ICD Dotaz Zobrazit nápovědu

CONTEXT: Practice guidelines do not recommend use of an implantable cardioverter-defibrillator (ICD) for primary prevention in patients recovering from a myocardial infarction or coronary artery bypass graft surgery and those with severe heart failure symptoms or a recent diagnosis of heart failure. OBJECTIVE: To determine the number, characteristics, and in-hospital outcomes of patients who receive a non-evidence-based ICD and examine the distribution of these implants by site, physician specialty, and year of procedure. DESIGN, SETTING, AND PATIENTS: Retrospective cohort study of cases submitted to the National Cardiovascular Data Registry-ICD Registry between January 1, 2006, and June 30, 2009. MAIN OUTCOME MEASURE: In-hospital outcomes. RESULTS: Of 111,707 patients, 25,145 received non-evidence-based ICD implants (22.5%). Patients who received a non-evidence-based ICD compared with those who received an evidence-based ICD had a significantly higher risk of in-hospital death (0.57% [95% confidence interval {CI}, 0.48%-0.66%] vs 0.18% [95% CI, 0.15%-0.20%]; P <.001) and any postprocedure complication (3.23% [95% CI, 3.01%-3.45%] vs 2.41% [95% CI, 2.31%-2.51%]; P <.001). There was substantial variation in non-evidence-based ICDs by site. The rate of non-evidence-based ICD implants was significantly lower for electrophysiologists (20.8%; 95% CI, 20.5%-21.1%) than nonelectrophysiologists (24.8% [95% CI, 24.2%-25.3%] for nonelectrophysiologist cardiologists; 36.1% [95% CI, 34.3%-38.0%] for thoracic surgeons; and 24.9% [95% CI, 23.8%-25.9%] for other specialties) (P<.001 for all comparisons). There was no clear decrease in the rate of non-evidence-based ICDs over time (24.5% [6908/28,233] in 2006, 21.8% [7395/33,965] in 2007, 22.0% [7245/32,960] in 2008, and 21.7% [3597/16,549] in 2009; P <.001 for trend from 2006-2009 and P = .94 for trend from 2007-2009). CONCLUSION: Among patients with ICD implants in this registry, 22.5% did not meet evidence-based criteria for implantation.

MeSH
defibrilátory implantabilní využití MeSH
dodržování směrnic MeSH
infarkt myokardu komplikace MeSH
kardiologie statistika a číselné údaje MeSH
kohortové studie MeSH
koronární bypass MeSH
lékařská praxe - způsoby provádění statistika a číselné údaje MeSH
lidé středního věku MeSH
lidé MeSH
medicína založená na důkazech MeSH
mortalita v nemocnicích MeSH
náhlá srdeční smrt etiologie prevence a kontrola MeSH
primární prevence MeSH
registrace MeSH
retrospektivní studie MeSH
senioři MeSH
srdeční selhání komplikace MeSH
výběr pacientů MeSH
výsledek terapie MeSH
Check Tag
lidé středního věku MeSH
lidé MeSH
mužské pohlaví MeSH
senioři MeSH
ženské pohlaví MeSH
Publikační typ
srovnávací studie MeSH
Geografické názvy
Spojené státy americké MeSH

Článek

Terapie implantabilními kardiovertery-defibrilátory (ICD) na prahu 3. tisíciletí
[Therapy with implantable cardioverter-defibrillators (ICD) in the early of third millenium]

without ventricular arrhythmias with markers of high risk of sudden cardiac death are indicated for ICD ...

V současnosti jsou k implantaci ICD indikováni i pacienti bez komorových arytmií, kteří se vyznačují ...

Kozák, Milan, 1967-
Autor Autorita

Vnitřní lékařství. 2010 ; 56 (8) : 860-864 příl..

Medvik
Zdroj

V současnosti jsou k implantaci ICD indikováni i pacienti bez komorových arytmií, kteří se vyznačují vysokým rizikem náhlé srdeční smrti. ICD systémy posledních generací jsou vybaveny vysokokapacitními bateriemi, řadou automatických funkcí, možností dálkového odesílání dat, a dokonce i predikcí zhoršení srdečního selhání. Současné ICD systémy kromě eliminace náhlé srdeční smrti umožňují i zmírnění symptomů chronického srdečního selhání cestou srdeční resynchronizační terapie.

The patients without ventricular arrhythmias with markers of high risk of sudden cardiac death are indicated for ICD implantation today. Last generation of ICD systems are equipped with high capacity batteries, with many automatic functions, capabilities of data sending and possibilities of prediction of worsening of heart failure. Nowadays ICD systems offers not only elimination of the risk of sudden cardiac death but reduction of symptoms of chronic heart failure through the resynchronization therapy, too.

Klíčová slova
indikace,
MeSH
defibrilátory implantabilní MeSH
lidé MeSH
náhlá srdeční smrt prevence a kontrola MeSH
srdeční arytmie komplikace terapie MeSH
technologie MeSH
Check Tag
lidé MeSH
Publikační typ
přehledy MeSH

Článek

Epidemiology of Bone Fractures in the Hand in Adult Population Using the ICD-10 Classification [Epidemiologie zlomenin kostí ruky dospělých s využitím klasifikace ICD-10]

These fractures were classified according to the International Classification of Diseases 10th edition (ICD ...

Acta chirurgiae orthopaedicae et traumatologiae Čechoslovaca. 2022 ; 89 (4) : 252-259. [pub] -

Acta chir. orthop. traumatol. Čechoslovaca
ISSN 0001-5415
Medvik
Zdroj

PURPOSE OF THE STUDY The purpose of this study was to conduct an epidemiological study of hand fractures in adult population. MATERIAL AND METHODS A retrospective observational study in a population of 470,000 habitants was performed. Over the course of three years, all patients over 16 years of age who were diagnosed with fracture or fracture-dislocation at the level of a carpal bone, metacarpal and/or phalange were included. These fractures were classified according to the International Classification of Diseases 10th edition (ICD-10). Incidence rates, along with gender and age distribution were also studied. RESULTS 1,267 patients with a total of 1,341 hand fractures were included. They represented 29.7% of all upper limb fractures and 7.6% of all traumatological emergencies involving a bone fracture during that period. The most frequent ICD-10 group was S62.3, with the fifth metacarpal as the most often affected bone (39.7%). The most frequent location at the level of the phalanges (S62.5) was the proximal third of the proximal phalanx of the fifth radius. The global incidence rate was 99 fractures per 100,000 persons/year. No seasonal variation was observed. Only 10.2% of hand fractures received surgical treatment. DISCUSSION Several epidemiological studies have been published on fractures in the hand, but none have used the ICD-10 classification. Although the distribution of our stratified sample by age and gender was similar to those previously published, the incidence rate in our study was much lower. We may possibly extrapolate our results to the rest of the Spanish population and even to the rest of the population of southern Europe, given the scarcity of epidemiological studies on this matter in these geographical areas. CONCLUSIONS The ICD-10 classification is useful for the description and classification of hand fractures. The most often affected group is that including metacarpals of the long fingers (S62.3), being the distal level of the fifth metacarpal in young male patients the most frequent one. Most fractures are treated conservatively and in case of surgical treatment, the preferred surgical techniques include K-wire fixation, interfragmentary compression screws and plate osteosynthesis. Key words: epidemiology, incidence, fracture, fracture dislocation, carpal bones, metacarpals, finger phalanges.