Early Albumin Administration in Veno-Arterial Extracorporeal Membrane Oxygenation.

Background: The clinical outcome and fluid balance of patients with veno-arterial extracorporeal membrane oxygenation (VA ECMO) or after extracorporeal cardiopulmonary resuscitation (eCPR) may be improved by addressing the high fluid demand with an early albumin administration.

Methods: In this prospective observational study, patients supported with VA ECMO or eCPR received early albumin administration (25 g/L) to prime the VA ECMO system. These patients were compared to patients who received a regimen based solely on balanced crystalloids (crystalloid group) or a regimen based on a 1:4 volume mixture of albumin (10 g/L) and balanced crystalloids (albumin group).

Evaluating the cost, cost-effectiveness and survival of an eHealth-facilitated integrated care model for allogeneic stem cell transplantation: Results of the German SMILe randomized, controlled implementation science trial.

Purpose: eHealth-facilitated integrated care models (eICMs) have proved effective in improving outcomes for chronically ill patients. However, evidence on cost-effectiveness of eICMs is scarce so far. Allogeneic stem cell transplantation (alloSCT) recipients' post-discharge treatment costs and mortality are greatly influenced by complications.

Delirium after cardiac arrest: incidence, risk factors, and association with neurologic outcome-insights from the Freiburg Delirium Registry.

Aim: Delirium in patients treated in the intensive care unit (ICU) is linked to adverse outcome, according to previous observations. However, data on patients recovering after cardiac arrest are sparse. The aim of this study was to assess incidence, risk factors, and outcome of patients with delirium after cardiac arrest in the Freiburg Delirium Registry (FDR).

[Identification of psychosocially stressed families by practice pediatricians : Results on the effectiveness of the PATH (Pediatric Attention To Help) intervention].

Background: In Germany, about a fifth of families with young children live under psychosocially stressful conditions that can threaten the healthy development of the child. In order to improve the referral of these families from pediatric practices to early childhood intervention services ("Frühe Hilfen"), the PATH intervention was developed and implemented in Baden-Württemberg. The first step in the referral process is to identify psychosocially stressed families.

Correlation of greyzone fibrosis compared to troponin T and late gadolinium enhancement with survival and ejection fraction in patients after acute myocardial infarction.

Aims: To quantify greyzone fibrosis (GZF) in patients after acute myocardial infarction (MI) and to evaluate its correlation with MI-free survival and improvements in left ventricular ejection fraction (LVEF) compared with the established risk factors high-sensitivity cardiac troponin T (hs-cTnT) and Late Gadolinium Enhancement (LGE).

Methods And Results: The study involved 176 patients who experienced acute MI and underwent cardiac magnetic resonance (CMR) prior to hospital discharge, followed by a second CMR on average six months later. LGE was quantified in both examinations, a separate analysis of the GZF was conducted only in the follow-up CMR after resolution of the initial infarct edema.

Myocarditis incidence and hospital mortality from 2007 to 2022: insights from a nationwide registry.

Objectives: To investigate the burden of disease of myocarditis in Germany and identify similarities and differences in myocarditis with or without COVID-19.

Methods: All patients hospitalized with myocarditis in Germany were included in this nationwide retrospective analysis. Data were retrieved from the Federal Statistical Office of Germany (DESTATIS) for the years from 2007 to 2022.

Estimated Annual Healthcare Costs After Acute Pulmonary Embolism: Results From a Prospective Multicentre Cohort Study.

Objective: Patients surviving acute pulmonary embolism (PE) necessitate long-term treatment and follow-up. However, the chronic economic impact of PE on European healthcare systems remains to be determined.

Methods And Results: We calculated the direct cost of illness during the first year after discharge for the index PE, analyzing data from a multicentre prospective cohort study in Germany.

Reweighting and validation of the hospital frailty risk score using electronic health records in Germany: a retrospective observational study.

Background: In the hospital setting, frailty is a significant risk factor, but difficult to measure in clinical practice. We propose a reweighting of an existing diagnoses-based frailty score using routine data from a tertiary care teaching hospital in southern Germany.

Methods: The dataset includes patient characteristics such as sex, age, primary and secondary diagnoses and in-hospital mortality.

The impact of the Covid-19 pandemic on the effectiveness of psychosomatic rehabilitation in Germany.

Background: The aim of the present study is to investigate the impact of the Covid-19 pandemic on the effectiveness of psychosomatic rehabilitation.

Methods: Between April 2019 and March 2022, a total of 18,388 patients from 7 rehabilitation centres could be included in the study. For each patient, score values from the HEALTH-49 and ICF AT-50 Psych questionnaires were calculated at the beginning and at the end of rehabilitation and the effectiveness of the rehabilitation program was determined by comparing the scores at the beginning and at the end of the rehabilitation programme.

The Impact of COVID-19 on Mortality and Clinical Characteristics in Hospitalized Patients With Peripheral Artery Disease in the Year 2020 in Germany.

Background: The COVID-19 pandemic developed its full destructive capacity in 2020. This retrospective study aimed to examine the effects of COVID-19 on the mortality and the clinical characteristics in PAD patients with COVID-19 compared to PAD patients without COVID-19.

Methods And Results: Data derived from a German nationwide register of the year 2020 which encompassed all hospitalized patients with PAD ( = 173.

Accuracy of Event Rate and Effect Size Estimation in Major Cardiovascular Trials: A Systematic Review.

Importance: For the design of a randomized clinical trial (RCT), estimation of the expected event rate and effect size of an intervention is needed to calculate the sample size. Overestimation may lead to an underpowered trial.

Objective: To evaluate the accuracy of published estimates of event rate and effect size in contemporary cardiovascular RCTs.

Drivers and recent trends of hospitalisation costs related to acute pulmonary embolism.

Background And Aims: The socio-economic burden imposed by acute pulmonary embolism (PE) on European healthcare systems is largely unknown. We sought to determine temporal trends and identify cost drivers of hospitalisation for PE in Germany.

Methods And Results: We analysed the totality of reimbursed hospitalisation costs in Germany (G-DRG system) in the years 2016-2020.

Longitudinal cardiac dimensions in patients undergoing LVAD implantation.

Background: In conventional left ventricular assist devices (LVAD), a separate outflow graft is sutured to the ascending aorta. Novel device designs may include a transventricular outflow cannula crossing the aortic valve (AV). While transversal ventricular dimensions are well investigated in patients with severe heart failure, little is known about the longitudinal dimensions.

Impact of a complex health services intervention in long-term care nursing homes on 3-year overall survival: results from the CoCare study.

Background: The Coordinated medical Care (CoCare) project aimed to improve the quality of medical care in nursing homes by optimizing collaboration between nurses and physicians. We analyze the impact of the CoCare intervention on overall survival.

Methods: The effect of time-varying treatment on 3-year overall survival was analyzed with treatment as time-varying covariate within the entire cohort.

Modelling costs of interventional pulmonary embolism treatment: implications of US trends for a European healthcare system.

Aims: Catheter-directed treatment (CDT) of acute pulmonary embolism (PE) is entering a growth phase in Europe following a steady increase in the USA in the past decade, but the potential economic impact on European healthcare systems remains unknown.

Methods And Results: We built two statistical models for the monthly trend of proportion of CDT among patients with severe (intermediate- or high-risk) PE in the USA. The conservative model was based on admission data from the National Inpatient Sample (NIS) 2016-20 and the model reflecting increasing access to advanced treatment from the PERT™ national quality assurance database registry 2018-21.

Transcatheter aortic valve replacement in Germany with need for a surgical bailout.

Background: In transcatheter aortic valve replacement (TAVR), complications may force the need for a surgical bailout, but knowledge is rare about outcomes in Germany.

Methods: Using national health records, we investigated all TAVR in German hospitals between 2007 and 2020, focusing on 2018-2020. We extracted data on those interventions with need for a surgical bailout.

Non-vitamin-K-antagonist oral anticoagulants (NOACs) after acute myocardial infarction: a network meta-analysis.

Background: Balancing the risk of bleeding and thrombosis after acute myocardial infarction (AMI) is challenging, and the optimal antithrombotic therapy remains uncertain. The potential of non-vitamin K antagonist oral anticoagulants (NOACs) to prevent ischaemic cardiovascular events is promising, but the evidence remains limited.

Objectives: To evaluate the efficacy and safety of non-vitamin-K-antagonist oral anticoagulants (NOACs) in addition to background antiplatelet therapy, compared with placebo, antiplatelet therapy, or both, after acute myocardial infarction (AMI) in people without an indication for anticoagulation (i.

The economic impact of a local, collaborative, stepped, and personalized care management for older people with chronic diseases: results from the randomized comparative effectiveness LoChro-trial.

Background: Within the ageing population of Western societies, an increasing number of older people have multiple chronic conditions. Because multiple health problems require the involvement of several health professionals, multimorbid older people often face a fragmented health care system. To address these challenges, in a two-group parallel randomized controlled trial, a newly developed care management approach (LoChro-Care) was compared with usual care.

Center Volumes Correlate with Likelihood of Stent Implantation in German Coronary Angiography.

Aims: Literature on percutaneous coronary intervention (PCI) stated an inverse relationship between hospital volume and mortality, but the effects on other characteristics are unclear.

Methods: Using German national records, all coronary angiographies with coronary artery disease in 2017 were identified. We applied risk-adjustment to account for differences in population characteristics.