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1. Venous thromboembolism and COVID-19: a single center experience from an academic tertiary referral hospital of Northern Italy

Author

Melazzini, Federica, Colaneri, Marta, Fumoso, Federica, Freddi, Giulia, Lenti, Marco Vincenzo, Pieri, Teresa Chiara, Piloni, Davide, Noris, Patrizia, Pieresca, Carla, Preti, Paola Stefania, Russo, Mariaconcetta, Corsico, Angelo, Tavazzi, Guido, Baldanti, Fausto, Triarico, Antonio, Mojoli, Francesco, Bruno, Raffaele, Di Sabatino, Antonio, Aronico, Nicola, Bergamaschi, Gaetano, Bertolino, Giampiera, Codega, Silvia, Costanzo, Filippo, Cresci, Roberto, Delliponti, Angela, Derosa, Giuseppe, Di Stefano, Michele, Falaschi, Francesco, Iadarola, Carmine, Lovati, Elisabetta, Lucotti, Pietro Carlo, Martignoni, Alessandra, Mengoli, Caterina, Miceli, Emanuela, Mugellini, Amedeo, Muggia, Chiara, Pagani, Elisabetta, Palumbo, Ilaria, Pecci, Alessandro, Perrone, Tiziano, Sgarlata, Carmelo, Siciliani, Luisa, Staniscia, Andrea, Vjera, Francesca Torello, Achilli, Giovanna, Agostinelli, Andrea, Antoci, Valentina, Ballesio, Alessia, Banfi, Francesco, Barteselli, Chiara, Benedetti, Irene, de Andreis, Federica Borrelli, Brattoli, Michele, Calabretta, Francesca, Cambiè, Ginevra, Canta, Roberta, Conca, Federico, Coppola, Luigi, Cremonte, Elisa Maria, Croce, Gabriele, Del Rio, Virginia, Di Terlizzi, Francesco, Ferrari, Maria Giovanna, Ferrari, Sara, Fiengo, Anna, Forni, Tommaso, Frigerio, Chiara, Fusco, Alessandra, Gabba, Margherita, Garolfi, Matteo, Gentile, Antonella, Gori, Giulia, Grandi, Giacomo, Grimaldi, Paolo, Lampugnani, Alice, Lapia, Francesco, Lepore, Federica, Lettieri, Gianluca, Mambella, Jacopo, Mercanti, Chiara, Merli, Stefania, Mordà, Francesco, Nardone, Alba, Pace, Luca, Padovini, Lucia, Parodi, Alessandro, Pellegrino, Ivan, Pitotti, Lavinia, Reduzzi, Margherita, Rigano, Giovanni, Romito, Giovanni, Rotola, Giorgio, Sabatini, Umberto, Salvi, Lucia, Santacroce, Giovanni, Savioli, Jessica, Soriano, Simone, Spataro, Carmine, Stefani, Debora, Aliberti, Anna Rita, Amatu, Alessandro, Anfossi, Laura, Arisi, Eric, Baldi, Chiara, Belliato, Mirko, Bellini, Lorenzo, Benzi, Alberto, Bichisao, Germana, Bolongaro, Antonia, Bottazzi, Andrea, Broglia, Federica, Bruschi, Giacomo, Caneva, Luca, Capaccio, Emanuele, Carboni, Valeria, Cavalloro, Fabrizio, Ciceri, Maria, Civardi, Luca, Delmonte, Maria Paola, Domenegati, Elisa Lucia, Ferrari, Federica, Ferrari, Fiorenza, Ferrari, Marta, Fuardo, Marinella, Gerletti, Maddalena Margherita, Gualdana, Simonetta, Ilardi, Marcella, Lo Coco, Claudia, Maggio, Giuseppe, Mascia, Maria Benedetta, Mencherini, Simonetta, Merati, Paola Maria, Mongodi, Silvia, Mori, Anna Maria, Morgante, Federica, Niebel, Thekla Larissa, Noli, Silvano, Orlando, Anita, Pagani, Michele, Passador, Debora, Pellicori, Simona, Perotti, Luciano, Picchioni, Raffaella, Poma, Silvia, Pozzi, Marco, Preti, Emanuela, Puce, Roberta, Radolovich, Danila Katia, Ragni, Gianluca, Repossi, Filippo, Riccardi, Francesca, Rizzardi, Roberto, Rodi, Giuseppe, Roldi, Emanuela, Rossi, Cristina, Sala Gallini, Giuseppe, Sciutti, Fabio, Sportiello, Debora, Ticozzelli, Giulia, Visconti, Federico, Zizzi, Silvia, Bagliani, Alessandro, Belotti, Corrado, Bossi, Chiara, Colombo, Andrea, Colombo, Costanza Natalia Julia, Cremascoli, Luca, Dammassa, Valentino, Discepoli, Roberto, Garlando, Maria Adelaide, Grandini, Filippo, Pellegrini, Andrea, Quaranta, Cecilia, Stella, Andrea, Torresani, Francesco, Mondelli, Mario, Brunetti, Enrico, Di Matteo, Angela, Seminari, Elena, Maiocchi, Laura, Zuccaro, Valentina, Pagnucco, Layla, Mariani, Bianca, Ludovisi, Serena, Lissandrin, Raffaella, Parisi, Aldo, Sacchi, Paolo, Patruno, Savino F. A., Michelone, Giuseppe, Gulminetti, Roberto, Zanaboni, Domenico, Novati, Stefano, Maserati, Renato, Orsolini, Paolo, Vecchia, Marco, Asperges, Erika, Di Filippo, Alessandro, Sambo, Margherita, Biscarini, Simona, Lupi, Matteo, Roda, Silvia, Gallazzi, Ilaria, Sachs, Michele, Valsecchi, Pietro, Ferrari, Alessandra, Bosio, Matteo, Cascina, Alessandro, Conio, Valentina, Di Domenica, Rita, Donnetta, Anna, Fraolini, Elia, Gualtieri, Giuseppe, Mangiarotti, Patrizia, Mariani, Francesca, Meloni, Federica, Oggionni, Tiberio, Pasturenzi, Lidia, Ronzoni, Vanessa, Saracino, Laura, Stella, Giulia, Tomaselli, Stefano, Abbate, Tommaso, Accordino, Giulia, Bertuccio, Francesco, Burattini, Cecilia, Cacciatore, Elisa, Cattaneo, Elena, Chino, Vittorio, Coretti, Manuela, Della Zoppa, Matteo, Infusino, Cristina, Lettieri, Sara, Maccabruni, Valeria, Mancinelli, Silvia, Tirelli, Claudio, and Vertui, Valentina

Subjects
medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), 030204 cardiovascular system & hematology, Single Center, Tertiary referral hospital, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Internal Medicine, Medicine, cardiovascular diseases, Mean platelet volume, biology, SARS-CoV-2, business.industry, Pulmonary embolism, C-reactive protein, Anticoagulants, Thrombosis, equipment and supplies, medicine.disease, Im - Original, 030220 oncology & carcinogenesis, biology.protein, Emergency Medicine, Observational study, business
Abstract

Preliminary evidence supports the notion that COVID-19 patients may have an increased susceptibility to develop venous thromboembolism (VTE). However, the magnitude of this association still needs to be defined. Furthermore, clinical predictors of thrombogenesis, and the relationship with the inflammatory status are currently unknown. On this basis, we conducted a retrospective, observational study on 259 consecutive COVID-19 patients admitted to an academic tertiary referral hospital in Northern Italy between March 19th and April 6th, 2020. Records of COVID-19 patients with a definite VTE event were reviewed for demographic information, co-morbidities, risk factors for VTE, laboratory tests, and anticoagulation treatment. Twenty-five cases among 259 COVID-19 patients developed VTE (9.6%), all of them having a Padua score > 4, although being under standard anticoagulation prophylaxis since hospital admission. In the VTE subcohort, we found a significant positive correlation between platelet count (PLT) and either C reactive protein (CRP) (p p = 0.0013), while a significant inverse correlation was observed between PLT and mean platelet volume (p p p = 0.002 and p = 0.005, respectively). No significant difference was found in d-dimer levels between VTE and non VTE patients, while significantly higher levels of LDH (p = 0.04) and IL-6 (p = 0.04) were observed in VTE patients in comparison to non-VTE patients. In conclusion, our findings showed a quite high prevalence of VTE in COVID-19 patients. Raised inflammatory indexes and increased serum levels of pro-inflammatory cytokines should raise the clinical suspicion of VTE.

Published
2020
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2. Correction to: Venous thromboembolism and COVID-19: a single center experience from an academic tertiary referral hospital of Northern Italy

Author

Melazzini, Federica, Colaneri, Marta, Fumoso, Federica, Freddi, Giulia, Lenti, Marco Vincenzo, Pieri, Teresa Chiara, Piloni, Davide, Noris, Patrizia, Pieresca, Carla, Preti, Paola Stefania, Russo, Mariaconcetta, Corsico, Angelo, Tavazzi, Guido, Baldanti, Fausto, Triarico, Antonio, Mojoli, Francesco, Bruno, Raffaele, Di Sabatino, Antonio, Aronico, Nicola, Bergamaschi, Gaetano, Bertolino, Giampiera, Codega, Silvia, Costanzo, Filippo, Cresci, Roberto, Delliponti, Angela, Derosa, Giuseppe, Di Stefano, Michele, Falaschi, Francesco, Iadarola, Carmine, Lovati, Elisabetta, Lucotti, Pietro Carlo, Martignoni, Alessandra, Mengoli, Caterina, Miceli, Emanuela, Mugellini, Amedeo, Muggia, Chiara, Pagani, Elisabetta, Palumbo, Ilaria, Pecci, Alessandro, Perrone, Tiziano, Sgarlata, Carmelo, Siciliani, Luisa, Staniscia, Andrea, Vjera, Francesca Torello, Achilli, Giovanna, Agostinelli, Andrea, Antoci, Valentina, Ballesio, Alessia, Banfi, Francesco, Barteselli, Chiara, Benedetti, Irene, Borrelli de Andreis, Federica, Brattoli, Michele, Calabretta, Francesca, Cambiè, Ginevra, Canta, Roberta, Conca, Federico, Coppola, Luigi, Cremonte, Elisa Maria, Croce, Gabriele, Del Rio, Virginia, Di Terlizzi, Francesco, Ferrari, Maria Giovanna, Ferrari, Sara, Fiengo, Anna, Forni, Tommaso, Frigerio, Chiara, Fusco, Alessandra, Gabba, Margherita, Garolfi, Matteo, Gentile, Antonella, Gori, Giulia, Grandi, Giacomo, Grimaldi, Paolo, Lampugnani, Alice, Lapia, Francesco, Lepore, Federica, Lettieri, Gianluca, Mambella, Jacopo, Mercanti, Chiara, Merli, Stefania, Mordà, Francesco, Nardone, Alba, Pace, Luca, Padovini, Lucia, Parodi, Alessandro, Pellegrino, Ivan, Pitotti, Lavinia, Reduzzi, Margherita, Rigano, Giovanni, Romito, Giovanni, Rotola, Giorgio, Sabatini, Umberto, Salvi, Lucia, Santacroce, Giovanni, Savioli, Jessica, Soriano, Simone, Spataro, Carmine, Stefani, Debora, Aliberti, Anna Rita, Amatu, Alessandro, Anfossi, Laura, Arisi, Eric, Baldi, Chiara, Belliato, Mirko, Bellini, Lorenzo, Benzi, Alberto, Bichisao, Germana, Bolongaro, Antonia, Bottazzi, Andrea, Broglia, Federica, Bruschi, Giacomo, Caneva, Luca, Capaccio, Emanuele, Carboni, Valeria, Cavalloro, Fabrizio, Ciceri, Maria, Civardi, Luca, Delmonte, Maria Paola, Domenegati, Elisa Lucia, Ferrari, Federica, Ferrari, Fiorenza, Ferrari, Marta, Fuardo, Marinella, Gerletti, Maddalena Margherita, Gualdana, Simonetta, Ilardi, Marcella, Lo Coco, Claudia, Maggio, Giuseppe, Mascia, Maria Benedetta, Mencherini, Simonetta, Merati, Paola Maria, Mongodi, Silvia, Mori, Anna Maria, Morgante, Federica, Niebel, Thekla Larissa, Noli, Silvano, Orlando, Anita, Pagani, Michele, Passador, Debora, Pellicori, Simona, Perotti, Luciano, Picchioni, Raffaella, Poma, Silvia, Pozzi, Marco, Preti, Emanuela, Puce, Roberta, Radolovich, Danila Katia, Ragni, Gianluca, Repossi, Filippo, Riccardi, Francesca, Rizzardi, Roberto, Rodi, Giuseppe, Roldi, Emanuela, Rossi, Cristina, Sala Gallini, Giuseppe, Sciutti, Fabio, Sportiello, Debora, Ticozzelli, Giulia, Visconti, Federico, Zizzi, Silvia, Bagliani, Alessandro, Belotti, Corrado, Bossi, Chiara, Colombo, Andrea, Colombo, Costanza Natalia Julia, Cremascoli, Luca, Dammassa, Valentino, Discepoli, Roberto, Garlando, Maria Adelaide, Grandini, Filippo, Pellegrini, Andrea, Quaranta, Cecilia, Stella, Andrea, Torresani, Francesco, Mondelli, Mario, Brunetti, Enrico, Di Matteo, Angela, Seminari, Elena, Maiocchi, Laura, Zuccaro, Valentina, Pagnucco, Layla, Mariani, Bianca, Ludovisi, Serena, Lissandrin, Raffaella, Parisi, Aldo, Sacchi, Paolo, Patruno, Savino F. A., Michelone, Giuseppe, Gulminetti, Roberto, Zanaboni, Domenico, Novati, Stefano, Maserati, Renato, Orsolini, Paolo, Vecchia, Marco, Asperges, Erika, Di Filippo, Alessandro, Sambo, Margherita, Biscarini, Simona, Lupi, Matteo, Roda, Silvia, Gallazzi, Ilaria, Sachs, Michele, Valsecchi, Pietro, Ferrari, Alessandra, Bosio, Matteo, Cascina, Alessandro, Conio, Valentina, Di Domenica, Rita, Donnetta, Anna, Fraolini, Elia, Gualtieri, Giuseppe, Mangiarotti, Patrizia, Mariani, Francesca, Meloni, Federica, Oggionni, Tiberio, Pasturenzi, Lidia, Ronzoni, Vanessa, Saracino, Laura, Stella, Giulia, Tomaselli, Stefano, Abbate, Tommaso, Accordino, Giulia, Bertuccio, Francesco, Burattini, Cecilia, Cacciatore, Elisa, Cattaneo, Elena, Chino, Vittorio, Coretti, Manuela, Della Zoppa, Matteo, Infusino, Cristina, Lettieri, Sara, Maccabruni, Valeria, Mancinelli, Silvia, Tirelli, Claudio, and Vertui, Valentina

Subjects
Adult, Male, medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), MEDLINE, Tertiary referral hospital, Single Center, Statistics, Nonparametric, Tertiary Care Centers, Prevalence, Internal Medicine, medicine, Humans, GeneralLiterature_REFERENCE(e.g.,dictionaries,encyclopedias,glossaries), Aged, Retrospective Studies, Aged, 80 and over, Academic Medical Centers, Task force, business.industry, Correction, COVID-19, Venous Thromboembolism, Middle Aged, Northern italy, Italy, Emergency medicine, Emergency Medicine, Female, business, Venous thromboembolism
Abstract

Preliminary evidence supports the notion that COVID-19 patients may have an increased susceptibility to develop venous thromboembolism (VTE). However, the magnitude of this association still needs to be defined. Furthermore, clinical predictors of thrombogenesis, and the relationship with the inflammatory status are currently unknown. On this basis, we conducted a retrospective, observational study on 259 consecutive COVID-19 patients admitted to an academic tertiary referral hospital in Northern Italy between March 19th and April 6th, 2020. Records of COVID-19 patients with a definite VTE event were reviewed for demographic information, co-morbidities, risk factors for VTE, laboratory tests, and anticoagulation treatment. Twenty-five cases among 259 COVID-19 patients developed VTE (9.6%), all of them having a Padua score 4, although being under standard anticoagulation prophylaxis since hospital admission. In the VTE subcohort, we found a significant positive correlation between platelet count (PLT) and either C reactive protein (CRP) (p 0.0001) or lactate dehydrogenase (LDH) (p = 0.0013), while a significant inverse correlation was observed between PLT and mean platelet volume (p 0.0001). Platelet-to-lymphocyte ratio significantly correlated with CRP (p 0.0001). The majority of VTE patients was male and younger compared to non-VTE patients (p = 0.002 and p = 0.005, respectively). No significant difference was found in D-dimer levels between VTE and non VTE patients, while significantly higher levels of LDH (p = 0.04) and IL-6 (p = 0.04) were observed in VTE patients in comparison to non-VTE patients. In conclusion, our findings showed a quite high prevalence of VTE in COVID-19 patients. Raised inflammatory indexes and increased serum levels of pro-inflammatory cytokines should raise the clinical suspicion of VTE.

Published
2021

3. Pentraxin 3 in patients with severe sepsis or shock: the ALBIOS trial

Author

Caironi, Pietro, Masson, Serge, Mauri, Tommaso, Bottazzi, Barbara, Leone, Roberto, Magnoli, Michela, Barlera, Simona, Mamprin, Filippo, Fedele, Andrea, Mantovani, Alberto, Tognoni, Gianni, Pesenti, Antonio, Gattinoni, Luciano, Latini, Roberto, Bruzzone, Paola, Pagan, Francesca, Russo, Riccarda, Confalonieri, Andrea, Abbruzzese, Chiara, Vergnano, Beatrice, Faenza, Stefano, Siniscalchi, Antonio, Pierucci, Elisabetta, Noto, Andrea, Pezzi, Angelo, Spanu, Paolo, Parrini, Vieri, Oggioni, Roberto, Pasetti, Giovanni Stefano, Casadio, Maria Cinzia, Buontempo, Rosa, Carrer, Sara, Piccoli, Francesca, Rizzi, Tatiana, Caricato, Anselmo, La Sala, Monica, Antonaci, Alessandra, Fassini, Paola, Paganini, Silvia, Porta, Virginia, Moise, Gabriella, Marell, Silvia, Furia, Mirella, Urbano, Maria Cristina, Carobbi, Roberta, Poleni, Simona, Kandil, Hassan, Ballotta, Andrea, Bettini, Fabrizio, Sanseverino, Manlio, Gatta, Alessandro, Cecchini, Francesca, Guatteri, Luca, Ciceri, Gabriella, Raimondi, Ferdinando, Colombo, Roberto, Ferraris, Sandra, Borelli, Massimo, Bellato, Valentina, Cancellieri, Franco, Senni, Silvia, Bertocchi, Ester, Ferri, Paola, Moioli, Gianpietro, Molin, Alexandra, Salati, Giovanni, Salsi, Pierpaolo, Brunori, Emanuela, Elisei, Daniele, Maggio, Giuseppe, Nicola, Federico Guardia, Cavana, Marco, Morelli, Giacomo, Guarino, Arturo, Isetta, Michele, Tulli, Giorgio, Mangani, Valerio, Rossi, Nicola, Ferrari, Marta, Bona, Francesco, Vay, Monica, Bartoli, Teresa, Gallo, Mauro, Vettoretto, Katiuscia, Della Morte, Mauro, Boselli, Enrico, Puscio, Daniela, Bovo, Monia, Galzerano, Antonio, Carli, Manuela, Zagara, Giovanni, Caironi, Pietro, Masson, Serge, Mauri, Tommaso, Bottazzi, Barbara, Leone, Roberto, Magnoli, Michela, Barlera, Simona, Mamprin, Filippo, Fedele, Andrea, Mantovani, Alberto, Tognoni, Gianni, Pesenti, Antonio, Gattinoni, Luciano, Latini, Roberto, Bruzzone, Paola, Pagan, Francesca, Russo, Riccarda, Confalonieri, Andrea, Abbruzzese, Chiara, Vergnano, Beatrice, Faenza, Stefano, Siniscalchi, Antonio, Pierucci, Elisabetta, Noto, Andrea, Pezzi, Angelo, Spanu, Paolo, Parrini, Vieri, Oggioni, Roberto, Pasetti, Giovanni Stefano, Casadio, Maria Cinzia, Buontempo, Rosa, Carrer, Sara, Piccoli, Francesca, Rizzi, Tatiana, Caricato, Anselmo, La Sala, Monica, Antonaci, Alessandra, Fassini, Paola, Paganini, Silvia, Porta, Virginia, Moise, Gabriella, Marell, Silvia, Furia, Mirella, Urbano, Maria Cristina, Carobbi, Roberta, Poleni, Simona, Kandil, Hassan, Ballotta, Andrea, Bettini, Fabrizio, Sanseverino, Manlio, Gatta, Alessandro, Cecchini, Francesca, Guatteri, Luca, Ciceri, Gabriella, Raimondi, Ferdinando, Colombo, Roberto, Ferraris, Sandra, Borelli, Massimo, Bellato, Valentina, Cancellieri, Franco, Senni, Silvia, Bertocchi, Ester, Ferri, Paola, Moioli, Gianpietro, Molin, Alexandra, Salati, Giovanni, Salsi, Pierpaolo, Brunori, Emanuela, Elisei, Daniele, Maggio, Giuseppe, Nicola, Federico Guardia, Cavana, Marco, Morelli, Giacomo, Guarino, Arturo, Isetta, Michele, Tulli, Giorgio, Mangani, Valerio, Rossi, Nicola, Ferrari, Marta, Bona, Francesco, Vay, Monica, Bartoli, Teresa, Gallo, Mauro, Vettoretto, Katiuscia, Della Morte, Mauro, Boselli, Enrico, Puscio, Daniela, Bovo, Monia, Galzerano, Antonio, Carli, Manuela, and Zagara, Giovanni

Subjects
0301 basic medicine, Male, Resuscitation, Clinical Biochemistry, 030204 cardiovascular system & hematology, albumin, pentraxin 3, prognosis, septic shock, severe sepsis, Gastroenterology, Severity of Illness Index, Biochemistry, 0302 clinical medicine, Albumin, Aged, Albumins, Biomarkers, C-Reactive Protein, Crystalloid Solutions, Female, Fluid Therapy, Humans, Isotonic Solutions, Italy, Linear Models, Middle Aged, Mortality, Multiple Organ Failure, Multivariate Analysis, Prognosis, Randomized Controlled Trials as Topic, Sepsis, Serum Amyloid P-Component, Shock, Septic, biology, Medicine (all), Shock, General Medicine, PTX3, 3. Good health, Shock (circulatory), Cohort, medicine.symptom, prognosi, medicine.medical_specialty, Article, 03 medical and health sciences, Internal medicine, Severity of illness, Settore MED/41 - ANESTESIOLOGIA, medicine, Septic shock, business.industry, Septic, C-reactive protein, medicine.disease, Surgery, 030104 developmental biology, biology.protein, business, severe sepsi
Abstract

Background The long pentraxin PTX3 is a key component of the humoral arm of innate immunity related to sepsis severity and mortality. We evaluated the clinical and prognostic significance of circulating PTX3 in the largest cohort ever reported of patients with severe sepsis or septic shock. Design Plasma PTX3 was measured on days 1, 2 and 7 after randomization of 958 patients to albumin or crystalloids for fluid resuscitation in the multicenter Albumin Italian Outcome Sepsis (ALBIOS) trial. We tested the association of PTX3 and its changes over time with clinical severity, prevalent and incident organ dysfunctions, 90-day mortality, and treatment. Results PTX3 was high at baseline (72 [33-186] ng/mL) and rose with the severity and number of organ dysfunctions (p

Published
2017
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4. Asthma management in a specialist setting: Results of an Italian Respiratory Society survey

Author

Giorgio Walter Canonica, Fulvio Braido, Angelo Corsico, Elena Bacci, Paola Rogliani, Giuseppe Girbino, Pierluigi Paggiaro, Fabiano Di Marco, Pierachille Santus, Michela Bellocchia, Maria D'Amato, Amelia Grosso, Ilaria Baiardini, Pietro Pirina, Manuela Latorre, Alfio Proietto, Stefano Centanni, Paolo Solidoro, Maria Teresa Busceti, Garuti Silvia, Maria Cristina Colanardi, Girolamo Pelaia, Umberto Zuccon, Nicola Scichilone, Giorgia Molinengo, Maria Pia Foschino Barbaro, Francesco Blasi, Silvia Terraneo, Josuel Ora, Caterina Bucca, Carlo Mereu, Pietro Alleri, Alida Benfante, Marta Ferrari, Carlo Barbetta, Alessandro G. Fois, Giovanni Florio, Sara Maniscalco, Marco Contoli, Francesco Mazza, Francesca Simioli, Dottorini Marco, Vincenzo Patella, Braido, Fulvio, Baiardini, Ilaria, Alleri, Pietro, Bacci, Elena, Barbetta, Carlo, Bellocchia, Michela, Benfante, Alida, Blasi, Francesco, Bucca, Caterina, Busceti, Maria Teresa, Centanni, Stefano, Colanardi, Maria Cristina, Contoli, Marco, Corsico, Angelo, D'Amato, Maria, Di Marco, Fabiano, Marco, Dottorini, Ferrari, Marta, Florio, Giovanni, Fois, Alessandro Giuseppe, Foschino Barbaro, Maria Pia, Silvia, Garuti, Girbino, Giuseppe, Grosso, Amelia, Latorre, Manuela, Maniscalco, Sara, Mazza, Francesco, Mereu, Carlo, Molinengo, Giorgia, Ora, Josuel, Paggiaro, Pierluigi, Patella, Vincenzo, Pelaia, Girolamo, Pirina, Pietro, Proietto, Alfio, Rogliani, Paola, Santus, Pierachille, Scichilone, Nicola, Simioli, Francesca, Solidoro, Paolo, Terraneo, Silvia, Zuccon, Umberto, and Canonica, Giorgio Walter

Subjects
Pulmonary and Respiratory Medicine, Adult, Male, medicine.medical_specialty, Concordance, Socio-culturale, Practice Patterns, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Severity of Illness Index, 03 medical and health sciences, 0302 clinical medicine, Quality of life (healthcare), Retrospective Studie, Surveys and Questionnaires, Severity of illness, Health care, medicine, Surveys and Questionnaire, Humans, Pharmacology (medical), 030212 general & internal medicine, Practice Patterns, Physicians', Aged, Asthma, Female, Italy, Middle Aged, Retrospective Studies, Quality of Life, Specialization, Modalities, Physicians', business.industry, Biochemistry (medical), Retrospective cohort study, medicine.disease, 030228 respiratory system, Test score, Family medicine, Physical therapy, business, Human
Abstract

Background Asthma considerably impairs patients' quality of life and increases healthcare costs. Severity, morbidity, and degree of disease control are the major drivers of its clinical and economic impact. National scientific societies are required to monitor the application of international guidelines and to adopt strategies to improve disease control and better allocate resources. Aim to provide a detailed picture of the characteristics of asthma patients and modalities of asthma management by specialists in Italy and to develop recommendations for the daily management of asthma in a specialist setting. Method: A quantitative research program was implemented. Data were collected using an ad hoc questionnaire developed by a group of specialists selected by the Italian Pneumology Society/Italian Respiratory Society. Results The records of 557 patients were analyzed. In the next few years, specialists are expected to focus their activity patients with more severe disease and will be responsible for selection of patients for personalized biological therapy; however, only 20% of patients attending Italian specialist surgery can be considered severe. In 84.4% of cases, the visit was a follow-up visit requested in 82.2% of cases by the specialist him/herself. The Asthma Control Test is used only in 65% of patients. When available, a significant association has been observed between the test score and asthma control as judged by the physician, although concordance was only moderate (κ = 0.68). Asthma was considered uncontrolled by the specialist managing the case in 29.1% of patients; nevertheless, treatment was not stepped up in uncontrolled or partly controlled patients (modified in only 37.2% of patients). Conclusions The results of this survey support re-evaluation of asthma management by Italian specialists. More resources should be made available for the initial visit and for more severely ill patients. In addition, more extensive use should be made of validated tools, and available drugs should be used more appropriately.

Published
2017

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