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Głowacka M, Polak-Szabela A, Sienkiewicz Z, Kornatowski M. Trait-anxiety, depressive symptoms, family support and life satisfaction as determinants conditioning the degree of adherence of people in pre-older adults and older adults. Front Public Health 2024; 12:1336020. [PMID: 38628854 PMCID: PMC11018875 DOI: 10.3389/fpubh.2024.1336020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/15/2024] [Indexed: 04/19/2024] Open
Abstract
The objective of the study was to determine the degree of adherence to pharmacological treatment in people in pre-older adults and older adults age groups and to analyse the correlation between selected sociodemographic parameters, severity of anxiety as a trait, symptoms of depression, a sense of family support and satisfaction with life, and adherence in people over 55 years of age. The study was conducted in a group of 2,040 people (1,406 women, 634 men) aged 55 to 100 (the average age was 65.4). The following sociodemographic variables were analysed: age, gender, education. The following scales were used: State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), Satisfaction With Life Scale (SWLS) and the Multidimensional Scale of Perceived Social Support (MSPSS). The Adherence in Chronic Diseases Scale (ACDS) was used to test adherence, understood as the implementation of the therapeutic plan. The results obtained in the ACDS ranged from 6 to 28 points; the median was 24 points (21-28). The multiple coefficients of determination (multiple R2 = 0.11; p < 0.001) indicated an explanation of approximately 11% of the value of the ACDS dependent variable. The total correlation of all variables (multiple R) with the ACDS general variable in the mean correlation was 0.33. Independent factors affecting adherence assessed in the ACDS were: severity of anxiety as a trait (p = -0.21 ± 0.03; p < 0.001), family support (p = 0.10 ± 0.04; p = 0.029), severity of depression symptoms (p = -0.08 ± 0.03; p = 0.005), age of respondents (p = 0.07 ± 0.02; p = 0.003) and satisfaction with life (p = 0.06 ± 0 0.03; p = 0.027). Severity of anxiety as a trait, age, severity of depressive symptoms, a sense of satisfaction with life and family support are important factors affecting adherence.
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Affiliation(s)
- Mariola Głowacka
- Collegium Medicum, The Mazovian University in Płock, Płock, Poland
| | - Anna Polak-Szabela
- Department of Geriatrics, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Zofia Sienkiewicz
- Department of Nursing Development, Social and Medical Sciences, Medical University of Warsaw, Warsaw, Poland
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Tu J, Ye Z, Cao Y, Xu M, Wang S. Establishment and evaluation of a nomogram for in-hospital new-onset atrial fibrillation after percutaneous coronary intervention for acute myocardial infarction. Front Cardiovasc Med 2024; 11:1370290. [PMID: 38562185 PMCID: PMC10982328 DOI: 10.3389/fcvm.2024.1370290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 03/07/2024] [Indexed: 04/04/2024] Open
Abstract
Background New-onset atrial fibrillation (NOAF) is prognostic in acute myocardial infarction (AMI). The timely identification of high-risk patients is essential for clinicians to improve patient prognosis. Methods A total of 333 AMI patients were collected who underwent percutaneous coronary intervention (PCI) at Zhejiang Provincial People's Hospital between October 2019 and October 2020. Least absolute shrinkage and selection operator regression (Lasso) and multivariate logistic regression analysis were applied to pick out independent risk factors. Secondly, the variables identified were utilized to establish a predicted model and then internally validated by 10-fold cross-validation. The discrimination, calibration, and clinical usefulness of the prediction model were evaluated using the receiver operating characteristic (ROC) curve, calibration curve, Hosmer-Lemeshow test decision curve analyses, and clinical impact curve. Result Overall, 47 patients (14.1%) developed NOAF. Four variables, including left atrial dimension, body mass index (BMI), CHA2DS2-VASc score, and prognostic nutritional index, were selected to construct a nomogram. Its area under the curve is 0.829, and internal validation by 10-fold cross-folding indicated a mean area under the curve is 0.818. The model demonstrated good calibration according to the Hosmer-Lemeshow test (P = 0.199) and the calibration curve. It showed satisfactory clinical practicability in the decision curve analyses and clinical impact curve. Conclusion This study established a simple and efficient nomogram prediction model to assess the risk of NOAF in patients with AMI who underwent PCI. This model could assist clinicians in promptly identifying high-risk patients and making better clinical decisions based on risk stratification.
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Affiliation(s)
- Junjie Tu
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
- Department of Cardiovascular Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
| | - Ziheng Ye
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
- Department of Cardiovascular Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
| | - Yuren Cao
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
- Department of Cardiovascular Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
| | - Mingming Xu
- Department of Cardiovascular Medicine, Zhejiang Greentown Cardiovascular Hospital, Hangzhou, China
| | - Shen Wang
- Department of Cardiovascular Medicine, Zhejiang Greentown Cardiovascular Hospital, Hangzhou, China
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Matsuki H, Genma T, Mandai S, Fujiki T, Mori Y, Ando F, Mori T, Susa K, Iimori S, Naito S, Sohara E, Rai T, Fushimi K, Uchida S. National Trends in Mortality and Urgent Dialysis after Acute Hypertension in Japan From 2010 Through 2019. Hypertension 2023; 80:2591-2600. [PMID: 37818643 DOI: 10.1161/hypertensionaha.123.21880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 09/25/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND Despite increasing incidences of hypertension, recent trends in mortality and urgent dialysis following acute hypertension (AHT) remain undetermined. METHODS This retrospective observational cohort study evaluated 50 316 hospitalized AHT patients from 2010 to 2019, using an administrative claims database in Japan. We examined trends in incidence, urgent dialysis, mortality, and its risk factors using Poisson regression models. Using International Classification of Disease and Related Health Problems, 10th Revision codes, AHT was categorized into 5 spectrums: malignant hypertension (n=1792), hypertensive emergency (n=17 907), hypertensive urgency (n=1562), hypertensive encephalopathy (n=6593), and hypertensive heart failure (HHF; n=22 462). RESULTS The median age of the patients was 76 years, and 54.9% were women. The total AHT incidence was 70 cases per 100 000 admission year. The absolute death rate increased from 1.83% (95% CI, 1.40-2.40) to 2.88% ([95% CI, 2.42-3.41]; Cochran-Armitage trend test, P<0.0001). Upward trends were observed in patients aged ≥80, with lean body mass index ≤18.4, and with HHF. Urgent dialysis rates increased from 1.52% (95% CI, 1.12-2.06) to 2.60% (2.17-3.1; Cochran-Armitage trend test; P=0.0071) in 48 235 patients, excluding maintenance dialysis patients. Older age, men, lean body mass, malignant hypertension, HHF, and underlying chronic kidney disease correlated with higher mortality risk; greater hospital volume correlated with lower mortality risk; and malignant hypertension, HHF, diabetes, chronic kidney disease, and scleroderma correlated with a higher risk of urgent dialysis. CONCLUSIONS Mortality and urgent dialysis rates following AHT have increased. Aging, complex comorbidities, and HHF-type AHT contributed to the rising trend of mortality.
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Affiliation(s)
- Hisazumi Matsuki
- Department of Nephrology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo, Tokyo, Japan (H.M., T.G., S.M., T.F., Y.M., F.A., T.M., K.S., S.I., S.N., E.S., T.R., S.U.)
| | - Taku Genma
- Department of Nephrology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo, Tokyo, Japan (H.M., T.G., S.M., T.F., Y.M., F.A., T.M., K.S., S.I., S.N., E.S., T.R., S.U.)
| | - Shintaro Mandai
- Department of Nephrology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo, Tokyo, Japan (H.M., T.G., S.M., T.F., Y.M., F.A., T.M., K.S., S.I., S.N., E.S., T.R., S.U.)
| | - Tamami Fujiki
- Department of Nephrology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo, Tokyo, Japan (H.M., T.G., S.M., T.F., Y.M., F.A., T.M., K.S., S.I., S.N., E.S., T.R., S.U.)
| | - Yutaro Mori
- Department of Nephrology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo, Tokyo, Japan (H.M., T.G., S.M., T.F., Y.M., F.A., T.M., K.S., S.I., S.N., E.S., T.R., S.U.)
| | - Fumiaki Ando
- Department of Nephrology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo, Tokyo, Japan (H.M., T.G., S.M., T.F., Y.M., F.A., T.M., K.S., S.I., S.N., E.S., T.R., S.U.)
| | - Takayasu Mori
- Department of Nephrology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo, Tokyo, Japan (H.M., T.G., S.M., T.F., Y.M., F.A., T.M., K.S., S.I., S.N., E.S., T.R., S.U.)
| | - Koichiro Susa
- Department of Nephrology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo, Tokyo, Japan (H.M., T.G., S.M., T.F., Y.M., F.A., T.M., K.S., S.I., S.N., E.S., T.R., S.U.)
| | - Soichiro Iimori
- Department of Nephrology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo, Tokyo, Japan (H.M., T.G., S.M., T.F., Y.M., F.A., T.M., K.S., S.I., S.N., E.S., T.R., S.U.)
| | - Shotaro Naito
- Department of Nephrology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo, Tokyo, Japan (H.M., T.G., S.M., T.F., Y.M., F.A., T.M., K.S., S.I., S.N., E.S., T.R., S.U.)
| | - Eisei Sohara
- Department of Nephrology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo, Tokyo, Japan (H.M., T.G., S.M., T.F., Y.M., F.A., T.M., K.S., S.I., S.N., E.S., T.R., S.U.)
| | - Tatemitsu Rai
- Department of Nephrology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo, Tokyo, Japan (H.M., T.G., S.M., T.F., Y.M., F.A., T.M., K.S., S.I., S.N., E.S., T.R., S.U.)
- Department of Nephrology and Hypertension, Dokkyo Medical University, Shimotsuga, Tochigi, Japan (T.R.)
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo, Tokyo, Japan (K.F.)
| | - Shinichi Uchida
- Department of Nephrology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo, Tokyo, Japan (H.M., T.G., S.M., T.F., Y.M., F.A., T.M., K.S., S.I., S.N., E.S., T.R., S.U.)
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Li Z, Maimaiti Z, Li ZY, Fu J, Hao LB, Xu C, Chen JY. Moderate-to-Severe Malnutrition Identified by the Controlling Nutritional Status (CONUT) Score Is Significantly Associated with Treatment Failure of Periprosthetic Joint Infection. Nutrients 2022; 14:nu14204433. [PMID: 36297116 PMCID: PMC9607573 DOI: 10.3390/nu14204433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/12/2022] [Accepted: 10/19/2022] [Indexed: 11/16/2022] Open
Abstract
The prevalence and role of malnutrition in periprosthetic joint infection (PJI) remain unclear. This study aimed to use measurable nutritional screening tools to assess the prevalence of malnutrition in PJI patients during two-stage exchange arthroplasty and to explore the association between malnutrition and treatment failure. Our study retrospectively included 183 PJI cases who underwent 1st stage exchange arthroplasty and had available nutritional parameters, of which 167 proceeded with 2nd stage reimplantation. The recently proposed Musculoskeletal Infection Society (MSIS) Outcome Reporting Tool was used to determine clinical outcomes. The Controlling Nutritional Status (CONUT), Nutritional Risk Index (NRI), and Naples Prognostic Score (NPS) were used to identify malnutrition at 1st and 2nd stage exchange, respectively. Multivariate logistic regression analyses were performed to determine the association between malnutrition and treatment failure. Restricted cubic spline models were further used to explore the dose−response association. Additionally, risk factors for moderate-to-severe malnutrition were evaluated. Malnourished patients identified by CONUT, NPS, and NRI accounted for 48.1% (88/183), 98.9% (181/183), and 55.7% (102/183) of patients at 1st stage, and 9.0% (15/167), 41.9% (70/167), and 43.1% (72/167) at 2nd stage, indicating a significant improvement in nutritional status. We found that poorer nutritional status was a predictor of treatment failure, with CONUT performing best as a predictive tool. Moderate-to-severe malnutrition at 1st stage identified by CONUT was significantly related to treatment failure directly caused by PJI (odds ratio [OR] = 5.86), while the OR was raised to 12.15 at 2nd stage (OR = 12.15). The linear dose−response associations between them were also confirmed (P for nonlinearity at both 1st and 2nd stage > 0.05). As for total treatment failure, moderate-to-severe malnutrition as determined by CONUT was associated with a 1.96-fold and 8.99-fold elevated risk at the 1st and 2nd stages, respectively. Age ≥ 68 years (OR = 5.35) and an increased number of previous surgeries (OR = 2.04) may be risk factors for moderate-to-severe malnutrition. Overall, the prevalence of malnutrition in PJI patients is very high. Given the strong association between moderate-to-severe malnutrition identified by CONUT and PJI treatment failure, COUNT could be a promising tool to evaluate the nutritional status of PJI patients to optimize treatment outcomes.
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Affiliation(s)
- Zhuo Li
- School of Medicine, Nankai University, Tianjin 300071, China
- Department of Orthopedics, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Zulipikaer Maimaiti
- Department of Orthopedics, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Zhi-Yuan Li
- Department of Orthopedics, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Jun Fu
- Department of Orthopedics, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
- Department of Orthopedics, The Fourth Medical Center, Chinese PLA General Hospital, Beijing 100048, China
| | - Li-Bo Hao
- Department of Orthopedics, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
- Department of Orthopedics, The Fourth Medical Center, Chinese PLA General Hospital, Beijing 100048, China
| | - Chi Xu
- Department of Orthopedics, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
- Department of Orthopedics, The Fourth Medical Center, Chinese PLA General Hospital, Beijing 100048, China
- Correspondence: (C.X.); (J.-Y.C.)
| | - Ji-Ying Chen
- Department of Orthopedics, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
- Department of Orthopedics, The Fourth Medical Center, Chinese PLA General Hospital, Beijing 100048, China
- Correspondence: (C.X.); (J.-Y.C.)
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