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  1. Article ; Online: Nonalcoholic fatty liver disease: an update.

    Bedogni, Giorgio / Palmese, Francesco / Foschi, Francesco Giuseppe

    Current opinion in lipidology

    2023  Volume 34, Issue 3, Page(s) 114–118

    Abstract: Purpose of review: We discuss two recent controversial issues in the research field of fatty liver: the proposal to replace nonalcoholic fatty liver disease (NAFLD) with metabolically associated fatty liver disease (MAFLD) and the suggestion to extend ... ...

    Abstract Purpose of review: We discuss two recent controversial issues in the research field of fatty liver: the proposal to replace nonalcoholic fatty liver disease (NAFLD) with metabolically associated fatty liver disease (MAFLD) and the suggestion to extend to primary care the noninvasive testing for liver fibrosis that was developed for secondary care.
    Recent findings: There is preliminary evidence that MAFLD-only patients are at greater risk of fibrosis than NAFLD-only patients. There are a large number of false positives associated with the downshift of noninvasive testing for liver fibrosis from secondary to primary care.
    Summary: More studies are needed to compare the MAFLD and NAFLD operational definitions. Noninvasive testing of liver fibrosis also needs further evaluation before it can be used in primary care or in the general population.
    MeSH term(s) Humans ; Non-alcoholic Fatty Liver Disease/complications ; Non-alcoholic Fatty Liver Disease/diagnosis ; Liver Cirrhosis/diagnosis
    Language English
    Publishing date 2023-02-22
    Publishing country England
    Document type Review ; Journal Article
    ZDB-ID 1045394-5
    ISSN 1473-6535 ; 0957-9672
    ISSN (online) 1473-6535
    ISSN 0957-9672
    DOI 10.1097/MOL.0000000000000874
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  2. Article: Comparison of PIV and Other Immune Inflammation Markers of Oncological and Survival Outcomes in Patients Undergoing Radical Cystectomy.

    Russo, Pierluigi / Palermo, Giuseppe / Iacovelli, Roberto / Ragonese, Mauro / Ciccarese, Chiara / Maioriello, Giuseppe / Fantasia, Fabrizio / Bizzarri, Francesco Pio / Marino, Filippo / Moosavi, Koosha / Nigro, Domenico / Filomena, Giovanni Battista / Gavi, Filippo / Rossi, Francesco / Pinto, Francesco / Racioppi, Marco / Foschi, Nazario

    Cancers

    2024  Volume 16, Issue 3

    Abstract: Inflammation is widely acknowledged as a significant characteristic of cancer, playing a substantial function in both the initiation and advancement of cancers. In this research, we planned to compare pan-immune inflammation markers and other well-known ... ...

    Abstract Inflammation is widely acknowledged as a significant characteristic of cancer, playing a substantial function in both the initiation and advancement of cancers. In this research, we planned to compare pan-immune inflammation markers and other well-known markers (systemic immune inflammation index and neutrophil to lymphocyte ratio) to predict prognosis in individuals treated with radical cystectomy for bladder cancer.
    Methods: In this retrospective analysis, we focused on preoperative PIV, systemic immune inflammation index (SII), and neutrophil-lymphocyte ratio (NLR) in 193 individuals managed with radical cystectomy for bladder cancer between January 2016 and November 2022. Multivariable logistic regression assessments were performed to assess the predictive capabilities of PIV, SII, and NLR for infiltration of lymph nodes (N), aggressive tumor stage (pT3/pT4), and any non-organ limited disease at the time of RC. Multivariable Cox regression analyses were conducted to assess the predictive impact of PIV on Relapse-free survival (RFS), Cancer-specific survival (CSS), and Overall survival (OS).
    Results: Our individuals were divided into high PIV and low PIV cohorts using the optimal cut-off value (340.96 × 10
    Conclusions: Our study suggests that PIV and SII are two very similar markers that may serve as independent and significant predictors of aggressive disease and worse survival impacts on individuals undergoing radical cystectomy for bladder neoplasm.
    Language English
    Publishing date 2024-02-03
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2527080-1
    ISSN 2072-6694
    ISSN 2072-6694
    DOI 10.3390/cancers16030651
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  3. Article ; Online: Prediction of cardiovascular risk in patients with hepatocellular carcinoma receiving anti-angiogenic drugs: lessons from sorafenib.

    Stefanini, Bernardo / Tovoli, Francesco / Trevisani, Franco / Marseglia, Mariarosaria / Di Costanzo, Giovan Giuseppe / Cabibbo, Giuseppe / Sacco, Rodolfo / Pellizzaro, Filippo / Pressiani, Tiziana / Chen, Rusi / Ponziani, Francesca Romana / Foschi, Francesco Giuseppe / Magini, Giulia / Granito, Alessandro / Piscaglia, Fabio

    Internal and emergency medicine

    2024  

    Abstract: Antiangiogenics are associated with an increased risk of major adverse cardiac and cerebrovascular events (MACE). The identification of at-risk subjects is relevant in the case of hepatocellular carcinoma (HCC), for which anti-angiogenic TKIs and ... ...

    Abstract Antiangiogenics are associated with an increased risk of major adverse cardiac and cerebrovascular events (MACE). The identification of at-risk subjects is relevant in the case of hepatocellular carcinoma (HCC), for which anti-angiogenic TKIs and bevacizumab are used in first and subsequent lines of therapy, to select alternative drugs for patients with excessive risk. We verified the ability to predict MACE in sorafenib-treated patients of the 2022 European Society of Cardiology (ESC-2022) score for anti-angiogenics and the recently proposed CARDIOSOR score. A retrospective analysis was conducted of prospectively collected data of the ARPES and ITA.LI.CA databases. All patients received sorafenib for unresectable HCC from 2008 to 2018. Baseline information to calculate the ESC-2022 and CARDIOSOR scores and registration of evolutive events (including MACE) were available for all patients. The predictive ability of both scores was verified using competing risk regressions and tests for goodness of fit. This study included 843 patients (median follow-up 11.3 months). Thirty-four (4.0%) patients presented a MACE. The four-tier ESC-2022 classification showed a progressive risk increase for every class (cumulative risk 1.7%, 2.7%, 4.3%, and 15.0% in the low, medium, high, and high-risk tiers, respectively). The dichotomous CARDIOSOR scale identified a high-risk group with a fourfold increased risk of MACE (sHR 4.66, p = 0.010; cumulative risk 3.8% and 16.4%). ESC-2022 showed a better goodness of fit compared to the CARDIOSOR score [C-index 0.671 (0.583-0.758) vs 0.562 (0.501-0.634), p = 0.021], but this gap was eliminated using the linear version of CARDIOSOR. Both the ESC-2022 and CARDIOSOR scores discriminated patients at increased risk for MACE. The use of these scores in clinical practice should be encouraged, since therapeutic measures can mitigate the cardiovascular risk.
    Language English
    Publishing date 2024-03-29
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2454173-4
    ISSN 1970-9366 ; 1828-0447
    ISSN (online) 1970-9366
    ISSN 1828-0447
    DOI 10.1007/s11739-024-03578-8
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  4. Article ; Online: Comparative Analysis of Subclassification Systems in Patients with Intermediate-Stage Hepatocellular Carcinoma (Barcelona Clinic Liver Classification B) Receiving Systemic Therapy.

    Ielasi, Luca / Stefanini, Bernardo / Conti, Fabio / Tonnini, Matteo / Tortora, Raffaella / Magini, Giulia / Sacco, Rodolfo / Pressiani, Tiziana / Trevisani, Franco / Foschi, Francesco Giuseppe / Piscaglia, Fabio / Granito, Alessandro / Tovoli, Francesco

    Current oncology (Toronto, Ont.)

    2024  Volume 31, Issue 1, Page(s) 547–557

    Abstract: Background: Intermediate-stage hepatocellular carcinoma (BCLC B HCC) occurs in a heterogeneous group of patients and can be addressed with a wide spectrum of treatments. Consequently, survival significantly varies among patients. In recent years, ... ...

    Abstract Background: Intermediate-stage hepatocellular carcinoma (BCLC B HCC) occurs in a heterogeneous group of patients and can be addressed with a wide spectrum of treatments. Consequently, survival significantly varies among patients. In recent years, several subclassification systems have been proposed to stratify patients' prognosis. We analyzed and compared these systems (Bolondi, Yamakado, Kinki, Wang, Lee, and Kim criteria) in patients undergoing systemic therapy.
    Methods: We considered 171 patients with BCLC B HCC treated with sorafenib as first-line systemic therapy in six Italian centers from 2010 to 2021 and retrospectively applied the criteria of six different subclassification systems.
    Results: Except for the Yamakado criteria, all the subclassification systems showed a statistically significant correlation to overall survival (OS). In the postestimation analysis, the Bolondi criteria (OS of subgroups 22.5, 11.9, and 6.6 mo, respectively; C-index 0.586; AIC 1338; BIC 1344) and the Wang criteria (OS of subgroups 20.6, 11.9, and 7.0, respectively; C-index 0.607; AIC 1337; BIC 1344) presented the best accuracy. Further analyses of these two subclassification systems implemented with the prognostic factor of alpha-fetoprotein (AFP) > 400 ng/mL have shown an increase in accuracy for both systems (C-index 0.599 and 0.624, respectively).
    Conclusions: Intermediate-stage subclassification systems maintain their predictive value also in the setting of systemic therapy. The Bolondi and Wang criteria showed the highest accuracy. AFP > 400 ng/mL enhances the performance of these systems.
    MeSH term(s) Humans ; Carcinoma, Hepatocellular/drug therapy ; Liver Neoplasms/drug therapy ; alpha-Fetoproteins ; Retrospective Studies ; Neoplasm Staging
    Chemical Substances alpha-Fetoproteins
    Language English
    Publishing date 2024-01-19
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 1236972-x
    ISSN 1718-7729 ; 1198-0052
    ISSN (online) 1718-7729
    ISSN 1198-0052
    DOI 10.3390/curroncol31010038
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  5. Article ; Online: Direct oral anticoagulants for the treatment of splanchnic vein thrombosis: A state of art.

    Monaco, Giovanni / Bucherini, Luca / Stefanini, Bernardo / Piscaglia, Fabio / Foschi, Francesco Giuseppe / Ielasi, Luca

    World journal of gastroenterology

    2023  Volume 29, Issue 33, Page(s) 4962–4974

    Abstract: Splanchnic vein thrombosis (SVT) is a manifestation of venous thromboembolism in an unusual site. Portal, mesenteric, and splenic veins are the most common vessels involved in SVT which occurs mainly in patients with liver cirrhosis, although non- ... ...

    Abstract Splanchnic vein thrombosis (SVT) is a manifestation of venous thromboembolism in an unusual site. Portal, mesenteric, and splenic veins are the most common vessels involved in SVT which occurs mainly in patients with liver cirrhosis, although non-cirrhotic patients could be affected as well. Thrombosis of hepatic veins, also known as Budd-Chiari syndrome, is another manifestation of SVT. Prompt diagnosis and intervention are mandatory in order to increase the recalization rate and reduce the risk of thrombus progression and hypertensive complications. Traditional anticoagulation with heparin and vitamin-K antagonists is the treatment of choice in these cases. However, recent studies have shown promising results on the efficacy and safety of direct oral anticoagulants (DOACs) in this setting. Available results are mainly based on retrospective studies with small sample size, but first clinical trials have been published in the last years. This manuscript aims to provide an updated overview of the current evidence regarding the role of DOACs for SVT in both cirrhotic and non-cirrhotic patients.
    MeSH term(s) Humans ; Retrospective Studies ; Anticoagulants/adverse effects ; Heparin ; Budd-Chiari Syndrome ; Venous Thromboembolism
    Chemical Substances Anticoagulants ; Heparin (9005-49-6)
    Language English
    Publishing date 2023-09-05
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2185929-2
    ISSN 2219-2840 ; 1007-9327
    ISSN (online) 2219-2840
    ISSN 1007-9327
    DOI 10.3748/wjg.v29.i33.4962
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  6. Article: Assessing Trifecta and Pentafecta Success Rates between Robot-Assisted vs. Open Radical Cystectomy: A Propensity Score-Matched Analysis.

    Gavi, Filippo / Foschi, Nazario / Fettucciari, Daniele / Russo, Pierluigi / Giannarelli, Diana / Ragonese, Mauro / Gandi, Carlo / Balocchi, Giovanni / Francocci, Alessandra / Bizzarri, Francesco Pio / Marino, Filippo / Filomena, Giovanni Battista / Palermo, Giuseppe / Totaro, Angelo / Racioppi, Marco / Bientinesi, Riccardo / Sacco, Emilio

    Cancers

    2024  Volume 16, Issue 7

    Abstract: Background: This study aimed to evaluate the surgical and oncological outcomes of robot-assisted radical cystectomy (RARC) versus open radical cystectomy (ORC) using trifecta and pentafecta parameters.: Methods: The clinical data of 41 patients who ... ...

    Abstract Background: This study aimed to evaluate the surgical and oncological outcomes of robot-assisted radical cystectomy (RARC) versus open radical cystectomy (ORC) using trifecta and pentafecta parameters.
    Methods: The clinical data of 41 patients who underwent RARC between 2018 and 2022 were prospectively collected and retrospectively compared to those of 330 patients undergoing ORC using 1:1 propensity score matching. Trifecta was defined as simultaneous negative surgical margins (SMs), a lymph node (LN) yield ≥ 16, and the absence of major complications (Clavien-Dindo grade III-V) within 90 days postoperatively. Pentafecta additionally included a 12-month recurrence-free rate and a time between the transurethral resection of a bladder tumor (TURBT) and radical cystectomy (RC) ≤ 3 months. The continuous variables were compared using the Mann-Whitney U test, and the categorical variables were analyzed using the chi-squared test.
    Results: No statistically significant differences in trifecta and pentafecta success rates were observed between the RARC and ORC cohorts after propensity score matching. However, the RARC group exhibited significantly reduced blood loss (RARC: 317 mL vs. ORC: 525 mL,
    Conclusions: RARC offers distinct advantages over ORC in terms of reduced blood loss, while trifecta and pentafecta success rates do not differ significantly between the two surgical approaches.
    Language English
    Publishing date 2024-03-25
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2527080-1
    ISSN 2072-6694
    ISSN 2072-6694
    DOI 10.3390/cancers16071270
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  7. Article ; Online: Predictive factors of surgical complications after pelvic exenteration for gynecological malignancies: a large single-institution experience.

    Tortorella, Lucia / Marco, Cintoni / Loverro, Matteo / Carmine, Conte / Persichetti, Eleonora / Bizzarri, Nicolò / Barbara, Costantini / Francesco, Santullo / Foschi, Nazario / Gallotta, Valerio / Avesani, Giacomo / Chiantera, Vito / Ercoli, Alfredo / Fanfani, Francesco / Fagotti, Anna / Mele, Maria Cristina / Restaino, Stefano / Gueli Alletti, Salvatore / Scambia, Giovanni /
    Vizzielli, Giuseppe

    Journal of gynecologic oncology

    2023  Volume 35, Issue 1, Page(s) e4

    Abstract: Objective: To evaluate pre-operative predictors of early (<30 days) severe complications (grade Dindo 3+) in patients with gynecological malignancy submitted to pelvic exenteration (PE).: Methods: We retrospectively analyzed 129 patients submitted to ...

    Abstract Objective: To evaluate pre-operative predictors of early (<30 days) severe complications (grade Dindo 3+) in patients with gynecological malignancy submitted to pelvic exenteration (PE).
    Methods: We retrospectively analyzed 129 patients submitted to surgery at Fondazione Policlinico Gemelli between 2010 and 2019. We included patients affected by primary or recurrent/persistent cervical, endometrial, or vulvar/vaginal cancers. Post-operative complications were graded according to the Dindo classification. Logistic regression was used to analyze potential predictors of complications.
    Results: We performed 63 anterior PE, 10 posterior PE, and 56 total PE. The incidence of early severe post-operative complications was 27.9% (n=36), and the early mortality rate was 2.3% (n=3). More frequent complications were related to the urinary diversion and intestinal surgery. In univariable analysis, hemoglobin ≤10 g/dL (odds ratio [OR]=4.2; 95% confidence interval [CI]=1.65-10.7; p=0.003), low albumin levels (OR=3.9; 95% CI=1.27-12.11; p=0.025), diabetes (OR=4.15; 95% CI=1.22-14.1; p=0.022), 2+ comorbidities at presentation (OR=5.18; 95% CI=1.49-17.93; p=0.012) were predictors of early severe complications. In multivariable analysis, only low hemoglobin and comorbidities at presentation were independent predictors of complications.
    Conclusion: Pelvic exenteration is an aggressive surgery characterized by a high rate of post-operative complications. Pre-operative assessment of comorbidities and patient health status are crucial to better select the right candidate for this type of surgery.
    MeSH term(s) Female ; Humans ; Genital Neoplasms, Female/epidemiology ; Pelvic Exenteration/adverse effects ; Retrospective Studies ; Vulvar Neoplasms/surgery ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Hemoglobins ; Neoplasm Recurrence, Local/epidemiology ; Neoplasm Recurrence, Local/etiology
    Chemical Substances Hemoglobins
    Language English
    Publishing date 2023-09-11
    Publishing country Korea (South)
    Document type Journal Article
    ZDB-ID 2478405-9
    ISSN 2005-0399 ; 2005-0380
    ISSN (online) 2005-0399
    ISSN 2005-0380
    DOI 10.3802/jgo.2024.35.e4
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    Zs.A 6484: Show issues Location:
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  8. Article ; Online: Characteristics and outcome of anti-hepatitis D virus positive patients with hepatocellular carcinoma.

    Giannini, Edoardo G / Pasta, Andrea / Pieri, Giulia / Plaz Torres, Maria Corina / Marseglia, Mariarosaria / Pelizzaro, Filippo / Sangiovanni, Angelo / Cabibbo, Giuseppe / Ghittoni, Giorgia / Di Marco, Mariella / Foschi, Francesco Giuseppe / Guarino, Maria / Biasini, Elisabetta / Saitta, Carlo / Campani, Claudia / Svegliati-Baroni, Gianluca / Gasbarrini, Antonio / Brunetto, Maurizia Rossana / Magalotti, Donatella /
    Azzaroli, Francesco / Mega, Andrea / Sacco, Rodolfo / Nardone, Gerardo / Sacerdoti, David / Masotto, Alberto / Vidili, Gianpaolo / Bucci, Laura / Vitale, Alessandro / Trevisani, Franco

    Liver international : official journal of the International Association for the Study of the Liver

    2024  

    Abstract: Background & aims: Chronic hepatitis D virus (HDV) often leads to end-stage liver disease and hepatocellular carcinoma (HCC). Comprehensive data pertaining to large populations with HDV and HCC are missing, therefore we sought to assess the ... ...

    Abstract Background & aims: Chronic hepatitis D virus (HDV) often leads to end-stage liver disease and hepatocellular carcinoma (HCC). Comprehensive data pertaining to large populations with HDV and HCC are missing, therefore we sought to assess the characteristics, management, and outcome of these patients, comparing them to patients with hepatitis B virus (HBV) infection.
    Methods: We analysed the Italian Liver Cancer database focusing on patients with positivity for HBV surface antigen and anti-HDV antibodies (HBV/HDV, n = 107) and patients with HBV infection alone (n = 588). Clinical and oncological characteristics, treatment, and survival were compared in the two groups.
    Results: Patients with HBV/HDV had worse liver function [Model for End-stage Liver Disease score: 11 vs. 9, p < .0001; Child-Turcotte-Pugh score: 7 vs. 5, p < .0001] than patients with HBV. HCC was more frequently diagnosed during surveillance (72.9% vs. 52.4%, p = .0002), and the oncological stage was more frequently Milan-in (67.3% vs. 52.7%, p = .005) in patients with HBV/HDV. Liver transplantation was more frequently performed in HBV/HDV than in HBV patients (36.4% vs. 9.5%), while the opposite was observed for resection (8.4% vs. 20.1%, p < .0001), and in a competing risk analysis, HBV/HDV patients had a higher probability of receiving transplantation, independently of liver function and oncological stage. A trend towards longer survival was observed in patients with HBV/HDV (50.4 vs. 44.4 months, p = .106).
    Conclusions: In patients with HBV/HDV, HCC is diagnosed more frequently during surveillance, resulting in a less advanced cancer stage in patients with more deranged liver function than HBV alone. Patients with HBV/HDV have a heightened benefit from liver transplantation, positively influencing survival.
    Language English
    Publishing date 2024-03-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2102783-3
    ISSN 1478-3231 ; 1478-3223
    ISSN (online) 1478-3231
    ISSN 1478-3223
    DOI 10.1111/liv.15855
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  9. Article ; Online: Sorafenib and Metronomic Capecitabine in Child-Pugh B patients with advanced HCC: A real-life comparison with best supportive care.

    Stefanini, Benedetta / Bucci, Laura / Santi, Valentina / Reggidori, Nicola / Lani, Lorenzo / Granito, Alessandro / Pelizzaro, Filippo / Cabibbo, Giuseppe / Di Marco, Mariella / Ghittoni, Giorgia / Campani, Claudia / Svegliati-Baroni, Gianluca / Foschi, Francesco Giuseppe / Giannini, Edoardo G / Biasini, Elisabetta / Saitta, Carlo / Magalotti, Donatella / Sangiovanni, Angelo / Guarino, Maria /
    Gasbarrini, Antonio / Rapaccini, Gian Ludovico / Masotto, Alberto / Sacco, Rodolfo / Vidili, Gianpaolo / Mega, Andrea / Azzaroli, Francesco / Nardone, Gerardo / Brandi, Giovanni / Sabbioni, Simone / Vitale, Alessandro / Trevisani, Franco

    Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver

    2024  

    Abstract: Background and aims: The efficacy of systemic therapy for unresectable advanced hepatocellular carcinoma (aHCC) has not been proven in patients with Child-Pugh (C-P) B cirrhosis. Nevertheless, in real-world these patients are treated both with tyrosine ... ...

    Abstract Background and aims: The efficacy of systemic therapy for unresectable advanced hepatocellular carcinoma (aHCC) has not been proven in patients with Child-Pugh (C-P) B cirrhosis. Nevertheless, in real-world these patients are treated both with tyrosine kinase inhibitors (TKIs) and with metronomic capecitabine (MC). This study aimed to compare sorafenib and MC outcomes versus best supportive care (BSC) in C-P B patients.
    Method: Between 2008 and 2020, among 774 C-P B patients with aHCC not amenable/responsive to locoregional treatments, 410 underwent sorafenib, 62 MC, and 302 BSC. The propensity score matching method was used to correct the baseline unbalanced prognostic factors.
    Results: In the unmatched population, median OS was 9.7 months in patients treated with sorafenib, 8.0 with MC, and 3.9 months with BSC. In sorafenib vs. BSC-matched patients (135 couples), median OS was 7.3 (4.9-9.6) vs. 3.9 (2.6-5.2) months (p<0.001). ECOG-Performance Status, tumor size, macrovascular invasion, AFP, treatment-naive, and sorafenib were independent predictors of survival. In MC vs. BSC-matched patients (40 couples), median OS was 9.0 (0.2-17.8) vs.3.0 (2.2-3.8) months (p<0.001). Median OS did not differ (p = 0.283) in sorafenib vs. MC-matched patients (55 couples).
    Conclusion: C-P B patients with aHCC undergoing BSC have poor survival. Both Sorafenib and MC treatment improve their prognosis.
    Language English
    Publishing date 2024-02-09
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1459373-7
    ISSN 1878-3562 ; 1125-8055
    ISSN (online) 1878-3562
    ISSN 1125-8055
    DOI 10.1016/j.dld.2024.01.199
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  10. Article ; Online: Development and internal validation of a multivariable model for the prediction of the probability of 1-year readmission to the emergency department for acute alcohol intoxication.

    Palmese, Francesco / Bonavita, Maria Elena / Pompili, Enrico / Reggidori, Nicola / Migliano, Maria Teresa / Di Stefano, Cecilia / Grieco, Marta / Colazzo, Stefano / Baldassarre, Maurizio / Caraceni, Paolo / Foschi, Francesco Giuseppe / Giostra, Fabrizio / Farina, Gabriele / Del Toro, Rossella / Bedogni, Giorgio / Domenicali, Marco

    Internal and emergency medicine

    2023  Volume 19, Issue 3, Page(s) 823–829

    Abstract: To develop and internally validate a multivariable logistic regression model (LRM) for the prediction of the probability of 1-year readmission to the emergency department (ED) in patients with acute alcohol intoxication (AAI). We developed and internally ...

    Abstract To develop and internally validate a multivariable logistic regression model (LRM) for the prediction of the probability of 1-year readmission to the emergency department (ED) in patients with acute alcohol intoxication (AAI). We developed and internally validated the LRM on a previously analyzed retrospective cohort of 3304 patients with AAI admitted to the ED of the Sant'Orsola-Malpighi Hospital (Bologna, Italy). The benchmark LRM employed readmission to the same ED for AAI within 1 year as the binary outcome, age as a continuous predictor, and sex, alcohol use disorder, substance use disorder, at least one previous admission for trauma, mental or behavioral disease, and homelessness as the binary predictors. Optimism correction was performed using the bootstrap on 1000 samples without replacement. The benchmark LRM was gradually simplified to get the most parsimonious LRM with similar optimism-corrected overall fit, discrimination and calibration. The 1-year readmission rate was 15.7% (95% CI 14.4-16.9%). A reduced LRM based on sex, age, at least one previous admission for trauma, mental or behavioral disease, and homelessness, performed nearly as well as the benchmark LRM. The reduced LRM had the following optimism-corrected metrics: scaled Brier score 17.0%, C-statistic 0.799 (95% CI 0.778 to 0.821), calibration in the large 0.000 (95% CI - 0.099 to 0.099), calibration slope 0.985 (95% CI 0.893 to 1.088), and an acceptably accurate calibration plot. An LRM based on sex, age, at least one previous admission for trauma, mental or behavioral disease, and homelessness can be used to estimate the probability of 1-year readmission to ED for AAI. To begin proving its clinical utility, this LRM should be validated in external cohorts.
    MeSH term(s) Humans ; Patient Readmission/statistics & numerical data ; Emergency Service, Hospital/statistics & numerical data ; Emergency Service, Hospital/organization & administration ; Male ; Female ; Adult ; Alcoholic Intoxication ; Middle Aged ; Retrospective Studies ; Italy ; Logistic Models ; Probability
    Language English
    Publishing date 2023-12-14
    Publishing country Italy
    Document type Journal Article ; Validation Study
    ZDB-ID 2454173-4
    ISSN 1970-9366 ; 1828-0447
    ISSN (online) 1970-9366
    ISSN 1828-0447
    DOI 10.1007/s11739-023-03490-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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