AIMS: Several methods exist to identify hospital admissions related to adverse drug events (ADEs). Clinical adjudication by healthcare professionals is the gold standard but is labour-intensive. Spontaneous reporting and routinely collected healthcare data using a set of International Classification of Diseases (ICD) codes often underestimate the prevalence of ADE-related admissions. Expanding the set of ICD codes could improve detection; however, validation is limited. The objective was to describe the agreement between ADE-related ICD-10 codes and clinically adjudicated ADE-related admissions in 2 settings. METHODS: This study analysed 2 datasets: 1102 readmissions from a hospital in the Netherlands (180 ADE-related) and 1228 admissions from a hospital in the Czech Republic (195 ADE-related). Clinical adjudication involved expert review including causality assessment to identify ADE-related hospital admissions. The sensitivities and specificities were calculated for a narrow code set (higher drug-likelihood codes containing words like drug-induced) and a broad code set of ICD-10 codes (including codes very likely, likely and possibly ADE-related). RESULTS: The narrow ICD-10 set showed a sensitivity of 3% (95% confidence interval [CI] 2-6%) and a specificity of 99.6% (95% CI 99-100%). The broad set increased sensitivity to 27% (95% CI 23-32%), with specificity decreasing slightly to 92% (95% CI 91-94%). Preventable ADEs were identified less frequently with both ICD-10 code sets. CONCLUSIONS: Only 3% of ADE-related admissions were detected by the narrow ICD-code set and 27% by the broad code set without a significant drop in the specificity. ADE-related ICD codes seem to serve as triggers for 1 in 4 ADE-related hospital admissions.

• Klíčová slova
• adverse drug events, electronic health records, hospitalization, international classification of diseases, pharmacovigilance, preventability,
• MeSH
• dospělí MeSH
• hospitalizace * statistika a číselné údaje   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mezinárodní klasifikace nemocí * MeSH
• nežádoucí účinky léčiv * epidemiologie   diagnóza   MeSH
• příjem pacientů * statistika a číselné údaje   MeSH
• senioři MeSH
• senzitivita a specificita MeSH
• systémy pro sběr zpráv o nežádoucích účincích léků * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• validační studie MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Nizozemsko epidemiologie   MeSH

BACKGROUND: The initial rhythm is a known predictor of survival in extracorporeal cardiopulmonary resuscitation (ECPR) patients. However, the effect of the rhythm at hospital admission on outcomes in these patients is less clear. METHODS: This observational, single-center study assessed the influence of the rhythm at hospital admission on 30-day survival and neurological outcomes at discharge in patients who underwent ECPR for out-of-hospital cardiac arrest (OHCA). RESULTS: Between January 2012 and December 2023, 1,219 OHCA patients were admitted, and 210 received ECPR. Of these, 196 patients were analyzed. The average age was 52.9 years (±13), with 80.6 % male. The median time to ECPR initiation was 61 min (IQR 54-72). Patients with ventricular fibrillation as both the initial and admission rhythm had the highest 30-day survival rate (52 %: 35/67), while those with asystole in both instances had the lowest (6 %: 1/17, log-rank p < 0.00001). After adjusting for age, sex, initial rhythm, resuscitation time, location, bystander, and witnessed status, asystole at admission was linked to higher 30-day mortality (OR 4.03, 95 % CI 1.49-12.38, p = 0.009) and worse neurological outcomes (Cerebral Performance Category 3-5) at discharge (OR 4.61, 95 % CI 1.49-17.62, p = 0.013). CONCLUSIONS: The rhythm at hospital admission affects ECPR outcomes. Patients presenting with and maintaining ventricular fibrillation have a higher chance of favorable neurological survival, whereas those presenting with or converting to asystole have poor outcomes. The rhythm at hospital admission appears to be a valuable criterion for deciding on ECPR initiation.

• Klíčová slova
• Cardiac arrest, Cardiac rhythm, Cardiopulmonary resuscitation, Extracorporeal cardiopulmonary resuscitation, Extracorporeal membrane oxygenation, Heart arrest, Heart rhythm, Rhythm conversion,
• MeSH
• dospělí MeSH
• fibrilace komor terapie   mortalita   komplikace   MeSH
• hospitalizace * statistika a číselné údaje   MeSH
• kardiopulmonální resuscitace metody   statistika a číselné údaje   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mimotělní membránová oxygenace * metody   statistika a číselné údaje   MeSH
• míra přežití trendy   MeSH
• mozek * patofyziologie   MeSH
• příjem pacientů * statistika a číselné údaje   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• srdeční frekvence * fyziologie   MeSH
• zástava srdce mimo nemocnici terapie   mortalita   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH

PURPOSE: To describe temporal trends in inpatient care use for adult mental disorders in Czechia from 1994 until 2015. METHODS: Data from the nationwide register of inpatient care use and yearly census data were used to calculate (a) yearly admissions rates, (b) median length of stay, and (c) standardized inpatient-years for adult mental disorders (ICD-10 codes F0-F6] or G30). Segmented regressions were used to analyze age- and sex-specific temporal trends. RESULTS: Admission rates were increasing in adults (average annual percent change = 0.51; 95% confidence interval = 0.16 to 0.86 for females and 1.01; 0.63 to 1.40 for males) and adolescents and emerging adults (3.27; 2.57 to 3.97 for females and 2.98; 2.08 to 3.88 for males), whereas in seniors, the trend was stable (1.22; -0.31 to 2.73 for females and 1.35; -0.30 to 2.98 for males). The median length of stay for studied mental disorders decreased across all age and sex strata except for a stable trend in male adolescents and emerging adults (-0.96; -2.02 to 0.10). Standardized inpatient-years were decreasing in adults of both sexes (-0.85; -1.42 to -0.28 for females and -0.87; -1.19 to -0.56 for males), increasing in female adolescents and emerging adults (0.95; 0.42 to 1.47), and stable in the remaining strata. CONCLUSION: Psychiatric hospital admissions were increasing or stable coupled with considerable reductions in median length of stay, suggesting that inpatient episodes for adult mental disorders have become more frequent and shorter over time. The overall psychiatric inpatient care use was decreasing or stable in adults and seniors, potentially implying a gradual shift away from hospital-based care.

• Klíčová slova
• Central and Eastern Europe, Common mental disorders, Healthcare services, Hospital-based care, National data, Psychiatric hospitalization, Schizophrenia, Substance use disorders, Temporal trends,
• MeSH
• délka pobytu * statistika a číselné údaje   MeSH
• dospělí MeSH
• duševní poruchy * terapie   epidemiologie   MeSH
• hospitalizace * statistika a číselné údaje   trendy   MeSH
• hospitalizovaní pacienti * statistika a číselné údaje   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• příjem pacientů statistika a číselné údaje   trendy   MeSH
• registrace * MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

BACKGROUND: The present survey aims to describe the intensive cardiac care unit organization and admission policies in Europe. METHODS: A total of 228 hospitals (61% academic) from 27 countries participated in this survey. In addition to the organizational aspects of the intensive cardiac care units, including classification of the intensive cardiac care unit levels, data on the admission diagnoses were gathered from consecutive patients who were admitted during a two-day period. Admission policies were evaluated by comparing illness severity with the intensive cardiac care unit level. Gross national income was used to differentiate high-income countries (n=13) from middle-income countries (n=14). RESULTS: A total of 98% of the hospitals had an intensive cardiac care unit: 70% had a level 1 intensive cardiac care unit, 76% had a level 2 intensive cardiac care unit, 51% had a level 3 intensive cardiac care unit, and 60% of the hospitals had more than one intensive cardiac care unit level. High-income countries tended to have more level 3 intensive cardiac care units than middle-income countries (55% versus 41%, p=0.07). A total of 5159 admissions were scored on illness severity: 63% were low severity, 24% were intermediate severity, and 12% were high severity. Patients with low illness severity were predominantly admitted to level 1 intensive cardiac care units, whereas patients with high illness severity were predominantly admitted to level 2 and 3 intensive cardiac care units. A policy mismatch was observed in 12% of the patients; some patients with high illness severity were admitted to level 1 intensive cardiac care units, which occurred more often in middle-income countries, whereas some patients with low illness severity were admitted to level 3 intensive cardiac care units, which occurred more frequently in high-income countries. CONCLUSION: More than one-third of the admitted patients were considered intermediate or high risk. Although patients with higher illness severity were mostly admitted to high-level intensive cardiac care units, an admission policy mismatch was observed in 12% of the patients; this mismatch was partly related to insufficient logistic intensive cardiac care unit capacity.

• Klíčová slova
• Intensive cardiac care unit, acute cardiovascular care, admission policy, organization,
• MeSH
• jednotky intenzivní péče organizace a řízení   MeSH
• lidé MeSH
• morbidita trendy   MeSH
• nemoci srdce epidemiologie   terapie   MeSH
• příjem pacientů statistika a číselné údaje   MeSH
• průzkumy a dotazníky MeSH
• rizikové faktory MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH

The World Health Organization declared COVID-19, the infectious disease caused by the coronavirus SARS-CoV-2, a pandemic on March 12, 2020. COVID-19 is causing massive health problems and economic suffering around the world. The European Association for the Study of Obesity (EASO) promptly recognised the impact that the outbreak could have on people with obesity. On one side, emerging data suggest that obesity represents a risk factor for a more serious and complicated course of COVID-19 in adults. On the other side, the health emergency caused by the outbreak diverts attention from the prevention and care of non-communicable chronic diseases to communicable diseases. This might be particularly true for obesity, a chronic and relapsing disease frequently neglected and linked to significant bias and stigmatization. The Obesity Management Task Force (OMTF) of EASO contributes in this paper to highlighting the key aspects of these two sides of the coin and suggests some specific actions.

• Klíčová slova
• Barrier to treatment, COVID-19, Obesity, Pandemic, SARS-CoV-2,
• MeSH
• Betacoronavirus * MeSH
• COVID-19 MeSH
• dospělí MeSH
• koronavirové infekce epidemiologie   přenos   MeSH
• lidé středního věku MeSH
• lidé MeSH
• náchylnost k nemoci MeSH
• obezita komplikace   epidemiologie   MeSH
• pandemie statistika a číselné údaje   MeSH
• příjem pacientů statistika a číselné údaje   MeSH
• rizikové faktory MeSH
• SARS-CoV-2 MeSH
• senioři MeSH
• stupeň závažnosti nemoci MeSH
• Světová zdravotnická organizace MeSH
• vakcinace MeSH
• virová nálož MeSH
• virová pneumonie epidemiologie   přenos   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH

Despite the increase in awareness of chronic disease, little is known about whether multimorbidity-defined as two or more coexisting chronic conditions-has had a diminished impact on health in Europe in the past decade. We used multiple cross-sectional data from the Survey of Health, Ageing and Retirement in Europe to estimate changes in the prevalence of multimorbidity and in its association with health outcomes in ten European countries between 2006-07 and 2015. We found that the prevalence of multimorbidity rose from 38.2 percent in 2006-07 to 41.5 percent in 2015. Over the ten-year study period we also found a marginal reduction of the impact of multimorbidity on primary care visits and functional capacity. We did not find a reduction of its impact on hospital admissions and quality of life. Austria, the Czech Republic, Germany, and Spain were the countries that showed the largest reduction in the impact of multimorbidity on health outcomes. Multimorbidity continues to pose challenges for European health care systems, with only marginal improvement on health care use and health outcomes since 2006-07.

• Klíčová slova
• Chronic disease management models, Elderly, Europe, Functional capacity, Healthcare utilisation, Quality of life, multimorbidity,
• MeSH
• chronická nemoc MeSH
• databáze faktografické MeSH
• geriatrické hodnocení metody   MeSH
• hodnocení rizik MeSH
• hodnocení výsledků zdravotní péče * MeSH
• kvalita života MeSH
• lékařská podpora ekonomika   statistika a číselné údaje   MeSH
• lidé MeSH
• multimorbidita trendy   MeSH
• poskytování zdravotní péče organizace a řízení   MeSH
• prevalence MeSH
• příjem pacientů statistika a číselné údaje   MeSH
• průřezové studie MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• vládní programy ekonomika   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
• Research Support, N.I.H., Extramural MeSH
• Geografické názvy
• Česká republika MeSH
• Evropa MeSH
• Německo MeSH
• Španělsko MeSH

BACKGROUND: Providing the correct level of care for patients with intracerebral hemorrhage (ICH) is crucial, but the level of care needed at initial presentation may not be clear. This study evaluated factors associated with admission to intensive care unit (ICU) level of care. METHODS: This is an observational study of all adult patients admitted to our institution with non-traumatic supratentorial ICH presenting within 72 h of symptom onset between 2009-2012 (derivation cohort) and 2005-2008 (validation cohort). Factors associated with neuroscience ICU admission were identified via logistic regression analysis, from which a triage model was derived, refined, and retrospectively validated. RESULTS: For the derivation cohort, 229 patients were included, of whom 70 patients (31 %) required ICU care. Predictors of neuroscience ICU admission were: younger age [odds ratio (OR) 0.94, 95 % CI 0.91-0.97; p = 0.0004], lower Full Outline of UnResponsiveness (FOUR) score (0.39, 0.28-0.54; p < 0.0001) or Glasgow Coma Scale (GCS) score (0.55, 0.45-0.67; p < 0.0001), and larger ICH volume (1.04, 1.03-1.06; p < 0.0001). The model was further refined with clinician input and the addition of intraventricular hemorrhage (IVH). GCS was chosen for the model rather than the FOUR score as it is more widely used. The proposed triage ICH model utilizes three variables: ICH volume ≥30 cc, GCS score <13, and IVH. The triage ICH model predicted the need for ICU admission with a sensitivity of 94.3 % in the derivation cohort [area under the curve (AUC) = 0.88; p < 0.001] and 97.8 % (AUC = 0.88) in the validation cohort. CONCLUSIONS: Presented are the derivation, refinement, and validation of the triage ICH model. This model requires prospective validation, but may be a useful tool to aid clinicians in determining the appropriate level of care at the time of initial presentation for a patient with a supratentorial ICH.

• Klíčová slova
• Intensive care, Intracerebral hemorrhage, Triage,
• MeSH
• cerebrální krvácení diagnóza   diagnostické zobrazování   terapie   MeSH
• Glasgowská stupnice následků * MeSH
• intraventrikulární krvácení do mozku diagnóza   terapie   MeSH
• jednotky intenzivní péče statistika a číselné údaje   MeSH
• lidé středního věku MeSH
• lidé MeSH
• modely neurologické MeSH
• příjem pacientů statistika a číselné údaje   MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• třídění pacientů metody   normy   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH

BACKGROUND/OBJECTIVES: After the creation of the moderately severe acute pancreatitis (MSAP) category in the Revised Atlanta Classification in 2012, predictors to identify these patients early have not been identified. The MSAP category includes patients with (peri)pancreatic necrosis, fluid collections, and transient organ failure in the same category. However, these outcomes have not been studied to determine whether they result in similar outcomes to merit inclusion in the same severity. METHODS: Retrospective, review of 514 consecutive, direct admissions for acute pancreatitis from 2010 to 2013. Multivariate logistic regression identified predictors of MSAP. RESULTS: Persistent SIRS was the best prognostic marker of MSAP with AUC 0.72. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for persistent SIRS to predict MSAP are: 55%, 88%, 40%, 93%, and 84%. Patients with necrosis had significantly longer length of stay (LOS) (p = 0.0001) and higher rates of ICU admission (p = 0.02) compared with patients with transient organ failure. Compared to those with acute fluid collections, patients with necrosis had longer LOS (p < 0.0001), higher rates of ICU admission (p = 0.0005), required more interventions (p = 0.001), and demonstrated higher mortality (0.003). DISCUSSION: Moderately severe pancreatitis can be distinguished from mild pancreatitis on the basis of persistent SIRS but cannot be accurately distinguished from severe pancreatitis in the first 48 h (Peri)pancreatic necrosis demonstrates significantly more morbidity compared to the other components of MSAP of fluid collections and transient organ failure.

• Klíčová slova
• Fluid collection, Moderate, Necrotizing pancreatitis, Organ failure,
• MeSH
• akutní nekrotizující pankreatitida klasifikace   diagnóza   terapie   MeSH
• délka pobytu MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• multiorgánové selhání etiologie   MeSH
• péče o pacienty v kritickém stavu statistika a číselné údaje   MeSH
• plocha pod křivkou MeSH
• prediktivní hodnota testů MeSH
• příjem pacientů statistika a číselné údaje   MeSH
• prognóza MeSH
• reprodukovatelnost výsledků MeSH
• retrospektivní studie MeSH
• senioři MeSH
• syndrom systémové zánětlivé reakce MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Aim To verify and compare the accuracies of mortality predictions in the Intensive Care Unit (ICU) of the Internal Clinic of Central Military Hospital in Prague, Czech Republic, using model APACHE II and the newer systems of the APACHE IV, SAPS 3 and MPMo III. Methods The data were collected retrospectively between 2011 and 2012, 1000 patients were evaluated. The assessment of the overall accuracy of the mortality predictions was performed using the standardized mortality ratio (SMR), and the calibration was assessed using the Lemeshow-Hosmer "goodness-of-fit" C statistic. Discrimination was evaluated using ROC curves based on calculations of the areas under the curve (AUCs). Results The APACHE II, SAPS 3, and MPMo III systems significantly overestimated the expected mortality, whereas the APACHE IV model led to correct estimations of the overall mortality. The discrimination capabilities of the models assessed according to the constructions of the ROC curves were evaluated as good, only the APACHE II was evaluated as satisfactory. The calibrations of all models were evaluated as unsatisfactory. Conclusion The best mortality estimation for the investigated population sample was provided by the APACHE IV system. The discrimination capabilities of all models for the studied population were satisfactory, but the calibration of all of the systems was unsatisfactory. The conclusions of our study are limited by the relatively small size of the investigated sample and the fact that this study was conducted at only a single site.

• Klíčová slova
• Czech Republic, ROC curve, calibration, health status indicators, humans, intensive care units, models, mortality, prognosis, retrospective studies,
• MeSH
• jednotky intenzivní péče statistika a číselné údaje   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mortalita v nemocnicích * MeSH
• příjem pacientů statistika a číselné údaje   MeSH
• retrospektivní studie MeSH
• ROC křivka MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• stupeň závažnosti nemoci MeSH
• teoretické modely MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

OBJECTIVES: The aim of our study was to elucidate the current pattern of acute poisoning among children admitted to a regional University Hospital in the prefecture of Evros in Northern Greece. We also compared the obtained findings with those of two previous studies performed in the same region. METHODS: Demographic and clinical data, management, and outcome of children with acute poisoning were recorded in our region, during the past 5-years (2005-2009, period C) and compared to similar studies carried out in the periods 1985-1989 (period A) and 1995-1999 (period B). RESULTS: Comparison between the three periods showed that in period Athe lower incidence of children's acute poisoning (CAP) was observed. Also this revealed a 20%-reduction in the frequency of poisoning over the past 5-years (period C) compared to period B (p = 0.219), a significant increase in tobacco intoxication over the years (in the order A-C; p < 0.001 for comparisons of periods A and B, and periods B and C), while poisoning from insecticides-pesticides decreased (p < 0.001). The incidence of poisoning via salicylates significantly reduced from 9.7% in period A to 6.2% in period B, and further to 4.7% in period C (p = 0.016), whereas during the same periods poisoning via paracetamol increased from 2.3% to 5.1% and then to 10.4%, respectively (p < 0.001). Atrend toward a higher incidence of suicide attempt via poisoning was found during the three periods (from 3.0% in period A to 4.7% and 6.6%, in periods B and C, respectively; p = 0.049). CONCLUSIONS: The frequency of acute poisoning among children has decreased over the past 5 years. The incidences of poisoning via paracetamol and tobacco, and attempted suicide have increased in recent years. Targeted and continuous educational preventive programs are mandatory.

• MeSH
• dítě MeSH
• incidence MeSH
• kojenec MeSH
• lidé MeSH
• nemocnice univerzitní MeSH
• otrava epidemiologie   MeSH
• předškolní dítě MeSH
• příjem pacientů statistika a číselné údaje   trendy   MeSH
• socioekonomické faktory MeSH
• výsledky a postupy - zhodnocení (zdravotní péče) statistika a číselné údaje   trendy   MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Řecko epidemiologie   MeSH