BACKGROUND: Optimal management of outpatients with heart failure (HF) requires serially updating the estimates of their risk for adverse clinical outcomes to guide treatment. Patient-reported outcomes (PROs) are becoming increasingly used in clinical care. The purpose of this study was to determine whether the inclusion of PROs can improve the risk prediction for HF hospitalization and death in ambulatory patients with HF. METHODS AND RESULTS: We included consecutive patients with HF with reduced ejection fraction (HFrEF) and HF with preserved EF (HFpEF) seen in a HF clinic between 2015 and 2019 who completed PROs as part of routine care. Cox regression with a least absolute shrinkage and selection operator regularization and gradient boosting machine analyses were used to estimate risk for a combined outcome of HF hospitalization, heart transplant, left ventricular assist device implantation, or death. The performance of the prediction models was evaluated with the time-dependent concordance index (Cτ). Among 1165 patients with HFrEF (mean age 59.1 ± 16.1, 68% male), the median follow-up was 487 days. Among 456 patients with HFpEF (mean age 64.2 ± 16.0 years, 55% male) the median follow-up was 494 days. Gradient boosting regression that included PROs had the best prediction performance - Cτ 0.73 for patients with HFrEF and 0.74 in patients with HFpEF, and showed very good stratification of risk by time to event analysis by quintile of risk. The Kansas City Cardiomyopathy Questionnaire overall summary score, visual analogue scale and Patient Reported Outcomes Measurement Information System dimensions of satisfaction with social roles and physical function had high variable importance measure in the models. CONCLUSIONS: PROs improve risk prediction in both HFrEF and HFpEF, independent of traditional clinical factors. Routine assessment of PROs and leveraging the comprehensive data in the electronic health record in routine clinical care could help more accurately assess risk and support the intensification of treatment in patients with HF.

• MeSH
• hodnocení rizik metody   MeSH
• hodnocení výsledků péče pacientem * MeSH
• hospitalizace statistika a číselné údaje   MeSH
• kvalita života * psychologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• následné studie MeSH
• retrospektivní studie MeSH
• senioři MeSH
• srdeční selhání * patofyziologie   psychologie   terapie   diagnóza   mortalita   MeSH
• tepový objem fyziologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

The study focuses on the use of follow-up social services by psychiatric patients following their discharge from a psychiatric hospital. The content solely addresses the issue of client referrals to mental health centres ("MHCs") in the Moravian-Silesian Region after discharge from the Psychiatric Hospital in Opava. The research aims to determine why follow-up social services are underused by individuals discharged from a psychiatric hospital, which factors primarily lead to the unsuccessful follow-up of the patient to an MHC after hospitalisation in a mental health facility, and the main reasons for rehospitalisation of persons with mental health challenges from a community MHC back into a psychiatric hospital. The study is based primarily on information from the internal patient database at the Psychiatric Hospital in Opava for 2023, and on field research in MHCs in the Moravian-Silesian Region - in which interviews with MHC staff and questionnaire surveys with clients of these organisations were conducted. The research survey findings identify gaps in the referring of clients to the MHC, which may include, for example, a client's failure to be within a target group, inadequate health condition, a client's lack of cooperation with the referred MHC, or lack of support of the client's family in the process of service referral. The capacity of mental health centres and regional differences in the availability of these services are also important constraints.

• MeSH
• duševní poruchy epidemiologie   MeSH
• hospitalizace statistika a číselné údaje   MeSH
• komunitní psychiatrická střediska * statistika a číselné údaje   MeSH
• lidé MeSH
• předání pacienta do jiné péče statistika a číselné údaje   MeSH
• průzkumy a dotazníky MeSH
• rozhovory jako téma MeSH
• ústavy pro duševně nemocné * statistika a číselné údaje   MeSH
• zdravotnický personál MeSH
• Check Tag
• lidé MeSH

OBJECTIVES: Elderly hospitalized patients with inflammatory bowel disease (IBD) flare and concurrent Clostridioides difficile infection (CDI) are considered at high risk of IBD-related complications. We aimed to evaluate the short-,intermediate-, and long-term post-discharge complications among these patients. METHODS: A retrospective multicenter cohort study assessing outcomes of elderly individuals (≥60 years) hospitalized for an IBD flare who were tested for CDI (either positive or negative) and discharged. The primary outcome was the 3-month post-discharge IBD-related complication rates defined as steroid dependency, re-admissions (emergency department or hospitalization), IBD-related surgery, or mortality. We assessed post-discharge IBD-related complications within 6 month and mortality at 12 month among secondary outcomes. Risk factors for complication were assessed by multivariable logistic regression. RESULTS: In a cohort of 654 patients hospitalized for IBD {age 68.9 (interquartile range [IQR]): 63.9-75.2 years, 60.9% ulcerative colitis (UC)}, 23.4% were CDI-positive. Post-discharge complication rates at 3 and 6 months, and 12 months mortality, did not differ significantly between CDI-positive and CDI-negative patients (32% vs 33.1%, p = 0.8; 40.5% vs 42.5%, p = 0.66; and 4.6% vs 8%, p = 0.153, respectively). The Charlson comorbidity index was the only significant risk factor for complications within 3 months (aOR 1.1), whereas mesalamine (5-aminosalicylic acid [5-ASA]) use was protective (aOR 0.6). An UC diagnosis was the sole risk factor for complication at 6 months (aOR 1.5). Clostridioides difficile infection did not significantly impact outcomes or interact with IBD type. CONCLUSIONS: In elderly IBD patients hospitalized for IBD flare and subsequently discharged, a concurrent CDI infection was not associated with post-discharge IBD-related complications or mortality up to 1 year.

• MeSH
• Clostridioides difficile MeSH
• hospitalizace statistika a číselné údaje   MeSH
• idiopatické střevní záněty * komplikace   MeSH
• klostridiové infekce * komplikace   epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• propuštění pacienta MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• senioři MeSH
• syndrom vzplanutí nemoci MeSH
• znovupřijetí pacienta statistika a číselné údaje   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

OBJECTIVES: The aim of this study is to determine the incidence of Mycoplasma pneumoniae pneumonia (MPP) in children and adolescents in Prague, Czech Republic, between January and July 2024, and to compare the findings with data from the preceding period. METHODS: A retrospective analysis of data of paediatric patients at our single tertiary care facility was conducted. Two distinct patient cohorts were subjected to analysis: the first comprising individuals who had been hospitalised between January 2019 and July 2024, and the second consisting of outpatients who had been treated during the periods of January to July 2023 and January to July 2024. RESULTS: A 12.3-fold increase in the number of outpatients diagnosed with MPP was observed between January and July 2024 in comparison to the same period in 2023, with 111 cases reported in 2024 versus 9 cases in 2023. A total of 23 patients were hospitalised with MPP between January 2019 and July 2024, with 15 of these hospitalisations having occurred between January and July 2024. The median age was 12 years, with an age range of 1 to 17 years. The majority of cases presented with a high fever, chest pain, and required oxygen support. A failure of the clarithromycin treatment was observed, resulting in 19.48% of doxycycline prescriptions being issued due to a prior failure of clarithromycin treatment. During the monitoring period, no cases of treatment failure with doxycycline were documented. CONCLUSION: The present study demonstrates an emerging trend of increased incidence of Mycoplasma pneumoniae pneumonia in the paediatric population during the initial seven months of 2024 in the Czech Republic. Doxycycline has been demonstrated to be the optimal antibiotic for the treatment of MPP and in accordance with the prevailing practice in other states it should be included in the therapeutic regimen even in children under the age of eight. The authors put forward recommendations for the implementation of measures aimed at reducing the negative impact of MPP on public health.

• MeSH
• antibakteriální látky * terapeutické užití   MeSH
• centra terciární péče MeSH
• dítě MeSH
• hospitalizace statistika a číselné údaje   MeSH
• incidence MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• Mycoplasma pneumoniae MeSH
• mykoplazmová pneumonie * epidemiologie   farmakoterapie   MeSH
• předškolní dítě MeSH
• retrospektivní studie MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

We estimated the effectiveness of the adapted monovalent XBB.1.5 COVID-19 vaccines against PCR-confirmed SARS-CoV-2 hospitalisation during the BA.2.86/JN.1 lineage-predominant period using a multicentre test-negative case-control study in Europe. We included older adults (≥ 65 years) hospitalised with severe acute respiratory infection from November 2023 to May 2024. Vaccine effectiveness was 46% at 14-59 days and 34% at 60-119 days, with no effect thereafter. The XBB.1.5 COVID-19 vaccines conferred protection against BA.2.86 lineage hospitalisation in the first 4 months post-vaccination.

• MeSH
• COVID-19 * prevence a kontrola   epidemiologie   imunologie   MeSH
• hospitalizace * statistika a číselné údaje   MeSH
• lidé MeSH
• SARS-CoV-2 * imunologie   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• studie případů a kontrol MeSH
• účinnost vakcíny * MeSH
• vakcinace statistika a číselné údaje   MeSH
• vakcíny proti COVID-19 * imunologie   aplikace a dávkování   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa MeSH

AIMS: To explore all medication administration errors (MAEs) throughout the entire process of medication administration by nurses in the inpatient setting, to describe their prevalence, and to analyse associated factors, including deviation from the good practice standards. BACKGROUND: Worldwide, MAEs are very common and regarded as a serious risk factor to inpatient safety. Nurses assume an essential role in the hospital setting during the administration of medications. DESIGN: The prospective observational study was carried out in accordance with the STROBE guidance. METHODS: This study was conducted in four regional hospitals from June to August 2021. MAEs were collected when nurses administered medications to the adult inpatients during the morning, noon, and evening medication rounds at the internal, surgical, and follow-up care departments in each hospital over three consecutive days. Direct observation by the multidisciplinary team was employed. MAEs were classified as major MAEs (from the potentially most serious and common to all drug forms), specific MAEs (specific to a drug form), and procedural MAEs (e.g., patient identification, hygiene standards, or generic drug substitution). Predictors of either major MAE or specific MAE frequency were analysed using the generalised linear model and the decision tree model. RESULTS: Overall, 58 nurses administering medication to 331 inpatients at 12 departments were observed. In total, 6356 medication administrations were observed, of which 461 comprised major MAEs, 1497 specific MAEs, and 12,045 procedural MAEs. The predictors of the occurrence of major MAEs and specific MAEs were the specific hospital, the nurse's length of practice (less than 2 years), and two procedural MAEs (the unclear prescription and the wrong strength). CONCLUSIONS: Non-adherence to the standard processes in healthcare facilities for prescribing and administering drugs increased the prevalence of severe MAEs. Determinants of MAE occurrence such as incorrect prescriptions or limited experience of nurses should be considered. IMPLICATION FOR THE PROFESSION AND PATIENT CARE: The identified determinants of MAE should be considered by hospital stakeholders in their support programs to reduce the level of burden for nurses during medication administration. PATIENT OR PUBLIC CONTRIBUTION: Neither patients nor public was not involved in the design, data collection, or dissemination plans of this study. The researchers observed nurse care delivery at medical departments acting as passive participants.

• MeSH
• dospělí MeSH
• hospitalizace * statistika a číselné údaje   MeSH
• lidé středního věku MeSH
• lidé MeSH
• medikační omyly * ošetřování   statistika a číselné údaje   prevence a kontrola   MeSH
• personál sesterský nemocniční statistika a číselné údaje   MeSH
• prospektivní studie MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• pozorovací studie MeSH

INTRODUCTION: The aim was to analyse mortality and estimate the life expectancy among people hospitalised for alcohol use disorders (AUD) compared with the general Czech population aged ≥20 years. A temporal perspective on excess mortality was used, covering three recent calendar periods before and during the pandemic. METHODS: Three retrospective cohorts of the target population were constructed using registry-based data. The target population was defined as all adult patients (aged ≥20 years) admitted to the hospital for AUD (ICD-10 dg. of F10.x) between 2010 and 2021. Age-adjusted mortality rates and life expectancies were calculated for the comparative analysis. Official Czech mortality and vital statistics were used for the comparison. A Poisson log-linear regression model was used to test the effect of the pandemic period (2020-2021) on mortality in the AUD target population. RESULTS: At age 20, the estimated life expectancy of the AUD target was 21-27 years less than that of the Czech general population. Excess mortality was relatively highest in young people aged 20-34 years and in adults aged 35-49 years. During the pandemic period 2020-2021, mortality rates in the target AUD increased significantly. However, relative inequalities with the general Czech population did not change significantly. DISCUSSION AND CONCLUSIONS: People hospitalised for AUD have much higher mortality rates, resulting in markedly reduced life expectancy. During the pandemic, their mortality rates increased even more. However, the increase was no greater than in the general Czech population.

• MeSH
• alkoholismus * mortalita   MeSH
• COVID-19 * epidemiologie   MeSH
• dospělí MeSH
• hospitalizace * trendy   statistika a číselné údaje   MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• naděje dožití * trendy   MeSH
• pandemie * MeSH
• poruchy způsobené alkoholem * mortalita   MeSH
• registrace MeSH
• retrospektivní studie MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

• Klíčová slova
• empagliflozin,
• MeSH
• chronická renální insuficience farmakoterapie   komplikace   moč   MeSH
• glifloziny * terapeutické užití   MeSH
• hospitalizace statistika a číselné údaje   MeSH
• kardiovaskulární látky klasifikace   terapeutické užití   MeSH
• klinická studie jako téma MeSH
• krevní tlak účinky léků   MeSH
• lidé MeSH
• prognóza MeSH
• srdeční selhání * farmakoterapie   komplikace   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• novinové články MeSH

Česká republika čelí výraznému stárnutí populace, což představuje nové výzvy pro zdravotní a sociální systémy. Počet osob starších 65 let tvoří zhruba 20,6 % populace, přičemž do roku 2100 by tato skupina mohla dosáhnout téměř třetiny populace. Potřeba zdravotní péče se s věkem exponenciálně zvyšuje, téměř 64 % osob nad 65 let trpí nějakou formou chronického onemocnění. Efektivní management potřeb seniorů je zásadní pro zlepšení jejich kvality života a optimalizaci zdravotnických zdrojů. Data ukazují, že senioři v péči geriatrů mají vyšší průměrné skóre Charlsonové komorbiditního indexu a čelí složitějším zdravotním výzvám než senioři ošetřovaní mimo geriatrickou péči. Mapování potřeb geriatrických pacientů na základě dostupných zdravotnických dat je ale složité, neboť nejsou definováni pouze věkem, ale mají i specifické potřeby přesahující zdravotní systém. Navíc existují výrazné regionální rozdíly v dostupnosti i tak personálně výrazně poddimenzované geriatrické péče. Zavedení nových kódů pro popis zdravotních stavů a intervencí a jejich důsledné vykazování mohou vést k přesnější identifikaci geriatrického pacienta ve zdravotních datech a umožní mapování potřeb geriatrických pacientů a úpravy systému zdravotní péče tak, aby byl připraven na demografické výzvy spojené se stárnutím české populace. Korespondenční adresa: RNDr. Jiří Jarkovský, Ph.D. Ústav zdravotnických informací a statistiky ČR Palackého náměstí 4 P. O. BOX 60, 128 01 Praha 2 e-mail: Jiri.Jarkovsky@uzis.cz

The Czech Republic is facing a significantly ageing population, which poses new challenges for health and social systems. The number of people over 65 years of age accounts for about 20.6 % of the population, and by 2100 this group could reach almost a third of the population. The need for healthcare increases exponentially with age, with almost 64 % of people over 65 suffering from some form of chronic disease. Effective management of the needs of the elderly is essential to improve their quality of life and optimise healthcare resources. Data show that seniors in geriatric care have higher average Charlson Comorbidity Index scores and face more complex health challenges than seniors cared for outside of geriatric care. However, mapping the needs of geriatric patients based on available healthcare data is difficult because they are not defined by age alone, but have specific needs that transcend the healthcare system. In addition, there are significant regional differences in the availability of already significantly understaffed geriatric care. The introduction of new codes to describe health conditions and interventions and their consistent reporting may lead to more accurate identification of geriatric patients in health data and allow mapping of geriatric patients’ needs and adjustments to the healthcare system to be prepared for the demographic challenges associated with the ageing of the Czech population.

• MeSH
• geriatrie organizace a řízení   statistika a číselné údaje   MeSH
• hospitalizace statistika a číselné údaje   MeSH
• komorbidita MeSH
• lidé MeSH
• senioři MeSH
• stárnutí * MeSH
• zdravotní služby pro seniory * organizace a řízení   statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Geografické názvy
• Česká republika MeSH

BACKGROUND AND AIMS: The question of when and how to treat truly asymptomatic patients with severe aortic stenosis (AS) and normal left ventricular (LV) systolic function is still subject to debate and ongoing research. Here, the results of extended follow-up of the AVATAR trial are reported (NCT02436655, ClinicalTrials.gov). METHODS: The AVATAR trial randomly assigned patients with severe, asymptomatic AS and LV ejection fraction ≥ 50% to undergo either early surgical aortic valve replacement (AVR) or conservative treatment with watchful waiting strategy. All patients had negative exercise stress testing. The primary hypothesis was that early AVR will reduce a primary composite endpoint comprising all-cause death, acute myocardial infarction, stroke, or unplanned hospitalization for heart failure (HF), as compared with conservative treatment strategy. RESULTS: A total of 157 low-risk patients (mean age 67 years, 57% men, mean Society of Thoracic Surgeons score 1.7%) were randomly allocated to either the early AVR group (n = 78) or the conservative treatment group (n = 79). In an intention-to-treat analysis, after a median follow-up of 63 months, the primary composite endpoint outcome event occurred in 18/78 patients (23.1%) in the early surgery group and in 37/79 patients (46.8%) in the conservative treatment group [hazard ratio (HR) early surgery vs. conservative treatment 0.42; 95% confidence interval (CI) 0.24-0.73, P = .002]. The Kaplan-Meier estimates for individual endpoints of all-cause death and HF hospitalization were significantly lower in the early surgery compared with the conservative group (HR 0.44; 95% CI 0.23-0.85, P = .012, for all-cause death and HR 0.21; 95% CI 0.06-0.73, P = .007, for HF hospitalizations). CONCLUSIONS: The extended follow-up of the AVATAR trial demonstrates better clinical outcomes with early surgical AVR in truly asymptomatic patients with severe AS and normal LV ejection fraction compared with patients treated with conservative management on watchful waiting.

• MeSH
• aortální chlopeň chirurgie   MeSH
• aortální stenóza * chirurgie   mortalita   terapie   MeSH
• asymptomatické nemoci terapie   MeSH
• avatar MeSH
• cévní mozková příhoda MeSH
• chirurgická náhrada chlopně * metody   MeSH
• hospitalizace statistika a číselné údaje   MeSH
• konzervativní terapie * metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• následné studie MeSH
• pozorné vyčkávání MeSH
• senioři MeSH
• tepový objem fyziologie   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• randomizované kontrolované studie MeSH
• srovnávací studie MeSH