3 research outputs found

    Process approach to management of patients with proximal femur fracture in city out-patient hospital

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    Objectives to analyze the results of process approach to managing patients with proximal femur fracture during one year after the injury, in primary health care center. Materials and methods.We compared the clinical data of patients with proximal femur fracture before the implementation of process management in primary health care and after it. The total number of patients was 233. We used statistical, analytical research methods, as well as organizational modeling. Results.The active use of process approach in the clinic resulted in statistically significant improvement in patients' complete rehabilitation, reduction of the number of local and general complications, and decrease of mortality rate during the first year after the injury from 35.2% to 8.5%. Conclusion.At the stage of primary health care, a step-by-step algorithm, which activates the patients effectively by involving a surgeon, a therapist and the patient's relatives in the rehabilitation process, contributes to mortality reduction, improvement of treatment and rehabilitation results

    Use of anticoagulants and antiplatelet agents in stable outpatients with coronary artery disease and atrial fibrillation. International CLARIFY registry

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    Chronic coronary syndromes without standard modifiable cardiovascular risk factors and outcomes: the CLARIFY registry

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    Background and Aims: It has been reported that patients without standard modifiable cardiovascular (CV) risk factors (SMuRFs—diabetes, dyslipidaemia, hypertension, and smoking) presenting with first myocardial infarction (MI), especially women, have a higher in-hospital mortality than patients with risk factors, and possibly a lower long-term risk provided they survive the post-infarct period. This study aims to explore the long-term outcomes of SMuRF-less patients with stable coronary artery disease (CAD). Methods: CLARIFY is an observational cohort of 32 703 outpatients with stable CAD enrolled between 2009 and 2010 in 45 countries. The baseline characteristics and clinical outcomes of patients with and without SMuRFs were compared. The primary outcome was a composite of 5-year CV death or non-fatal MI. Secondary outcomes were 5-year all-cause mortality and major adverse cardiovascular events (MACE—CV death, non-fatal MI, or non-fatal stroke). Results: Among 22 132 patients with complete risk factor and outcome information, 977 (4.4%) were SMuRF-less. Age, sex, and time since CAD diagnosis were similar across groups. SMuRF-less patients had a lower 5-year rate of CV death or non-fatal MI (5.43% [95% CI 4.08–7.19] vs. 7.68% [95% CI 7.30–8.08], P = 0.012), all-cause mortality, and MACE. Similar results were found after adjustments. Clinical event rates increased steadily with the number of SMuRFs. The benefit of SMuRF-less status was particularly pronounced in women. Conclusions: SMuRF-less patients with stable CAD have a substantial but significantly lower 5-year rate of CV death or non-fatal MI than patients with risk factors. The risk of CV outcomes increases steadily with the number of risk factors
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