Author: "Alberto Zucchelli" / Publication Year Range: Last 10 years - Searchworks@Jio Institute Digital Library Search Results

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48 results on '"Alberto Zucchelli"'

1. Frailty detection among primary care older patients through the Primary Care Frailty Index (PC-FI)

Author: Davide Liborio Vetrano, Alberto Zucchelli, Graziano Onder, Laura Fratiglioni, Amaia Calderón-Larrañaga, Alessandra Marengoni, Ettore Marconi, Iacopo Cricelli, Pierangelo Lora Aprile, Roberto Bernabei, Claudio Cricelli, and Francesco Lapi
Subjects: Medicine, Science
Abstract: Abstract The prompt identification of frailty in primary care is the first step to offer personalized care to older individuals. We aimed to detect and quantify frailty among primary care older patients, by developing and validating a primary care frailty index (PC-FI) based on routinely collected health records and providing sex-specific frailty charts. The PC-FI was developed using data from 308,280 primary care patients ≥ 60 years old part of the Health Search Database (HSD) in Italy (baseline 2013–2019) and validated in the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K; baseline 2001–2004), a well-characterized population-based cohort including 3363 individuals ≥ 60 years old. Potential health deficits part of the PC-FI were identified through ICD-9, ATC, and exemption codes and selected through an optimization algorithm (i.e., genetic algorithm), using all-cause mortality as the main outcome for the PC-FI development. The PC-FI association at 1, 3 and 5 years, and discriminative ability for mortality and hospitalization were tested in Cox models. The convergent validity with frailty-related measures was verified in SNAC-K. The following cut-offs were used to define absent, mild, moderate and severe frailty:
Published: 2023
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2. Development and validation of an electronic database-based frailty index to predict mortality and hospitalization in a population-based study of adults with SARS-CoV-2

Author: Paola Rebora, Carlo Alberto Scirè, Giuseppe Occhino, Francesco Bortolan, Olivia Leoni, Francesco Cideni, Alberto Zucchelli, Emanuele Focà, Alessandra Marengoni, Giuseppe Bellelli, and Maria Grazia Valsecchi
Subjects: care transitions, health services, public health, COVID-19, hospital, community, Medicine (General), R5-920
Abstract: BackgroundElectronic health databases are used to identify people at risk of poor outcomes. Using electronic regional health databases (e-RHD), we aimed to develop and validate a frailty index (FI), compare it with a clinically based FI, and assess its association with health outcomes in community-dwellers with SARS-CoV-2.MethodsData retrieved from the Lombardy e-RHD were used to develop a 40-item FI (e-RHD-FI) in adults (i.e., aged ≥18 years) with a positive nasopharyngeal swab polymerase chain reaction test for SARS-CoV-2 by May 20, 2021. The considered deficits referred to the health status before SARS-CoV-2. The e-RHD-FI was validated against a clinically based FI (c-FI) obtained from a cohort of people hospitalized with COVID-19 and in-hospital mortality was evaluated. e-RHD-FI performance was evaluated to predict 30-day mortality, hospitalization, and 60-day COVID-19 WHO clinical progression scale, in Regional Health System beneficiaries with SARS-CoV-2.ResultsWe calculated the e-RHD-FI in 689,197 adults (51.9% females, median age 52 years). On the clinical cohort, e-RHD-FI correlated with c-FI and was significantly associated with in-hospital mortality. In a multivariable Cox model, adjusted for confounders, each 0.1-point increment of e-RHD-FI was associated with increased 30-day mortality (Hazard Ratio, HR 1.45, 99% Confidence Intervals, CI: 1.42–1.47), 30-day hospitalization (HR per 0.1-point increment = 1.47, 99%CI: 1.46–1.49), and WHO clinical progression scale (Odds Ratio = 1.84 of deteriorating by one category, 99%CI 1.80–1.87).ConclusionThe e-RHD-FI can predict 30-day mortality, 30-day hospitalization, and WHO clinical progression scale in a large population of community-dwellers with SARS-CoV-2 test positivity. Our findings support the need to assess frailty with e-RHD.
Published: 2023
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3. CT based radiomic approach on first line pembrolizumab in lung cancer

Author: Marta Zerunian, Damiano Caruso, Alberto Zucchelli, Michela Polici, Carlo Capalbo, Marco Filetti, Federica Mazzuca, Paolo Marchetti, and Andrea Laghi
Subjects: Medicine, Science
Abstract: Abstract Clinical evaluation poorly predicts outcomes in lung cancer treated with immunotherapy. The aim of the study is to assess whether CT-derived texture parameters can predict overall survival (OS) and progression-free survival (PFS) in patients with advanced non-small-cell lung cancer (NSCLC) treated with first line Pembrolizumab. Twenty-one patients with NSLC were prospectively enrolled; they underwent contrast enhanced CT (CECT) at baseline and during Pembrolizumab treatment. Response to therapy was assessed both with clinical and iRECIST criteria. Two radiologists drew a volume of interest of the tumor at baseline CECT, extracting several texture parameters. ROC curves, a univariate Kaplan-Meyer analysis and Cox proportional analysis were performed to evaluate the prognostic value of texture analysis. Twelve (57%) patients showed partial response to therapy while nine (43%) had confirmed progressive disease. Among texture parameters, mean value of positive pixels (MPP) at fine and medium filters showed an AUC of 72% and 74% respectively (P
Published: 2021
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4. Technologies for the Instrumental Evaluation of Physical Function in Persons Affected by Chronic Obstructive Pulmonary Disease: A Systematic Review

Author: Alberto Zucchelli, Simone Pancera, Luca Nicola Cesare Bianchi, Alessandra Marengoni, and Nicola Francesco Lopomo
Subjects: COPD, technology, instrumental evaluation, physical function, Chemical technology, TP1-1185
Abstract: Several systems, sensors, and devices are now available for the instrumental evaluation of physical function in persons with Chronic Obstructive Pulmonary Disease (COPD). We aimed to systematically review the literature about such technologies. The literature search was conducted in all major scientific databases, including articles published between January 2001 and April 2022. Studies reporting measures derived from the instrumental assessment of physical function in individuals with COPD were included and were divided into application and validation studies. The quality of validation studies was assessed with the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) risk of bias tool. From 8752 articles retrieved, 21 application and 4 validation studies were included in the systematic review. Most application studies employed accelerometers, gait analysis systems, instrumented mattresses, or force plates to evaluate walking. Surface electro-myography or near-infrared spectroscopy were employed in four studies. Validation studies were heterogeneous and presented a risk of bias ranging from inadequate to doubtful. A variety of data regarding physical function can be retrieved from technologies used in COPD studies. However, a general lack of standardization and limitations in study design and sample size hinder the implementation of the instrumental evaluation of function in clinical practice.
Published: 2022
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5. Comparing the prognostic value of geriatric health indicators: a population-based study

Author: Alberto Zucchelli, Davide L. Vetrano, Giulia Grande, Amaia Calderón-Larrañaga, Laura Fratiglioni, Alessandra Marengoni, and Debora Rizzuto
Subjects: Health indicators, Older persons, Prognosis, Medicine
Abstract: Abstract Background The identification of individuals at increased risk of poor health-related outcomes is a priority. Geriatric research has proposed several indicators shown to be associated with these outcomes, but a head-to-head comparison of their predictive accuracy is still lacking. We therefore aimed to compare the accuracy of five geriatric health indicators in predicting different outcomes among older persons: frailty index (FI), frailty phenotype (FP), walking speed (WS), multimorbidity, and a summary score including clinical diagnoses, functioning, and disability (the Health Assessment Tool; HAT). Methods Data were retrieved from the Swedish National Study on Aging and Care in Kungsholmen, an ongoing longitudinal study including 3363 people aged 60+. To inspect the accuracy of geriatric health indicators, we employed areas under the receiver operating characteristic curve (AUC) for the prediction of 3-year and 5-year mortality, 1-year and 3-year unplanned hospitalizations (1+), and contacts with healthcare providers in the 6 months before and after baseline evaluation (2+). Results FI, WS, and HAT showed the best accuracy in the prediction of mortality [AUC(95%CI) for 3-year mortality 0.84 (0.82–0.86), 0.85 (0.83–0.87), 0.87 (0.85–0.88) and AUC(95%CI) for 5-year mortality 0.84 (0.82–0.86), 0.85 (0.83–0.86), 0.86 (0.85–0.88), respectively]. Unplanned hospitalizations were better predicted by the FI [AUC(95%CI) 1-year 0.73 (0.71–0.76); 3-year 0.72 (0.70–0.73)] and HAT [AUC(95%CI) 1-year 0.73 (0.71–0.75); 3-year 0.71 (0.69–0.73)]. The most accurate predictor of multiple contacts with healthcare providers was multimorbidity [AUC(95%CI) 0.67 (0.65–0.68)]. Predictions were generally less accurate among younger individuals (
Published: 2019
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6. Special Issue—'Multimorbidity Development and Evolution: Clinical Implications'

Author: Alberto Zucchelli, Amaia Calderón-Larrañaga, and Davide Liborio Vetrano
Subjects: n/a, Medicine
Abstract: Multimorbidity, the co-existence of multiple chronic diseases in the same individual, is not only extremely common in older persons but is also strongly associated with several poor health outcomes [...]
Published: 2021
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7. Depression and heart failure: an intricate relationship

Author: Gaetano Aloisi, Alberto Zucchelli, Bruno Aloisi, Giuseppe Romanelli, and Alessandra Marengoni
Subjects: Heart failure, depression, screening, antidepressants, Medicine
Abstract: In patients with heart failure (HF), depression is common and associated with adverse outcomes such as reduced adherence to treatment, poor quality of life, increased hospitalizations and elevated mortality. Despite these adverse impacts, depression remain underdiagnosed in HF patients. We performed a target review of the literature to identify the association between HF and depression, to examine the mechanisms that link these two conditions and to identify instruments for an accurate diagnosis and treatment of depression in HF patients. Depression is associated with the development and progression of HF, including increased rates of mortality, mediated by behavioral and pathophysiological mechanisms. The overlap of symptoms between depression and HF often makes the diagnosis of depression difficult and late. Currently, specific guidelines for depression screening in HF patients are lacking, partly because evidences showing that depression screening improves cardiac outcomes are insufficient. European guidelines suggest the early use of instruments such as the Beck Depression Inventory (BDI) and the Geriatric Depression Scale (GDS), both characterized by accuracy and administration simplicity. There is limited evidence of pharmacological treatment and psychotherapy efficacy in patients with HF. However, cognitive-behavioral therapy has been shown to improve outcomes HF patients, and selective serotonin reuptake inhibitors appear safe in this cohort.
Published: 2019
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8. Multimorbidity Patterns and Unplanned Hospitalisation in a Cohort of Older Adults

Author: Roselyne Akugizibwe, Amaia Calderón-Larrañaga, Albert Roso-Llorach, Graziano Onder, Alessandra Marengoni, Alberto Zucchelli, Debora Rizzuto, and Davide L. Vetrano
Subjects: hospitalisation, multimorbidity, older adults, person-centred care, Medicine
Abstract: The presence of multiple chronic conditions (i.e., multimorbidity) increases the risk of hospitalisation in older adults. We aimed to examine the association between different multimorbidity patterns and unplanned hospitalisations over 5 years. To that end, 2,250 community-dwelling individuals aged 60 years and older from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K) were studied. Participants were grouped into six multimorbidity patterns using a fuzzy c-means cluster analysis. The associations between patterns and outcomes were tested using Cox models and negative binomial models. After 5 years, 937 (41.6%) participants experienced at least one unplanned hospitalisation. Compared to participants in the unspecific multimorbidity pattern, those in the cardiovascular diseases, anaemia and dementia pattern, the psychiatric disorders pattern and the metabolic and sleep disorders pattern presented with a higher hazard of first unplanned hospitalisation (hazard ratio range: 1.49–2.05; p < 0.05 for all), number of unplanned hospitalisations (incidence rate ratio (IRR) range: 1.89–2.44; p < 0.05 for all), in-hospital days (IRR range: 1.91–3.61; p < 0.05 for all), and 30-day unplanned readmissions (IRR range: 2.94–3.65; p < 0.05 for all). Different multimorbidity patterns displayed a differential association with unplanned hospital care utilisation. These findings call for a careful primary care follow-up of older adults with complex multimorbidity patterns.
Published: 2020
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9. Understanding Factors Associated With Psychomotor Subtypes of Delirium in Older Inpatients With Dementia

Author: Rispoli, Vincenzo, Malara, Alba, Spadea, Fausto, Di Cello, Serena, Ceravolo, Francesco, Fabiano, Francesco, Chiaradia, Giuseppe, Gabriele, Amedeo, Lenino, Peluso, Andrea, Taristano, Settembrini, Vincenzo, Capomolla, Domenico, Citrino, Antonella, Scriva, Antonietta, Bruno, Irene, Secchi, Roberto, De Martino, Eugenio, Muccinelli, Roberto, Lupi, Gerardo, Paonessa, Patrizio, Fabbri, Andrea, Passuti, Maria Teresa, Castellari, Sofia, Po, Andrea, Gaggioli, Guido, Varesi, Massimo, Moneti, Paolo, Capurso, Sebastiano, Latini, Vincenzo, Ghidotti, Stefano, Riccardelli, Francesco, Macchi, Maurizio, Rigo, Rosaria, Claudio, Pascale, Angelo, Bosio, Flavio, Cerrato, Benedetta, Bardelli, Boffelli, Stefano, Cassinadri, Angela, Franzoni, Simone, Spazzini, Elena, Andretto, Daniela, Tonini, Gabriele, Andreani, Laura, Coralli, Mirco, Balotta, Antonio, Cancelliere, Roberto, Ballardini, Giorgio, Simoncelli, Margherita, Mancini, Annarita, Strazzacapa, Mara, Fabio, Stefano, De Filippi, Francesco, Giudice, Chiara, Dentizzi, Cosimo, Azzini, Margherita, Cazzadori, Marco, Mastroeni, Valeria, Bertassello, Paolo, Claudia Benati, Helena Santana, Nesta, Elisa, Tobaldini, Chiara, Guerini, Fabio, Elena, Tambara, Mombelloni, Paolo, Fontanini, Fulvio, Gabriella, Lassa, Pizzorni, Crosio, Oliverio, Martina, Del Grosso, Luciano Luca, Giavedoni, Cristina, Bidoli, Giuliano, Mazzei, Bruno, Corsonello, Andrea, Fusco, Sergio, Vena, Silvio, De Vuono, Tommaso, Maiuri, Giorgio, Luca, Fimognari Filippo, Andrea, Arone, Giovanni, Sgrò, Rossella, Nicolazzo, Castegnaro, Eugenio, De Rosa, Salvatore, Sechi, Rossella Bazzano, Benvenuti, Enrico, Del Lungo, Ilaria, Giardini, Sante, Giulietti, Chiara, Mauro, Di Bari, Eleonora, Barghini, Martina, Paoli, Irene, Fiordelli, Riccardo, Barucci, Federica, Sgrilli, Ilaria, Del Lungo, Bertoletti, Erik, D'Amico, Ferdinando, Caronzolo, Francesco, Grippa, Alessandro, Lombardo, Giuseppina, Pipicella, Tiziana, Antonino, Saitta, Francesco, Corica, Valeria, Prestipino Giarritta, Daniela, Larosa, Domenico, Cucinotta, Giorgio, Basile, March, Albert, Nitti, Maria Teresa, Felici, Alessandro, Pavan, Silvia, Piazzani, Fabrizio, Lunelli, Alessandra, Dimori, Sergio, Margotta, Alessandro, Soglia, Tiziano, Postacchini, Demetrio, Brunelli, Roberto, Santini, Silvia, Francavilla, Monia, Macchiati, Ilenia, Sorvillo, Francesca, Giuli, Cinzia, Mecocci, Patrizia, Longo, Annalisa, Perticone, Francesco, Addesi, Desireè, Rosa, Paola Cerra, Bencardino, Giuseppe, Falbo, Tania, Grillo, Nadia, Marco, Filice, Mirella, Flippo, Fantò, Fausto, Isaia, Gianluca, Pezzilli, Stella, Bergamo, Daniele, Furno, Elisabetta, Rrodhe, Sokol, Lucarini, Simonetta, Dijk, Babette, Dall'Acqua, Francesca, Cappelletto, Francesco, Calvani, Donatella, Becheri, Dimitri, Giuseppe, Mottino, Costanza, Mitidieri, Vito, Antonio, Francesca, Bartalucci, Magherini, Lorenza, Novella, Malin, Franca, Boni, Lucia Gambardella, Paoli Martina, Valente, Carlo, Ilaria, Bracali, Alice, Foschini, Bo, Mario, Porrino, Paola, Ceci, Giacomo, Giuliana, Bottignole, Michela, Tibaldi, Eleonora, Coppo, Ettore, Evaristo, Camellini, Cinzia, Servello, Adriana, Grassi, Alessandro, Rozzini, Renzo, Tironi, Sara, Grassi, Maria Grazia, Troisi, Elio, Carlo, Caltagirone, Simona Gabriella, Di Santo, Flaminia, Franchini, Federica, Ratto, Beatrice, Pavoni, Sofia, Toniolo, Gabutto, Anna, Quazzo, Loredana, Rosatello, Annalisa, Suraci, Domenico, Tagliabue, Benedetta, Perrone, Chiara, Ferrara, Lucia, Castagna, Alberto, Tremolada, Maria Luisa, Giuseppe, Castoldi, Stefano, Barbero, Davide, Oltramonti, Piano, Simonetta, Serviddio, Gaetano, Lo Buglio, Aurelio, Gurrera, Tiziana, Merlo, Valeria, Rovai, Carla, Cotroneo, Antonino Maria, Carlucci, Rosaria, Abbaldo, Anna, Monzani, Fabio, Qasem, Ahmad Amedeo, Bini, Giacomo, Tafuto, Silvia, Galli, Giovanni, Bruni, Amalia Cecilia, Mancuso, Giovanna, Mancuso, Gerardo, Calipari, Daniela, Giuseppe Massimiliano, De Luca, Bernardini, Bruno, Corsini, Carla, Michele, Ciccarelli, Sara, Dal Farra, Cagnin, Annachiara, Fragiacomo, Federica, Pompanin, Sara, Piero, Amodio, Marco, Cagnin, Zurlo, Amedeo, Guerra, Gianluca, Pala, Marco, Menozzi, Luca, Gatti, Chiara Delli, Magon, Stefania, Roberto, Manfredini, Alfredo, De Giorgi, Fabio, Fabbian, Ruana, Tiseo, Elisa, Misurati, Benedetta, Boari, Christian, Molino, Marco, Pala, Massimo, Gallerani, Di Francesco, Vincenzo, Faccioli, Silvia, Pellizzari, Luca, Giorgia, Fontana, Barbagallo, Giuseppe, Lunardelli, Maria Lia, Martini, Emilio, Ferrari, Eleonora, Macchiarulo, Maria, Corneli, Maria, Bacci, Monica, Battaglia, Giuseppe, Anastasio, Luigi, Lo Storto, Mario Sostene, Seresin, Chiara, Simonato, Matteo, Loreggian, Michele, Cestonaro, Fausta, Durando, Mario, Latella, Raffaele, Mazzoleni, Marta, Russo, Giuseppe, Ponte, Martino, Valchera, Alessandro, Salustri, Giuseppe, Petritola, Donatella, Costa, Alfredo, Sinforiani, Elena, Cotta, Matteo Ramusino, Pizio, Renato Nicola, Cester, Alberto, Formilan, Marino, Pietro, Bonometto, Carbone, Pasqualina, Cazzaniga, Ilaria, Appollonio, Ildebrando, Cereda, Diletta, Stabile, Andrea, Xhani, Rubjona, Acampora, Roberto, Tremolizzo, Lucio, Federico, Pieruzzi, Antonio, Ciaccio, Valerio, Pontecorvi, Cesare, Burti, Zhirajr, Mokini, Giovanni, Vitale, Maria, Amigoni, Mariaelena, Sparacino, Bottacchi, Edo, Bucciantini, Elisabetta, Di Giovanni, Marco, Franchi, Fabrizio, Lucchetti, Lucio, Mariani, Claudio, Grande, Giulia, Rapazzini, Piero, Marco, Mauri, Romanelli, Giuseppe, Marengoni, Alessandra, Franco, Nicosia, Alessio, Margola, Stefano, Bonardelli, Nicola, Latronico, Laura, Porcella, Nazario, Portolani, Carlo, Concoreggi, Chiara, Grassini, Soccorso, Pronto, Andrea, Salvi, Luca, Bianchetti, Francesca, Spagnoli, Roberto, Apuzzo, Marco, Fontanella, Anna, Ceraso, Francesco, Castelli, Fugazza, Luciano, Guerrini, Chiara, De Paduanis, Giovanna, Iallonardo, Lucia, Palumbo, Pasquale, Zuliani, Giovanni, Ortolani, Beatrice, Capatti, Eleonora, Soavi, Cecilia, Bianchi, Lara, Francesconi, Daniela, Miselli, Agata, Gloria, Brombo, Tommaso, Romagnoli, Chiara, Pazzaglini, Agata, Miselli Maria, Marco, Dall'Agata, Luca, Menozzi, Gianluca, Guerra, Suardi, Teresa, Mazzone, Andrea, Zaccarini, Cinzia, Manuela, Riva, Mirra, Gianluca, Muti, Ettore, Bottura, Renato, Gianpaolo, Moretti, Secreto, Piero, Bisio, Erika, Cecchettani, Marco, Naldi, Tamara, Pallavicino, Alessandra, Pugliese, Michela, Iozzo, Rosaria Cosima, Grassi, Guido, Michele, Bombelli, Raffaella, Dell'Oro, Fosca, Quarti Trevano, Giorgio, Giussani Carlo, Giovanni, Paternò, Ernesto, Contro, Mannironi, Antonio, Giorli, Elisa, Oberti, Sara, Fierro, Brigida, Piccoli, Tommaso, Giacalone, Fabio, Mandas, Antonella, Serchisu, Luca, Costaggiu, Diego, Pinna, Elisa, Orrù, Francesca, Mannai, Martina, Cordioli, Zeno, Pelizzari, Luca, Turcato, Emanuela, Arduini, Pietro, Cacace, Carlo, Chiloiro, Roberta, Cimino, Rosella, Ruberto, Carmen, Giovanni, Ruotolo, Pietro, Gareri, Laura, Greco, Alberto, Castagna, Carmen, Ruberto, Santo, Pierluigi Dal, Andriolli, Antonino, Burattin, Giuseppe, Rossi, Laura, Andreolli Antonino, Cervati Giovanna, Giuseppe, Catalano, Tezza, Fabiana, Maddalena, Pizzardini, Laura, Stievano, Crippa, Patrizia, Aloisio, Paola, Di Monda, Tiziana, Malighetti, Alessandro, Galbassini, Gloria, Salutis, Domus, Ivaldi, Claudio, Russo, Anna Maria, Bennati, Ettore, Pino, Elisabetta, Zavarise, Gianmaria, Pesci, Alberto, Suigo, Giulia, Faverio, Paola, Andrea, Gori, Sabrina, Perego, Zanasi, Massimo, Moniello, Giovanni, Rostagno, Carlo, Cartei, Alessandro, Polidori, Gianluca, Ungar, Andrea, Melis, Maria Ramona, Martellini, Eleonora, Enrico, Mossello, Monica, Torrini, Antonella, Giordano, Giovanna, Leone, Migliorini, Marta, Caramelli, Francesca, Battiston, Bruno, Berardino, Maurizio, Cavallo, Simona, Alessandro, Massè, Anna, Santoro, Lombardi, Bruna, D'Ippolito, Pierpaolo, Furini, Angela, Villani, Daniele, Clara, Raimondi, Guarneri, Massimo, Paolucci, Stefano, Bassi, Andrea, Coiro, Paola, De Angelis, Domenico, Morone, Giovanni, Venturiero, Vincenzo, Palleschi, Lorenzo, Raganato, Paolo, Di Niro, Giuseppina, Rosa, Casini Anna, Loredana, Bove, Imoscopi, Alessandra, Isaia, Giancarlo, Tibaldi, V., Bottignole G, G., Calvi, E., Clementi, C., Zanocchi, M., Agosta, L., Nortarelli, Antonella, Provenzano, Giuseppe, Mari, Daniela, Romano, Federica Ylenia, Rosini, Francesca, Mansi, Marta, Rossi, Silvia, Geriatria, Alex Riccardelli, Inzaghi, Lorenzo, Bonini, Giulia, Rossi, Paolo, Potena, Alfredo, Lichii, Mihaela, Candiani, Tiziana, Grimaldi, William, Bertani, Emiliano, Alessandra, Porta, Calogero, Pietro, Pinto, Daniela, Bernardi, Roberto, Nicolino, Francesco, Galetti, Caterina, Gianstefani, Alice, Giulia, Corvalli, Lorenzo, Mulazzani, Odetti, Patrizio, Monacelli, Fiammetta, Prefumo, Matteo, Fiammetta, Monacelli, Canepa, Marta, Minaglia, Cecilia, Paolisso, Giuseppe, Rizzo, Maria Rosaria, Prestano, Raffaele, Dalise, Anna Maria, Barra, Davide, Bosco, Livio Dal, Asprinio, Vincenzo, Dallape, Luciana, Perina, Elisa, Incalzi, Raffaele Antonelli, Bartoli, Isaura Rossi, Pluderi, Alice, Maina, Antonella, Pecoraro, Elisabetta, Sciarra, Michela, Prudente, Angela, Paola, Maina, Francesca, Mete, Manuel, Ventura, Luisella, Cesari, Maria, Pernigotti Luigi, Tina, Santangelo, Benini, Lucia, Levato, Francesco, Mhiuta, Victor, Alius, Florin, Davidoaia, Diana, Giardini, Vittorio, Garancini, Mattia, Bellamoli, Claudio, Terranova, Luciano, Bozzini, Claudia, Tosoni, Paolo, Provoli, Emma, Cascone, Luisa, Dioli, Andrea, Ferrarin, Gianfranco, Bucci, Adelmo, Bua, Guido, Fenu, Sara, Bianchi, Giovanna, Casella, Silvia, Romano, Valentina, Maurizio, Poli, Mascherona, Ilenia, Belotti, Gloria, Cavaliere, Sabina, Cuni, Estella, Merciuc, Nina, Oberti, Rosella, Veneziani, Silvia, Capoferri, Emanuela, De Bernardi, Elisabetta, Colombo, Katia, Bravi, Marco, Nicoletta, Negrinotti, D'Arcangelo, Paolo, Montenegro, Nicola, Montanari, Roberto, Lamanna, Pierpaolo, Gasperini, Beatrice, Isabella, Montesi, Stefania, Diotallevi, Gaia, Altobelli, Filippo, Calcinaro, Palamà, Chiara, Di Emidio, Chiara, Scarpini, Elio, Arighi, Andrea, Fumagalli, Giorgio, Basilico, Paola, De Amicis Margherita, Migone, Marta, Mancarella, Diletta, Maira, Granata, Antonino, Ranalli, Claudia, Cammilli, Alessandra, Cavallini, Maria Chiara, Tricca, Manola, Natella, Daniela, Gabbani, Luciano, Tesi, Francesca, Martella, Letizia, Imbrici, Rosalba, Guerrini, Gianbattista, Scotuzzi, Anna Maria, Sozzi, Ferdinando, Valenti, Luigi, Chiarello, Antonino, Monia, Monella, Pilotto, Alberto, Prete, Camilla, Senesi, Barbara, Meta, Anna Cristina, Pendenza, Enrico, Pasqualetti, Giuseppe, Polini, Antonio, Tognini, Sara, Ballino, Elena, Cherubini, Antonio, Dell'Aquila, Giuseppina, Gasparrini, Pina Maria, Marotti, Elisabetta, Migale, Monica, Scrimieri, Antonia, Falsetti, Lorenzo, Salvi, Aldo, Toigo, Gabriele, Ceschia, Giuliano, Rosso, Alessia, Tongiorgi, Chiara, Scarpa, Cristina, Maurizio, Pacchioni, De Dominicis, Luigino, Pucci, Eugenio, Renzi, Sara, Cartechini, Elisabetta, Tomassini, Pia Francesca, Del Gobbo, Maurizio, Ugenti, Francesca, Romeo, Pasquale, Nardelli, Anna, Lauretani, Fulvio, Visioli, Sandra, Montanari, Ilaria, Ermini, Francesca, Giordano, Antonio, Pigato, Giorgio, Simeone, Emilio, Barbujani, Mario, Giampieri, Marina, Amoruso, Raffaele, Piccinini, Maristella, Ferrari, Camilla, Gambetti, Claudio, Sfrappini, Mario, Semeraro, Letizia, Striuli, Rinaldo, Mariani, Claudia, Pelliccioni, Giuseppe, Marinelli, Donatella, Fabi, Katia, Rossi, Tommaso, Pesallaccia, Martina, Sabbatini, Debora, Gobbi, Beatrice, Cerqua, Raffaella, Tagliani, Giancarla, Schlauser, Elena, Caser, Luciano, Caramello, Elisa, Sandigliano, Franca, Rosso, Giorgio, Ferrari, Alberto, Bendini, Chiara, Luisa, Davoli Maria, Casella, Monica, Prampolini, Raffaella, Scevola, Moreno, Vitale, Enrico, Roberto, Brugiolo, Carlo, Fagherazzi, Sergio, Fusco, Alberto, Scarpa, Daniela, Zara, Giulia, Bertozzo, Serena, Granziera, Michele, Barazzuol, Maugeri, Domenico, Sorace, Rosaria, Anzaldi, Massimiliano, De Gesu, Roberto, Morrone, Giuseppe, Davolio, Federica, Fabbo, Andrea, Palmieri, Marina, Zoli, Marco, Forti, Paola, Pirazzoli, Luca, Fabbri, Elisa, Terenzi, Laura, Bergolari, Federica, Wenter, Christian, Ruffini, Ingrid, Insam, Miriam, Abraham, Elisabeth, Kirchlechner, Christine, Cucinotta, Domenico, Antonino, Lasco, Basile, Giorgio, Grazia, Arena Maria, Parise, Pasquale, Boccali, Andrea, Amici, Serena, Gambacorta, Maurizia, Lasagni, Anna, Lovati, Roberto, Giovinazzo, Francesca, Kimak, Elzbieta, Zappa, Paolo, Medici, Francesco, Lo Castro, Marika, Mauro, Flavia, De Luca, Alessandro, Sancesario, Giuseppe, Martorana, Alessandro, Scaricamazza, Beatrice, Toniolo, Sofia, Di Lorenzo, Francesco, Liguori, Claudio, Lasco, Antonino, Vita, Natale, Giomi, Mirna, Forte, Floriana, Padovani, Alessandro, Rozzini, Luca, Ceraso, Anna, Salvatore, Caratozzolo, Cottino, Maria, Vitali, Silvia, Marelli, Eleonora, Tripi, Gabriele, Miceli, Salvatore, Urso, Giovanni, Grioni, Giuseppe, Vezzadini, Giuliana, Misaggi, Giulia, Forlani, Chiara, Avanzi, Stefano, Serena, Saulle, Claudia, Casarini, Marilena, Viggiano, Alberto, Luisa, Diego, Ghianda, Alessandro, Giordano, Iemolo, Francesco, Giordano, Antonello, Sanzaro, Enzo, D'Asta, Gabriele, Proietto, Maria, Carnemolla, Anna, Razza, Grazia, Spadaro, Daniela, Bertolotti, Marco, Mussi, Chiara, Neviani, Francesca, Roberto, Chiesa, Valentina, Guerzoni, Linda, Morselli, Francesca, Venturelli, Tarozzi, Adriano, Balestri, Francesca, Mannarino, Giulio, Bigolari, Michela, Natale, Alessia, Grassi, Simona, Bottaro, Cinzia, Stefanelli, Sara, Bovone, Ugo, Tortorolo, Umberto, Quadri, Roberto, Leone, Giuseppe, Ponzetto, Maria, Frasson, Paola, Annoni, Giorgio, Bellelli, Giuseppe, Bruni, Adriana, Confalonieri, Roberto, Corsi, Maurizio, Moretti, Daniela, Teruzzi, Fabiola, Umidi, Simona, Mazzola, Paolo, Perego, Sabrina, Persico, Ilaria, Olivieri, Giulia, Bonfanti, Alessandra, Hajnalka, Szabò, Galeazzi, Marianna, Massariello, Francesca, Anzuini, Alessandra, Caffarra, Paolo, Barocco, Federica, Spallazzi, Marco, Paolo, Ceda Gian, Simonetta, Morganti, Andrea, Artoni, Chioatto, Paolo, Bortolamei, Sandra, Soattin, Lucia, Ruotolo, Giovanni, Beneamino, Borelli, Giuseppe, Barilaro, Bertazzoli, Marco, Rota, Elisabetta, Adobati, Annamaria, Scarpa, Alberto, Granziera, Serena, Zuccher, Paola, Fabbro, Angela Dal, Zara, Daniela, Lo Nigro, Ambra, Franchetti, Lorena, Toniolo, Marika, Marcuzzo, Cinzia, Rollone, Marco, Guerriero, Fabio, Sgarlata, Carmelo, Massè, Alessandro, Zatti, Giovanni, Piatti, Massimiliano, Graci, Jole, Benati, Giuseppe, Boschi, Federica, Biondi, Mario, Fiumi, Nicoletta, Erika, Tamburini, Locatelli, Sergio Mario, Mauri, Sabrina, Beretta, Mauro, Margheritis, Laura, Desideri, Giovanbattista, Liberatore, Ester, Carucci, Anna Cecilia, Bonino, Paolo, Caput, Margherita, Antonietti, Maria Paola, Polistena, Giuseppe, De la Pierre, Franz, Mari, Marcello, Massignani, Paola, Tombesi, Fabio, Selvaggio, Fabio, Verbo, Brunella, Bodoni, Paolo, Marchionni, Niccolò, Mossello, Enrico, Sabatini, Tony, Mussio, Eleonora, Magni, Eugenio, Bianchetti, Angelo, Crucitti, Andrea, Titoldini, Giulia, Cossu, Beatrice, Fascendini, Sara, Licini, Cristina, Tomasoni, Angela, Calderazzo, Massimo, Daniela, Tropiano, Valentina, Laganà, Melotti, Rita Maria, Lilli, Albina, Buda, Simona, Adversi, Marco, Noro, Gabriele, Turco, Renato, Ubezio, M Chiara, Mantovani, Anna Roberta, Viola, Maria Cristina, Serrati, Carlo, Pretta, Stefano, Infante, Maria, Gentile, Simona, Morandi, Alessandro, D'Ambrosio, Viviana, Mazzanti, Paolo, Brambilla, Cristina, Sportelli, Silvia, Platto, Caterina, Faraci, Bianca, Quattrocchi, Daniela, Pernigotti, Luigi Maria, Pisu, Cristina, Sicuro, Francesca, Zagnoni, Piergiuseppe, Ghiglia, Stefania, Mosca, Massimiliano, Corazzin, Ileana, Deola, Mariangela, Biagini, Carlo Adriano, Bencini, Francesca, Cantini, Claudia, Tonon, Elisabetta, Pierinelli, Silvia, Onofrj, Marco, Thomas, Astrid, Filomena, Borbone, Bonanni, Laura, Gabriella, Cacchiò, Comi, Giancarlo, Magnani, Giuseppe, Santangelo, Roberto, Mazzeo, Salvatore, Giuseppe, Magnani, Francesca, Caso, Giordano, Cecchetti, Roberto, Sant'Angelo, Barbieri, Cristina, Giroldi, Liviana, Bandini, Fabio, Masina, Marco, Malservisi, Simona, Cicognani, Annalena, Ricca, Laura, Piccininni, Maristella, Tassinari, Tiziana, Brogi, Davide, Sugo, Annalisa, Alessandra, Filippi, Sonia, Manfredi, Valerio, Vanni, Andrea, Usai Carlo, Enrico, Colombo, Vera, Renna Francesca, Assunta, Sauchella, Gianmaria, Zavarise, Mauro, Prete, Pietro, Bisagni, Roberto, Masini, Salvatore, Carrabetta, Barone, Antonella, Razzano, Monica, Giuseppe, Imperoli, Angela, Bini, Francesco, Serra, Valeria, D'Agostino, Federico, Gianolla, Lucia, Pietrangeli, Antonella, Velardi, Elisabetta, Di Cello, Cristina, Rosati, Nadia, Casali, Maria, Sessa, Luciano, Abruzzi, Chiara, Costanzi, Bini, Paolo, Pignata, Michele, Enrico, Buonagurio, Maria, Vollery, Giovanni, Carrieri, Giorgio, Cioni, Andrea, Toschi, Marco, Metra, Piera, Ranieri, Alberto, Zucchelli, Ceccon, Anna, Magrin, Laura, Marin, Sara, Barbara, Sofia, Marco, Masina, Laura, Ghedini, Matteo, Moroni, Marco, Paragona, Caterina, Pallotti Maria, Carla, Rota, Federica, Gottardi, Clara, Tomasoni, Melania, Cappuccio, Giampaolo, Bonini, Stefano, Guerini, Valeria, Guerini, Lucia, Merla, Giovambattista, Desideri, Ester, Liberatore, Cecilia, Carucci Anna, Maurizio, Tovaglieri, Vera, Renna Frandesca, Nadia, Bongiorni, Grillo, Antonio, Arenare, Francesca, Tonino, Mineo, David, Kanah, Giorgio, Vianello Piero, Ubaldo, Balducci, Vincenzo, Sidoti, Stefano, Montanari, Marino, Formilan, Busonera Flavio, Murelli Teodolindo, Paolo, Albanese, Monica, Maselli, Francesco, Bolzetta, Roberto, Fabris, Paolo, Bonino, DuranteMangoni, Emanuele, Testoni, Michela, Fabio, Di Stefano, Loredana, Seccia, Valeria, Sonzini, Fabiano, Maria, Annabella, Di Giorgio, Salvatore, De Cosmo, Greco, Antonio, Grazia, D'Onofrio, Daniele, Sancarlo, Gianluca, Resta, Renzo, Girardello, Sergio, Minervini, Morena, Boni, Vitali, Mariagrazia, Marina, Pizzoni, Paolo, De Colle, Cristina, Scarpa, Alessandra, Frattola, Orlandini, Francesco, La Regina, Micaela, Desirée, Addesi, Mirella, Filippo, Mario, Bo, Paola, Porrino, Padulo, Filomena, Cristina, Margheriti, Dario, Rolano, Giancarla, Moscatelli, Guido, Radaelli, Elena, Montini, Prete, Cosimo, Marileda, Novello, Igor, Bramuzzo, Nicole, Bertin, Elena, Rinaldo, Paolillo, Ciro, Riccardi, Angela, Claudia, Benedetti, Barbara, Rizzi, Francesca, Montagna, Silvia, Vitali, Chiara, Cutaia, Oliver, Baca, Mauro, Colombo, Eleonora, Marelli, Giuseppe, Procino, Rosaria, Tararà, Maria, Cottino, Davide, Dell'Acqua, Stefania, Cislaghi, Marco, Cairati, Massimo, Porta, Luca, Scaglione, Martina, De Feo, Paola, Vertolli, Lia, Salvati, Sandro, Cinotti, Valentina, De Santis, Erminia, Biferi, Paola, Cheli, Romina, Rebizzo, Minisola, Salvatore, Luciano, Colangelo, Pasquale, Abete, Ilaria, Liguori, Francesca, Curcio, Guglielmo, Spassini, Marco, Engheben, Sara, Rotunno, Paola, Arosio, Claudio, Angelini, Francesco, Reggiani, Alessandro, Cappelli, Simona, Marcheselli, Lara, Fratticci, Paola, Ranzani, Simonetta, Cesarini, Antonella, Cerini, Generoso, Uomo, Fernando, Gallucci, Giuliano, Ceschia, Emanuela, Serra, Mariolina, Sola, Alessandro, Delitala, Chiara, Pes, Giulia, Lobianco, Alessandro, Giani, Famularo, Simone, Sandini, Marta, Pinotti, Enrico, Gianotti, Luca, Antonella, Battuello, Giulia, Pintore, Sante, Giardini, Rossi, Andrea, Rubele, Sofia, Sant, Selena, Marco, Vignati, Danila, Clerici, Fabio, Rosa, Bandirali, Maria Pia, Nicoletta, Cattaneo, Laura, Boffi, Paolo, Tosoni, Luciano, Terranova, Leonello, Avalli, Margherita, Scanziani, Stefania, De Notaris, Pierluigi, Del Santo, Laura, Rossi, Fabiana, Tezza, Giovanna, Cervati, Antonino, Andreolli, Felice, Catalano, Giuseppe, Burattin, Danilo, Fogli, Giovanna, Di Bella, Francesco, Landi, Salini, Sara, Angela, Brunetti Maria, Giorgetta, Cappa, Giovanni, Galvagno, Paola, Cena, Gerardo, Bruno, Silvio, Raspo, Letizia, Semeraro, Sabrina, Pedrotti, Davide, Barra, Rosaria, Rizzo Maria, Maria, Dalise Anna, Raffaele, Prestano, Palmieri, Vincenzo Ostilio, Palasciano, Giuseppe, Belfiore, Anna, Portincasa, Piero, Carlo, Sabbà, Vincenzo, Solfrizzi, Alessia, D'introno, Valiani, Vincenzo, Carolina, Bologna, Tiziana, Ciarambino, Paola, Turelli, Ugo, Pazzaglia, Federica, Rodella, Giacomo, Piana, Castellano, Maurizio, Anna, Garelli, Elisa, Casella, Federica, Campana, Antonietta, Coschignano Maria, Luigi, Marinangeli, Fabio, Lorico, Salvatore, Bazzano, Giuseppe, Menculini, Gelosa, Giorgio, Viviana, Ambrogio Teresa, Piras, Valentina, Andrea, Ciricugno, Alessandra, Bollari, Coen, Daniele, Magliola, Renata, Milanesio, Deborah, Muzzulini, Carlo Lorenzo, Paolo, Fogliacco, Marinella, Turla, Sofia, Cotelli Maria, Marta, Bianchi, Siano, Pietro, Capo, Giuseppe, Napoletano, Rosa, Cecilia, Politi, Mancini, Concetta, Del Buono, Corrado, De Bartolomeo, Giuseppe, Addolorata, Martinelli, Carmen, Cefalogli, Roberto, Cozzi, Giovanni, Virtuani Angelo, Moschettini, Gianfilippo, Franco, Mastroianni, Daniela, Roglia, D'Amico, Gabriella, Mirella, Palella, Endrizzi, Cristina, Trotta, Lucia, Ciarambino, Tiziana, Orazio, Zanetti, Emanuela, Terazzi, Marta, Sacchetti, Thomas, Fleetwood, Giacomo, Tondo, Ignazio, Di Fazio, Andrea, Bruni, Giuseppe, Orsitto, Emanuela, Fabbro, Serena, Amici, Elena, D'Imporzano, Anna, Casanova, Serena, Bertolio, Erika, Nervo, Roberto, Silvestri, Elena, Semproni, Manuela, Pintus, Francesca, Aloe, Angelo, Tagliaccica, Zambon, Antonella, and Di Santo, Simona G.
Published: 2020
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10. Instrumental evaluation of gait smoothness and history of falling in older persons: results from an exploratory case–control study

Author: Alberto Zucchelli, Daniela Lucente, Chiara Filippini, Alessandra Marengoni, and Nicola Francesco Lopomo
Subjects: Aging, Older persons, SPARC, Gait smoothness, Fall risk, Geriatrics and Gerontology
Published: 2023

11. Hyperactive delirium in the emergency department: the continued case of B.M

Author: Federico Braglia Orlandini, Annalisa Pirozzi, Anita Chizzoli, Giuseppe Romanelli, Alberto Zucchelli, and Alessandra Marengoni
Subjects: Aging, Geriatrics and Gerontology
Published: 2023

12. Beyond Chronological Age: A Multidimensional Approach to Survival Prediction in Older Adults

Author: Jérôme Salignon, Debora Rizzuto, Amaia Calderón-Larrañaga, Alberto Zucchelli, Laura Fratiglioni, Christian G Riedel, and Davide L Vetrano
Subjects: Aging, Geriatrics and Gerontology
Abstract: Background There is a growing interest in generating precise predictions of survival to improve the assessment of health and life-improving interventions. We aimed to (a) test if observable characteristics may provide a survival prediction independent of chronological age; (b) identify the most relevant predictors of survival; and (c) build a metric of multidimensional age. Methods Data from 3 095 individuals aged ≥60 from the Swedish National Study on Aging and Care in Kungsholmen. Eighty-three variables covering 5 domains (diseases, risk factors, sociodemographics, functional status, and blood tests) were tested in penalized Cox regressions to predict 18-year mortality. Results The best prediction of mortality at different follow-ups (area under the receiver operating characteristic curves [AUROCs] 0.878–0.909) was obtained when 15 variables from all 5 domains were tested simultaneously in a penalized Cox regression. Significant prediction improvements were observed when chronological age was included as a covariate for 15- but not for 5- and 10-year survival. When comparing individual domains, we find that a combination of functional characteristics (ie, gait speed, cognition) gave the most accurate prediction, with estimates similar to chronological age for 5- (AUROC 0.836) and 10-year (AUROC 0.830) survival. Finally, we built a multidimensional measure of age by regressing the predicted mortality risk on chronological age, which displayed a stronger correlation with time to death (R = −0.760) than chronological age (R = −0.660) and predicted mortality better than widely used geriatric indices. Conclusions Combining easily accessible characteristics can help in building highly accurate survival models and multidimensional age metrics with potentially broad geriatric and biomedical applications.
Published: 2022

13. COVID-19 as an effect modifier of the relationship between age and in-hospital survival in older patients admitted to an Italian Emergency Department

Author: Alberto Zucchelli, Catello Sepe, Luca Tarozzi, Anna Garelli, Francesca Benedusi, Samuele Pignataro, Ciro Paolillo, and Alessandra Marengoni
Subjects: Aged, 80 and over, Aging, SARS-CoV-2, Older age, COVID-19, Emergency Department, COVID-19 survival, Tertiary Care Centers, COVID-19 Testing, Humans, Hospital Mortality, Geriatrics and Gerontology, Emergency Service, Hospital, Aged, Retrospective Studies
Abstract: Background The SARS-CoV-2 pandemic modified how persons got into contact with emergency services, particularly during the first wave. Aim The aim is to describe the characteristics of older persons with and without COVID-19 visiting the Emergency Department of a tertiary hospital and to investigate the impact of age on in-hospital survival in the two groups. Methods Patients older than 70 years were followed-up till discharge or in-hospital death. Cox regression models stratified by COVID-19 diagnosis were used to investigate survival. Results Out of 896 patients, 36.7% had COVID-19. Those without COVID-19 were older and affected by a higher number of chronic conditions but exhibited lower mortality (10.5 vs 48.1%). After the adjustment, age was associated with mortality only among those with COVID-19. Discussion COVID-19 modified the relationship between older age and in-hospital survival: whether this finding is explained by other biological vulnerabilities or by a selection of treatments based on age should be further investigated.
Published: 2022

14. 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

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

Author: Crisafulli, Ernesto, Sartori, Giulia, Vianello, Alice, Busti, Fabiana, Nobili, Alessandro, Mannucci, Pier Mannuccio, Girelli, Domenico Investigators—Domenico Prisco, Elena, Silvestri, Giacomo, Emmi, Alessandra, Bettiol, Irene Mattioli (Azienda Ospedaliero Universitaria Careggi Firenze, SOD Medicina Interna Interdisciplinare), Gianni, Biolo, Michela, Zanetti, Giacomo, Bartelloni, Michele, Zaccari, Massi- miliano Chiuch (Azienda Sanitaria Universitaria Integrata di Trieste, Clinica Medica Generale, e Terapia Medica), Massimo, Vanoli, Giulia, Grignani, Edoardo Alessandro Pulixi (Azienda Ospedaliera della Pro- vincia di Lecco, Ospedale di Merate, Lecco, Medicina, Interna), Matteo, Pirro, Graziana, Lupattelli, Vanessa, Bianconi, Riccardo, Alcidi, Alessia, Giotta, Mannarino (Azienda Ospedaliera Santa Maria della Misericordia, Massimo R., Perugia, Medicina, Interna, Angiologia Malattie da Arteriosclerosi), Domenico, Girelli, Fabiana, Busti, Giacomo Marchi (Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Medicina Generale e Malattie Aterotrombotiche, e Degenerative), Mario, Barbagallo, Ligia, Dominguez, Vincenza, Beneduce, Federica Cacioppo (Azienda Ospedaliera Universitaria Policlinico Giaccone Policlinico di Palermo, Palermo, Unità Operativa di Geriatria, e Lun- godegenza), Salvatore, Corrao, Giuseppe, Natoli, Salvatore, Mularo, Massimo, Raspanti, Christiano, Argano, Civico, Federica Cavallaro (A. R. N. A. S., Cristina, Di, Benfratelli, Palermo, UOC Medicina Interna ad Indirizzo Geriatrico- Riabilitativo), Marco, Zoli, Maria Laura Mata- cena, Giuseppe, Orio, Eleonora, Magnolfi, Giovanni, Serafini, Angelo, Simili, Mattia, Brunori, Ilaria, Lazzari, Orsola-Malpighi, Angelo Simili (Azienda Ospe- daliera Universitaria Policlinico S., Bologna, Unità Operativa di Medicina Interna Zoli), Maria Domenica Cappellini, Gio- vanna Fabio, Margherita Migone De Amicis, Giacomo De Luca, Nata- lia Scaramellini, Valeria Di Stefano, Simona, Leoni, Sonia, Seghezzi, Alessandra Danuto Di Mauro, Diletta, Maira, Marta Mancarella (Fon- dazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Unità Operativa Medicina Interna IA), Tiziano, Lucchi, Paolo Dionigi Rossi, Marta, Clerici, Alessandra Danuta Di Mauro, Giulia, Bonini, Federica, Conti, Silvia, Prolo, Maddalena, Fabrizi, Miriana, Martelengo, Giulia, Vigani, Paola Nicolini (Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Geriatria), Antonio Di Sabatino, Emanuela, Miceli, Marco Vincenzo Lenti, Martina, Pisati, Lavinia, Pitotti, Donatella, Padula, Valentina, Antoci, Ginevra Cambiè (IRCCS Policlinico San Matteo di Pavia, Pavia, Clinica Medica, I, Reparto, 11), Roberto, Pontremoli, Valentina, Beccati, Giulia, Nobili, Giovanna, Leoncini, Jacopo, Alberto, Federico Cattaneo (IRCCS Azienda Ospedaliera Universitaria San Martino-IST di Genova, Gen-, Ova, Clinica di Medicina Interna 2), Luigi, Anastasio, Lucia, Sofia, Maria Carbone (Ospedale Civile Jazzolino di Vibo Valentia, Vibo Val- entia, Medicina, Generale), Francesco, Cipollone, Maria Teresa Guag- nano, Ilaria, Rossi, Emanuele, Valeriani, Damiani, D’Ardes, Lucia, Esposito, Simona, Sestili, Annunziata, Ermanno Angelucci (Ospedale Clinicizzato SS., Chieti, Clinica, Medica), Gerardo, Mancuso, Daniela, Calipari, Mosè Bartone (Ospedale Giovanni Paolo II Lamezia Terme, Catanzaro, Unità Operativa Complessa Medicina Interna), Giuseppe, Delitala, Maria, Berria, Alessandro Delitala (Azienda ospedaliera- universitaria di Sassari, Maurizio, Muscaritoli, Ales- sio Molfino, Enrico, Petrillo, Antonella, Giorgi, Christian, Gracin, Gio- vanni Imbimbo (Policlinico Umberto, I, Sapienza Università di Roma, Medicina Interna, e Nutrizione Clinica Policlinico Umberto I), Giuseppe, Zuccalà, Gemelli, Gabriella D’Aurizio (Policlinico Universitario A., Roma, Roma, Unità Operativa Complessa Medicina d'Urgenza, e Pronto Soccorso)Giuseppe Romanelli, Alessandra, Marengoni, Andrea, Volpini, Daniela, Lucente, Francesca, Manzoni, Annalisa, Pirozzi, Alberto Zucchelli (Unità Operativa Complessa di Medicina I, a indirizzo geriatrico, Spedali, Civili, Montichiari, Brescia), Antonio, Picardi, Umberto Vespasiani Gentilucci, Paolo, Gallo, Chiara Dell’Unto (Università Campus Bio- Medico, Roma, Medicina Clinica-Epatolo- gia), Giuseppe, Bellelli, Maurizio, Corsi, Cesare, Antonucci, Chiara, Sidoli, Giulia, Principato, Alessandra, Bonfanti, Hajnalka, Szabo, Paolo, Mazzola, Andrea, Piazzoli, Gerardo, Maurizio Corsi (Università degli studi di Milano-Bicocca Ospedale S., Monza, Unità Operativa di Geri- atria), Franco, Arturi, Elena, Succurro, Bruno, Tassone, Federica Giofrè (Università degli Studi Magna Grecia, Policlinico Mater Domini, Cat-, Anzaro, Unità Operativa Complessa di Medicina Interna), Maria Grazia Serra, Maria Antonietta Bleve (Azienda Ospedaliera, Lecce, Unità Operativa Complessa Medicina), Antonio, Brucato, Teresa De Falco, Enrica, Negro, Martino, Brenna, Lucia, Trotta, Giovanni Lorenzo Squintani (ASST FatebenefratelliSacco, Maria Luisa Randi, Fabrizio, Fabris, Irene, Bertozzi, Giulia, Bogoni, Maria Victoria Rabuini, Tancredi, Prandini, Francesco, Ratti, Chiara, Zurlo, Lorenzo, Cerruti, Elisabetta Cosi (Azienda Ospe- daliera Università di Padova, Padova, Clinica Medica I), Roberto Man- fredini, Benedetta, Boari, Alfredo De Giorgi, Ruana, Tiseo, Giulia Marta Viglione, Caterina Savriè (Azienda OspedalieraUniversitaria Sant'Anna, Ferrara, Unità Operativa Clinica Medica), Giuseppe, Paolisso, Maria Rosaria Rizzo, Claudia, Catalano, Irene Di Meo (Azienda Ospedaliera Universitaria della Seconda Università degli Studi di Napoli, Napoli, VI Divisione di Medicina Interna, e Malattie Nutrizionali dell'Invecchiamento), Claudio, Borghi, Enrico, Strocchi, Eugenia, Ianniello, Mario, Soldati, Silvia, Schiavone, Alessio, Bragagni, 13 Francesca Giulia Leoni, Valeria De Sando, Sara, Scarduelli, Michela, Cammarosano, Orsola-Malpighi, Ilenia Pareo (Azienda Ospedaliera Universitaria Poli- clinico S., Unità Operativa di Medicina Interna Borghi), Carlo, Sabbà, Francesco Saverio Vella, Patrizia Sup- pressa, Giovanni Michele De Vincenzo, Alessio, Comitangelo, Ema- nuele Amoruso, Carlo, Custodero, Giuseppe, Re, Andrea, Schilardi, Francesca Loparco (Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, Bari, Frugoni), Medicina Interna Universitaria C., Luigi, Fenoglio, Andrea, Falcetta, Alessia Valentina Giraudo, Salvatore D’Aniano (Azienda Sanitaria Ospedaliera Santa Croce, e Carle di Cuneo, Cuneo, Ademe, Medicina Interna), S. C., Fracanzani, Anna L., Silvia, Tiraboschi, Annalisa, Cespiati, Giovanna, Oberti, Giordano, Sigon, Felice Cinque (Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, UOC Medicina Generale ad Indirizzo Metabolico), Flora, Peyvandi, Raffaella, Rossio, Colombo, Giulia, Pasquale, Agosti, Erica, Pagliaro, Eleonora Semproni (Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Medicina Interna, 2, Emato- logia non tumorale, e Coagulopatie), Canetta, Ciro, Valter, Monzani, Valeria, Savojardo, Giuliana, Ceriani, Christian Folli (Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Medicina Interna Alta Intensità di Cure), Francesco, Salerno, Giada Pallini (IRCCS Policlinico San Donato, e Università di Milano, San Donato Milanese, Fabrizio, Montecucco, Luciano, Ottonello, Lara, Caserza, Giulia, Vischi, Salam, Kassem, Luca Liberale (IRCCS Ospedale Policlinico San Martino, e Università di Genova, Genova, Clinica Medica, 1, Medicina Interna, e Specialità Mediche), Nicola Lucio Liberato, Tiziana Tognin (ASST di Pavia, UOSD Medicina Interna, Ospedale di Casorate Primo, Pavia), Francesco, Purrello, Antonino Di Pino, Salvatore Piro (Ospedale Garibaldi Nesima, Catania, Giorgia, Renzo, Rozzini, Lina, Falanga, Maria Stella Pisciotta, Francesco Baffa Bellucci, Stefano Buf- felli, Camillo, Ferrandina, Francesca, Mazzeo, Elena, Spazzini, Giulia, Cono, Giulia Cesaroni (Ospedale Poliambulanza, Brescia, Medicina Interna, e Geriatria), Giuseppe, Montrucchio, Paolo, Peasso, Edoardo, Favale, Cesare, Poletto, Carl, Margaria, Maura Sanino (Dipartimento di Scienze Mediche, Università di Torino, Città della Scienza, e della Salute, Torino, Medicina Interna, 2 Unità Indirizzo d'Urgenza), Franc- esco Violi, Ludovica Perri (Policlinico Umberto, I, Prima Clinica Medica), Guasti, Luigina, Rotunno, Francesca, Castiglioni, Luana, Maresca, ANDREA MARIA, Squizzato, Alessandro, Campiotti, Leonardo, Ales- sandra Grossi, Diprizio, ROBERTO DAVIDE, Francesco Dentali (Università degli Studi dell'Insubria, Ospedale di Circolo, e Fondazione Macchi, Varese, Elena, Medicina, e Geriatria), Marco, Bertolotti, Chiara, Mussi, Giulia, Lancellotti, Maria Vittoria Libbra, Matteo, Galassi, Yasmine, Grassi, Alessio, Greco, Elena, Bigi, Elisa, Pellegrini, Laura, Orlandi, Giulia, Dondi, Lucia Carulli (Università di Modena, e Reggio Emilia, Azienda Ospedaliero-Universitaria di Modena, Ospedale Civile di Baggiovara, Unità Operativa di Geriatria), Angela, Sciacqua, Maria, Perticone, Rosa, Battaglia, Raffaele, Maio, Aleandra, Scozzafava, Valentino, Condoleo, Tania, Falbo, Lidia, Colangelo, Marco Filice, Elvira Clausi (Università Geriatriche), Vincenzo, Stanghellini, Eugenio, Ruggeri, Sara del Vec- chio, Ilaria Benzoni (Dipartimento di Scienze Mediche, e Chirurgiche, Unità Operativa di Medicina Interna, Orsola-Malpighi, Università degli Studi di Bologna/ Azienda Ospedaliero- Universitaria S., Bologna), Andrea, Salvi, Roberto, Leonardi, Giampaolo Damiani (Spedali Civili di Brescia, Medicina Generale), U. O. 3a., Gianluca, Moroncini, William, Capeci, Massimo, Mattioli, Giuseppe Pio Martino, Lorenzo, Biondi, Pietro, Pettinari, Monica, Ormas, Emanuele, Filippini, Devis, Benfaremo, Roberto Romiti (Clinica Medica, Azienda Ospedaliera Universitaria- Ospedali Riuniti di Ancona), Riccardo, Ghio, Anna Dal Col (Azienda Ospedaliera Università San Martino, Medicina, III), Salvatore, Minisola, Luciano, Colangelo, Mirella, Cilli, Giancarlo Labbadia (Poli- clinico Umberto, I, SMSC03Medicina Interna F, e Malattie Meta- boliche dell'osso), Antonella, Afeltra, Benedetta, Marigliano, Maria Elena Pipita (Policlinico Campus Biomedico Roma, Medicina, Clinica), Pietro, Castellino, Luca, Zanoli, Alfio, Gennaro, Agostino, Gaudio, Emanuele, Samuele Pignataro (Azienda Ospedaliera Universitaria Poli- clinico – V., Catania, Dipartimento di Medicina), Francesca, Mete, Miriam Gino (Ospedale degli Infermi di Rivoli, Medicina Interna)Guido Moreo, Gloria Pina (Clinica San Carlo Casa di Cura Polispecialistica, Paderno, Dugnano, Unità Operativa di Medicina Generale Emilio Bernardelli), Alberto Balle- strero, Fabio, Ferrando, Roberta, Gonella, Domenico, Cerminara, Paolo, Setti, Chiara, Traversa, Camilla Scarsi (Clinica Di Medicina Interna ad Indirizzo Oncologico, Azienda Ospedaliera Università San Martino di Genova), Bruno, Graziella, Stefano, Baldassarre, Salvatore, Fragapani, Gabriella Gruden (Medicina Interna III, Giovanni Battista Molinette, Ospedale S., Torino), Franco, Berti, Giuseppe, Famularo, Patrizia Tarsitani (Azienda Ospedaliera San Camillo Forlanini, Medicina Interna II), Roberto, Castello, Michela Pasino (Ospedale Civile Maggiore Borgo Trento, Medicina Generale, e Sezione di Decisione Cli- nica), Marcello Giuseppe Maggio Gian Paolo Ceda, Simonetta Mor- ganti, Andrea, Artoni, Margherita Grossi (Azienda Ospedaliero Uni- versitaria di Parma, Clinica Geriatrica), U. O. C., Stefano Del Giacco, Davide, Firinu, Giulia, Costanzo, Giacomo, Argiolas, Giovanni, Paoletti, Francesca Losa (Policlinico Universitario Duilio Casula, Azienda Ospedaliero-Universitaria di Cagliari, Cagliari, Allergologia ed Immunologia Clinica), Giuseppe, Montalto, Anna, Licata, Filippo Alessandro Montalto, Angelo Rizzo (Azienda Ospe- daliera Universitaria Policlinico Paolo Giaccone, UOC di Medicina Interna), Francesco, Corica, Giorgio, Basile, Antonino Cata- lano, Federica, Bellone, Martino, Concetto Principato (Azienda Ospedaliera Universitaria Policlinico G., Messina, Lorenzo, Malatino, Benedetta, Stancanelli, Valentina, Terranova, Salvatore Di Marca, Rosario Di Quattro, Lara La Malfa, Rossella Caruso (Azienda Ospedaliera per l'Emergenza Cannizzaro, Clinica Medica Università di Catania), Patrizia, Mecocci, Carmelinda, Ruggiero, della Misericordia, Virginia Boccardi (Università degli Studi di Perugia-Azienda Ospedaliera S. M., Struttura Complessa di Geriatria), Tiziana, Meschi, Andrea, Ticinesi, Antonio Nouvenne (Azienda Ospedaliera Universitaria di Parma, Medicina Interna e Lungodegenza Critica), U. O., Pietro, Minuz, Luigi, Fondrieschi, Giandomen- ico Nigro Imperiale, Sarah Morellini (Azienda Ospedaliera Universi- taria Verona, Policlinico GB Rossi, Medicina Generale per lo Studio ed il Trattamento dell’Ipertensione Arteriosa), Mario, Pirisi, Gian Paolo Fra, Daniele, Sola, Mattia Bellan (Azienda Ospedaliera Universitaria Maggiore della Carità, Medicina Interna 1), Roberto, Quadri, Erica, Larovere, Marco Novelli (Ospedale di Ciriè, Asl, To4, Emilio, Simeone, Rosa, Scurti, Fabio Tolloso (Ospedale Spirito Santo di Pescara, Geriatria), Roberto Tar- quini, Alice, Valoriani, Silvia, Dolenti, Giulia Vannini (Ospedale San Giuseppe, Empoli, USL Toscana Centro, Firenze, Medicina Interna I), Riccardo, Volpi, Pietro, Bocchi, Alessandro Vignali (Azienda Ospe- daliera Universitaria di Parma, Clinica, e Terapia Medica), Sergio, Harari, Chiara, Lonati, Federico, Napoli, Italia Aiello (Divisione di Medicina Interna, Multimedica, Ircss, Milano), Antonino Di Pino (Ospedale GaribaldiNesima, – Catania, Medicina Interna), U. O. C., Teresa, Salvatore, Lucio, Monaco, Vanvitelli, Carmen Ricozzi (Policlinico Università della Campania L., UOC Medicina Interna), Alberto, Pilotto, Ilaria, Indiano, Federica Gandolfo (Ente Ospe- daliero Ospedali Galliera Genova, SC Geriatria Dipartimento Cure Geriatriche, Ortogeriatria, e Riabilitazione)Franco Laghi Pasini, Pier Leopoldo Capecchi (Azienda Ospedaliera Universitaria Senese, Siena, Unità Operativa Complessa Medicina 2), Ranuccio, Nuti, Roberto Val- enti, Martina, Ruvio, Silvia, Cappelli, Alberto Palazzuoli (Azienda Ospedaliera Università Senese, Mauro Ber- nardi, Silvia Li Bassi, Luca, Santi, Giacomo Zaccherini (Azienda Ospe- daliera Policlinico Sant’Orsola-Malpighi, Semeiotica Medica Bernardi), Vittorio, Durante, Daniela, Tirotta, Giovanna Eusebi (Ospedale di Cattolica, Rimini, Marco, Cattaneo, Maria Valentina Amoruso, Paola, Fracasso, Cristina Fasolino (Azienda ospedaliera San Paolo, Moreno, Tresoldi, Enrica 13 Internal and Emergency Medicine Internal and Emergency Medicine Bozzolo, Sarah Damanti (IRCCS Ospedale San Raffaele, – Milano, Medicina Generale, e delle Cure Avanzate), Massimo, Porta, Miriam Gino (AOU Città della Salute e della Scienza di Torino, – Torino, and Medicina Interna, 1U).
Subjects: Hospital cure, Chronic obstructive pulmonary disease, Heart failure, Mortality, Multimorbidity, Prognosis
Published: 2023

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

Author: Salvatore, Corrao, Alessandro, Nobili, Giuseppe, Natoli, Pier Mannuccio Mannucci, Francesco, Perticone, Antonello, Pietrangelo, Christiano, Argano, Giuseppe, Licata, Francesco, Violi, Gino Roberto Corazza, Alessandra, Marengoni, Francesco, Salerno, Matteo, Cesari, Mauro, Tettamanti, Luca, Pasina, Carlotta, Franchi, Laura, Cortesi, Gabriella, Miglio, Ilaria, Ardoino, Alessio, Novella, Domenico, Prisco, Elena, Silvestri, Giacomo, Emmi, Alessandra, Bettiol, Cenci, Caterina, Gianni, Biolo, Michela, Zanetti, Martina, Guadagni, Michele, Zaccari, Massimiliano, Chiuch, Massimo, Vanoli, Giulia, Grignani, Edoardo Alessandro Pulixi, Mauro, Bernardi, Silvia Li Bassi, Luca, Santi, Giacomo, Zaccherini, Graziana, Lupattelli, Elmo, Mannarino, Vanessa, Bianconi, Francesco, Paciullo, Riccardo, Alcidi, Ranuccio, Nuti, Roberto, Valenti, Martina, Ruvio, Silvia, Cappelli, Alberto, Palazzuoli, Domenico, Girelli, Fabiana, Busti, Giacomo, Marchi, Mario, Barbagallo, Ligia, Dominguez, Floriana, Cocita, Vincenza, Beneduce, Lidia, Plances, Salvatore, Mularo, Massimo, Raspanti, Marco, Zoli, Ilaria, Lazzari, Mattia, Brunori, Elisa, Fabbri, Donatella, Magalotti, Raffaella, Arnò, 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, Margherita Migone De Amicis, Giacomo De Luca, Natalia, Scaramellini, Paolo Dionigi Rossi, Sarah, Damanti, Marta, Clerici, Federica, Conti, Giulia, Bonini, Barbara Brignolo Ottolini, Antonio Di Sabatino, Emanuela, Miceli, Marco Vincenzo Lenti, Martina, Pisati, Costanza Caccia Dominioni, Giovanni, Murialdo, Alessio, Marra, Federico, Cattaneo, Roberto, Pontremoli, Valentina, Beccati, Giulia, Nobili, Maria Beatrice Secchi, Davide, Ghelfi, Luigi, Anastasio, Lucia, Sofia, Maria, Carbone, Francesco, Cipollone, Maria Teresa Guagnano, Emanuele, Valeriani, Ilaria, Rossi, Gerardo, Mancuso, Daniela, Calipari, Mosè, Bartone, Giuseppe, Delitala, Maria, Berria, Chiara, Pes, Alessandro, Delitala, Maurizio, Muscaritoli, Alessio, Molfino, Enrico, Petrillo, Giuseppe, Zuccalà, Gabriella, D'Aurizio, Giuseppe, Romanelli, Alberto, Zucchelli, Francesca, Manzoni, Andrea, Volpini, 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, Bruno, Tassone, Giorgio, Sesti, 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, Paolo, Scarinzi, Annalisa, Amabile, Elisabetta, Omenetto, Tancredi, Prandini, Manfredini, Roberto, Fabbian, Fabio, Boari, Benedetta, DE GIORGI, Alfredo, Tiseo, Ruana, DE GIORGIO, Roberto, Giuseppe, Paolisso, Maria Rosaria Rizzo, Claudio, Borghi, Enrico, Strocchi, Eugenia, Ianniello, Mario, Soldati, Carlo, Sabbà, Francesco Saverio Vella, Patrizia, Suppressa, Andrea, Schilardi, Francesca, Loparco, Giovanni Michele De Vincenzo, Alessio, Comitangelo, Emanuele, Amoruso, Luigi, Fenoglio, Andrea, Falcetta, Christian, Bracco, Anna, L Fracanzani Silvia Fargion, Silvia, Tiraboschi, Annalisa, Cespiati, Giovanna, Oberti, Giordano, Sigon, Flora, Peyvandi, Raffaella, Rossio, Barbara, Ferrari, Giulia, Colombo, Pasquale, Agosti, 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, Paolo, Peasso, Edoardo, Favale, Cesare, Poletto, Raffaella, Salmi, Piergiorgio, 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Filippo Alessandro Montalto, Antonino, Lasco, Giorgio, Basile, Antonino, Catalano, Lorenzo, Malatino, Benedetta, Stancanelli, Valentina, Terranova, Salvatore Di Marca, Rosario Di Quattro, Lara La Malfa, Rossella, Caruso, Patrizia, Mecocci, Carmelinda, Ruggiero, Virginia, Boccardi, Tiziana, Meschi, Fulvio, Lauretani, Andrea, Ticinesi, Antonio, Nouvenne, Pietro, Minuz, Luigi, Fondrieschi, Mario, Pirisi, Gian Paolo Fra, Daniele, Sola, Massimo, Porta, Piero, Riva, Roberto, Quadri, Erica, Larovere, Marco, Novelli, 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, Sergio, Harari, Chiara, Lonati, Mara, Cattaneo, Federico, Napoli., Corrao S, Nobili A, Natoli G, Mannucci PM, Perticone F, Pietrangelo A, Argano C, REPOSI Investigator, Borghi C, Corrao S., Nobili A., Natoli G., Mannucci P.M., Perticone F., Pietrangelo A., Argano C., Licata G., Violi F., Corazza G.R., Marengoni A., Salerno F., Cesari M., Tettamanti M., Pasina L., Franchi C., Cortesi L., Miglio G., Ardoino I., Novella A., Prisco D., Silvestri E., Emmi G., Bettiol A., Caterina C., Biolo G., Zanetti M., Guadagni M., Zaccari M., Chiuch M., Vanoli M., Grignani G., Pulixi E.A., Bernardi M., Bassi S.L., Santi L., Zaccherini G., Lupattelli G., Mannarino E., Bianconi V., Paciullo F., Alcidi R., Nuti R., Valenti R., Ruvio M., Cappelli S., Palazzuoli A., Girelli D., Busti F., Marchi G., Barbagallo M., Dominguez L., Cocita F., Beneduce V., Plances L., Mularo S., Raspanti M., Zoli M., Lazzari I., Brunori M., Fabbri E., Magalotti D., Arno R., 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., De Amicis M.M., De Luca G., Scaramellini N., Rossi P.D., Damanti S., Clerici M., Conti F., Bonini G., Ottolini B.B., Di Sabatino A., Miceli E., Lenti M.V., Pisati M., Dominioni C.C., Murialdo G., Marra A., Cattaneo F., Pontremoli R., Beccati V., Nobili G., Secchi M.B., Ghelfi D., Anastasio L., Sofia L., Carbone M., Cipollone F., Guagnano M.T., Valeriani E., Rossi I., Mancuso G., Calipari D., Bartone M., Delitala G., Berria M., Pes C., Delitala A., Muscaritoli M., Molfino A., Petrillo E., Zuccala G., D'Aurizio G., Romanelli G., Zucchelli A., Manzoni F., Volpini 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., Tassone B., Sesti G., 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., Scarinzi P., Amabile A., Omenetto E., Prandini T., Manfredini R., Fabbian F., Boari B., De Giorgi A., Tiseo R., De Giorgio R., Paolisso G., Rizzo M.R., Borghi C., Strocchi E., Ianniello E., Soldati M., Sabba C., Vella F.S., Suppressa P., Schilardi A., Loparco F., De Vincenzo G.M., Comitangelo A., Amoruso E., Fenoglio L., Falcetta A., Bracco C., Fargion A.L.F.S., Tiraboschi S., Cespiati A., Oberti G., Sigon G., Peyvandi F., Rossio R., Ferrari B., Colombo G., Agosti P., 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., Peasso P., Favale E., Poletto C., Salmi R., Gaudenzi P., Perri L., Landolfi R., Montalto M., Mirijello A., Guasti L., Castiglioni L., Maresca A., Squizzato A., Campiotti L., Grossi A., Bertolotti M., Mussi C., Lancellotti G., Libbra M.V., Dondi G., Pellegrini E., Carulli L., Galassi M., Grassi Y., Perticone M., Battaglia R., FIlice M., Maio R., Stanghellini V., Ruggeri E., del Vecchio S., Salvi A., Leonardi R., Damiani G., Capeci W., Gabrielli A., Mattioli M., Martino G.P., Biondi L., Pettinari P., Ghio R., Col A.D., Minisola S., Colangelo L., Cilli M., Labbadia G., Afeltra A., Marigliano B., Pipita M.E., Castellino P., Zanoli L., Pignataro S., Gennaro A., Blanco J., 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., Tarsitani P., Castello R., Pasino M., Ceda G.P., Maggio M.G., Morganti S., Artoni A., Del Giacco S., Firinu D., Losa F., Paoletti G., Costanzo G., Montalto G., Licata A., Malerba V., Montalto F.A., Lasco A., Basile G., Catalano A., Malatino L., Stancanelli B., Terranova V., Di Marca S., Di Quattro R., La Malfa L., Caruso R., Mecocci P., Ruggiero C., Boccardi V., Meschi T., Lauretani F., Ticinesi A., Nouvenne A., Minuz P., Fondrieschi L., Pirisi M., Fra G.P., Sola D., Porta M., Riva P., Quadri R., Larovere E., Novelli M., 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., Napoli F., Corrao, S., Nobili, A., Natoli, G., Mannucci, P. M., Perticone, F., Pietrangelo, A., Argano, C., Licata, G., Violi, F., Corazza, G. R., Marengoni, A., Salerno, F., Cesari, M., Tettamanti, M., Pasina, L., Franchi, C., Cortesi, L., Miglio, G., Ardoino, I., Novella, A., Prisco, D., Silvestri, E., Emmi, G., Bettiol, A., Caterina, C., Biolo, G., Zanetti, M., Guadagni, M., Zaccari, M., Chiuch, M., Vanoli, M., Grignani, G., Pulixi, E. A., Bernardi, M., Bassi, S. L., Santi, L., Zaccherini, G., Lupattelli, G., Mannarino, E., Bianconi, V., Paciullo, F., Alcidi, R., Nuti, R., Valenti, R., Ruvio, M., Cappelli, S., Palazzuoli, A., Girelli, D., Busti, F., Marchi, G., Barbagallo, M., Dominguez, L., Cocita, F., Beneduce, V., Plances, L., Mularo, S., Raspanti, M., Zoli, M., Lazzari, I., Brunori, M., Fabbri, E., Magalotti, D., Arno, R., 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., De Amicis, M. M., De Luca, G., Scaramellini, N., Rossi, P. D., Damanti, S., Clerici, M., Conti, F., Bonini, G., Ottolini, B. B., Di Sabatino, A., Miceli, E., Lenti, M. V., Pisati, M., Dominioni, C. C., Murialdo, G., Marra, A., Cattaneo, F., Pontremoli, R., Beccati, V., Nobili, G., Secchi, M. B., Ghelfi, D., Anastasio, L., Sofia, L., Carbone, M., Cipollone, F., Guagnano, M. T., Valeriani, E., Rossi, I., Mancuso, G., Calipari, D., Bartone, M., Delitala, G., Berria, M., Pes, C., Delitala, A., Muscaritoli, M., Molfino, A., Petrillo, E., Zuccala, G., D'Aurizio, G., Romanelli, G., Zucchelli, A., Manzoni, F., Volpini, 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., Tassone, B., Sesti, G., 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., Scarinzi, P., Amabile, A., Omenetto, E., Prandini, T., Manfredini, R., Fabbian, F., Boari, B., De Giorgi, A., Tiseo, R., De Giorgio, R., Paolisso, G., Rizzo, M. R., Borghi, C., Strocchi, E., Ianniello, E., Soldati, M., Sabba, C., Vella, F. S., Suppressa, P., Schilardi, A., Loparco, F., De Vincenzo, G. M., Comitangelo, A., Amoruso, E., Fenoglio, L., Falcetta, A., Bracco, C., Fargion, A. L. F. S., Tiraboschi, S., Cespiati, A., Oberti, G., Sigon, G., Peyvandi, F., Rossio, R., Ferrari, B., Colombo, G., Agosti, P., 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., Peasso, P., Favale, E., Poletto, C., Salmi, R., Gaudenzi, P., Perri, L., Landolfi, R., Montalto, M., Mirijello, A., Guasti, L., Castiglioni, L., Maresca, A., Squizzato, A., Campiotti, L., Grossi, A., Bertolotti, M., Mussi, C., Lancellotti, G., Libbra, M. V., Dondi, G., Pellegrini, E., Carulli, L., Galassi, M., Grassi, Y., Perticone, M., Battaglia, R., Filice, M., Maio, R., Stanghellini, V., Ruggeri, E., del Vecchio, S., Salvi, A., Leonardi, R., Damiani, G., Capeci, W., Gabrielli, A., Mattioli, M., Martino, G. P., Biondi, L., Pettinari, P., Ghio, R., Col, A. D., Minisola, S., Colangelo, L., Cilli, M., Labbadia, G., Afeltra, A., Marigliano, B., Pipita, M. E., Castellino, P., Zanoli, L., Pignataro, S., Gennaro, A., Blanco, J., 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., Tarsitani, P., Castello, R., Pasino, M., Ceda, G. P., Maggio, M. G., Morganti, S., Artoni, A., Del Giacco, S., Firinu, D., Losa, F., Paoletti, G., Costanzo, G., Montalto, G., Licata, A., Malerba, V., Montalto, F. A., Lasco, A., Basile, G., Catalano, A., Malatino, L., Stancanelli, B., Terranova, V., Di Marca, S., Di Quattro, R., La Malfa, L., Caruso, R., Mecocci, P., Ruggiero, C., Boccardi, V., Meschi, T., Lauretani, F., Ticinesi, A., Nouvenne, A., Minuz, P., Fondrieschi, L., Pirisi, M., Fra, G. P., Sola, D., Porta, M., Riva, P., Quadri, R., Larovere, E., Novelli, M., 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., Napoli, F., Corrao, S, Nobili, A, Natoli, G, Mannucci, P, Perticone, F, Pietrangelo, A, Argano, C, Licata, G, Violi, F, Corazza, G, Marengoni, A, Salerno, F, Cesari, M, Tettamanti, M, Pasina, L, Franchi, C, Cortesi, L, Miglio, G, Ardoino, I, Novella, A, Prisco, D, Silvestri, E, Emmi, G, Bettiol, A, Caterina, C, Biolo, G, Zanetti, M, Guadagni, M, Zaccari, M, Chiuch, M, Vanoli, M, Grignani, G, Pulixi, E, Bernardi, M, Bassi, S, Santi, L, Zaccherini, G, Lupattelli, G, Mannarino, E, Bianconi, V, Paciullo, F, Alcidi, R, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Palazzuoli, A, Girelli, D, Busti, F, Marchi, G, Barbagallo, M, Dominguez, L, Cocita, F, Beneduce, V, Plances, L, Mularo, S, Raspanti, M, Zoli, M, Lazzari, I, Brunori, M, Fabbri, E, Magalotti, D, Arno, R, Pasini, F, Capecchi, P, Palasciano, G, Modeo, M, Di Gennaro, C, Cappellini, M, Maira, D, Di Stefano, V, Fabio, G, Seghezzi, S, Mancarella, M, De Amicis, M, De Luca, G, Scaramellini, N, Rossi, P, Damanti, S, Clerici, M, Conti, F, Bonini, G, Ottolini, B, Di Sabatino, A, Miceli, E, Lenti, M, Pisati, M, Dominioni, C, Murialdo, G, Marra, A, Cattaneo, F, Pontremoli, R, Beccati, V, Nobili, G, Secchi, M, Ghelfi, D, Anastasio, L, Sofia, L, Carbone, M, Cipollone, F, Guagnano, M, Valeriani, E, Rossi, I, Mancuso, G, Calipari, D, Bartone, M, Delitala, G, Berria, M, Pes, C, Delitala, A, Muscaritoli, M, Molfino, A, Petrillo, E, Zuccala, G, D'Aurizio, G, Romanelli, G, Zucchelli, A, Manzoni, F, Volpini, 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, Tassone, B, Sesti, G, Serra, M, Bleve, M, Gasbarrone, L, Sajeva, M, Brucato, A, Ghidoni, S, Fabris, F, Bertozzi, I, Bogoni, G, Rabuini, M, Cosi, E, Scarinzi, P, Amabile, A, Omenetto, E, Prandini, T, Manfredini, R, Fabbian, F, Boari, B, De Giorgi, A, Tiseo, R, De Giorgio, R, Paolisso, G, Rizzo, M, Borghi, C, Strocchi, E, Ianniello, E, Soldati, M, Sabba, C, Vella, F, Suppressa, P, Schilardi, A, Loparco, F, De Vincenzo, G, Comitangelo, A, Amoruso, E, Fenoglio, L, Falcetta, A, Bracco, C, Fargion, A, Tiraboschi, S, Cespiati, A, Oberti, G, Sigon, G, Peyvandi, F, Rossio, R, Ferrari, B, Colombo, G, Agosti, P, 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, Peasso, P, Favale, E, Poletto, C, Salmi, R, Gaudenzi, P, Perri, L, Landolfi, R, Montalto, M, Mirijello, A, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Campiotti, L, Grossi, A, Bertolotti, M, Mussi, C, Lancellotti, G, Libbra, M, Dondi, G, Pellegrini, E, Carulli, L, Galassi, M, Grassi, Y, Perticone, M, Battaglia, R, Filice, M, Maio, R, Stanghellini, V, Ruggeri, E, del Vecchio, S, Salvi, A, Leonardi, R, Damiani, G, Capeci, W, Gabrielli, A, Mattioli, M, Martino, G, Biondi, L, Pettinari, P, Ghio, R, Col, A, Minisola, S, Colangelo, L, Cilli, M, Labbadia, G, Afeltra, A, Marigliano, B, Pipita, M, Castellino, P, Zanoli, L, Pignataro, S, Gennaro, A, Blanco, J, 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, Tarsitani, P, Castello, R, Pasino, M, Ceda, G, Maggio, M, Morganti, S, Artoni, A, Del Giacco, S, Firinu, D, Losa, F, Paoletti, G, Costanzo, G, Montalto, G, Licata, A, Malerba, V, Montalto, F, Lasco, A, Basile, G, Catalano, A, Malatino, L, Stancanelli, B, Terranova, V, Di Marca, S, Di Quattro, R, La Malfa, L, Caruso, R, Mecocci, P, Ruggiero, C, Boccardi, V, Meschi, T, Lauretani, F, Ticinesi, A, Nouvenne, A, Minuz, P, Fondrieschi, L, Pirisi, M, Fra, G, Sola, D, Porta, M, Riva, P, Quadri, R, Larovere, E, Novelli, M, 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, and Napoli, F
Subjects: Registrie, Male, Comorbidity, Diabetes, Disability, Elderly, Hyperglycemia, Mortality, Aged, Aged, 80 and over, Female, Hospital Mortality, Hospitals, Humans, Internal Medicine, Registries, Hospitalization, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Socio-culturale, Renal function, 030204 cardiovascular system & hematology, Diabete, Hospital, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Rating scale, Internal medicine, Diabetes mellitus, 80 and over, medicine, LS4_4, 030212 general & internal medicine, Class III obesity, business.industry, Mortality rate, Comorbidity, Diabetes, Disability, Elderly, Hyperglycemia, Mortality, General Medicine, medicine.disease, Mood disorders, Geriatric Depression Scale, Original Article, business, Human
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 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.
Published: 2021

17. Frailty, multimorbidity patterns and mortality in institutionalized older adults in Italy

Author: Cecilia Damiano, Graziano Onder, Maria Beatrice Zazzara, Angelo Carfì, Alberto Zucchelli, Alessandra Marengoni, and Davide L. Vetrano
Subjects: Multimorbidity patterns, Aging, Frailty, Frail Elderly, Multimorbidity, Middle Aged, Nursing Homes, Older persons, Humans, Mortality, Geriatrics and Gerontology, Nursing homes, Aged, Proportional Hazards Models
Abstract: Little is known on how frailty influences clinical outcomes in persons with specific multimorbidity patterns.To investigate the interplay between multimorbidity and frailty in the association with mortality in older individuals living in nursing homes (NH).We considered 4,131 NH residents aged 60 years and over, assessed through the interRAI LTCF instrument between 2014 and 2018. Follow-up was until 2019. Considering four multimorbidity patterns identified via principal component analysis, subjects were stratified in tertiles (T) with respect to their loading values. Frailty Index (FI) considered 23 variables and a cut-off of 0.24 distinguished between high and low frailty levels. For each pattern, all possible combinations of tertiles and FI were evaluated. Their association (Hazard Ratio [HR] and 95% confidence interval) with mortality was tested in Cox regression models.In the heart diseases and dementia and sensory impairments patterns, the hazard of death increases progressively with patterns expression and frailty severity (being HR T3 vs. T1 = 2.36 [2.01-2.78]; HR T3 vs. T1 = 2.12 [1.83-2.47], respectively). In heart, respiratory and psychiatric diseases and diabetes, musculoskeletal and vascular diseases patterns, frailty seems to have a stronger impact on mortality than patterns' expression.Frailty increases mortality risk in all the patterns and provides additional prognostic information in NH residents with different multimorbidity patterns.These findings support the need to routinely assess frailty. Older people affected by specific groups of chronic diseases need a specific care approach and have high risk of negative health outcomes.
Published: 2022

18. The effect of frailty on in-hospital and medium-term mortality of patients with COronaVIrus Disease-19: the FRACOVID study

Author: Alberto Zucchelli, FRACoViD Team, Paolo Mazzola, Isabella Ceravolo, Alessandra Marengoni, Giuseppe Citerio, Paolo Bonfanti, Giuseppe Bellelli, Alberto Finazzi, Fiona Ecarnot, Maria Grazia Valsecchi, Alice M Ornago, Paola Rebora, Stefania Arsuffi, Andrea Salvatori, Emanuele Focà, Rebora, P, Focà, E, Salvatori, A, Zucchelli, A, Ceravolo, I, Ornago, A, Finazzi, A, Arsuffi, S, Bonfanti, P, Citerio, G, Mazzola, P, Ecarnot, F, Valsecchi, M, Marengoni, A, and Bellelli, G
Subjects: Male, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Frail Elderly, Frailty Index, Disease, Medium term, Hospital, Internal medicine, medicine, Humans, Hospital Mortality, cOvid-19, Mortality, Geriatric Assessment, Aged, Frailty, business.industry, General Medicine, Length of Stay, Middle Aged, Multicenter study, Female, Smoking status, Functional status, Risk of death, business
Abstract: BacKGrOUnd: Older people hospitalized for cOvid-19 are at highest risk of death. Frailty assessment can detect heterogeneity in risk among people of the same chronological age. We investigated the association between frailty and in-hospital and medium-term mortality in middle-aged and older adults with COVID-19 during the first two pandemic waves. meTHOdS: This study is an observational multicenter study. We recorded sociodemographic factors (age, sex), smoking status, date of symp-tom onset, biological data, need for supplemental oxygen, comorbidities, cognitive and functional status, in-hospital mortality. We calculated a Frailty Index (FI) as the ratio between deficits presented and total deficits considered for each patient (theoretical range 0-1). We also assessed the clinical Frailty Scale (cFS). mortality at follow-up was ascertained from a regional registry. reSULTS: in total, 1344 patients were included; median age 68 years (Q1-Q3, 56-79); 857 (64%) were men. median cFS score was 3 (Q1-Q3 2-5) and was lower in younger vs. older patients. median Fi was 0.06 (Q1-Q3 0.03-0.09) and increased with increasing age. Overall, 244 (18%) patients died in-hospital and 288 (22%) over a median follow-up of 253 days. FI and CFS were significantly associated with risk of death. In two different models using the same covariates, each increment of 0.1 in Fi increased the overall hazard of death by 35% (Hr=1.35, 95%ci 1.23-1.48), similar to the hazard for each increment of cFS (Hr=1.37, 95%ci 1.25-1.50). cOncLUSiOnS: Frailty, assessed with the Fi or cFS, predicts in-hospital and medium-term mortality and may help estimate vulnerability in middle-aged and older cOvid-19 patients.
Published: 2022

19. Mechanical Ventilation in COVID-19 Patients: Insights into the Role of Age and Frailty from a Multicentre Observational Study

Author: FRACoViD Team, Giuseppe Bellelli, Alessandra Marengoni, Maria Grazia Valsecchi, Giuseppe Citerio, Alberto Zucchelli, Emanuele Focà, Paola Rebora, Fiona Ecarnot, Ecarnot, F, Rebora, P, Focà, E, Zucchelli, A, Citerio, G, Valsecchi, M, Marengoni, A, and Bellelli, G
Subjects: COVID-19, elderly, frailty, mechanical ventilation, Cell Biology, Neurology (clinical), Geriatrics and Gerontology, Pathology and Forensic Medicine
Abstract: In patients with COVID-19, frailty has been shown to better predict outcomes than age alone. We investigated factors associated with mechanical ventilation (MV) during hospitalization for COVID-19 among older adults in a multicentre study during the first two waves in Italy. Using data from the FRACOVID project, we included consecutive patients admitted to the participating centres during the first and second waves. We recorded sociodemographics, comorbidities, time since symptom onset, ventilatory support at admission, and chest X-ray findings. Frailty was assessed using a frailty index (FI). Results are reported as hazard ratios (HR) with 95%CI. 1,344 patients were included; 487 females (36.2%), median age 68 (56; 79) years; 52.4% had hypertension, 10.6% had chronic obstructive pulmonary disease, 15.2% were obese. Median FI was 0.088 (0.03, 0.20), and 67% had bilateral consolidations at admission. Median time since symptom onset was 7 days (4, 10). During hospitalization, 47 patients (3.6%, 95%CI 0.33-13.6%) received MV. Multivariable Cox regression analysis found that the likelihood of intubation decreased with increasing age (HR 0.945 (95%CI 0.921-0.969), p0.0001), while heart rate110bpm (HR 3.429 (95%CI 1.583-7.429), p=0.0018), and need for continuous positive airway pressure (CPAP) at admission (HR 2.626 (95%CI 1.330-5.186), p=0.0054) were significantly associated with a greater likelihood of intubation. Older patients are less likely to receive intubation, while those with heart rate110 bpm and need for CPAP at admission are more likely to receive MV during hospitalization for COVID-19.
Published: 2022

20. Delirium Increases In-Hospital and Post-Discharge Mortality in COVID-19 Patients: The FRACOVID Multicenter Prospective Study

Author: Caterina Trevisan, Giulia Grande, Paola Rebora, Alberto Zucchelli, Maria Grazia Valsecchi, Emanuele Focà, Fiona Ecarnot, Alessandra Marengoni, and Giuseppe Bellelli
Published: 2022

21. Health trajectories in older patients hospitalized for COVID-19: Results from the GeroCovid multicenter study

Author: Caterina Trevisan, Francesco Tonarelli, Alberto Zucchelli, Ilaria Parrotta, Riccardo Calvani, Alba Malara, Fabio Monzani, Pietro Gareri, Gianluca Zia, and Raffaele Antonelli Incalzi
Subjects: Pulmonary and Respiratory Medicine, History, Polymers and Plastics, Aged, COVID-19, Health transitions, Trajectories, Settore MED/09 - MEDICINA INTERNA, Business and International Management, Industrial and Manufacturing Engineering
Abstract: COVID-19 has disproportionately affected older adults. Yet, healthcare trajectories experienced by older persons hospitalized for COVID-19 have not been investigated. This study aimed at estimating the probabilities of transitions between severity states in older adults admitted in COVID-19 acute wards and at identifying the factors associated with such dynamics.COVID-19 patients aged ≥60 years hospitalized between March and December 2020 were involved in the multicentre GeroCovid project-acute wards substudy. Sociodemographic and health data were obtained from medical records. Clinical states during hospitalization were categorized on a seven-category scale, ranging from hospital discharge to death. Based on the transitions between these states, first, we defined patients' clinical course as positive (only improvements), negative (only worsening), or fluctuating (both improvements and worsening). Second, we focused on the single transitions between clinical states and estimated their probability (through multistage Markov modeling) and associated factors (with proportional intensity models).Of the 1024 included patients (mean age 78.1 years, 51.1% women), 637 (62.2%) had a positive, 66 (6.4%) had a fluctuating, and 321 (31.3%) had a negative clinical course. Patients with a fluctuating clinical course were younger, had better mobility and cognitive levels, fewer diseases, but a higher prevalence of cardiovascular disease and obesity. Considering the single transitions, the probability that older COVID-19 patients experienced clinical changes was higher within a 10-day timeframe, especially for milder clinical states. Older age, male sex, lower mobility level, multimorbidity, and hospitalization during the COVID-19 first wave (compared with the second one) were associated with an increased probability of progressing towards worse clinical states or with a lower recovery.COVID-19 in older inpatients has a complex and dynamic clinical course. Identifying individuals more likely to experience a fluctuating clinical course and sudden worsening may help organize healthcare resources and clinical management across settings at different care intensity levels.
Published: 2023

22. Multimorbidity Patterns and 5-Year Mortality in Institutionalized Older Adults

Author: Davide L. Vetrano, Cecilia Damiano, Clare Tazzeo, Alberto Zucchelli, Alessandra Marengoni, Hao Luo, Maria Beatrice Zazzara, Hein van Hout, Graziano Onder, General practice, and APH - Aging & Later Life
Subjects: Multimorbidity patterns, Heart Diseases, Health Policy, Multimorbidity, General Medicine, personalized medicine, Middle Aged, mortality, nursing home, Humans, Dementia, Geriatrics and Gerontology, General Nursing, Aged, Proportional Hazards Models, Retrospective Studies
Abstract: Objectives: The aim was to characterize multimorbidity patterns in a large sample of older individuals living in nursing homes (NHs) and to investigate their association with mortality, also considering the effect of functional status. Design: Observational and retrospective study. Setting and Participants: We analyzed data on 4131 NH residents in Italy, aged 60 years and older, assessed through the interRAI long-term care facility instrument. Entry date was between 2014 and 2018, and participants were followed until 2019. Methods: Multimorbidity patterns were identified through principal component analysis; for the identified components, subjects were stratified in quintiles (Q) with respect to their loading values, with the higher quantiles indicating greater expression of the component's pattern. Their association [hazard ratio (HR) and 95% CI] with mortality was tested in Cox regression models. Analyses were stratified by disability status. Results: Four patterns of multimorbidity were identified: (1) heart diseases; (2) dementia and sensory impairments; (3) heart, respiratory, and psychiatric diseases; and (4) diabetes, musculoskeletal, and vascular diseases. For the heart diseases pattern [HR Q5 vs Q1 = 1.83 (1.53–2.20)] and the dementia and sensory impairments pattern [HR Q5 vs Q1 = 1.23 (1.06–1.42)], as the specific multimorbidity expression increases, the risk of mortality increases. On stratifying by disability status, the association between the multimorbidity patterns and mortality was not always present. Conclusions and Implications: Different multimorbidity patterns are differentially associated with mortality in older residents of NHs, confirming that multimorbidity's prognosis is strictly dependent on the underlying disease combinations. This knowledge may be useful to implement personalized preventive and therapeutic care pathways for institutionalized older adults, which respond to individuals’ health needs.
Published: 2021

23. Triple inhaled therapy in COPD patients: determinants of prescription in primary care

Author: Alberto Ricci, Elisa Bianchini, Alessio Piraino, Claudio Cricelli, Alberto Zucchelli, Francesco Lapi, Davide L. Vetrano, Marco Zibellini, and Graziano Onder
Subjects: Clinical guidelines, Male, Outcome Assessment, Comorbidity, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, clinical guidelines, copd, primary care, triple inhaled therapy, Adrenal Cortex Hormones, Outcome Assessment, Health Care, 80 and over, 030212 general & internal medicine, Triple inhaled therapy, Aged, 80 and over, COPD, biology, Incidence (epidemiology), Hazard ratio, Middle Aged, Lama, Primary care, Italy, Combination, Practice Guidelines as Topic, Cohort, Disease Progression, Drug Therapy, Combination, Female, Pulmonary and Respiratory Medicine, Chronic Obstructive, Respiratory Therapy, medicine.medical_specialty, Muscarinic Antagonists, Pulmonary Disease, 03 medical and health sciences, Drug Therapy, Internal medicine, medicine, Humans, Medical prescription, Adrenergic beta-2 Receptor Agonists, Aged, Primary Health Care, business.industry, biology.organism_classification, medicine.disease, Follow-Up Studies, Health Care, 030228 respiratory system, Heart failure, business
Abstract: Objective To assess the incidence and determinants of the triple inhaled therapy in chronic obstructive pulmonary disease (COPD) primary care patients. Methods Data derived from the Health Search Database (HSD) gathering information on 700 Italian general practitioners. A cohort of COPD patients, prescribed for the first time with inhaled treatments, was followed-up between January 2002 and December 2014. The outcome was the first incident prescription of a triple inhaled therapy, namely the combination of inhaled corticosteroids (ICS), long-acting beta agonists (LABA), and long-acting muscarinic antagonists (LAMA). Cox regressions were used to test the association (hazard ratios, HR) between candidate determinants and the outcome. Results Out of 17589 patients (mean age 71.1 ± 11.3 years; 37.4% females), 3693 (21%) were prescribed with a triple inhaled therapy during follow-up. Older age (HR = 1.79 to 2.61), current and former smoking habit (HR = 1.72 and 1.66), higher GOLD stage (HR = 1.45 to 2.79), the number of moderate and severe COPD exacerbations (HR = 1.10 to 2.63), and heart failure (HR = 1.17) resulted statistically significantly associated with an increased incident prescription of the triple inhaled therapy. Female sex (HR = 0.80) and some comorbidities (HR = 0.21 to 0.87) resulted negatively associated with the outcome. Furthermore, patients initially treated with LAMA (HR = 1.5) and LABA/ICS (HR = 1.23) were more likely to escalate to the triple therapy, than those on LABA. Conversely, patients initially treated with ICS presented a negative hazard (HR = 0.72). Conclusions The knowledge of demographic and clinical determinants of the escalation to the triple inhaled therapy in real-world COPD patients may help clinicians to better personalize respiratory pharmacological treatments of their patients, and inform international societies that issue clinical guidelines.
Published: 2019

24. Development and validation of a delirium risk assessment tool in older patients admitted to the Emergency Department Observation Unit

Author: Alessandro Padovani, Giuseppe Bellelli, Alberto Zucchelli, S. De Bianchi, V. Prestipino, R. Apuzzo, Alessandra Marengoni, C. Paolillo, Giuseppe Romanelli, Zucchelli, A, Apuzzo, R, Paolillo, C, Prestipino, V, De Bianchi, S, Romanelli, G, Padovani, A, Marengoni, A, and Bellelli, G
Subjects: Aging, medicine.medical_specialty, Risk management tools, Older person, Risk Assessment, Prediction score, Hospital, 03 medical and health sciences, 0302 clinical medicine, Older patients, Clinical Observation Units, mental disorders, 80 and over, medicine, Humans, Dementia diagnosis, 030212 general & internal medicine, Prospective Studies, Geriatric Assessment, Aged, Aged, 80 and over, Emergency Service, Geriatrics gerontology, business.industry, Emergency department, Delirium, Older persons, Emergency Service, Hospital, Emergency medicine, Original Article, Geriatrics and Gerontology, medicine.symptom, business, 030217 neurology & neurosurgery, Observation unit
Abstract: Background Delirium is frequent though undetected in older patients admitted to the Emergency Department (ED). Aims To develop and validate a delirium risk assessment tool for older persons admitted to the ED Observation Unit (OU). Methods We used data from two samples of 65 + year-old patients, one admitted to the ED of Brescia Hospital (n = 257) and one to the ED of Desio Hospital (n = 107), Italy. Data from Brescia were used as training sample, those collected in Desio as testing one. Delirium was assessed using the 4AT and patients’ characteristic were retrieved from medical charts. Variables found to be associated with delirium in the training sample were tested for the creation of a delirium risk assessment tool. The resulting tool’s performances were assessed in the testing subsample. Results Of all possible scores tested, the combination with the highest discriminative ability in the training sample included: age ≥ 75 years, dementia diagnosis, chronic use of neuroleptics, and hearing impairment. The delirium score exhibited an AUC of 0.874 and 0.893 in the training and testing samples, respectively. For a 1-point increase in the score, the odds of delirium increased more than twice in both samples. Discussion We propose a delirium risk assessing tool that includes variables that can be easily collected at ED admission and that can be calculated rapidly. Conclusion A risk assessment tool could help improving delirium detection in older persons referring to ED.
Published: 2021

25. Multimorbidity burden and dementia risk in older adults : The role of inflammation and genetics

Author: Laura Fratiglioni, Alessandra Marengoni, Albert Roso-Llorach, Amaia Calderón-Larrañaga, Chengxuan Qiu, Giulia Grande, Debora Rizzuto, Alberto Zucchelli, and Davide L. Vetrano
Subjects: Apolipoprotein E, Male, medicine.medical_specialty, Neurology, Genotype, Epidemiology, Apolipoprotein E4, dementia, genetics, inflammation, multimorbidity patterns, Cohort Studies, 03 medical and health sciences, Cellular and Molecular Neuroscience, 0302 clinical medicine, Developmental Neuroscience, Risk Factors, Internal medicine, Genetics, Medicine, Dementia, Humans, Genetic Predisposition to Disease, 030212 general & internal medicine, Aged, Geriatrics, Aged, 80 and over, Sweden, Inflammation, Multimorbidity patterns, business.industry, Featured Articles, Health Policy, Hazard ratio, Cancer, Multimorbidity, Featured Article, medicine.disease, Confidence interval, Psychiatry and Mental health, C-Reactive Protein, Female, Neurology (clinical), Geriatrics and Gerontology, business, 030217 neurology & neurosurgery
Abstract: Funding: Swedish National study on Aging and Care; Ministry of Health and Social Affairs; Swedish Research Council, Grant/Award Number: 2016-00981; Swedish Research Council for Health,Working Life andWelfare, Grant/Award Number: 2017-01764; Italian Ministry of Health, Grant/Award Number: PE-2016-02364885 We investigate dementia risk in older adults with different disease patterns and explore the role of inflammation and apolipoprotein E (APOE) genotype. A total of 2,478 dementia-free participants with two or more chronic diseases (ie, multimorbidity) part of the Swedish National study on Aging and Care in Kungsholmen (SNAC-K) were grouped according to their multimorbidity patterns and followed to detect clinical dementia. The potential modifier effect of C-reactive protein (CRP) and apolipoprotein E (APOE) genotype was tested through stratified analyses. People with neuropsychiatric, cardiovascular, and sensory impairment/cancer multimorbidity had increased hazards for dementia compared to the unspecific (Hazard ration (HR) 1.66, 95% confidence interval [CI] 1.13-2.42; 1.61, 95% CI 1.17-2.29; 1.32, 95% CI 1.10-1.71, respectively). Despite the lack of statistically significant interaction, high CRP increased dementia risk within these patterns, and being APOE ε4 carriers heightened dementia risk for neuropsychiatric and cardiovascular multimorbidity. Individuals with neuropsychiatric, cardiovascular, and sensory impairment/cancer patterns are at increased risk for dementia and APOE ε4, and inflammation may further increase the risk. Identifying such high-risk groups might allow tailored interventions for dementia prevention.
Published: 2021

26. Special Issue—'Multimorbidity Development and Evolution: Clinical Implications'

Author: Amaia Calderón-Larrañaga, Alberto Zucchelli, and Davide L. Vetrano
Subjects: medicine.medical_specialty, business.industry, 05 social sciences, MEDLINE, Multiple Chronic Diseases, General Medicine, macromolecular substances, Health outcomes, 03 medical and health sciences, 0302 clinical medicine, Editorial, n/a, 0502 economics and business, Medicine, Multimorbidity, 050211 marketing, business, Intensive care medicine, 030217 neurology & neurosurgery
Abstract: Multimorbidity, the co-existence of multiple chronic diseases in the same individual, is not only extremely common in older persons but is also strongly associated with several poor health outcomes [...]
Published: 2021

27. Why data on frailty and SARS-CoV-2 infection are basic to progress

Author: Alberto Zucchelli, E. Bologna, and Alessandra Marengoni
Subjects: Aging, medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Short Communication, Hospital mortality, Serology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, 80 and over, Humans, 030212 general & internal medicine, Hospital Mortality, Aged, Aged, 80 and over, Frailty, Geriatrics gerontology, business.industry, SARS-CoV-2, COVID-19, medicine.disease, Pneumonia, Older persons, Italy, Geriatrics and Gerontology, business, 030217 neurology & neurosurgery
Abstract: Several studies showed that frailty was a predictor of in-hospital death in older adults with COVID-19. The mechanisms through which frailty increases the severity of COVID-19 are several, including immunosenescense and dysregulated inflammation. Whether individuals affected by frailty exhibit a higher susceptibility to SARS-CoV-2 infection remains an open question. Here we report the case series of 40 older persons that in February 2020, before the first case of COVID-19 was detected in Italy, went together on a winter holiday. Back home, 7 of them developed influenza-like symptoms and one was hospitalized due to COVID-19 pneumonia. Between May and July, the seniors were offered the possibility to be tested for SARS-CoV-2 antibody positivity. Twenty-seven of them accepted: 13 had a positive serological test whereas no active infection was found. Comparing the characteristics of those who tested positive and the others, we found that the former group was frailer, exhibiting higher Clinical Frailty Scale scores.
Published: 2021

28. An Incidental Diagnosis of SARS-CoV-2 Pneumonia With Magnetic Resonance Imaging

Author: Andrea Laghi, Marco Di Girolamo, Alberto Zucchelli, and Emanuele Muscogiuri
Subjects: Thorax, covid-19 pneumonia, medicine.medical_specialty, Pulmonology, Anosmia, Infectious Disease, 030204 cardiovascular system & hematology, Asymptomatic, sars-cov-2 related pneumonia, 03 medical and health sciences, 0302 clinical medicine, medicine, magnetic resonance imaging, interstitial pneumonia, medicine.diagnostic_test, business.industry, Respiratory disease, General Engineering, Magnetic resonance imaging, Ageusia, medicine.disease, respiratory tract diseases, sars-cov-2, Pneumonia, medicine.anatomical_structure, Abdomen, Radiology, medicine.symptom, business, 030217 neurology & neurosurgery
Abstract: The Coronavirus disease 2019 (COVID-19) is caused by the human severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus. The most common clinical findings related to COVID-19 are fever and cough, with the proportion of patients developing interstitial pneumonia. Other symptoms include dyspnea, expectoration, headache, anosmia, ageusia, myalgia and malaise. To date, the diagnostic criteria for COVID-19 include nasopharyngeal and oropharyngeal swabs. Computed tomography (CT) scans of the thorax showing signs of interstitial pneumonia are important in the management of respiratory disease and in the evaluation of lung involvement. In the literature, there are few cases of COVID-19 pneumonia diagnosis made using magnetic resonance imaging (MRI). In our report, we describe a case of accidental detection of findings related to interstitial pneumonia in a patient who underwent abdominal MRI for other clinical reasons. A 71-year-old woman was referred to our department for an MRI scan of the abdomen as her oncological follow-up. She was asymptomatic at the time of the examination and had passed the triage carried out on all the patients prior to diagnostic tests during the COVID-19 pandemic. The images acquired in the upper abdomen showed the presence of areas of altered signal intensity involving asymmetrically both pulmonary lower lobes, with a patchy appearance and a preferential peripheral subpleural distribution. We considered these features as highly suspicious for COVID-19 pneumonia. The nasopharyngeal swab later confirmed the diagnosis of SARS-CoV-2 infection. There are limited reports about MRI features of COVID-19 pneumonia, considering that high-resolution chest CT is the imaging technique of choice to diagnose pneumonia. Nevertheless, this clinical case confirmed that it is possible to detect MRI signs suggestive of COVID-19 pneumonia. The imaging features described could help in the evaluation of the lung parenchyma to assess the presence of signs suggestive of COVID-19 pneumonia, especially in asymptomatic patients during the pandemic phase of the disease.
Published: 2020

29. Comment on: 'Beyond Chronological Age: Frailty and Multimorbidity Predict In-hospital Mortality in Patients With Coronavirus Disease 2019'

Author: Eva Andrea Beindorf, Giuseppe Romanelli, Emanuele Botteri, Laura Fratiglioni, Franco Nicosia, Graziano Onder, Roberto Bernabei, Andrea Armellini, Paola Giansiracusa, Emirena Garrafa, Alberto Zucchelli, Davide L. Vetrano, Alessandra Marengoni, and Luigi Ferrucci
Subjects: Male, Aging, 2019-20 coronavirus outbreak, Pediatrics, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), multimorbidity, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Frail Elderly, Population, 030204 cardiovascular system & hematology, 03 medical and health sciences, AcademicSubjects/MED00280, 0302 clinical medicine, Risk Factors, Internal medicine, Intensive care, COVID-19, frailty, in-hospital mortality, medicine, Multimorbidity, Humans, In patient, 030212 general & internal medicine, Hospital Mortality, education, Letter to the Editor, Pandemics, Geriatric Assessment, Aged, Aged, 80 and over, education.field_of_study, In hospital mortality, Frailty, business.industry, SARS-CoV-2, Hazard ratio, Chronological age, Ageing, Italy, AcademicSubjects/SCI00960, Female, Geriatrics and Gerontology, business, Research Article
Abstract: Background We evaluated whether frailty and multimorbidity predict in-hospital mortality in patients with COVID-19 beyond chronological age. Method A total of 165 patients admitted from March 8th to April 17th, 2020, with COVID-19 in an acute geriatric ward in Italy were included. Predisease frailty was assessed with the Clinical Frailty Scale (CFS). Multimorbidity was defined as the co-occurrence of ≥2 diseases in the same patient. The hazard ratio (HR) of in-hospital mortality as a function of CFS score and number of chronic diseases in the whole population and in those aged 70+ years were calculated. Results Among the 165 patients, 112 were discharged, 11 were transferred to intensive care units, and 42 died. Patients who died were older (81.0 vs 65.2 years, p < .001), more frequently multimorbid (97.6 vs 52.8%; p < .001), and more likely frail (37.5 vs 4.1%; p < .001). Less than 2.0% of patients without multimorbidity and frailty, 28% of those with multimorbidity only, and 75% of those with both multimorbidity and frailty died. Each unitary increment in the CFS was associated with a higher risk of in-hospital death in the whole sample (HR = 1.3; 95% CI = 1.05–1.62) and in patients aged 70+ years (HR = 1.29; 95% CI = 1.04–1.62), whereas the number of chronic diseases was not significantly associated with higher risk of death. The CFS addition to age and sex increased mortality prediction by 9.4% in those aged 70+ years. Conclusions Frailty identifies patients with COVID-19 at risk of in-hospital death independently of age. Multimorbidity contributes to prognosis because of the very low probability of death in its absence.
Published: 2020

30. Multimorbidity Patterns and Unplanned Hospitalisation in a Cohort of Older Adults

Author: Alessandra Marengoni, Roselyne Akugizibwe, Amaia Calderón-Larrañaga, Davide L. Vetrano, Debora Rizzuto, Albert Roso-Llorach, Alberto Zucchelli, and Graziano Onder
Subjects: multimorbidity, lcsh:Medicine, Rate ratio, Disease cluster, Article, 03 medical and health sciences, 0302 clinical medicine, Medicine, Multimorbidity, Dementia, 030212 general & internal medicine, older adults, business.industry, Proportional hazards model, hospitalisation, lcsh:R, Hazard ratio, General Medicine, medicine.disease, Cohort, person-centred care, Multiple Chronic Conditions, business, 030217 neurology & neurosurgery, Demography
Abstract: The presence of multiple chronic conditions (i.e., multimorbidity) increases the risk of hospitalisation in older adults. We aimed to examine the association between different multimorbidity patterns and unplanned hospitalisations over 5 years. To that end, 2,250 community-dwelling individuals aged 60 years and older from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K) were studied. Participants were grouped into six multimorbidity patterns using a fuzzy c-means cluster analysis. The associations between patterns and outcomes were tested using Cox models and negative binomial models. After 5 years, 937 (41.6%) participants experienced at least one unplanned hospitalisation. Compared to participants in the unspecific multimorbidity pattern, those in the cardiovascular diseases, anaemia and dementia pattern, the psychiatric disorders pattern and the metabolic and sleep disorders pattern presented with a higher hazard of first unplanned hospitalisation (hazard ratio range: 1.49&ndash, 2.05, p &lt, 0.05 for all), number of unplanned hospitalisations (incidence rate ratio (IRR) range: 1.89&ndash, 2.44, 0.05 for all), in-hospital days (IRR range: 1.91&ndash, 3.61, 0.05 for all), and 30-day unplanned readmissions (IRR range: 2.94&ndash, 3.65, 0.05 for all). Different multimorbidity patterns displayed a differential association with unplanned hospital care utilisation. These findings call for a careful primary care follow-up of older adults with complex multimorbidity patterns.
Published: 2020

31. Multimorbidity Patterns and 6-Year Risk of Institutionalization in Older Persons: The Role of Social Formal and Informal Care

Author: Davide L. Vetrano, Amaia Calderón-Larrañaga, Clare Tazzeo, Alberto Zucchelli, Alessandra Marengoni, Graziano Onder, Debora Rizzuto, and Albert Roso-Llorach
Subjects: Gerontology, Aging, Anemia, Population, Psychological intervention, Care provision, older people, 03 medical and health sciences, 0302 clinical medicine, 80 and over, Medicine, Dementia, Multimorbidity, Humans, 030212 general & internal medicine, Prospective Studies, education, Prospective cohort study, General Nursing, Aged, Multimorbidity patterns, Aged, 80 and over, education.field_of_study, business.industry, Health Policy, Institutionalization, General Medicine, medicine.disease, informal care, Relative risk, formal care, Independent Living, Geriatrics and Gerontology, institutionalization, business, 030217 neurology & neurosurgery
Abstract: Objectives The aim was to evaluate patterns of multimorbidity that increase the risk of institutionalization in older persons, also exploring the potential buffering effect of formal and informal care. Design Prospective cohort study. Setting and Participants The population-based Swedish National study on Aging and Care in Kungsholmen, Stockholm, Sweden. Measures In total, 2571 community-dwelling older adults were grouped at baseline according to their underlying multimorbidity patterns, using a fuzzy c-means cluster algorithm, and followed up for 6 years to test the association between multimorbidity patterns and institutionalization. Results Six patterns of multimorbidity were identified: psychiatric diseases; cardiovascular diseases, anemia, and dementia; metabolic and sleep disorders; sensory impairments and cancer; musculoskeletal, respiratory, and gastrointestinal diseases; and an unspecific pattern including diseases of which none were overrepresented. In total, 110 (4.3%) participants were institutionalized during the follow-up, ranging from 1.7% in the metabolic and sleep disorders pattern to 8.4% in the cardiovascular diseases, anemia, and dementia pattern. Compared with the unspecific pattern, only the cardiovascular diseases, anemia, dementia pattern was significantly associated with institutionalization [relative risk ratio (RRR) = 2.23; 95% confidence interval (CI) 1.07‒4.65)], after adjusting for demographic characteristics and disability status at baseline. In stratified analyses, those not receiving formal care in the psychiatric diseases pattern (RRR 3.34; 95% CI 1.20‒9.32) and those not receiving formal or informal care in the ‘cardiovascular diseases, anemia, dementia’ pattern (RRR 2.99; 95% CI 1.20‒7.46; RRR 2.79; 95% CI 1.16‒6.71, respectively) had increased risks of institutionalization. Conclusions and Implications Older persons suffering from specific multimorbidity patterns have a higher risk of institutionalization, especially if they lack formal or informal care. Interventions aimed at preventing the clustering of diseases could reduce the associated burden on residential long-term care. Formal and informal care provision may be effective strategies in reducing the risk of institutionalization.
Published: 2020

32. The impact of delirium on outcomes for older adults hospitalised with COVID-19

Author: Giulia Grande, Alessandra Marengoni, Laura Fratiglioni, Debora Rizzuto, and Alberto Zucchelli
Subjects: Male, Aging, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Pneumonia, Viral, Short Report, Comorbidity, behavioral disciplines and activities, older people, Betacoronavirus, AcademicSubjects/MED00280, Internal medicine, mental disorders, medicine, Humans, Hospital Mortality, Pandemics, Aged, Retrospective Studies, Aged, 80 and over, Frailty, SARS-CoV-2, business.industry, Incidence, Incidence (epidemiology), Confounding, COVID-19, Delirium, delirium, Retrospective cohort study, General Medicine, medicine.disease, Hospitals, Ageing, Italy, Female, medicine.symptom, Geriatrics and Gerontology, Coronavirus Infections, business, Older people
Abstract: Introduction Delirium is a frequent condition in hospitalized older patients and it usually has a negative prognostic value. A direct effect of SARS-COV-2 on the central nervous system (CNS) has been hypothesized. Objective To evaluate the presence of delirium in older patients admitted for a suspected diagnosis of COVID-19 and its impact on in-hospital mortality. Setting and subjects 91 patients, aged 70-years and older, admitted to an acute geriatric ward in Northern Italy from March 8th to April 17th, 2020. Methods COVID-19 cases were confirmed by reverse transcriptase-polymerase chain reaction assay for SARS-Cov-2 RNA from nasal and pharyngeal swabs. Delirium was diagnosed by two geriatricians according to the Diagnostic and Statistical Manual of Mental Disorders V (DMS V) criteria. The number of chronic diseases was calculated among a pre-defined list of 60. The pre-disease Clinical Frailty Scale (CFS) was assessed at hospital admission. Results Of the total sample, 39 patients died, 49 were discharged and 3 were transferred to ICU. Twenty-five patients (27.5%) had delirium. Seventy-two percent of patients with delirium died during hospitalization compared to 31.8% of those without delirium. In a multivariate logistic regression model adjusted for potential confounders, patients with delirium were four times more likely to die during hospital stay compared to those without delirium (OR = 3.98;95%CI = 1.05–17.28; p = 0.047). Conclusions Delirium is common in older patients with COVID-19 and strongly associated with in-hospital mortality. Regardless of causation, either due to a direct effect of SARS-COV-2 on the CNS or to a multifactorial cause, delirium should be interpreted as an alarming prognostic indicator in older people.
Published: 2020
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33. Heart failure, frailty, and pre-frailty: A systematic review and meta-analysis of observational studies

Author: Vincenzo Brandi, Alberto Zucchelli, Roberto Bernabei, Katie Palmer, Graziano Onder, Davide L. Vetrano, Marius Ciutan, Carmen Lavinia Panait, Gaetano Aloisi, and Alessandra Marengoni
Subjects: medicine.medical_specialty, Frail Elderly, Pre-frailty, 030204 cardiovascular system & hematology, Health outcomes, Odds, Frailty, Heart failure, Meta-analysis, Systematic review, Pre frailty, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Prevalence, Humans, 030212 general & internal medicine, Aged, Heart Failure, business.industry, Publication bias, medicine.disease, Prognosis, Newcastle–Ottawa scale, Cross-Sectional Studies, Observational study, Cardiology and Cardiovascular Medicine, business
Abstract: Frailty is a syndrome characterized by reduced physiological reserves, increased vulnerability to stressors and adverse health outcomes. Frailty can change the prognosis and treatment approach of several chronic diseases, including heart failure (HF). The aim of this study was to conduct a systematic review and meta-analysis assessing the association of HF with frailty and pre-frailty. We employed PRISMA guidelines for reporting the results. We searched PubMed, Web of Science, and Embase from 01/01/2002 to 29/11/2019.The quality of the studies was evaluated with the Newcastle Ottawa Scale. Pooled estimates were obtained through random-effect models and Mantel-Haenszel weighting. Homogeneity (I2) and publication bias were assessed. We selected 54 studies (52 cross-sectional, one longitudinal, and one with both designs). The pooled prevalence of pre-frailty in individuals with HF was 46% (95% CI = 38–53; I2 = 93.1%) and 40% (95% CI = 31–48; I2 = 97%) for frailty. The proportion of pre-frail individuals with HF was 20% (95%CI = 15–25; I2 = 99.2%) and the proportion of frail individuals with HF was 31% (95% CI = 17–45; I2 = 98.7%). Two studies using the same frailty definition reported estimates for the association between frailty and HF (pooled OR = 3.44; 95% CI = 0.75–15.73; I2 = 95.8%). In conclusion, frailty and pre-frailty are frequent in people with HF. Persons with HF have 3.4-fold increased odds of frailty. Longitudinal studies examining bidirectional pathophysiological pathways between HF and frailty are needed to further clarify this relationship and to assess if specific treatment for HF may prevent or delay the onset of frailty and vice versa.
Published: 2020

34. Adherence to COPD free triple inhaled therapy in the real world: a primary care based study

Author: Alessio Piraino, Francesco Paolo Lombardo, Alberto Ricci, Claudio Cricelli, Alberto Zucchelli, Alessandra Marengoni, Davide L. Vetrano, Elisa Bianchini, Francesco Lapi, and Marco Zibellini
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, triple inhaled therapy, Logistic regression, 03 medical and health sciences, adherence, COPD, guidelines, primary care, 0302 clinical medicine, Quality of life, Internal medicine, Immunology and Allergy, Medicine, 030212 general & internal medicine, Medical prescription, Stage (cooking), Genetics (clinical), Depression (differential diagnoses), business.industry, Vascular disease, medicine.disease, 030228 respiratory system, copd, guidelines, adherence, primary care, triple inhaled therapy, Heart failure, business
Abstract: Introduction The development of new pharmacological treatments for chronic obstructive pulmonary disease (COPD) has improved health-related quality of life of patients. However, suboptimal adherence may limit its potential. Objective The aim of the present study was to assess the adherence to free triple inhaled therapy and to investigate poor adherence determinants among primary care patients. Methods Data were derived from a primary care database in Italy. Patients aged 40+ affected by COPD and prescribed with inhaled corticosteroids, long-acting beta agonists and long-acting muscarinic antagonists (N = 3177) were enrolled. Low adherence was defined as a proportion of days covered (PDC) by medications prescription lower than 80%. Predictors of low adherence were tested using logistic regression models. Results and conclusions The 85% of enrolled patients showed poor adherence to free triple inhaled therapy. Comorbidities, such as heart failure (OR 1.78, 95%CI 1.19-2.75), depression (OR 1.41, 95%CI 1.06-1.88) and peripheral vascular disease (OR 1.32, 95%CI 1.01-1.74) were associated with poor adherence. Former (OR 0.52, 95%CI 0.34-0.78) or current smokers (OR 0.61, 95%CI 0.41-0.93) and patients with more severe airways obstruction or history of severe exacerbations (OR 0.64, 95%CI 0.52-0.79) were less likely to exhibit poor adherence. Real-world adherence to triple inhaled therapy with different inhalers is generally low. Higher GOLD airways obstruction stage and current or former smoking status are associated with increased adherence to treatment. Reduced perceived benefit on symptoms control is probably linked to poorer adherence to free triple therapy.
Published: 2020

35. Using a genetic algorithm to derive a highly predictive and context-specific frailty index

Author: Alberto, Zucchelli, Alessandra, Marengoni, Debora, Rizzuto, Amaia, Calderón-Larrañaga, Maurizio, Zucchelli, Roberto, Bernabei, Graziano, Onder, Laura, Fratiglioni, and Davide Liborio, Vetrano
Subjects: Aged, 80 and over, Male, Sweden, Aging, Frailty index, Frailty, Frail Elderly, Incidence, Genetic algorithm, Humans, Female, Geriatric, Geriatric Assessment, Algorithms, Aged, Research Paper
Abstract: The frailty index (FI) is one of the most widespread tools used to predict poor, health-related outcomes in older persons. The selection of clinical and functional deficits to include in a FI is mostly based on the users’ clinical experience. However, this approach may not be sufficiently accurate to predict health outcomes in particular subgroups of individuals. In this study, we implemented an optimization algorithm, the genetic algorithm, to create a highly performant (FI) based on our prediction goals, rather than on a predetermined clinical selection of deficits, using data from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K) and 109 potential deficits identified in the dataset. The algorithm was personalized to obtain a FI with high discrimination ability in the prediction of mortality. The resulting FI included 40 deficits and showed areas under the curve consistently higher than 0.80 (range 0.81-0.90) in the prediction of 3-year and 6-year mortality in the whole sample and in sex and age subgroups. This methodology represents a promising opportunity to optimize the exploitation of medical and administrative databases in the construction of clinically relevant frailty indices.
Published: 2020

36. The impact of COVID-19 on health status of home-dwelling elderly patients with dementia in East Lombardy, Italy: results from COVIDEM network

Author: Nives Medici, Matteo Peli Psy, Elisa Zanacchi Psy, Elena Lucchi Psy, Melania Cappuccio, Marinella Turla, Angelo Bianchetti, Alessandro Padovani, Simona Gentile, Chiara Vecchi Psy, Alessandra Marengoni, Salvatore Caratozzolo, Mara Zanni, Marco Di Cesare, Daniele Bellandi, Renzo Rozzini, Andrea Scalvini, Rosanna Turrone Psy, Giuseppe Bellelli, Ignazio Di Fazio, Lina Falanga, Eleonora Grossi Psy, Federica Gottardi Psy, Maura Cosseddu Psy, Marina Zanetti Psy, Giuliana Vezzadini, Stefano Boffelli, Claudia Caminati, Marco Trabucchi, Maria Cotelli, Sara Fascendini, Alberto Zucchelli, Nives Palamini, Silvia Pelizzari Psy, Marta Grigolo Psy, Chiara Forlani Psy, Caratozzolo, S, Zucchelli, A, Turla, M, Cotelli, M, Fascendini, S, Zanni, M, Bianchetti, A, Psy, M, Rozzini, R, Boffelli, S, Cappuccio, M, Psy, F, Psy, C, Bellandi, D, Caminati, C, Gentile, S, Psy, E, Di Fazio, I, Vezzadini, G, Psy, R, Psy, S, Scalvini, A, Di Cesare, M, Falanga, L, Medici, N, Palamini, N, Bellelli, G, Marengoni, A, Trabucchi, M, and Padovani, A
Subjects: Male, Aging, medicine.medical_specialty, Health Status, Pneumonia, Viral, 030204 cardiovascular system & hematology, 03 medical and health sciences, Betacoronavirus, 0302 clinical medicine, Internal medicine, Diabetes mellitus, Pandemic, Medicine, Dementia, Humans, 030212 general & internal medicine, Viral, Pandemics, Aged, COPD, business.industry, SARS-CoV-2, Mortality rate, Medical record, COVID-19, Health status, Home dwelling, Coronavirus Infections, Female, Hospitalization, Italy, Health statu, Pneumonia, medicine.disease, Vaccination, Ageing, Original Article, Geriatrics and Gerontology, business, Complication
Abstract: Background COVID-19 outbreak has led to severe health burden in the elderly. Age, morbidity and dementia have been associated with adverse outcome. Aims To evaluate the impact of COVID-19 on health status in home-dwelling patients. Methods 848 home-dwelling outpatients with dementia contacted from April 27 to 30 and evaluated by a semi-structured interview to evaluate possible health complication due to COVID-19 from February 21 to April 30. Age, sex, education, clinical characteristics (including diagnosis of dementia) and flu vaccination history were obtained from previous medical records. Items regarding change in health status and outcome since the onset of the outbreak were collected. COVID-19 was diagnosed in patients who developed symptoms according to WHO criteria or tested positive at nasal/throat swab if hospitalized. Unplanned hospitalization, institutionalization and mortality were recorded. Results Patients were 79.7 years old (SD 7.1) and 63.1% were females. Ninety-five (11.2%) patients developed COVID-19-like symptoms. Non COVID-19 and COVID-19 patients differed for frequency of diabetes (18.5% vs. 37.9%, p p p Discussion/conclusions A high proportion of adverse outcome related to COVID-19 was observed in home-dwelling elderly patients with dementia. Active monitoring though telehealth programs would be useful particularly for those at highest risk of developing COVID-19 and its adverse outcomes.
Published: 2020

37. Frailty predicts short-term survival even in older adults without multimorbidity

Author: Alberto Zucchelli, Giuseppe Romanelli, Davide L. Vetrano, Laura Fratiglioni, Amaia Calderón-Larrañaga, Debora Rizzuto, Giulia Grande, and Alessandra Marengoni
Subjects: Male, Frail Elderly, 030204 cardiovascular system & hematology, Health outcomes, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Internal Medicine, Humans, Medicine, Multimorbidity, 030212 general & internal medicine, Mortality, Geriatric Assessment, Aged, Aged, 80 and over, Sweden, Frailty, business.industry, Mortality rate, Middle Aged, Increased risk, Cohort, Short term survival, National study, Female, Multiple Chronic Conditions, business, Demography
Abstract: Background Frailty and multimorbidity are both strongly associated with poor health-related outcomes, including mortality. Being multimorbidity one of the major determinants of frailty, we aimed to explore whether, and to what extent, frailty without multimorbidity plays an independent role in shortening life. Methods We used data from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K). Among the 3363 adults aged 60+ enrolled at baseline, those without multimorbidity (i.e.: less than two chronic diseases) (N = 1115) have been characterized according to Fried's frailty phenotype (i.e. robust, prefrail, and frail). The association between frailty and mortality was estimated using piecewise proportional hazard regression models in three five-year time periods. Results Among participants without multimorbidity, 424 (38%) were prefrail and 19 (2%) were frail. During the 15-year follow-up, 263 (24%) participants died: 19%, 29%, and 63% of those who were robust, prefrail, and frail at baseline, respectively. Within the first 5 years of follow-up, prefrail and frail participants had more than doubled mortality risk in comparison to robust ones (HR for pre-frailty 2.08, 95% CI 1.15–3.76; HR for frailty 2.69, 95% CI 1.22–5.97). Beyond 5 years, a trend of increased mortality rate was still detectable for prefrail and frail subjects in comparison to robust ones. Conclusions Physical frailty and pre-frailty are associated with short-term mortality in a cohort of older adults free from multimorbidity. Frailty could be a clinical indicator of increased risk of negative health outcomes even among subjects without multiple chronic conditions.
Published: 2018

38. Patterns of oral corticosteroids use in primary care patients with severe asthma

Author: Francesco Paolo Lombardo, Francesco Lapi, Ettore Marconi, Elisa Bianchini, Alberto Zucchelli, Davide L. Vetrano, and Claudio Cricelli
Subjects: Pulmonary and Respiratory Medicine, Clinical guidelines, Oral, Male, medicine.medical_specialty, Data Interpretation, Databases, Factual, Severe asthma, Administration, Oral, Disease, Primary care, Comorbidity, Severity of Illness Index, Cohort Studies, 03 medical and health sciences, Databases, 0302 clinical medicine, Adrenal Cortex Hormones, Internal medicine, Osteoarthritis, medicine, Corticosteroids, Humans, 030212 general & internal medicine, Asthma, Data Interpretation, Statistical, Disease Progression, Female, Follow-Up Studies, Gastroesophageal Reflux, Treatment Outcome, Primary Health Care, Medical prescription, Factual, Proportional hazards model, business.industry, Reflux, Statistical, medicine.disease, 030228 respiratory system, Cohort, Administration, business
Abstract: Aim To assess the pattern of use of oral corticosteroids (OC) in primary care patients with severe asthma. Methods Data derived from the Health Search Database (HSD) gathering information on 700 Italian general practitioners. A cohort of severe asthma patients was identified between 2013 and 2017 and followed-up for one year. The association between candidate predictors and the incident escalation to OC was tested through a multivariate Cox regression model. Results Among patients with asthma (N = 55,075), 284 were diagnosed with severe asthma. Among them, the proportion of OC users decreased from 82.2% in 2013 to 75.3% in 2017. For what concerns the determinants of OC prescriptions, among 284 patients being defined at baseline (2013–2016) as those suffering from severe asthma, 216 (76.1%) were first-ever prescribed with OC at least once during one year of follow-up. The presence of gastroesophageal reflux disease (HR 1.37; 95% CI 1.02–1.85), osteoarthritis (HR 1.54; 95% CI 1.12–2.12) and moderate asthma exacerbations (HR 1.72; 95% CI 1-02-2.93) was significantly associated with the outcome. Conclusions The optimization of asthma treatment and the management of comorbidities may be potential leverages to reduce the inappropriate use of OC in patients with severe asthma.
Published: 2019

39. Beyond Chronological Age: Frailty and Multimorbidity Predict In-Hospital Mortality in Patients With COVID-19

Author: Alberto Zucchelli, Alessandra Marengoni, Davide Vetrano, Luigi Ferrucci, Laura Fratiglioni, Roberto Bernabei, Graziano Onder, and Giuseppe Romanelli
Subjects: Abstracts, Health (social science), Life-span and Life-course Studies, AcademicSubjects/SOC02600, Health Professions (miscellaneous), COVID-19 Outcomes for Older Adults, Session 1055 (Paper)
Abstract: Background: We evaluated whether frailty and multimorbidity predict in-hospital mortality in patients with COVID-19 beyond chronological age. Methods: 165 patients admitted from March 8th to April 17th, 2020, with COVID-19 in an acute geriatric ward in Italy were included. Pre-disease frailty was assessed with the Clinical Frailty Scale (CFS). Multimorbidity was defined as the co-occurrence of ≥2 of these in the same patient. The hazard (HR) of in-hospital mortality as a function of CFS score and number of chronic diseases in the whole population and in those aged 70+ years were calculated. Results Among the 165 patients, 112 were discharged, 11 were transferred to intensive care units and 42 died. Patients who died were older (81.0 vs. 65.2 years, p
Published: 2021

40. Understanding Factors Associated With Psychomotor Subtypes of Delirium in Older Inpatients With Dementia

Author: Morandi, Alessandro, primary, Zambon, Antonella, additional, Di Santo, Simona G., additional, Mazzone, Andrea, additional, Cherubini, Antonio, additional, Mossello, Enrico, additional, Bo, Mario, additional, Marengoni, Alessandra, additional, Bellelli, Giuseppe, additional, Rispoli, Vincenzo, additional, Malara, Alba, additional, Spadea, Fausto, additional, Di Cello, Serena, additional, Ceravolo, Francesco, additional, Fabiano, Francesco, additional, Chiaradia, Giuseppe, additional, Gabriele, Amedeo, additional, Lenino, Peluso, additional, Andrea, Taristano, additional, Settembrini, Vincenzo, additional, Capomolla, Domenico, additional, Citrino, Antonella, additional, Scriva, Antonietta, additional, Bruno, Irene, additional, Secchi, Roberto, additional, De Martino, Eugenio, additional, Muccinelli, Roberto, additional, Lupi, Gerardo, additional, Paonessa, Patrizio, additional, Fabbri, Andrea, additional, Passuti, Maria Teresa, additional, Castellari, Sofia, additional, Po, Andrea, additional, Gaggioli, Guido, additional, Varesi, Massimo, additional, Moneti, Paolo, additional, Capurso, Sebastiano, additional, Latini, Vincenzo, additional, Ghidotti, Stefano, additional, Riccardelli, Francesco, additional, Macchi, Maurizio, additional, Rigo, Rosaria, additional, Claudio, Pascale, additional, Angelo, Bosio, additional, Flavio, Cerrato, additional, Benedetta, Bardelli, additional, Boffelli, Stefano, additional, Cassinadri, Angela, additional, Franzoni, Simone, additional, Spazzini, Elena, additional, Andretto, Daniela, additional, Tonini, Gabriele, additional, Andreani, Laura, additional, Coralli, Mirco, additional, Balotta, Antonio, additional, Cancelliere, Roberto, additional, Ballardini, Giorgio, additional, Simoncelli, Margherita, additional, Mancini, Annarita, additional, Strazzacapa, Mara, additional, Fabio, Stefano, additional, De Filippi, Francesco, additional, Giudice, Chiara, additional, Dentizzi, Cosimo, additional, Azzini, Margherita, additional, Cazzadori, Marco, additional, Mastroeni, Valeria, additional, Bertassello, Paolo, additional, Claudia Benati, Helena Santana, additional, Nesta, Elisa, additional, Tobaldini, Chiara, additional, Guerini, Fabio, additional, Elena, Tambara, additional, Mombelloni, Paolo, additional, Fontanini, Fulvio, additional, Gabriella, Lassa, additional, Pizzorni, Crosio, additional, Oliverio, Martina, additional, Del Grosso, Luciano Luca, additional, Giavedoni, Cristina, additional, Bidoli, Giuliano, additional, Mazzei, Bruno, additional, Corsonello, Andrea, additional, Fusco, Sergio, additional, Vena, Silvio, additional, De Vuono, Tommaso, additional, Maiuri, Giorgio, additional, Luca, Fimognari Filippo, additional, Andrea, Arone, additional, Giovanni, Sgrò, additional, Rossella, Nicolazzo, additional, Castegnaro, Eugenio, additional, De Rosa, Salvatore, additional, Sechi, Rossella Bazzano, additional, Benvenuti, Enrico, additional, Del Lungo, Ilaria, additional, Giardini, Sante, additional, Giulietti, Chiara, additional, Mauro, Di Bari, additional, Eleonora, Barghini, additional, Martina, Paoli, additional, Irene, Fiordelli, additional, Riccardo, Barucci, additional, Federica, Sgrilli, additional, Ilaria, Del Lungo, additional, Bertoletti, Erik, additional, D'Amico, Ferdinando, additional, Caronzolo, Francesco, additional, Grippa, Alessandro, additional, Lombardo, Giuseppina, additional, Pipicella, Tiziana, additional, Antonino, Saitta, additional, Francesco, Corica, additional, Valeria, Prestipino Giarritta, additional, Daniela, Larosa, additional, Domenico, Cucinotta, additional, Giorgio, Basile, additional, March, Albert, additional, Nitti, Maria Teresa, additional, Felici, Alessandro, additional, Pavan, Silvia, additional, Piazzani, Fabrizio, additional, Lunelli, Alessandra, additional, Dimori, Sergio, additional, Margotta, Alessandro, additional, Soglia, Tiziano, additional, Postacchini, Demetrio, additional, Brunelli, Roberto, additional, Santini, Silvia, additional, Francavilla, Monia, additional, Macchiati, Ilenia, additional, Sorvillo, Francesca, additional, Giuli, Cinzia, additional, Mecocci, Patrizia, additional, Longo, Annalisa, additional, Perticone, Francesco, additional, Addesi, Desireè, additional, Rosa, Paola Cerra, additional, Bencardino, Giuseppe, additional, Falbo, Tania, additional, Grillo, Nadia, additional, Marco, Filice, additional, Mirella, Flippo, additional, Fantò, Fausto, additional, Isaia, Gianluca, additional, Pezzilli, Stella, additional, Bergamo, Daniele, additional, Furno, Elisabetta, additional, Rrodhe, Sokol, additional, Lucarini, Simonetta, additional, Dijk, Babette, additional, Dall'Acqua, Francesca, additional, Cappelletto, Francesco, additional, Calvani, Donatella, additional, Becheri, Dimitri, additional, Giuseppe, Mottino, additional, Costanza, Mitidieri, additional, Vito, Antonio, additional, Francesca, Bartalucci, additional, Magherini, Lorenza, additional, Novella, Malin, additional, Franca, Boni, additional, Lucia Gambardella, Paoli Martina, additional, Valente, Carlo, additional, Ilaria, Bracali, additional, Alice, Foschini, additional, Porrino, Paola, additional, Ceci, Giacomo, additional, Giuliana, Bottignole, additional, Michela, Tibaldi, additional, Eleonora, Coppo, additional, Ettore, Evaristo, additional, Camellini, Cinzia, additional, Servello, Adriana, additional, Grassi, Alessandro, additional, Rozzini, Renzo, additional, Tironi, Sara, additional, Grassi, Maria Grazia, additional, Troisi, Elio, additional, Carlo, Caltagirone, additional, Simona Gabriella, Di Santo, additional, Flaminia, Franchini, additional, Federica, Ratto, additional, Beatrice, Pavoni, additional, Sofia, Toniolo, additional, Gabutto, Anna, additional, Quazzo, Loredana, additional, Rosatello, Annalisa, additional, Suraci, Domenico, additional, Tagliabue, Benedetta, additional, Perrone, Chiara, additional, Ferrara, Lucia, additional, Castagna, Alberto, additional, Tremolada, Maria Luisa, additional, Giuseppe, Castoldi, additional, Stefano, Barbero, additional, Davide, Oltramonti, additional, Piano, Simonetta, additional, Serviddio, Gaetano, additional, Lo Buglio, Aurelio, additional, Gurrera, Tiziana, additional, Merlo, Valeria, additional, Rovai, Carla, additional, Cotroneo, Antonino Maria, additional, Carlucci, Rosaria, additional, Abbaldo, Anna, additional, Monzani, Fabio, additional, Qasem, Ahmad Amedeo, additional, Bini, Giacomo, additional, Tafuto, Silvia, additional, Galli, Giovanni, additional, Bruni, Amalia Cecilia, additional, Mancuso, Giovanna, additional, Mancuso, Gerardo, additional, Calipari, Daniela, additional, Giuseppe Massimiliano, De Luca, additional, Bernardini, Bruno, additional, Corsini, Carla, additional, Michele, Ciccarelli, additional, Sara, Dal Farra, additional, Cagnin, Annachiara, additional, Fragiacomo, Federica, additional, Pompanin, Sara, additional, Piero, Amodio, additional, Marco, Cagnin, additional, Zurlo, Amedeo, additional, Guerra, Gianluca, additional, Pala, Marco, additional, Menozzi, Luca, additional, Gatti, Chiara Delli, additional, Magon, Stefania, additional, Roberto, Manfredini, additional, Alfredo, De Giorgi, additional, Fabio, Fabbian, additional, Ruana, Tiseo, additional, Elisa, Misurati, additional, Benedetta, Boari, additional, Christian, Molino, additional, Marco, Pala, additional, Massimo, Gallerani, additional, Di Francesco, Vincenzo, additional, Faccioli, Silvia, additional, Pellizzari, Luca, additional, Giorgia, Fontana, additional, Barbagallo, Giuseppe, additional, Lunardelli, Maria Lia, additional, Martini, Emilio, additional, Ferrari, Eleonora, additional, Macchiarulo, Maria, additional, Corneli, Maria, additional, Bacci, Monica, additional, Battaglia, Giuseppe, additional, Anastasio, Luigi, additional, Lo Storto, Mario Sostene, additional, Seresin, Chiara, additional, Simonato, Matteo, additional, Loreggian, Michele, additional, Cestonaro, Fausta, additional, Durando, Mario, additional, Latella, Raffaele, additional, Mazzoleni, Marta, additional, Russo, Giuseppe, additional, Ponte, Martino, additional, Valchera, Alessandro, additional, Salustri, Giuseppe, additional, Petritola, Donatella, additional, Costa, Alfredo, additional, Sinforiani, Elena, additional, Cotta, Matteo Ramusino, additional, Pizio, Renato Nicola, additional, Cester, Alberto, additional, Formilan, Marino, additional, Pietro, Bonometto, additional, Carbone, Pasqualina, additional, Cazzaniga, Ilaria, additional, Appollonio, Ildebrando, additional, Cereda, Diletta, additional, Stabile, Andrea, additional, Xhani, Rubjona, additional, Acampora, Roberto, additional, Tremolizzo, Lucio, additional, Federico, Pieruzzi, additional, Antonio, Ciaccio, additional, Valerio, Pontecorvi, additional, Cesare, Burti, additional, Zhirajr, Mokini, additional, Giovanni, Vitale, additional, Maria, Amigoni, additional, Mariaelena, Sparacino, additional, Bottacchi, Edo, additional, Bucciantini, Elisabetta, additional, Di Giovanni, Marco, additional, Franchi, Fabrizio, additional, Lucchetti, Lucio, additional, Mariani, Claudio, additional, Grande, Giulia, additional, Rapazzini, Piero, additional, Marco, Mauri, additional, Romanelli, Giuseppe, additional, Franco, Nicosia, additional, Alessio, Margola, additional, Stefano, Bonardelli, additional, Nicola, Latronico, additional, Laura, Porcella, additional, Nazario, Portolani, additional, Carlo, Concoreggi, additional, Chiara, Grassini, additional, Soccorso, Pronto, additional, Andrea, Salvi, additional, Luca, Bianchetti, additional, Francesca, Spagnoli, additional, Roberto, Apuzzo, additional, Marco, Fontanella, additional, Anna, Ceraso, additional, Francesco, Castelli, additional, Fugazza, Luciano, additional, Guerrini, Chiara, additional, De Paduanis, Giovanna, additional, Iallonardo, Lucia, additional, Palumbo, Pasquale, additional, Zuliani, Giovanni, additional, Ortolani, Beatrice, additional, Capatti, Eleonora, additional, Soavi, Cecilia, additional, Bianchi, Lara, additional, Francesconi, Daniela, additional, Miselli, Agata, additional, Gloria, Brombo, additional, Tommaso, Romagnoli, additional, Chiara, Pazzaglini, additional, Agata, Miselli Maria, additional, Marco, Dall'Agata, additional, Luca, Menozzi, additional, Gianluca, Guerra, additional, Suardi, Teresa, additional, Zaccarini, Cinzia, additional, Manuela, Riva, additional, Mirra, Gianluca, additional, Muti, Ettore, additional, Bottura, Renato, additional, Gianpaolo, Moretti, additional, Secreto, Piero, additional, Bisio, Erika, additional, Cecchettani, Marco, additional, Naldi, Tamara, additional, Pallavicino, Alessandra, additional, Pugliese, Michela, additional, Iozzo, Rosaria Cosima, additional, Grassi, Guido, additional, Michele, Bombelli, additional, Raffaella, Dell'Oro, additional, Fosca, Quarti Trevano, additional, Giorgio, Giussani Carlo, additional, Giovanni, Paternò, additional, Ernesto, Contro, additional, Mannironi, Antonio, additional, Giorli, Elisa, additional, Oberti, Sara, additional, Fierro, Brigida, additional, Piccoli, Tommaso, additional, Giacalone, Fabio, additional, Mandas, Antonella, additional, Serchisu, Luca, additional, Costaggiu, Diego, additional, Pinna, Elisa, additional, Orrù, Francesca, additional, Mannai, Martina, additional, Cordioli, Zeno, additional, Pelizzari, Luca, additional, Turcato, Emanuela, additional, Arduini, Pietro, additional, Cacace, Carlo, additional, Chiloiro, Roberta, additional, Cimino, Rosella, additional, Ruberto, Carmen, additional, Giovanni, Ruotolo, additional, Pietro, Gareri, additional, Laura, Greco, additional, Alberto, Castagna, additional, Carmen, Ruberto, additional, Santo, Pierluigi Dal, additional, Andriolli, Antonino, additional, Burattin, Giuseppe, additional, Rossi, Laura, additional, Andreolli Antonino, Cervati Giovanna, additional, Giuseppe, Catalano, additional, Tezza, Fabiana, additional, Maddalena, Pizzardini, additional, Laura, Stievano, additional, Crippa, Patrizia, additional, Aloisio, Paola, additional, Di Monda, Tiziana, additional, Malighetti, Alessandro, additional, Galbassini, Gloria, additional, Salutis, Domus, additional, Ivaldi, Claudio, additional, Russo, Anna Maria, additional, Bennati, Ettore, additional, Pino, Elisabetta, additional, Zavarise, Gianmaria, additional, Pesci, Alberto, additional, Suigo, Giulia, additional, Faverio, Paola, additional, Andrea, Gori, additional, Sabrina, Perego, additional, Zanasi, Massimo, additional, Moniello, Giovanni, additional, Rostagno, Carlo, additional, Cartei, Alessandro, additional, Polidori, Gianluca, additional, Ungar, Andrea, additional, Melis, Maria Ramona, additional, Martellini, Eleonora, additional, Enrico, Mossello, additional, Monica, Torrini, additional, Antonella, Giordano, additional, Giovanna, Leone, additional, Migliorini, Marta, additional, Caramelli, Francesca, additional, Battiston, Bruno, additional, Berardino, Maurizio, additional, Cavallo, Simona, additional, Alessandro, Massè, additional, Anna, Santoro, additional, Lombardi, Bruna, additional, D'Ippolito, Pierpaolo, additional, Furini, Angela, additional, Villani, Daniele, additional, Clara, Raimondi, additional, Guarneri, Massimo, additional, Paolucci, Stefano, additional, Bassi, Andrea, additional, Coiro, Paola, additional, De Angelis, Domenico, additional, Morone, Giovanni, additional, Venturiero, Vincenzo, additional, Palleschi, Lorenzo, additional, Raganato, Paolo, additional, Di Niro, Giuseppina, additional, Rosa, Casini Anna, additional, Loredana, Bove, additional, Imoscopi, Alessandra, additional, Isaia, Giancarlo, additional, Tibaldi, V., additional, Bottignole G, G., additional, Calvi, E., additional, Clementi, C., additional, Zanocchi, M., additional, Agosta, L., additional, Nortarelli, Antonella, additional, Provenzano, Giuseppe, additional, Mari, Daniela, additional, Romano, Federica Ylenia, additional, Rosini, Francesca, additional, Mansi, Marta, additional, Rossi, Silvia, additional, Geriatria, Alex Riccardelli, additional, Inzaghi, Lorenzo, additional, Bonini, Giulia, additional, Rossi, Paolo, additional, Potena, Alfredo, additional, Lichii, Mihaela, additional, Candiani, Tiziana, additional, Grimaldi, William, additional, Bertani, Emiliano, additional, Alessandra, Porta, additional, Calogero, Pietro, additional, Pinto, Daniela, additional, Bernardi, Roberto, additional, Nicolino, Francesco, additional, Galetti, Caterina, additional, Gianstefani, Alice, additional, Giulia, Corvalli, additional, Lorenzo, Mulazzani, additional, Odetti, Patrizio, additional, Monacelli, Fiammetta, additional, Prefumo, Matteo, additional, Fiammetta, Monacelli, additional, Canepa, Marta, additional, Minaglia, Cecilia, additional, Paolisso, Giuseppe, additional, Rizzo, Maria Rosaria, additional, Prestano, Raffaele, additional, Dalise, Anna Maria, additional, Barra, Davide, additional, Bosco, Livio Dal, additional, Asprinio, Vincenzo, additional, Dallape, Luciana, additional, Perina, Elisa, additional, Incalzi, Raffaele Antonelli, additional, Bartoli, Isaura Rossi, additional, Pluderi, Alice, additional, Maina, Antonella, additional, Pecoraro, Elisabetta, additional, Sciarra, Michela, additional, Prudente, Angela, additional, Paola, Maina, additional, Francesca, Mete, additional, Manuel, Ventura, additional, Luisella, Cesari, additional, Maria, Pernigotti Luigi, additional, Tina, Santangelo, additional, Benini, Lucia, additional, Levato, Francesco, additional, Mhiuta, Victor, additional, Alius, Florin, additional, Davidoaia, Diana, additional, Giardini, Vittorio, additional, Garancini, Mattia, additional, Bellamoli, Claudio, additional, Terranova, Luciano, additional, Bozzini, Claudia, additional, Tosoni, Paolo, additional, Provoli, Emma, additional, Cascone, Luisa, additional, Dioli, Andrea, additional, Ferrarin, Gianfranco, additional, Bucci, Adelmo, additional, Bua, Guido, additional, Fenu, Sara, additional, Bianchi, Giovanna, additional, Casella, Silvia, additional, Romano, Valentina, additional, Maurizio, Poli, additional, Mascherona, Ilenia, additional, Belotti, Gloria, additional, Cavaliere, Sabina, additional, Cuni, Estella, additional, Merciuc, Nina, additional, Oberti, Rosella, additional, Veneziani, Silvia, additional, Capoferri, Emanuela, additional, De Bernardi, Elisabetta, additional, Colombo, Katia, additional, Bravi, Marco, additional, Nicoletta, Negrinotti, additional, D'Arcangelo, Paolo, additional, Montenegro, Nicola, additional, Montanari, Roberto, additional, Lamanna, Pierpaolo, additional, Gasperini, Beatrice, additional, Isabella, Montesi, additional, Stefania, Diotallevi, additional, Gaia, Altobelli, additional, Filippo, Calcinaro, additional, Palamà, Chiara, additional, Di Emidio, Chiara, additional, Scarpini, Elio, additional, Arighi, Andrea, additional, Fumagalli, Giorgio, additional, Basilico, Paola, additional, De Amicis Margherita, Migone, additional, Marta, Mancarella, additional, Diletta, Maira, additional, Granata, Antonino, additional, Ranalli, Claudia, additional, Cammilli, Alessandra, additional, Cavallini, Maria Chiara, additional, Tricca, Manola, additional, Natella, Daniela, additional, Gabbani, Luciano, additional, Tesi, Francesca, additional, Martella, Letizia, additional, Imbrici, Rosalba, additional, Guerrini, Gianbattista, additional, Scotuzzi, Anna Maria, additional, Sozzi, Ferdinando, additional, Valenti, Luigi, additional, Chiarello, Antonino, additional, Monia, Monella, additional, Pilotto, Alberto, additional, Prete, Camilla, additional, Senesi, Barbara, additional, Meta, Anna Cristina, additional, Pendenza, Enrico, additional, Pasqualetti, Giuseppe, additional, Polini, Antonio, additional, Tognini, Sara, additional, Ballino, Elena, additional, Dell'Aquila, Giuseppina, additional, Gasparrini, Pina Maria, additional, Marotti, Elisabetta, additional, Migale, Monica, additional, Scrimieri, Antonia, additional, Falsetti, Lorenzo, additional, Salvi, Aldo, additional, Toigo, Gabriele, additional, Ceschia, Giuliano, additional, Rosso, Alessia, additional, Tongiorgi, Chiara, additional, Scarpa, Cristina, additional, Maurizio, Pacchioni, additional, De Dominicis, Luigino, additional, Pucci, Eugenio, additional, Renzi, Sara, additional, Cartechini, Elisabetta, additional, Tomassini, Pia Francesca, additional, Del Gobbo, Maurizio, additional, Ugenti, Francesca, additional, Romeo, Pasquale, additional, Nardelli, Anna, additional, Lauretani, Fulvio, additional, Visioli, Sandra, additional, Montanari, Ilaria, additional, Ermini, Francesca, additional, Giordano, Antonio, additional, Pigato, Giorgio, additional, Simeone, Emilio, additional, Barbujani, Mario, additional, Giampieri, Marina, additional, Amoruso, Raffaele, additional, Piccinini, Maristella, additional, Ferrari, Camilla, additional, Gambetti, Claudio, additional, Sfrappini, Mario, additional, Semeraro, Letizia, additional, Striuli, Rinaldo, additional, Mariani, Claudia, additional, Pelliccioni, Giuseppe, additional, Marinelli, Donatella, additional, Fabi, Katia, additional, Rossi, Tommaso, additional, Pesallaccia, Martina, additional, Sabbatini, Debora, additional, Gobbi, Beatrice, additional, Cerqua, Raffaella, additional, Tagliani, Giancarla, additional, Schlauser, Elena, additional, Caser, Luciano, additional, Caramello, Elisa, additional, Sandigliano, Franca, additional, Rosso, Giorgio, additional, Ferrari, Alberto, additional, Bendini, Chiara, additional, Luisa, Davoli Maria, additional, Casella, Monica, additional, Prampolini, Raffaella, additional, Scevola, Moreno, additional, Vitale, Enrico, additional, Roberto, Brugiolo, additional, Carlo, Fagherazzi, additional, Sergio, Fusco, additional, Alberto, Scarpa, additional, Daniela, Zara, additional, Giulia, Bertozzo, additional, Serena, Granziera, additional, Michele, Barazzuol, additional, Maugeri, Domenico, additional, Sorace, Rosaria, additional, Anzaldi, Massimiliano, additional, De Gesu, Roberto, additional, Morrone, Giuseppe, additional, Davolio, Federica, additional, Fabbo, Andrea, additional, Palmieri, Marina, additional, Zoli, Marco, additional, Forti, Paola, additional, Pirazzoli, Luca, additional, Fabbri, Elisa, additional, Terenzi, Laura, additional, Bergolari, Federica, additional, Wenter, Christian, additional, Ruffini, Ingrid, additional, Insam, Miriam, additional, Abraham, Elisabeth, additional, Kirchlechner, Christine, additional, Cucinotta, Domenico, additional, Antonino, Lasco, additional, Basile, Giorgio, additional, Grazia, Arena Maria, additional, Parise, Pasquale, additional, Boccali, Andrea, additional, Amici, Serena, additional, Gambacorta, Maurizia, additional, Lasagni, Anna, additional, Lovati, Roberto, additional, Giovinazzo, Francesca, additional, Kimak, Elzbieta, additional, Zappa, Paolo, additional, Medici, Francesco, additional, Lo Castro, Marika, additional, Mauro, Flavia, additional, De Luca, Alessandro, additional, Sancesario, Giuseppe, additional, Martorana, Alessandro, additional, Scaricamazza, Beatrice, additional, Toniolo, Sofia, additional, Di Lorenzo, Francesco, additional, Liguori, Claudio, additional, Lasco, Antonino, additional, Vita, Natale, additional, Giomi, Mirna, additional, Forte, Floriana, additional, Padovani, Alessandro, additional, Rozzini, Luca, additional, Ceraso, Anna, additional, Salvatore, Caratozzolo, additional, Cottino, Maria, additional, Vitali, Silvia, additional, Marelli, Eleonora, additional, Tripi, Gabriele, additional, Miceli, Salvatore, additional, Urso, Giovanni, additional, Grioni, Giuseppe, additional, Vezzadini, Giuliana, additional, Misaggi, Giulia, additional, Forlani, Chiara, additional, Avanzi, Stefano, additional, Serena, Saulle, additional, Claudia, Casarini, additional, Marilena, Viggiano, additional, Alberto, Luisa, additional, Diego, Ghianda, additional, Alessandro, Giordano, additional, Iemolo, Francesco, additional, Giordano, Antonello, additional, Sanzaro, Enzo, additional, D'Asta, Gabriele, additional, Proietto, Maria, additional, Carnemolla, Anna, additional, Razza, Grazia, additional, Spadaro, Daniela, additional, Bertolotti, Marco, additional, Mussi, Chiara, additional, Neviani, Francesca, additional, Roberto, Chiesa, additional, Valentina, Guerzoni, additional, Linda, Morselli, additional, Francesca, Venturelli, additional, Tarozzi, Adriano, additional, Balestri, Francesca, additional, Mannarino, Giulio, additional, Bigolari, Michela, additional, Natale, Alessia, additional, Grassi, Simona, additional, Bottaro, Cinzia, additional, Stefanelli, Sara, additional, Bovone, Ugo, additional, Tortorolo, Umberto, additional, Quadri, Roberto, additional, Leone, Giuseppe, additional, Ponzetto, Maria, additional, Frasson, Paola, additional, Annoni, Giorgio, additional, Bruni, Adriana, additional, Confalonieri, Roberto, additional, Corsi, Maurizio, additional, Moretti, Daniela, additional, Teruzzi, Fabiola, additional, Umidi, Simona, additional, Mazzola, Paolo, additional, Perego, Sabrina, additional, Persico, Ilaria, additional, Olivieri, Giulia, additional, Bonfanti, Alessandra, additional, Hajnalka, Szabò, additional, Galeazzi, Marianna, additional, Massariello, Francesca, additional, Anzuini, Alessandra, additional, Caffarra, Paolo, additional, Barocco, Federica, additional, Spallazzi, Marco, additional, Paolo, Ceda Gian, additional, Simonetta, Morganti, additional, Andrea, Artoni, additional, Chioatto, Paolo, additional, Bortolamei, Sandra, additional, Soattin, Lucia, additional, Ruotolo, Giovanni, additional, Beneamino, Borelli, additional, Giuseppe, Barilaro, additional, Bertazzoli, Marco, additional, Rota, Elisabetta, additional, Adobati, Annamaria, additional, Scarpa, Alberto, additional, Granziera, Serena, additional, Zuccher, Paola, additional, Fabbro, Angela Dal, additional, Zara, Daniela, additional, Lo Nigro, Ambra, additional, Franchetti, Lorena, additional, Toniolo, Marika, additional, Marcuzzo, Cinzia, additional, Rollone, Marco, additional, Guerriero, Fabio, additional, Sgarlata, Carmelo, additional, Massè, Alessandro, additional, Zatti, Giovanni, additional, Piatti, Massimiliano, additional, Graci, Jole, additional, Benati, Giuseppe, additional, Boschi, Federica, additional, Biondi, Mario, additional, Fiumi, Nicoletta, additional, Erika, Tamburini, additional, Locatelli, Sergio Mario, additional, Mauri, Sabrina, additional, Beretta, Mauro, additional, Margheritis, Laura, additional, Desideri, Giovanbattista, additional, Liberatore, Ester, additional, Carucci, Anna Cecilia, additional, Bonino, Paolo, additional, Caput, Margherita, additional, Antonietti, Maria Paola, additional, Polistena, Giuseppe, additional, De la Pierre, Franz, additional, Mari, Marcello, additional, Massignani, Paola, additional, Tombesi, Fabio, additional, Selvaggio, Fabio, additional, Verbo, Brunella, additional, Bodoni, Paolo, additional, Marchionni, Niccolò, additional, Sabatini, Tony, additional, Mussio, Eleonora, additional, Magni, Eugenio, additional, Bianchetti, Angelo, additional, Crucitti, Andrea, additional, Titoldini, Giulia, additional, Cossu, Beatrice, additional, Fascendini, Sara, additional, Licini, Cristina, additional, Tomasoni, Angela, additional, Calderazzo, Massimo, additional, Daniela, Tropiano, additional, Valentina, Laganà, additional, Melotti, Rita Maria, additional, Lilli, Albina, additional, Buda, Simona, additional, Adversi, Marco, additional, Noro, Gabriele, additional, Turco, Renato, additional, Ubezio, M Chiara, additional, Mantovani, Anna Roberta, additional, Viola, Maria Cristina, additional, Serrati, Carlo, additional, Pretta, Stefano, additional, Infante, Maria, additional, Gentile, Simona, additional, Morandi, Alessandro, additional, D'Ambrosio, Viviana, additional, Mazzanti, Paolo, additional, Brambilla, Cristina, additional, Sportelli, Silvia, additional, Platto, Caterina, additional, Faraci, Bianca, additional, Quattrocchi, Daniela, additional, Pernigotti, Luigi Maria, additional, Pisu, Cristina, additional, Sicuro, Francesca, additional, Zagnoni, Piergiuseppe, additional, Ghiglia, Stefania, additional, Mosca, Massimiliano, additional, Corazzin, Ileana, additional, Deola, Mariangela, additional, Biagini, Carlo Adriano, additional, Bencini, Francesca, additional, Cantini, Claudia, additional, Tonon, Elisabetta, additional, Pierinelli, Silvia, additional, Onofrj, Marco, additional, Thomas, Astrid, additional, Filomena, Borbone, additional, Bonanni, Laura, additional, Gabriella, Cacchiò, additional, Comi, Giancarlo, additional, Magnani, Giuseppe, additional, Santangelo, Roberto, additional, Mazzeo, Salvatore, additional, Giuseppe, Magnani, additional, Francesca, Caso, additional, Giordano, Cecchetti, additional, Roberto, Sant'Angelo, additional, Barbieri, Cristina, additional, Giroldi, Liviana, additional, Bandini, Fabio, additional, Masina, Marco, additional, Malservisi, Simona, additional, Cicognani, Annalena, additional, Ricca, Laura, additional, Piccininni, Maristella, additional, Tassinari, Tiziana, additional, Brogi, Davide, additional, Sugo, Annalisa, additional, Alessandra, Filippi, additional, Sonia, Manfredi, additional, Valerio, Vanni, additional, Andrea, Usai Carlo, additional, Enrico, Colombo, additional, Vera, Renna Francesca, additional, Assunta, Sauchella, additional, Gianmaria, Zavarise, additional, Mauro, Prete, additional, Pietro, Bisagni, additional, Roberto, Masini, additional, Salvatore, Carrabetta, additional, Barone, Antonella, additional, Razzano, Monica, additional, Giuseppe, Imperoli, additional, Angela, Bini, additional, Francesco, Serra, additional, Valeria, D'Agostino, additional, Federico, Gianolla, additional, Lucia, Pietrangeli, additional, Antonella, Velardi, additional, Elisabetta, Di Cello, additional, Cristina, Rosati, additional, Nadia, Casali, additional, Maria, Sessa, additional, Luciano, Abruzzi, additional, Chiara, Costanzi, additional, Bini, Paolo, additional, Pignata, Michele, additional, Enrico, Buonagurio, additional, Maria, Vollery, additional, Giovanni, Carrieri, additional, Giorgio, Cioni, additional, Andrea, Toschi, additional, Marco, Metra, additional, Piera, Ranieri, additional, Alberto, Zucchelli, additional, Ceccon, Anna, additional, Magrin, Laura, additional, Marin, Sara, additional, Barbara, Sofia, additional, Marco, Masina, additional, Laura, Ghedini, additional, Matteo, Moroni, additional, Marco, Paragona, additional, Caterina, Pallotti Maria, additional, Carla, Rota, additional, Federica, Gottardi, additional, Clara, Tomasoni, additional, Melania, Cappuccio, additional, Giampaolo, Bonini, additional, Stefano, Guerini, additional, Valeria, Guerini, additional, Lucia, Merla, additional, Giovambattista, Desideri, additional, Ester, Liberatore, additional, Cecilia, Carucci Anna, additional, Maurizio, Tovaglieri, additional, Vera, Renna Frandesca, additional, Nadia, Bongiorni, additional, Grillo, Antonio, additional, Arenare, Francesca, additional, Tonino, Mineo, additional, David, Kanah, additional, Giorgio, Vianello Piero, additional, Ubaldo, Balducci, additional, Vincenzo, Sidoti, additional, Stefano, Montanari, additional, Marino, Formilan, additional, Busonera Flavio, Murelli Teodolindo, additional, Paolo, Albanese, additional, Monica, Maselli, additional, Francesco, Bolzetta, additional, Roberto, Fabris, additional, Paolo, Bonino, additional, DuranteMangoni, Emanuele, additional, Testoni, Michela, additional, Fabio, Di Stefano, additional, Loredana, Seccia, additional, Valeria, Sonzini, additional, Fabiano, Maria, additional, Annabella, Di Giorgio, additional, Salvatore, De Cosmo, additional, Greco, Antonio, additional, Grazia, D'Onofrio, additional, Daniele, Sancarlo, additional, Gianluca, Resta, additional, Renzo, Girardello, additional, Sergio, Minervini, additional, Morena, Boni, additional, Vitali, Mariagrazia, additional, Marina, Pizzoni, additional, Paolo, De Colle, additional, Cristina, Scarpa, additional, Alessandra, Frattola, additional, Orlandini, Francesco, additional, La Regina, Micaela, additional, Desirée, Addesi, additional, Mirella, Filippo, additional, Mario, Bo, additional, Paola, Porrino, additional, Padulo, Filomena, additional, Cristina, Margheriti, additional, Dario, Rolano, additional, Giancarla, Moscatelli, additional, Guido, Radaelli, additional, Elena, Montini, additional, Prete, Cosimo, additional, Marileda, Novello, additional, Igor, Bramuzzo, additional, Nicole, Bertin, additional, Elena, Rinaldo, additional, Paolillo, Ciro, additional, Riccardi, Angela, additional, Claudia, Benedetti, additional, Barbara, Rizzi, additional, Francesca, Montagna, additional, Silvia, Vitali, additional, Chiara, Cutaia, additional, Oliver, Baca, additional, Mauro, Colombo, additional, Eleonora, Marelli, additional, Giuseppe, Procino, additional, Rosaria, Tararà, additional, Maria, Cottino, additional, Davide, Dell'Acqua, additional, Stefania, Cislaghi, additional, Marco, Cairati, additional, Massimo, Porta, additional, Luca, Scaglione, additional, Martina, De Feo, additional, Paola, Vertolli, additional, Lia, Salvati, additional, Sandro, Cinotti, additional, Valentina, De Santis, additional, Erminia, Biferi, additional, Paola, Cheli, additional, Romina, Rebizzo, additional, Minisola, Salvatore, additional, Luciano, Colangelo, additional, Pasquale, Abete, additional, Ilaria, Liguori, additional, Francesca, Curcio, additional, Guglielmo, Spassini, additional, Marco, Engheben, additional, Sara, Rotunno, additional, Paola, Arosio, additional, Claudio, Angelini, additional, Francesco, Reggiani, additional, Alessandro, Cappelli, additional, Simona, Marcheselli, additional, Lara, Fratticci, additional, Paola, Ranzani, additional, Simonetta, Cesarini, additional, Antonella, Cerini, additional, Generoso, Uomo, additional, Fernando, Gallucci, additional, Giuliano, Ceschia, additional, Emanuela, Serra, additional, Mariolina, Sola, additional, Alessandro, Delitala, additional, Chiara, Pes, additional, Giulia, Lobianco, additional, Alessandro, Giani, additional, Famularo, Simone, additional, Sandini, Marta, additional, Pinotti, Enrico, additional, Gianotti, Luca, additional, Antonella, Battuello, additional, Giulia, Pintore, additional, Sante, Giardini, additional, Rossi, Andrea, additional, Rubele, Sofia, additional, Sant, Selena, additional, Marco, Vignati, additional, Danila, Clerici, additional, Fabio, Rosa, additional, Bandirali, Maria Pia, additional, Nicoletta, Cattaneo, additional, Laura, Boffi, additional, Paolo, Tosoni, additional, Luciano, Terranova, additional, Leonello, Avalli, additional, Margherita, Scanziani, additional, Stefania, De Notaris, additional, Pierluigi, Del Santo, additional, Laura, Rossi, additional, Fabiana, Tezza, additional, Giovanna, Cervati, additional, Antonino, Andreolli, additional, Felice, Catalano, additional, Giuseppe, Burattin, additional, Danilo, Fogli, additional, Giovanna, Di Bella, additional, Francesco, Landi, additional, Salini, Sara, additional, Angela, Brunetti Maria, additional, Giorgetta, Cappa, additional, Giovanni, Galvagno, additional, Paola, Cena, additional, Gerardo, Bruno, additional, Silvio, Raspo, additional, Letizia, Semeraro, additional, Sabrina, Pedrotti, additional, Davide, Barra, additional, Rosaria, Rizzo Maria, additional, Maria, Dalise Anna, additional, Raffaele, Prestano, additional, Palmieri, Vincenzo Ostilio, additional, Palasciano, Giuseppe, additional, Belfiore, Anna, additional, Portincasa, Piero, additional, Carlo, Sabbà, additional, Vincenzo, Solfrizzi, additional, Alessia, D'introno, additional, Valiani, Vincenzo, additional, Carolina, Bologna, additional, Tiziana, Ciarambino, additional, Paola, Turelli, additional, Ugo, Pazzaglia, additional, Federica, Rodella, additional, Giacomo, Piana, additional, Castellano, Maurizio, additional, Anna, Garelli, additional, Elisa, Casella, additional, Federica, Campana, additional, Antonietta, Coschignano Maria, additional, Luigi, Marinangeli, additional, Fabio, Lorico, additional, Salvatore, Bazzano, additional, Giuseppe, Menculini, additional, Gelosa, Giorgio, additional, Viviana, Ambrogio Teresa, additional, Piras, Valentina, additional, Andrea, Ciricugno, additional, Alessandra, Bollari, additional, Coen, Daniele, additional, Magliola, Renata, additional, Milanesio, Deborah, additional, Muzzulini, Carlo Lorenzo, additional, Paolo, Fogliacco, additional, Marinella, Turla, additional, Sofia, Cotelli Maria, additional, Marta, Bianchi, additional, Siano, Pietro, additional, Capo, Giuseppe, additional, Napoletano, Rosa, additional, Cecilia, Politi, additional, Mancini, Concetta, additional, Del Buono, Corrado, additional, De Bartolomeo, Giuseppe, additional, Addolorata, Martinelli, additional, Carmen, Cefalogli, additional, Roberto, Cozzi, additional, Giovanni, Virtuani Angelo, additional, Moschettini, Gianfilippo, additional, Franco, Mastroianni, additional, Daniela, Roglia, additional, D'Amico, Gabriella, additional, Mirella, Palella, additional, Endrizzi, Cristina, additional, Trotta, Lucia, additional, Ciarambino, Tiziana, additional, Orazio, Zanetti, additional, Emanuela, Terazzi, additional, Marta, Sacchetti, additional, Thomas, Fleetwood, additional, Giacomo, Tondo, additional, Ignazio, Di Fazio, additional, Andrea, Bruni, additional, Giuseppe, Orsitto, additional, Emanuela, Fabbro, additional, Serena, Amici, additional, Elena, D'Imporzano, additional, Anna, Casanova, additional, Serena, Bertolio, additional, Erika, Nervo, additional, Roberto, Silvestri, additional, Elena, Semproni, additional, Manuela, Pintus, additional, Francesca, Aloe, additional, and Angelo, Tagliaccica, additional
Published: 2020
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41. Depression and heart failure: an intricate relationship

Author: Alberto Zucchelli, Bruno Aloisi, Gaetano Aloisi, Alessandra Marengoni, and Giuseppe Romanelli
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, MEDLINE, lcsh:Medicine, Heart failure, Prevalence, medicine, Humans, Mass Screening, In patient, Intensive care medicine, Antidepressants, Depression, Screening, Depression (differential diagnoses), Psychiatric Status Rating Scales, Cognitive Behavioral Therapy, business.industry, lcsh:R, Beck Depression Inventory, medicine.disease, Depression screening, Antidepressive Agents, Hospitalization, Cohort, Disease Progression, Quality of Life, Geriatric Depression Scale, Cardiology and Cardiovascular Medicine, business, Selective Serotonin Reuptake Inhibitors
Abstract: In patients with heart failure (HF), depression is common and associated with adverse outcomes such as reduced adherence to treatment, poor quality of life, increased hospitalizations and elevated mortality. Despite these adverse impacts, depression remain underdiagnosed in HF patients. We performed a target review of the literature to identify the association between HF and depression, to examine the mechanisms that link these two conditions and to identify instruments for an accurate diagnosis and treatment of depression in HF patients. Depression is associated with the development and progression of HF, including increased rates of mortality, mediated by behavioral and pathophysiological mechanisms. The overlap of symptoms between depression and HF often makes the diagnosis of depression difficult and late. Currently, specific guidelines for depression screening in HF patients are lacking, partly because evidences showing that depression screening improves cardiac outcomes are insufficient. European guidelines suggest the early use of instruments such as the Beck Depression Inventory (BDI) and the Geriatric Depression Scale (GDS), both characterized by accuracy and administration simplicity. There is limited evidence of pharmacological treatment and psychotherapy efficacy in patients with HF. However, cognitive-behavioral therapy has been shown to improve outcomes HF patients, and selective serotonin reuptake inhibitors appear safe in this cohort.
Published: 2019

42. Predictors of iron-deficiency anemia in primary care older adults: a real-world European multi-country longitudinal study

Author: Francesco Lapi, Ettore Marconi, N Cataldo, Miriam Levi, F. Heiman, Alberto Zucchelli, Davide L. Vetrano, Claudio Cricelli, and V. Pegoraro
Subjects: Male, Aging, Longitudinal study, Pediatrics, medicine.medical_specialty, Anemia, Disease, Lower risk, 03 medical and health sciences, 0302 clinical medicine, Belgium, hemic and lymphatic diseases, Germany, 80 and over, Medicine, Humans, 030212 general & internal medicine, Longitudinal Studies, Early diagnosis, Iron deficiency, Older persons, Primary care, Aged, Aged, 80 and over, Europe, Female, Italy, Primary Health Care, Retrospective Studies, Spain, Anemia, Iron-Deficiency, business.industry, Proportional hazards model, Hazard ratio, nutritional and metabolic diseases, Iron-Deficiency, medicine.disease, Comorbidity, Iron-deficiency anemia, Geriatrics and Gerontology, business, 030217 neurology & neurosurgery
Abstract: Iron deficiency is a major cause of anemia in older people. Increasing the knowledge on the predictors of iron-deficiency anemia (IDA) may facilitate its timely diagnosis. To investigate the predictors of IDA in older people in four European countries. Retrospective longitudinal study. Primary care patients aged 65 or older (N = 24,051) in four European countries. IDA predictors were estimated using multivariate Cox regression based on information gathered from national primary care databases: Italy (years 2002–2013), Belgium, Germany and Spain (years 2007–2012). Adjusted hazard ratios (aHR) with 95% confidence intervals (CIs) were estimated. In Spain and Belgium, men were at greater risk of IDA than women, while they had a lower risk in Italy. Weakness, irritability, alopecia and xerostomia were signs and symptoms significantly associated with IDA. Concurrent diseases, potential causes of anemia, positively associated with IDA were small bowel polyposis, stomach cancer, obesity, gastritis and peptic ulcer, esophagitis, Crohn’s disease, celiac disease, lymphangiectasis, gastrectomy or gastric atrophy, gut resection or bypass, and cardiac prosthetic valve. Aspirin users had a 12–35% higher hazard of IDA than non-users. Similarly, corticosteroids and anti-acids were positively associated with IDA. A higher level of comorbidity was associated with an increased hazard of IDA in all countries. Specific signs and symptoms, chronic conditions, a greater comorbidity burden, and specific pharmacological treatments registered in primary care databases represent relevant predictors and correlates of incident IDA in older people in Europe. General practitioners might employ this information to obtain early diagnosis of IDA in community-dwelling older adults.
Published: 2019

43. Prevalence of use and appropriateness of antidepressants prescription in acutely hospitalized elderly patients

Author: Franchi Carlotta, Rossio Raffaella, Ardoino Ilaria, Nobili Alessandro, Mannucci Pier Mannuccio, Pier Mannuccio Mannucci, Alessandro Nobili, Antonello Pietrangelo, Francesco Perticone, Giuseppe Licata, Francesco Violi, Gino Roberto Corazza, Salvatore Corrao, Alessandra Marengoni, Francesco Salerno, Matteo Cesari, Mauro Tettamanti, Luca Pasina, Carlotta Franchi, Laura Cortesi, Gabriella Miglio, Ilaria Ardoino, Alessio Novella, Domenico Prisco, Elena Silvestri, Giacomo Emmi, Alessandra Bettiol, Cenci Caterina, Gianni Biolo, Michela Zanetti, Martina Guadagni, Michele Zaccari, Massimiliano Chiuch, Massimo Vanoli, Giulia Grignani, Edoardo Alessandro Pulixi, Mauro Bernardi, Silvia Li Bassi, Luca Santi, Giacomo Zaccherini, Graziana Lupattelli, Elmo Mannarino, Vanessa Bianconi, Francesco Paciullo, Riccardo Alcidi, Ranuccio Nuti, Roberto Valenti, Martina Ruvio, Silvia Cappelli, Alberto Palazzuoli, Domenico Girelli, Fabiana Busti, Giacomo Marchi, Mario Barbagallo, Ligia Dominguez, Floriana Cocita, Vincenza Beneduce, Lidia Plances, Giuseppe Natoli, Salvatore Mularo, Massimo Raspanti, Federica Cavallaro, Marco Zoli, Ilaria Lazzari, Mattia Brunori, Elisa Fabbri, Donatella Magalotti, Raffaella Arnò, 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, Margherita Migone De Amicis, Giacomo De Luca, Natalia Scaramellini, Paolo Dionigi Rossi, Sarah Damanti, Marta Clerici, Federica Conti, Giulia Bonini, Barbara Brignolo Ottolini, Antonio Di Sabatino, Emanuela Miceli, Marco Vincenzo Lenti, Martina Pisati, Costanza Caccia Dominioni, Giovanni Murialdo, Alessio Marra, Federico Cattaneo, Roberto Pontremoli, Valentina Beccati, Giulia Nobili, Maria Beatrice Secchi, Davide Ghelfi, Luigi Anastasio, Lucia Sofia, Maria Carbone, Francesco Cipollone, Maria Teresa Guagnano, Emanuele Valeriani, Ilaria Rossi, Gerardo Mancuso, Daniela Calipari, Mosè Bartone, Giuseppe Delitala, Maria Berria, Chiara Pes, Alessandro Delitala, Maurizio Muscaritoli, Alessio Molfino, Enrico Petrillo, Giuseppe Zuccalà, Gabriella D’Aurizio, Giuseppe Romanelli, Alberto Zucchelli, Francesca Manzoni, Andrea Volpini, 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, Bruno Tassone, Giorgio Sesti, Medicina Interna, 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, Paolo Scarinzi, Annalisa Amabile, Elisabetta Omenetto, Tancredi Prandini, Roberto Manfredini, Fabio Fabbian, Benedetta Boari, Alfredo De Giorgi, Ruana Tiseo, Roberto De Giorgio, Giuseppe Paolisso, Maria Rosaria Rizzo, Claudio Borghi, Enrico Strocchi, Eugenia Ianniello, Mario Soldati, Carlo Sabbà, Francesco Saverio Vella, Patrizia Suppressa, Andrea Schilardi, Francesca Loparco, Giovanni Michele De Vincenzo, Alessio Comitangelo, Emanuele Amoruso, Luigi Fenoglio, Andrea Falcetta, Christian Bracco, Anna L. Fracanzani, Silvia Fargion, Silvia Tiraboschi, Annalisa Cespiati, Giovanna Oberti, Giordano Sigon, Flora Peyvandi, Raffaella Rossio, Barbara Ferrari, Giulia Colombo, Pasquale Agosti, 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, Paolo Peasso, Edoardo Favale, Cesare Poletto, Raffaella Salmi, Piergiorgio Gaudenzi, Ludovica Perri, Raffaele Landolfi, Massimo Montalto, Antonio Mirijello, Luigina Guasti, Luana Castiglioni, Andrea Maresca, Alessandro Squizzato, Leonardo Campiotti, Alessandra Grossi, Marco Bertolotti, Chiara Mussi, Giulia Lancellotti, Maria Vittoria Libbra, Giulia Dondi, Elisa Pellegrini, Lucia Carulli, Matteo Galassi, Yasmine Grassi, Maria Perticone, Rosa Battaglia, Marco FIlice, Raffaele Maio, Vincenzo Stanghellini, Eugenio Ruggeri, Sara del Vecchio, Andrea Salvi, Roberto Leonardi, Giampaolo Damiani, William Capeci, Armando Gabrielli, Massimo Mattioli, Giuseppe Pio Martino, Lorenzo Biondi, Pietro Pettinari, Riccardo Ghio, Anna Dal Col, Salvatore Minisola, Luciano Colangelo, Mirella Cilli, Giancarlo Labbadia, Antonella Afeltra, Benedetta Marigliano, Maria Elena Pipita, Pietro Castellino, Luca Zanoli, Samuele Pignataro, Alfio Gennaro, Julien Blanco, 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, Patrizia Tarsitani, Roberto Castello, Michela Pasino, Gian Paolo Ceda, Marcello Giuseppe Maggio, Simonetta Morganti, Andrea Artoni, Stefano Del Giacco, Davide Firinu, Francesca Losa, Giovanni Paoletti, Giulia Costanzo, Giuseppe Montalto, Anna Licata, Valentina Malerba, Filippo Alessandro Montalto, Antonino Lasco, Giorgio Basile, Antonino Catalano, Lorenzo Malatino, Benedetta Stancanelli, Valentina Terranova, Salvatore Di Marca, Rosario Di Quattro, Lara La Malfa, Rossella Caruso, Patrizia Mecocci, Carmelinda Ruggiero, Virginia Boccardi, Tiziana Meschi, Fulvio Lauretani, Andrea Ticinesi, Antonio Nouvenne, Pietro Minuz, Luigi Fondrieschi, Mario Pirisi, Gian Paolo Fra, Daniele Sola, Massimo Porta, Piero Riva, Roberto Quadri, Erica Larovere, Marco Novelli, 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, Sergio Harari, Chiara Lonati, Mara Cattaneo, Federico Napoli, Carlotta, F., Raffaella, R., Ilaria, A., Alessandro, N., Mannuccio, M. P., Mannucci, P. M., Nobili, A., Pietrangelo, A., Perticone, F., Licata, G., Violi, F., Corazza, G. R., Corrao, S., Marengoni, A., Salerno, F., Cesari, M., Tettamanti, M., Pasina, L., Franchi, C., Cortesi, L., Miglio, G., Ardoino, I., Novella, A., Prisco, D., Silvestri, E., Emmi, G., Bettiol, A., Caterina, C., Biolo, G., Zanetti, M., Guadagni, M., Zaccari, M., Chiuch, M., Vanoli, M., Grignani, G., Pulixi, E. A., Bernardi, M., Bassi, S. L., Santi, L., Zaccherini, G., Lupattelli, G., Mannarino, E., Bianconi, V., Paciullo, F., Alcidi, R., Nuti, R., Valenti, R., Ruvio, M., Cappelli, S., Palazzuoli, A., Girelli, D., Busti, F., Marchi, G., Barbagallo, M., Dominguez, L., Cocita, F., Beneduce, V., Plances, L., Natoli, G., Mularo, S., Raspanti, M., Cavallaro, F., Zoli, M., Lazzari, I., Brunori, M., Fabbri, E., Magalotti, D., Arno, R., Pasini, F. L., Capecchi, P. L., Palasciano, G., Modeo, M. E., Gennaro, C. D., Cappellini, M. D., Maira, D., Di Stefano, V., Fabio, G., Seghezzi, S., Mancarella, M., De Amicis, M. M., De Luca, G., Scaramellini, N., Rossi, P. D., Damanti, S., Clerici, M., Conti, F., Bonini, G., Ottolini, B. B., Di Sabatino, A., Miceli, E., Lenti, M. V., Pisati, M., Dominioni, C. C., Murialdo, G., Marra, A., Cattaneo, F., Pontremoli, R., Beccati, V., Nobili, G., Secchi, M. B., Ghelfi, D., Anastasio, L., Sofia, L., Carbone, M., Cipollone, F., Guagnano, M. T., Valeriani, E., Rossi, I., Mancuso, G., Calipari, D., Bartone, M., Delitala, G., Berria, M., Pes, C., Delitala, A., Muscaritoli, M., Molfino, A., Petrillo, E., Zuccala, G., D'Aurizio, G., Romanelli, G., Zucchelli, A., Manzoni, F., Volpini, 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., Tassone, B., Sesti, G., Interna, 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., Scarinzi, P., Amabile, A., Omenetto, E., Prandini, T., Manfredini, R., Fabbian, F., Boari, B., Giorgi, A. D., Tiseo, R., De Giorgio, R., Paolisso, G., Rizzo, M. R., Borghi, C., Strocchi, E., Ianniello, E., Soldati, M., Sabba, C., Vella, F. S., Suppressa, P., Schilardi, A., Loparco, F., De Vincenzo, G. M., Comitangelo, A., Amoruso, E., Fenoglio, L., Falcetta, A., Bracco, C., Fracanzani, A. L., Fargion, S., Tiraboschi, S., Cespiati, A., Oberti, G., Sigon, G., Peyvandi, F., Rossio, R., Ferrari, B., Colombo, G., Agosti, P., 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., Peasso, P., Favale, E., Poletto, C., Salmi, R., Gaudenzi, P., Perri, L., Landolfi, R., Montalto, M., Mirijello, A., Guasti, L., Castiglioni, L., Maresca, A., Squizzato, A., Campiotti, L., Grossi, A., Bertolotti, M., Mussi, C., Lancellotti, G., Libbra, M. V., Dondi, G., Pellegrini, E., Carulli, L., Galassi, M., Grassi, Y., Perticone, M., Battaglia, R., Filice, M., Maio, R., Stanghellini, V., Ruggeri, E., del Vecchio, S., Salvi, A., Leonardi, R., Damiani, G., Capeci, W., Gabrielli, A., Mattioli, M., Martino, G. P., Biondi, L., Pettinari, P., Ghio, R., Col, A. D., Minisola, S., Colangelo, L., Cilli, M., Labbadia, G., Afeltra, A., Marigliano, B., Pipita, M. E., Castellino, P., Zanoli, L., Pignataro, S., Gennaro, A., Blanco, J., 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., Tarsitani, P., Castello, R., Pasino, M., Ceda, G. P., Maggio, M. G., Morganti, S., Artoni, A., Del Giacco, S., Firinu, D., Losa, F., Paoletti, G., Costanzo, G., Montalto, G., Licata, A., Malerba, V., Montalto, F. A., Lasco, A., Basile, G., Catalano, A., Malatino, L., Stancanelli, B., Terranova, V., Di Marca, S., Di Quattro, R., La Malfa, L., Caruso, R., Mecocci, P., Ruggiero, C., Boccardi, V., Meschi, T., Lauretani, F., Ticinesi, A., Nouvenne, A., Minuz, P., Fondrieschi, L., Pirisi, M., Fra, G. P., Sola, D., Porta, M., Riva, P., Quadri, R., Larovere, E., Novelli, M., 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., Napoli, F., Carlotta F., Raffaella R., Ilaria A., Alessandro N., Mannuccio M.P., Mannucci P.M., Nobili A., Pietrangelo A., Perticone F., Licata G., Violi F., Corazza G.R., Corrao S., Marengoni A., Salerno F., Cesari M., Tettamanti M., Pasina L., Franchi C., Cortesi L., Miglio G., Ardoino I., Novella A., Prisco D., Silvestri E., Emmi G., Bettiol A., Caterina C., Biolo G., Zanetti M., Guadagni M., Zaccari M., Chiuch M., Vanoli M., Grignani G., Pulixi E.A., Bernardi M., Bassi S.L., Santi L., Zaccherini G., Lupattelli G., Mannarino E., Bianconi V., Paciullo F., Alcidi R., Nuti R., Valenti R., Ruvio M., Cappelli S., Palazzuoli A., Girelli D., Busti F., Marchi G., Barbagallo M., Dominguez L., Cocita F., Beneduce V., Plances L., Natoli G., Mularo S., Raspanti M., Cavallaro F., Zoli M., Lazzari I., Brunori M., Fabbri E., Magalotti D., Arno R., Pasini F.L., Capecchi P.L., Palasciano G., Modeo M.E., Gennaro C.D., Cappellini M.D., Maira D., Di Stefano V., Fabio G., Seghezzi S., Mancarella M., De Amicis M.M., De Luca G., Scaramellini N., Rossi P.D., Damanti S., Clerici M., Conti F., Bonini G., Ottolini B.B., Di Sabatino A., Miceli E., Lenti M.V., Pisati M., Dominioni C.C., Murialdo G., Marra A., Cattaneo F., Pontremoli R., Beccati V., Nobili G., Secchi M.B., Ghelfi D., Anastasio L., Sofia L., Carbone M., Cipollone F., Guagnano M.T., Valeriani E., Rossi I., Mancuso G., Calipari D., Bartone M., Delitala G., Berria M., Pes C., Delitala A., Muscaritoli M., Molfino A., Petrillo E., Zuccala G., D'Aurizio G., Romanelli G., Zucchelli A., Manzoni F., Volpini 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., Tassone B., Sesti G., Interna 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., Scarinzi P., Amabile A., Omenetto E., Prandini T., Manfredini R., Fabbian F., Boari B., Giorgi A.D., Tiseo R., De Giorgio R., Paolisso G., Rizzo M.R., Borghi C., Strocchi E., Ianniello E., Soldati M., Sabba C., Vella F.S., Suppressa P., Schilardi A., Loparco F., De Vincenzo G.M., Comitangelo A., Amoruso E., Fenoglio L., Falcetta A., Bracco C., Fracanzani A.L., Fargion S., Tiraboschi S., Cespiati A., Oberti G., Sigon G., Peyvandi F., Rossio R., Ferrari B., Colombo G., Agosti P., 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., Peasso P., Favale E., Poletto C., Salmi R., Gaudenzi P., Perri L., Landolfi R., Montalto M., Mirijello A., Guasti L., Castiglioni L., Maresca A., Squizzato A., Campiotti L., Grossi A., Bertolotti M., Mussi C., Lancellotti G., Libbra M.V., Dondi G., Pellegrini E., Carulli L., Galassi M., Grassi Y., Perticone M., Battaglia R., FIlice M., Maio R., Stanghellini V., Ruggeri E., del Vecchio S., Salvi A., Leonardi R., Damiani G., Capeci W., Gabrielli A., Mattioli M., Martino G.P., Biondi L., Pettinari P., Ghio R., Col A.D., Minisola S., Colangelo L., Cilli M., Labbadia G., Afeltra A., Marigliano B., Pipita M.E., Castellino P., Zanoli L., Pignataro S., Gennaro A., Blanco J., 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., Tarsitani P., Castello R., Pasino M., Ceda G.P., Maggio M.G., Morganti S., Artoni A., Del Giacco S., Firinu D., Losa F., Paoletti G., Costanzo G., Montalto G., Licata A., Malerba V., Montalto F.A., Lasco A., Basile G., Catalano A., Malatino L., Stancanelli B., Terranova V., Di Marca S., Di Quattro R., La Malfa L., Caruso R., Mecocci P., Ruggiero C., Boccardi V., Meschi T., Lauretani F., Ticinesi A., Nouvenne A., Minuz P., Fondrieschi L., Pirisi M., Fra G.P., Sola D., Porta M., Riva P., Quadri R., Larovere E., Novelli M., 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., Napoli F., Carlotta, F, Raffaella, R, Ilaria, A, Alessandro, N, Mannuccio, M, Mannucci, P, Nobili, A, Pietrangelo, A, Perticone, F, Licata, G, Violi, F, Corazza, G, Corrao, S, Marengoni, A, Salerno, F, Cesari, M, Tettamanti, M, Pasina, L, Franchi, C, Cortesi, L, Miglio, G, Ardoino, I, Novella, A, Prisco, D, Silvestri, E, Emmi, G, Bettiol, A, Caterina, C, Biolo, G, Zanetti, M, Guadagni, M, Zaccari, M, Chiuch, M, Vanoli, M, Grignani, G, Pulixi, E, Bernardi, M, Bassi, S, Santi, L, Zaccherini, G, Lupattelli, G, Mannarino, E, Bianconi, V, Paciullo, F, Alcidi, R, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Palazzuoli, A, Girelli, D, Busti, F, Marchi, G, Barbagallo, M, Dominguez, L, Cocita, F, Beneduce, V, Plances, L, Natoli, G, Mularo, S, Raspanti, M, Cavallaro, F, Zoli, M, Lazzari, I, Brunori, M, Fabbri, E, Magalotti, D, Arno, R, Pasini, F, Capecchi, P, Palasciano, G, Modeo, M, Gennaro, C, Cappellini, M, Maira, D, Di Stefano, V, Fabio, G, Seghezzi, S, Mancarella, M, De Amicis, M, De Luca, G, Scaramellini, N, Rossi, P, Damanti, S, Clerici, M, Conti, F, Bonini, G, Ottolini, B, Di Sabatino, A, Miceli, E, Lenti, M, Pisati, M, Dominioni, C, Murialdo, G, Marra, A, Cattaneo, F, Pontremoli, R, Beccati, V, Nobili, G, Secchi, M, Ghelfi, D, Anastasio, L, Sofia, L, Carbone, M, Cipollone, F, Guagnano, M, Valeriani, E, Rossi, I, Mancuso, G, Calipari, D, Bartone, M, Delitala, G, Berria, M, Pes, C, Delitala, A, Muscaritoli, M, Molfino, A, Petrillo, E, Zuccala, G, D'Aurizio, G, Romanelli, G, Zucchelli, A, Manzoni, F, Volpini, 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, Tassone, B, Sesti, G, Interna, M, Serra, M, Bleve, M, Gasbarrone, L, Sajeva, M, Brucato, A, Ghidoni, S, Fabris, F, Bertozzi, I, Bogoni, G, Rabuini, M, Cosi, E, Scarinzi, P, Amabile, A, Omenetto, E, Prandini, T, Manfredini, R, Fabbian, F, Boari, B, Giorgi, A, Tiseo, R, De Giorgio, R, Paolisso, G, Rizzo, M, Borghi, C, Strocchi, E, Ianniello, E, Soldati, M, Sabba, C, Vella, F, Suppressa, P, Schilardi, A, Loparco, F, De Vincenzo, G, Comitangelo, A, Amoruso, E, Fenoglio, L, Falcetta, A, Bracco, C, Fracanzani, A, Fargion, S, Tiraboschi, S, Cespiati, A, Oberti, G, Sigon, G, Peyvandi, F, Rossio, R, Ferrari, B, Colombo, G, Agosti, P, 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, Peasso, P, Favale, E, Poletto, C, Salmi, R, Gaudenzi, P, Perri, L, Landolfi, R, Montalto, M, Mirijello, A, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Campiotti, L, Grossi, A, Bertolotti, M, Mussi, C, Lancellotti, G, Libbra, M, Dondi, G, Pellegrini, E, Carulli, L, Galassi, M, Grassi, Y, Perticone, M, Battaglia, R, Filice, M, Maio, R, Stanghellini, V, Ruggeri, E, del Vecchio, S, Salvi, A, Leonardi, R, Damiani, G, Capeci, W, Gabrielli, A, Mattioli, M, Martino, G, Biondi, L, Pettinari, P, Ghio, R, Col, A, Minisola, S, Colangelo, L, Cilli, M, Labbadia, G, Afeltra, A, Marigliano, B, Pipita, M, Castellino, P, Zanoli, L, Pignataro, S, Gennaro, A, Blanco, J, 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, Tarsitani, P, Castello, R, Pasino, M, Ceda, G, Maggio, M, Morganti, S, Artoni, A, Del Giacco, S, Firinu, D, Losa, F, Paoletti, G, Costanzo, G, Montalto, G, Licata, A, Malerba, V, Montalto, F, Lasco, A, Basile, G, Catalano, A, Malatino, L, Stancanelli, B, Terranova, V, Di Marca, S, Di Quattro, R, La Malfa, L, Caruso, R, Mecocci, P, Ruggiero, C, Boccardi, V, Meschi, T, Lauretani, F, Ticinesi, A, Nouvenne, A, Minuz, P, Fondrieschi, L, Pirisi, M, Fra, G, Sola, D, Porta, M, Riva, P, Quadri, R, Larovere, E, Novelli, M, 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, and Napoli, F
Subjects: Male, medicine.medical_specialty, Socio-culturale, Inappropriate Prescribing, Potentially inappropriate medication, older, Practice Patterns, depression, hospitalized patients, drugs, elderly, drugs, antidepressivi anziano, Polypharmacy | Inappropriate Prescribing | Medications PIMs, antidepressant agent, escitalopram, paroxetine, Internal Medicine, medicine, Hospital discharge, older, Escitalopram, Humans, LS4_4, Medical prescription, Practice Patterns, Physicians', Depression (differential diagnoses), Aged, Polypharmacy, Sertraline, Physicians', antidepressant, business.industry, Trazodone, hospitalized patients, Antidepressive Agents, Hospitalization, Acute Disease, Female, Italy, antidepressants, Emergency medicine, depression, Polypharmacy , Inappropriate Prescribing , Medications, PIM, Delirium, Potentially inappropriate medication, medicine.symptom, business, medicine.drug
Abstract: Depression is often under-recognized in older patients, even if antidepressants (AD) are commonly prescribed, with a prevalence of use that increase with ageing [ 1 ]. Nevertheless, even if a diagnosis of depression is established, inappropriate treatment can occur [ 2 ]. Beers criteria are the most widely screening tools used to detect inappropriate prescription of drugs in people aged 65 years or more [ 3 ]. Since 2010, attempts to adapt the Beers' criteria have been made in Europe [ 4 , 5 ]. Tricyclic drugs are the ADs to be always avoided in the elderly, owing to their anticholinergic side effects, such as cognitive impairment, delirium, urinary retention and falls [ 3 ]. Selective serotonin reuptake inhibitors (SSRIs) should be used with caution because they can cause or exacerbate hyponatraemia [ 3 ]. To our knowledge no studies have been conducted on recent data collected in hospitalized older patients in order to assess the appropriateness of prescription of ADs. With this background, the objectives of this study were to investigate the prevalence of AD use and prescription appropriateness, according to the above-cited criteria, in a large cohort of older patients hospitalized in Italian internal medicine and geriatric wards from 2010 to 2017.
Published: 2019

44. Use and prescription appropriateness of drugs for peptic ulcer and gastrooesophageal reflux disease in hospitalized older people

Author: Carlotta, Franchi, Pier Mannuccio Mannucci, Alessandro, Nobili, Ilaria, Ardoino, Domenico, Prisco, Elena, Silvestri, Giacomo, Emmi, Alessandra, Bettiol, Cenci, Caterina, Gianni, Biolo, Michela, Zanetti, Martina, Guadagni, Michele, Zaccari, Massimiliano, Chiuch, Massimo, Vanoli, Giulia, Grignani, Edoardo Alessandro Pulixi, Mauro, Bernardi, Silvia Li Bassi, Luca, Santi, Giacomo, Zaccherini, Graziana, Lupattelli, Elmo, Mannarino, Vanessa, Bianconi, Francesco, Paciullo, Riccardo, Alcidi, Ranuccio, Nuti, Roberto, Valenti, Martina, Ruvio, Silvia, Cappelli, Alberto, Palazzuoli, Domenico, Girelli, Fabiana, Busti, Giacomo, Marchi, Mario, Barbagallo, Ligia, Dominguez, Floriana, Cocita, Vincenza, Beneduce, Lidia, Plances, Salvatore, Corrao, Giuseppe, Natoli, Salvatore, Mularo, Massimo, Raspanti, Federica, Cavallaro, Marco, Zoli, Ilaria, Lazzari, Mattia, Brunori, Elisa, Fabbri, Donatella, Magalotti, Raffaella, Arnò, 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, Margherita Migone De Amicis, Giacomo De Luca, Natalia, Scaramellini, Matteo, Cesari, Paolo Dionigi Rossi, Sarah, Damanti, Marta, Clerici, Federica, Conti, Giulia, Bonini, Barbara Brignolo Ottolini, Antonio Di Sabatino, Emanuela, Miceli, Marco Vincenzo Lenti, Martina, Pisati, Costanza Caccia Dominioni, Giovanni, Murialdo, Alessio, Marra, Federico, Cattaneo, Roberto, Pontremoli, Valentina, Beccati, Giulia, Nobili, Maria Beatrice Secchi, Davide, Ghelfi, Luigi, Anastasio, Lucia, Sofia, Maria, Carbone, Francesco, Cipollone, Maria Teresa Guagnano, Emanuele, Valeriani, Ilaria, Rossi, Gerardo, Mancuso, Daniela, Calipari, Mosè, Bartone, Giuseppe, Delitala, Maria, Berria, Chiara, Pes, Alessandro, Delitala, Maurizio, Muscaritoli, Alessio, Molfino, Enrico, Petrillo, Giuseppe, Zuccalà, Gabriella, D’Aurizio, Giuseppe, Romanelli, Alessandra, Marengoni, Alberto, Zucchelli, Francesca, Manzoni, Andrea, Volpini, 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, Bruno, Tassone, Giorgio, Sesti, 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, Paolo, Scarinzi, Annalisa, Amabile, Elisabetta, Omenetto, Tancredi, Prandini, Manfredini, Roberto, Fabbian, Fabio, Benedetta, Boari, Alfredo De Giorgi, Ruana, Tiseo, DE GIORGIO, Roberto, Giuseppe, Paolisso, Maria Rosaria Rizzo, Claudio, Borghi, Enrico, Strocchi, Eugenia, Ianniello, Mario, Soldati, Carlo, Sabbà, Francesco Saverio Vella, Patrizia, Suppressa, Pasquale, Agosti, Andrea, Schilardi, Francesca, Loparco, Giovanni Michele De Vincenzo, Alessio, Comitangelo, Emanuele, Amoruso, Luigi, Fenoglio, Andrea, Falcetta, Christian, Bracco, Fracanzani Silvia Fargion, Anna L., Silvia, Tiraboschi, Annalisa, Cespiati, Giovanna, Oberti, Giordano, Sigon, Flora, Peyvandi, Raffaella, Rossio, Barbara, Ferrari, Giulia, Colombo, Valter, Monzani, Valeria, Savojardo, Christian, Folli, Giuliana, Ceriani, Francesco, Salerno, 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, Paolo, Peasso, Edoardo, Favale, Cesare, Poletto, Raffaella, Salmi, Piergiorgio, Gaudenzi, Francesco, Violi, Ludovica, Perri, Raffaele, Landolfi, Massimo, Montalto, Antonio, Mirijello, Luigina, Guasti, Luana, Castiglioni, Andrea, Maresca, Alessandro, Squizzato, Leonardo, Campiotti, Alessandra, Grossi, Marco, Bertolotti, Chiara, Mussi, Giulia, Lancellotti, Maria Vittoria Libbra, Giulia, Dondi, Elisa, Pellegrini, Lucia, Carulli, Matteo, Galassi, Yasmine, Grassi, Francesco, Perticone, Maria, Perticone, Rosa, Battaglia, Marco, Filice, Raffaele, Maio, Vincenzo, Stanghellini, Eugenio, Ruggeri, Sara del Vecchio, Andrea, Salvi, Roberto, Leonardi, Giampaolo, Damiani, William, Capeci, Armando, Gabrielli, Massimo, Mattioli, Giuseppe Pio Martino, Lorenzo, Biondi, Pietro, Pettinari, Riccardo, Ghio, Anna Dal Col, Salvatore, Minisola, Luciano, Colangelo, Mirella, Cilli, Giancarlo, Labbadia, Antonella, Afeltra, Benedetta, Marigliano, Maria Elena Pipita, Pietro, Castellino, Luca, Zanoli, Samuele, Pignataro, Alfio, Gennaro, Julien, Blanco, 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, Patrizia, Tarsitani, Roberto, Castello, Michela, Pasino, Gian Paolo Ceda, Marcello Giuseppe Maggio, Simonetta, Morganti, Andrea, Artoni, Stefano Del Giacco, Davide, Firinu, Francesca, Losa, Giovanni, Paoletti, Giulia, Costanzo, Giuseppe, Montalto, Anna, Licata, Valentina, Malerba, Filippo Alessandro Montalto, Antonino, Lasco, Giorgio, Basile, Antonino, Catalano, Lorenzo, Malatino, Benedetta, Stancanelli, Valentina, Terranova, Salvatore Di Marca, Rosario Di Quattro, Lara La Malfa, Rossella, Caruso, Patrizia, Mecocci, Carmelinda, Ruggiero, Virginia, Boccardi, Tiziana, Meschi, Fulvio, Lauretani, Andrea, Ticinesi, Antonio, Nouvenne, Pietro, Minuz, Luigi, Fondrieschi, Mario, Pirisi, Gian Paolo Fra, Daniele, Sola, Massimo, Porta, Piero, Riva, Roberto, Quadri, Erica, Larovere, Marco, Novelli, 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, Sergio, Harari, Chiara, Lonati, Mara, Cattaneo, and Federico, Napoli.
Subjects: Drug, Male, medicine.medical_specialty, Peptic Ulcer, Appropriateness, Drug prescription, Hospital setting, Older people, Proton pump inhibitors, Prescription Drugs, Proton pump inhibitors, media_common.quotation_subject, Drug prescription, Socio-culturale, Context (language use), Inappropriate Prescribing, 030226 pharmacology & pharmacy, Drug Prescriptions, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Gastrooesophageal reflux disease, medicine, Prevalence, LS7_3, Humans, Pharmacology (medical), Appropriateness, 030212 general & internal medicine, Medical prescription, Reimbursement, media_common, Aged, Pharmacology, biology, business.industry, General Medicine, Helicobacter pylori, biology.organism_classification, medicine.disease, digestive system diseases, Drug Utilization, Patient Discharge, Hospitalization, Cross-Sectional Studies, Italy, Peptic ulcer, GERD, Gastroesophageal Reflux, Female, Hospital setting, Older people, business
Abstract: The aims of this study were to assess the prevalence of use and prescription appropriateness of drugs for peptic ulcer and gastrooesophageal reflux disease (GERD) at hospital admission and discharge. Patients aged 65 years or more hospitalized from 2010 to 2016 in 101 Italian internal medicine and geriatric wards in the context of the REPOSI register were scrutinized to assess if they were prescribed with drugs for peptic ulcer and GERD at hospital admission and discharge. Appropriateness of prescription was assessed considering the presence of specific conditions (i.e., history of peptic ulcer or gastrointestinal hemorrhages, advanced age, Helicobacter Pylori) or gastro-toxic drug combinations, according to the criteria provided by the reimbursement rules of the Agenzia Italiana del Farmaco (NOTA 1 and 48). Among 4715 enrolled patients, 3899 were discharged alive. At hospital discharge, 2412 (61.9%, 95%CI: 60.3–63.4%) patients were prescribed with drugs for peptic ulcer and GERD, a 12% of increase from hospital admission. Almost half of the patients (N = 1776, 45.6%, 95%CI: 44.0–47.1%) were inappropriately prescribed or not prescribed: among the drugs for peptic ulcer and GERD users, about 60% (1444/2412) were overprescribed, and among nonusers, 22% (332/1487) were underprescribed. Among patients newly prescribed at hospital discharge, 60% (392/668) were inappropriately prescribed. The appropriateness of drugs for peptic ulcer and GERD therapy decreased by 3% from hospital admission to discharge. Hospitalization missed the opportunity to improve the quality of prescription of this class of drug.
Published: 2019

45. Inappropriate prescription of benzodiazepines in acutely hospitalized older patients

Author: Carlotta, Franchi, Raffaella, Rossio, Ilaria, Ardoino, Pier Mannuccio Mannucci, Alessandro, Nobili, Domenico, Prisco, Elena, Silvestri, Giacomo, Emmi, Alessandra, Bettiol, Caterina, Cenci, Gianni, Biolo, Michela, Zanetti, Martina, Guadagni, Michele, Zaccari, Massimiliano, Chiuch, Massimo, Vanoli, Giulia, Grignani, Edoardo Alessandro Pulixi, Mauro, Bernardi, Silvia Li Bassi, Luca, Santi, Giacomo, Zaccherini, Graziana, Lupattelli, Elmo, Mannarino, Vanessa, Bianconi, Francesco, Paciullo, Riccardo, Alcidi, Ranuccio, Nuti, Roberto, Valenti, Martina, Ruvio, Silvia, Cappelli, Alberto, Palazzuoli, Domenico, Girelli, Fabiana, Busti, Giacomo, Marchi, Mario, Barbagallo, Ligia, Dominguez, Floriana, Cocita, Vincenza, Beneduce, Lidia, Plances, Salvatore, Corrao, Giuseppe, Natoli, Salvatore, Mularo, Massimo, Raspanti, Federica, Cavallaro, Marco, Zoli, Ilaria, Lazzari, Mattia, Brunori, Elisa, Fabbri, Donatella, Magalotti, Raffaella, Arnò, 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, Margherita Migone De Amicis, Giacomo De Luca, Natalia, Scaramellini, Matteo, Cesari, Paolo Dionigi Rossi, Sarah, Damanti, Marta, Clerici, Federica, Conti, Giulia, Bonini, Barbara Brignolo Ottolini, Antonio Di Sabatino, Emanuela, Miceli, Marco Vincenzo Lenti, Martina, Pisati, Costanza Caccia Dominioni, Giovanni, Murialdo, Alessio, Marra, Federico, Cattaneo, Roberto, Pontremoli, Valentina, Beccati, Giulia, Nobili, Maria Beatrice Secchi, Davide, Ghelfi, Luigi, Anastasio, Lucia, Sofia, Maria, Carbone, Francesco, Cipollone, Maria Teresa Guagnano, Emanuele, Valeriani, Ilaria, Rossi, Gerardo, Mancuso, Daniela, Calipari, Mosè, Bartone, Giuseppe, Delitala, Maria, Berria, Chiara, Pes, Alessandro, Delitala, Maurizio, Muscaritoli, Alessio, Molfino, Enrico, Petrillo, Giuseppe, Zuccalà, Gabriella, D’Aurizio, Giuseppe, Romanelli, Alessandra, Marengoni, Alberto, Zucchelli, Francesca, Manzoni, Andrea, Volpini, 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, Bruno, Tassone, Giorgio, Sesti, 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, Paolo, Scarinzi, Annalisa, Amabile, Elisabetta, Omenetto, Tancredi, Prandini, Manfredini, Roberto, Fabbian, Fabio, Benedetta, Boari, Alfredo De Giorgi, Ruana, Tiseo, DE GIORGIO, Roberto, Giuseppe, Paolisso, Maria Rosaria Rizzo, Claudio, Borghi, Enrico, Strocchi, Eugenia, Ianniello, Mario, Soldati, Carlo, Sabbà, Francesco Saverio Vella, Patrizia, Suppressa, Pasquale, Agosti, Andrea, Schilardi, Francesca, Loparco, Giovanni Michele De Vincenzo, Alessio, Comitangelo, Emanuele, Amoruso, Luigi, Fenoglio, Andrea, Falcetta, Christian, Bracco, Fracanzani, Anna L., Silvia, Fargion, Silvia, Tiraboschi, Annalisa, Cespiati, Giovanna, Oberti, Giordano, Sigon, Flora, Peyvandi, Barbara, Ferrari, Giulia, Colombo, Valter, Monzani, Valeria, Savojardo, Christian, Folli, Giuliana, Ceriani, Francesco, Salerno, 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, Paolo, Peasso, Edoardo, Favale, Cesare, Poletto, Raffaella, Salmi, Piergiorgio, Gaudenzi, Francesco, Violi, Ludovica, Perri, Raffaele, Landolfi, Massimo, Montalto, Antonio, Mirijello, Luigina, Guasti, Luana, Castiglioni, Andrea, Maresca, Alessandro, Squizzato, Leonardo, Campiotti, Alessandra, Grossi, Marco, Bertolotti, Chiara, Mussi, Giulia, Lancellotti, Maria Vittoria Libbra, Giulia, Dondi, Elisa, Pellegrini, Lucia, Carulli, Matteo, Galassi, Yasmine, Grassi, Francesco, Perticone, Maria, Perticone, Rosa, Battaglia, Marco, Filice, Raffaele, Maio, Vincenzo, Stanghellini, Eugenio, Ruggeri, Sara del Vecchio, Andrea, Salvi, Roberto, Leonardi, Giampaolo, Damiani, William, Capeci, Armando, Gabrielli, Massimo, Mattioli, Giuseppe Pio Martino, Lorenzo, Biondi, Pietro, Pettinari, Riccardo, Ghio, Anna Dal Col, Salvatore, Minisola, Luciano, Colangelo, Mirella, Cilli, Giancarlo, Labbadia, Antonella, Afeltra, Benedetta, Marigliano, Maria Elena Pipita, Pietro, Castellino, Luca, Zanoli, Samuele, Pignataro, Alfio, Gennaro, Julien, Blanco, 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, Patrizia, Tarsitani, Roberto, Castello, Michela, Pasino, Gian Paolo Ceda, Marcello Giuseppe Maggio, Simonetta, Morganti, Andrea, Artoni, Stefano Del Giacco, Davide, Firinu, Francesca, Losa, Giovanni, Paoletti, Giulia, Costanzo, Giuseppe, Montalto, Anna, Licata, Valentina, Malerba, Filippo Alessandro Montalto, Antonino, Lasco, Giorgio, Basile, Antonino, Catalano, Lorenzo, Malatino, Benedetta, Stancanelli, Valentina, Terranova, Salvatore Di Marca, Rosario Di Quattro, Lara La Malfa, Rossella, Caruso, Patrizia, Mecocci, Carmelinda, Ruggiero, Virginia, Boccardi, Tiziana, Meschi, Fulvio, Lauretani, Andrea, Ticinesi, Antonio, Nouvenne, Pietro, Minuz, Luigi, Fondrieschi, Mario, Pirisi, Gian Paolo Fra, Daniele, Sola, Massimo, Porta, Piero, Riva, Roberto, Quadri, Erica, Larovere, Marco, Novelli, 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, Sergio, Harari, Chiara, Lonati, Mara, Cattaneo, Federico, Napoli., Franchi, C., Rossio R., Ardoino I., Mannucci P. M., Nobili A., and Rinaldi, Luca
Subjects: Male, medicine.medical_specialty, Beers Criteria, Socio-culturale, Inappropriate Prescribing, Hypnotic, 03 medical and health sciences, Benzodiazepines, 0302 clinical medicine, Older patients, Older peopl, Internal medicine and geriatric wards, Appropriateness of prescription, Benzodiazepine, Hypnotics, Older people, REPOSI register, 80 and over, Medicine, Humans, Pharmacology (medical), Medical prescription, Biological Psychiatry, Aged, Pharmacology, Aged, 80 and over, business.industry, Settore MED/09 - MEDICINA INTERNA, Patient Discharge, 030227 psychiatry, Hospitalization, Psychiatry and Mental health, Internal medicine and geriatric ward, Increased risk, Neurology, Hospital admission, Emergency medicine, Female, Neurology (clinical), business, Nursing homes, Appropriateness of prescription, Benzodiazepine, Hypnotics, Internal medicine and geriatric wards, Older peopl, 030217 neurology & neurosurgery, Human
Abstract: Benzodiazepines (BDZs) are widely prescribed in older people. The aims of the study are to assess the prevalence of inappropriate prescription of BZDs and the associated factors in acutely hospitalized older patients. Patients aged 65 years or more hospitalized from 2010 to 2017 in more than 100 Italian internal medicine and geriatric wards in the frame of the REPOSI register were included if prescribed with BDZs at hospital admission or discharge. Appropriateness of prescription was assessed according to the 2015 Beers criteria and their modified French and German versions. Among 4681 patients discharged from hospital, 15% (N = 710) were discharged with BDZs, and 62% of them (N = 441, 95% CI: 58.5%–65.6%) were inappropriately prescribed, being prescribed with BDZ to be always avoided in the elderly (45%), at higher doses than recommended (31%) or with no appropriate clinical conditions (19%). From admission to discharge the prevalence of inappropriate BDZ prescription decreased by 4%, but 62% of patients inappropriately prescribed at admission were still inappropriately prescribed at discharge. Among the 179 patients first prescribed at the time of discharge, half were inappropriately prescribed. Being female (OR 1.32, 95%CI 0.95–1.85), enrolled in REPOSI during the years 2016 and 2017 (OR 1.94, 95%CI 1.10–3.39; OR 1.57, 95%CI 0.95–2.58) and living in nursing homes (OR 2.04, 95%CI 0.95–4.37) were associated with an increased risk to be inappropriately prescribed. This study shows a high prevalence of inappropriate use of BDZ in acutely hospitalized older patients both at hospital admission and discharge.
Published: 2019

46. 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

47. A GENETIC ALGORITHM-BASED APPROACH TO OPTIMIZE THE CONSTRUCTION OF A FRAILTY INDEX

Author: Alberto Zucchelli, Alessandra Marengoni, Laura Fratiglioni, Graziano Onder, Debora Rizzuto, Amaia Calderón-Larrañaga, and Davide L. Vetrano
Subjects: Abstracts, Health (social science), Computer science, Genetic algorithm, Frailty Index, Session 3325 (Poster), Data mining, Frailty and Sarcopenia, Life-span and Life-course Studies, computer.software_genre, Health Professions (miscellaneous), computer
Abstract: The frailty index (FI) is a reliable prognostic indicator based on an individual clinical and functional deficits, which is strongly associated with poor outcomes. We hypothesize that an optimization algorithm may help to select the best candidate deficits to generate a highly-predictive FI. We aimed to optimize the predictive accuracy (area under the curve; AUC) of a FI employing a “genetic algorithm”, an iterative meta-heuristic that selects and recombines the most accurate FIs among randomly-generated ones. We used data from 3363 individuals aged 60+ enrolled in the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K). To avoid overfitting, the algorithm was run on a randomly-chosen subsample (70%) of 10 imputed datasets. About 825,000 FIs were built, evaluated, and recombined. The best genetic algorithm-based FI (ga-FI) was compared in terms of 3- and 6-year mortality prediction with a clinically-generated FI (c-FI) in the remaining 30% of the data. Ga-FI showed better AUCs in comparison to the c-FI, overall and in all age and sex subsamples. Several sensitivity analyses were carried out. The major AUC improvement was seen among participants aged
Published: 2019

48. ASSOCIATION OF FRAILTY WITH FIFTEEN-YEAR MORTALITY IN OLDER ADULTS WITHOUT MULTIMORBIDITY

Author: Giulia Grande, Alberto Zucchelli, Laura Fratiglioni, Davide L. Vetrano, Amaia Calderón-Larrañaga, G. Romanelli, Alessandra Marengoni, and Debora Rizzuto
Subjects: Gerontology, Abstracts, Health (social science), business.industry, Multimorbidity, Medicine, Life-span and Life-course Studies, business, Association (psychology), Health Professions (miscellaneous)
Abstract: Frailty and multimorbidity are both strongly associated with poor health-related outcomes, including mortality. As multimorbidity is one of the major determinant of frailty, we aimed to explore whether and to what extent frailty without multimorbidity plays an independent role in shortening life. Using data from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), we grouped 1115 subjects free from multimorbidity (affected by less than two chronic diseases). We assessed their frailty-status according to Fried’s frailty phenotype (frail, prefrail, and robust). Vital status was retrieved up to 15 years from the Swedish National Cause of Death Register. We estimated the association between frailty and mortality in 5-year intervals using piecewise proportional hazard regression models. Among the subjects free from multimorbidity, 424 (38%) were pre-frail and 19 (2%) were frail. During 15-year follow-up, 263 (24%) participants died. Within the first 5 years, prefrail and frail subjects had a more than doubled risk of death, compared to robust ones (HR for pre-frailty 2.08; HR for frailty 2.69 - p
Published: 2018

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