von Hans-Josef Feistritzer ; Alexander Jobs ; Uwe Zeymer ; Steffen Schneider ; Philipp Lauten ; Miroslaw Ferenc ; Maren Weferling ; Regine Brinkmann ; Sebastian Winkler ; Ulf Landmesser ; Tobias Daniel Trippel ; Christoph Stellbrink ; Harm Wienbergen ; Georg Fürnau ; Helge Möllmann ; Axel Linke ; Christian Jung ; Alexander Lauten ; Stephan Achenbach ; Tienush Rassaf ; Thomas Schmitz ; Sebastian Cremer ; Christoph Olivier ; Volker Schächinger ; Samuel Tobias Sossalla ; Karl Toischer ; Christian Templin ; Daniel Sedding ; Peter Clemmensen ; Eike Philipp Tigges ; Felix Meincke ; Haitham Abu Sharar ; Saarraaken Kulenthiran ; Paul Christian Schulze ; Claudius Jacobshagen ; Derk Frank ; Stephan Baldus ; Ralf Lehmann ; Christian Spies ; Norbert Klein ; Ingo Eitel ; Ralf Zahn ; Alexander Schmeisser ; Tommaso Gori ; Philipp Lurz ; Ibrahim Akın ; Georgios Chatzis ; Konstantinos Rizas ; Thorsten Keßler ; Fadil Ademaj ; Albrecht Elsässer ; Lars Siegfried Maier ; Alper Öner ; Alexander Staudt ; Nikos Werner ; Tobias Geisler ; Mirjam Keßler ; Markus Ferrari ; Melchior Seyfarth ; Peter Johann Nordbeck ; Sebastian Ewen ; Christian Bietau ; Arash Haghikia ; Sebastian J. Reinstadler ; Alexander Geppert ; Nadine Hösler ; Gabor Toth-Gayor ; Björn Ulrich Nicolas Billmann ; Ramon Tschierschke ; Christian Schmidt ; Stephan Fichtlscherer ; Holger Thiele
Online verfügbar: 8. April 2025, Artikelversion: 1. Mai 2025 ; Gesehen am 19.08.2025
Background - Multivessel coronary artery disease (CAD) is present in 30% to 70% of patients presenting with non-ST-segment elevation myocardial infarction (NSTEMI) depending on varying age and risk profiles. In contrast to the STEMI cohort, there is only limited scientific evidence derived from randomized controlled trials directing the general decision for or against complete revascularization in the NSTEMI population. - Primary hypothesis - The COMPLETE-NSTEMI trial aims to investigate whether multivessel percutaneous coronary intervention (PCI) is superior over culprit-lesion only PCI in patients with NSTEMI and multivessel CAD. - Design - COMPLETE-NSTEMI is a prospective, randomized, controlled, multicenter, parallel group, open-label trial. It will enroll 3390 NSTEMI patients with multivessel CAD at 65 to 70 sites in Germany and Austria. Patients will be randomized 1:1 to either complete revascularization with PCI or culprit lesion-only PCI. - Endpoints - The primary efficacy endpoint is a composite of cardiovascular death or rehospitalization for nonfatal myocardial infarction during follow-up. The trial is event-driven and will be stopped as soon as 578 primary endpoint events and a minimal follow-up duration of 12 months for each patient are reached. - Current status - The first patient was enrolled at October 27, 2023. By April 2025, 51 sites have been activated and >500 patients have been randomized. Completion of recruitment is expected for the first half of 2027. The final results of the primary endpoint are expected in 2028. - Outlook - COMPLETE NSTEMI will be the first dedicated trial to answer the question about the optimal revascularization strategy in patients with NSTEMI and multivessel CAD. - Trial registration: ClinicalTrials.gov - NCT05786131
American heart journal Amsterdam [u.a.] : Elsevier, 1925 287(2025), Seite 94-106 Online-Ressource
Online veröffentlicht: 5. Juni 2024 ; Gesehen am 22.01.2025
childhood interstitial lung disease; health related quality of life
Introduction Childhood interstitial lung disease (chILD) is a heterogeneous group of mostly chronic respiratory disorders. Assessment of health-related quality of life (HrQoL) in chILD has become increasingly important in clinical care and research. The aim of this study was to assess differences between patient-reported (self) and caregiver-reported (proxy) HrQoL scores. Methods This study used data obtained from the chILD-EU Register. After inclusion (baseline), the patient's health status was followed up at predefined study visits. At each study visit, caregivers and patients were handed validated, age-specific HrQoL questionnaires. HrQoL data entered at baseline were used to compare self- and proxy-reported HrQoL scores. For the longitudinal analysis, we compared HrQoL scores between the baseline and the next follow-up visit. Results No differences between patient- and caregiver-reported HrQoL scores were found for school functioning, chILD-specific questionnaire score, and physical health summary score. Self-reported HrQoL scores were higher for the subscales emotional functioning (77.4 vs. 70.7; p < .001), social functioning (81.9 vs. 76.2; p < .001), as well as psycho-social summary score (76.5 vs. 71.8; p < .001) and total score (74.7 vs. 70.8; <.001). The longitudinal analysis showed that a significant change in a patient-reported HrQoL score resulted in a significant change in a caregiver-reported HrQoL score after a mean time of 11.0 months (SD 9.4). Conclusions We found a good agreement between children- and caregiver-related HrQoL scores. In chILD, caregivers are able to sense changes in children's HrQoL scores over time and may be used as a proxy for children unable to complete HrQoL questionnaires.
Pediatric pulmonology New York, NY [u.a.] : Wiley-Liss, 1985 59(2024), 10 vom: Okt., Seite 2572-2579 Online-Ressource
von Raymond Voltz ; Gloria Dust ; Nicolas Schippel ; Stefanie Hamacher ; Sheila Payne ; Nadine Scholten ; Holger Pfaff ; Christian Rietz ; Julia Strupp ; Lena Ansmann
adult palliative care; change management; quality in health care
Objectives To set up a pragmatic Plan-Do-Study-Act cycle by analysing patient experiences and determinants of satisfaction with care in the last year of life. - Design Cross-sectional postbereavement survey. - Setting Regional health services research and development structure representing all health and social care providers involved in the last year of life in Cologne, a city with 1 million inhabitants in Germany. - Participants 351 bereaved relatives of adult decedents, representative for age and gender, accidental and suspicious deaths excluded. - Results For the majority (89%) of patients, home was the main place of care during their last year of life. Nevertheless, 91% of patients had at least one hospital admission and 42% died in hospital. Only 60% of informants reported that the decedent had been told that the disease was leading to death. Hospital physicians broke the news most often (58%), with their communication style often (30%) being rated as ‘not sensitive’. Informants indicated highly positive experiences with care provided by hospices (89% ‘good’) and specialist palliative home care teams (87% ‘good’). This proportion dropped to 41% for acute care hospitals, this rating being determined by the feeling of not being treated with respect and dignity (OR=23.80, 95% CI 7.503 to 75.498) and the impression that hospitals did not work well together with other services (OR=8.37, 95% CI 2.141 to 32.71). - Conclusions Following those data, our regional priority for action now is improvement of care in acute hospitals, with two new projects starting, first, how to recognise and communicate a limited life span, and second, how to improve care during the dying phase. Results and further improvement projects will be discussed in a working group with the city of Cologne, and repeating this survey in 2 years will be able to measure regional achievements. - Trial registration number DRKS00011925.
BMJ open London : BMJ Publishing Group, 2011 10(2020,11) Artikel-Nummer e035988, 10 Seiten Online-Ressource
