herroelen, An-Sofie Decavele, An Vanacker","doi":"10.1080/17843286.2022.2070974","DOIUrl":"https://doi.org/10.1080/17843286.2022.2070974","url":null,"abstract":"Idiopathic inflammatory myopathies (IIM) are historically classified by The Bohan and Peter criteria. The presentation of IIM is versatile and clinical-serological findings can aid in diagnosing the underlying form of IIM. Over the past years, the discovery and the use of myositis-specific autoantibodies (MSA) and myositis-associated autoantibodies (MAA) have led to a more heterogeneous classification by the European League Against Rheumatism and American College of Rheumatology (EULAR/ACR).This paper describes a case of dermatomyositis sine dermatitis. A 70-year -old woman presented with complaints of muscle weakness and was admitted because of severe oliguric renal failure due to rhabdomyolysis. Despite treatment with hemodialysis and initial recovery, her clinic worsened again. The disease course in combination with electromyography findings, PET-scan results, and positive myositis-specific autoantibodies, that is, anti-NXP-2 antibodies, ultimately led to the diagnosis.Today, commercial kits based on line immunoassay and dot blot have mostly replaced the labor-intensive immunoprecipitation of RNA and/or proteins for detecting MSA. Though it makes routine testing of multiple MSA easy to implement in clinical practice, more validation studies are required and clinicians should be aware of its limitations, including false-positive results. When clinical suspicion for IIM is high, a negative screening for antinuclear antibodies (ANA) result does not exclude IIM and the first test of choice remains a multi-specific immunoassay for the whole spectrum of MSA.In this paper, we want to underline that there is no shortcut in diagnosing IIM. Caution is required in interpreting different EMG, PET-scan, histological, and laboratory findings. Especially in the case of rhabdomyolysis, as this is a severe and wary manifestation of myositis.","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":"78 2","pages":"160-164"},"PeriodicalIF":1.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10852441","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}

引用次数: 1

Changes in the use and uptake of a national out-of-hours telephone triage service by younger and older patients seeking non-urgent unplanned care surrounding the COVID-19 pandemic in Flanders (Belgium). 法兰德斯(比利时)在COVID-19大流行期间寻求非紧急计划外护理的年轻和老年患者使用和接受国家非工作时间电话分诊服务的变化。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2023-04-01 DOI: 10.1080/17843286.2022.2068296

Farah Islam, Koen Milisen, Marc Gellens, Joël Enckels, Ewa Kocot, Christoph Sowada, Marc Sabbe

{"title":"Changes in the use and uptake of a national out-of-hours telephone triage service by younger and older patients seeking non-urgent unplanned care surrounding the COVID-19 pandemic in Flanders (Belgium).","authors":"Farah Islam, Koen Milisen, Marc Gellens, Joël Enckels, Ewa Kocot, Christoph Sowada, Marc Sabbe","doi":"10.1080/17843286.2022.2068296","DOIUrl":"https://doi.org/10.1080/17843286.2022.2068296","url":null,"abstract":"Background: This study seeks to examine if and how the COVID-19 pandemic has prompted changes in the use and uptake of a national out-of-hours (OOH) telephone triage service by younger and older patients seeking non-urgent unplanned care in Flanders (Belgium).Methods: A descriptive study was conducted using registry data obtained from the 1733 OOH telephone triage service in a Flemish region of Belgium. All calls received between 1 January 2019 and 31 December 2020 were analyzed.Results: A significant association was found between patient age and period of call (χ2 = 594.54, p < .001). Calls made to the 1733 OOH telephone triage service were significantly less likely to be dispatched to a higher level of urgency by operators compared to calls made before the COVID-19 period (OR = 0.80, 95% CI [0.74-0.85]). While calls concerning older adults were significantly more likely to be dispatched to a higher level of urgency by operators compared to younger adults (regardless of period of call) (65 to 74 yrs: OR = 5.75, 95% CI [4.86-6.80]; 75 to 84 yrs: OR = 15.21, 95% CI [13.18-17.56]; ≥ 85 yrs: OR = 28.77, 95% CI [25.01-33.09]), only 6.7% of all COVID-19 related calls involved older adults over 65 years of age.Conclusion: Findings showed that there was a general decline in the number of calls dispatched to a higher level of urgency by operators during the COVID-19 period but that there were differences in the use and uptake of these services by younger and older age segments.","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":"78 2","pages":"87-95"},"PeriodicalIF":1.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9398272","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}

引用次数: 1

A Belgian student with black eschars. 一个比利时学生，身上有黑色疤痕。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2023-04-01 DOI: 10.1080/17843286.2022.2090181

Astrid Van Reempts, Liesbet De Meester, Koen Blot, Ann-Sophie Candaele, Hilde Beele, Jo Van Dorpe, Diana Huis In 't Veld

{"title":"A Belgian student with black eschars.","authors":"Astrid Van Reempts, Liesbet De Meester, Koen Blot, Ann-Sophie Candaele, Hilde Beele, Jo Van Dorpe, Diana Huis In 't Veld","doi":"10.1080/17843286.2022.2090181","DOIUrl":"https://doi.org/10.1080/17843286.2022.2090181","url":null,"abstract":"Background: Human cowpox virus infection is a rare zoonotic disease. Cowpox virus is a member of the Orthopoxvirus genus, like smallpox. Over the last years records of cowpox virus transmission from pet cats and pet rats to humans in Europe have increased. This observation may result from the loss of cross-immunity against orthopoxviruses after discontinuation of routine smallpox vaccination in the 1980s.Case presentation: We report the first case of a human cowpox infection in an unvaccinated Belgian citizen. This 19-year-old student presented with multiple necrotic skin lesions on the chin, the scalp and the pubic region, and with cervical lymphadenopathy and flu-like symptoms. The diagnosis of human cowpox was based on electron microscopic findings and PCR examination performed on a skin biopsy of the pubic lesion. Close contact with cats (her domestic cats or cats from a local shelter) was probably the source of transmission. Spreading of the lesions was likely the result of autoinoculation. After six months all lesions spontaneously healed with atrophic scars.Discussion: To enhance awareness of this rare viral zoonosis and to verify the suspected increase in incidence and symptom severity after cessation of smallpox vaccination, one could argue whether human cowpox should become a notifiable disease.","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":"78 2","pages":"180-184"},"PeriodicalIF":1.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9415996","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}

引用次数: 0

Associations between obesity, self-reported weakness and their combinations with mortality in nursing home residents. 养老院居民肥胖、自述虚弱及其与死亡率的关系。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2023-04-01 DOI: 10.1080/17843286.2022.2075180

Gulistan Bahat, Birkan Ilhan, Nezahat Muge Catikkas, Asli Tufan, Savaş Ozturk, Hafize Dogan, Mehmet Akif Karan

{"title":"Associations between obesity, self-reported weakness and their combinations with mortality in nursing home residents.","authors":"Gulistan Bahat, Birkan Ilhan, Nezahat Muge Catikkas, Asli Tufan, Savaş Ozturk, Hafize Dogan, Mehmet Akif Karan","doi":"10.1080/17843286.2022.2075180","DOIUrl":"https://doi.org/10.1080/17843286.2022.2075180","url":null,"abstract":"Objectives: There are studies on associations between obesity and mortality in nursing home (NH) residents, but the presence of concomitant muscle weakness has not been examined. We considered that self-reported weakness might be a low muscle strength proxy marker. We aimed to examine associations of obesity alone, self-reported muscle weakness alone, and their combination with mortality in NH residents.Methods: This is a retrospective longitudinal follow-up study. We noted age, sex, nutritional status, functionality, number of chronic diseases, and regular medication. Obesity was assessed by the body fat-percentage method estimated by bioimpedance analysis. Weakness was identified by self-reported muscle weakness. Survival was evaluated with a univariate log-rank test and multivariate Cox regression analyses.Results: We included 214 participants. In a median follow-up time of 46 months, mortality occurred in 37.4%. In multivariate analysis adjusted by age, sex, undernutrition, number of chronic diseases, and regular medication, functional scores; 'non-weak non-obese' participants or 'weak alone' participants or 'weak+obese' participants had higher mortality risk when compared with the 'obesity alone' participants [hazard ratio (HR) = 2.6, 95% confidence interval (CI) = 1.2-5.5, p = 0.01; HR = 2.6, 95% CI = 1.2-5.9, p = 0.02; HR = 3.0, 95% CI = 1.2-7.7, p = 0.02].Conclusion: This is the first report showing that obesity was associated with lower mortality risk if the weakness was not present in NH residents. However, obesity with concomitant weakness was associated with mortality risk similar to non-weak non-obese or weak alone participants. Our study suggests a simple consideration of weakness that can easily be integrated into everyday practice.","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":"78 2","pages":"112-121"},"PeriodicalIF":1.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10857757","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}

引用次数: 3

Glycomics-based serum markers as reliable tool for assessment of viral response after treatment with direct-acting antiviral drugs in hepatitis C virus infection. 基于糖组学的血清标志物是评估丙型肝炎病毒感染直接作用抗病毒药物治疗后病毒反应的可靠工具。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2023-04-01 DOI: 10.1080/17843286.2022.2072110

Nicky Somers, Elisabeth Vandekerckhove, Anja Geerts, Helena Degroote, Sander Lefere, Lindsey Devisscher, Leander Meuris, Nico Callewaert, Hans Van Vlierberghe, Xavier Verhelst

{"title":"Glycomics-based serum markers as reliable tool for assessment of viral response after treatment with direct-acting antiviral drugs in hepatitis C virus infection.","authors":"Nicky Somers, Elisabeth Vandekerckhove, Anja Geerts, Helena Degroote, Sander Lefere, Lindsey Devisscher, Leander Meuris, Nico Callewaert, Hans Van Vlierberghe, Xavier Verhelst","doi":"10.1080/17843286.2022.2072110","DOIUrl":"https://doi.org/10.1080/17843286.2022.2072110","url":null,"abstract":"Objectives: Patients with chronic hepatitis C virus (HCV) infection have a genuine risk of developing liver fibrosis and cirrhosis, potentially resulting in hepatocellular carcinoma (HCC), a risk that remains even after sustained viral response (SVR). Glycomics-based biomarkers are an attractive tool to closely monitor these patients during and after antiviral treatment, as alterations in the abundance of N-glycans reflect an altered state of the liver. This study assessed serum glycomics for the evaluation of inflammation-related fibrosis regression during and after treatment of HCV with DAAs.Methods: The GlycoFibroTest and GlycoCirrhoTest were analyzed in the sera 36 HCV-infected patients with advanced fibrosis (F3) or established cirrhosis (F4), before (week 0), during (week 12) and after (week 24) a twelve-week oral administration of DAAs therapy - using an optimized glycomic technology on a DNA sequencer.Results: All patients achieved SVR after treatment and two of them developed HCC in the subsequent five years. A significant decrease of the GlycoFibroTest (p < 0.0001) was seen after 12 weeks, consistent with other measured biomarkers (APRI, FIB-4, FibroTest). Statistical analysis was performed in IBM SPSS Statistics version 28.0, using the non-parametric Friedman's test with a statistical significance α level of 0.05.Conclusion: This study suggests that the GlycoFibroTest is a serum biomarker for viral response in HCV patients. The rapid decrease of the glycomics-based biomarker probably reflects the amelioration of liver inflammation as underlying process, rather than the improvement of liver fibrosis itself.","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":"78 2","pages":"96-102"},"PeriodicalIF":1.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9398693","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}

引用次数: 0

Hepatic arterial infusion chemotherapy versus transarterial chemoembolization for patients with unresectable hepatocellular carcinoma: a systematic review and meta-analysis. 肝动脉输注化疗与经动脉化疗栓塞治疗不可切除肝癌:一项系统回顾和荟萃分析。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2023-04-01 DOI: 10.1080/17843286.2022.2076791

Shun-Yu Kong, Jiao-Jiao Song, Yao-Qi Jin, Man-Jun Deng, Jing-Xin Yan

{"title":"Hepatic arterial infusion chemotherapy versus transarterial chemoembolization for patients with unresectable hepatocellular carcinoma: a systematic review and meta-analysis.","authors":"Shun-Yu Kong, Jiao-Jiao Song, Yao-Qi Jin, Man-Jun Deng, Jing-Xin Yan","doi":"10.1080/17843286.2022.2076791","DOIUrl":"https://doi.org/10.1080/17843286.2022.2076791","url":null,"abstract":"Background: We carried out a systematic review and meta-analysis to assess the safety and effectiveness of hepatic arterial infusion chemotherapy (HAIC) compared with transarterial chemoembolization (TACE) for patients with unresectable hepatocellular carcinoma (uHCC).Methods: Eligible studies were searched by MEDLINE, the Cochrane Library, Embase, and Web of Science from January 1995 to January 2022, investigating eligible literature comparing HAIC and TACE for patients with HCC. The main outcome measures included progression-free survival (PFS), overall survival (OS), adverse events (AEs), objective response rate (ORR), and diseases control rate (DCR).Results: Eight literature and 1028 patients were enrolled in this meta-analysis. The pooled PFS, OS, ORR, and DCR were HR = 0.89 (95% CI, 0.81-0.98), HR = 0.84 (95% CI, 0.75-0.93), OR = 2.77 (95% CI, 2.01-3.80), and OR = 4.64 (95% CI, 2.40-8.99), respectively. The adverse events of HAIC were lower than TACE.Conclusion: Our meta-analysis revealed that HAIC can achieve a better effect and survival benefits than TACE in patients with uHCC.","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":"78 2","pages":"171-179"},"PeriodicalIF":1.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10841376","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}

引用次数: 4

Differences in antibiotic prescribing quality in Belgian out-of-hours primary care services. 比利时非工作时间初级保健服务抗生素处方质量的差异。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2023-04-01 DOI: 10.1080/17843286.2022.2081772

Jeroen De Man, Roy Remmen, Hilde Philips

{"title":"Differences in antibiotic prescribing quality in Belgian out-of-hours primary care services.","authors":"Jeroen De Man, Roy Remmen, Hilde Philips","doi":"10.1080/17843286.2022.2081772","DOIUrl":"https://doi.org/10.1080/17843286.2022.2081772","url":null,"abstract":"Objectives: This study aims to compare trends in antibiotic prescribing behaviour for lower urinary tract infections among different out-of-hours primary care services.Methods: Cross-sectional study using routine prescription data extracted from electronic health records from six out-of-hours services. The study population included 5888 cases diagnosed with an uncomplicated lower urinary tract infection from 2016 to 2020. Prescriptions were assessed based on the national guidelines.Results: Considering the total study period, an antibiotic was prescribed in 98.9% of cases. Among these cases, 55.0% was prescribed a guideline recommended antibiotic, 21.0% was prescribed fosfomycin, 17.4% was prescribed a quinolone and 1.8% was prescribed more than one antibiotic. Guideline recommended prescribing improved substantially over time. However, there were significant differences among out-of-hours services in terms of proportion over the total study period (between 49.0% and 66.7%) as well as in terms of time-trend pattern.Conclusion: Substantial differences among out-of-hours services suggest a potential for further improvement in the quality of antibiotic prescribing. Monitoring prescribing behaviour per out-of-hours primary care service can guide focused interventions.","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":"78 2","pages":"122-127"},"PeriodicalIF":1.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9103743","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}

引用次数: 0

Changes in lipid lowering medication and lipid levels over time in patients with stable coronary artery disease. 稳定冠状动脉疾病患者降脂药物和脂质水平随时间的变化

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2023-04-01 DOI: 10.1080/17843286.2022.2084948

Clara François, A M Willems, L Van Calster, E Germonpré, Johan De Sutter

{"title":"Changes in lipid lowering medication and lipid levels over time in patients with stable coronary artery disease.","authors":"Clara François, A M Willems, L Van Calster, E Germonpré, Johan De Sutter","doi":"10.1080/17843286.2022.2084948","DOIUrl":"https://doi.org/10.1080/17843286.2022.2084948","url":null,"abstract":"Background/aim: To provide longitudinal data on the evolution of lipid levels and the intake of lipid-lowering therapies in patients with stable coronary artery disease.Methods: Single-centre retrospective study with inclusion of 350 patients with a first coronary artery event in 2014 or earlier and outpatient cardiac clinic follow-up in 2015 and 2019. Lipid levels were collected within a time frame of 3 months of their visits.This retrospective study protocol (2020.086) was approved by the ethical committee and by the Data Privacy Officer of AZ Maria Middelares Ghent. For this type of study, formal consent is not required, following local law and regulations.Results: Average LDL levels were 82 (±26) mg/dl in 2015 and 70 (±24) mg/dl in 2019 (p < 0.001). Most patients included were already on statin treatment before inclusion in the trial (94%), with a significant increase in high-intensity statin use (45% vs. 58%) after a 5-year follow-up. At the same time, we observed a significant increase in ezetimibe use (in combination with statin therapy or in monotherapy) (8% vs. 22%) during follow-up. LDL ≤70 mg/dl was 34% in 2015 and 53% in 2019. LDL ≤55 mg/dl was 13% in 2015 and 28% in 2019.Conclusion: This study shows significant intensification of lipid-lowering therapy use during follow-up, and a significant lipid level lowering after 5-year follow-up, in an outpatient cardiac clinic follow-up. Further improvement in lipid control is still desirable, especially after the European Society of Cardiology recommend stricter lipid levels in the 2021 Prevention Guidelines.","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":"78 2","pages":"135-139"},"PeriodicalIF":1.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9454871","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}

引用次数: 0

Organization, feasibility and patient appreciation of a follow-up consultation in surgical critically ill patients with favorable baseline quality of life and prolonged ICU-stay: a pilot study. 基线生活质量良好且icu住院时间延长的外科危重患者随访会诊的组织、可行性和患者评价:一项试点研究。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2023-02-01 DOI: 10.1080/17843286.2022.2050003

Sofie F M Vanderhaeghen, Johan M Decruyenaere, Dominique D Benoit, Sandra G Oeyen

{"title":"Organization, feasibility and patient appreciation of a follow-up consultation in surgical critically ill patients with favorable baseline quality of life and prolonged ICU-stay: a pilot study.","authors":"Sofie F M Vanderhaeghen, Johan M Decruyenaere, Dominique D Benoit, Sandra G Oeyen","doi":"10.1080/17843286.2022.2050003","DOIUrl":"https://doi.org/10.1080/17843286.2022.2050003","url":null,"abstract":"Objectives: Intensive care unit (ICU) survivors are often left with impairments in physical, mental and cognitive functioning (Post-Intensive Care Syndrome (PICS)). We evaluated the organization, the feasibility for caregivers and patients and the patients' appreciation of a post-ICU consultation aiming to detect these PICS-symptoms.Methods: A single-center prospective observational pilot study was conducted during an 18 month-period in the surgical ICU of a tertiary care hospital. Consecutive adult patients with an ICU-stay of ≥8 days and a favorable baseline quality of life (utility index ≥0.6 on EQ-5D-3 L) were eligible for inclusion. A post-ICU follow-up consultation consisting of a structured interview was scheduled 3 months after hospital discharge. Characteristics of the consultation (CG) and no consultation group (NCG) were compared. P-values <0.05 were considered significant.Results: Of 133 eligible patients, 85 (64%) consented for the study and 42 (49%) attended the consultation. A total of 148 phone calls were made to schedule the consultations. Consultations took a median of 68 (61-74) minutes. Compared to CG-patients, NCG-patients were more often discharged to a care facility (P = 0.003) and had more problems with mobility (P = 0.014), self-care (P < 0.001) and usual activities (P = 0.005) after 3 months. At least one PICS-related problem was documented in all patients in the CG and NCG. Thirty-four CG-patients (81%) appreciated the initiative.Conclusion: Organizing an ICU-follow-up consultation was difficult and feasibility was low, but most attending patients appreciated the initiative. Better developed structures for ICU-follow-up are needed in view of the high number of PICS-related problems documented.","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":"78 1","pages":"25-35"},"PeriodicalIF":1.6,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10529960","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}

引用次数: 1

Identifying vulnerable older adults at risk for functional decline in cardiac care wards: time to shift the paradigm. 识别易受伤害的老年人在心脏护理病房功能下降的风险:时间转变范式。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2023-02-01 DOI: 10.1080/17843286.2022.2031374

Anthony Jeuris, Bastiaan Van Grootven, Lisa Geyskens, Koen Milisen, Johan Flamaing, Mieke Deschodt

{"title":"Identifying vulnerable older adults at risk for functional decline in cardiac care wards: time to shift the paradigm.","authors":"Anthony Jeuris, Bastiaan Van Grootven, Lisa Geyskens, Koen Milisen, Johan Flamaing, Mieke Deschodt","doi":"10.1080/17843286.2022.2031374","DOIUrl":"https://doi.org/10.1080/17843286.2022.2031374","url":null,"abstract":"Objective: To determine whether routine screening with the Flemish version of the Triage Risk Screening Tool (fTRST) is a valid approach to determine which patients on cardiac care wards are at risk for inhospital functional decline and would benefit from geriatric expertise consultation.Methods: A secondary data-analysis of the G-COACH before-cohort, describing patient profiles and routine care processes, in 189 older adults on two cardiac care wards in the University Hospitals Leuven between September 2016 and June 2017. Inhospital functional decline was defined as an increase of at least one point on the Katz Index of Activities of Daily Living or death between hospital admission and discharge.Results: Nine in 10 patients had at least one geriatric syndrome and one-third developed functional decline. Based on the fTRST proposed cut-off of ≥2, 156 (82.5%) patients were at risk for functional decline (sensitivity of 95.2%, specificity of 23.8%, negative predictive value of 90.9% and Area Under the Curve of 0.60). Of the 156 'at risk' patients, 43 (27.6%) received a consultation by the geriatric consultation team after a median of four hospitalization days. A positive fTRST was not significantly related to geriatric consultations (x2 = 0.57; p = 0.45).Conclusion: The fTRST has a low discriminative value in identifying older cardiology patients at risk for functional decline. Given the high prevalence of geriatric syndromes, we propose a new paradigm were all older adults on cardiac care wards undergo a needs assessment upon hospital admission.","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":"78 1","pages":"44-50"},"PeriodicalIF":1.6,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9095448","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}

引用次数: 0