Comparison between the General Assessment of Hospitalised Patient Tool and the Barthel Index: A Retrospective Study.

Among hospitalised patients, functional decline and increased dependence on others are common health problems. Identifying critical needs is an important starting point to empower patients to improve their own health and behaviour. Once these needs are determined, the most relevant goals for addressing patients' needs and health potential can be established. This study aimed to test a model for profiling patients using the General Assessment of Hospitalised Patients (ASGO) compared to the Barthel Index (BI) as the gold standard. A retrospective approach was conducted by reviewing administrative data recorded between 2017 and 2020 at the University of Padova, Italy. Data from patients (a) older than 18 years, (b) admitted to a local hospital, and (c) with a stay of at least three days were included in the study. The ASGO and the BI were both used on patients' admission and discharge from the ward. Data were analysed using STATA software (v.16) (StataCorp. 2019. Stata Statistical Software: Release 16. College Station, TX: StataCorp LLC). The database used for the analysis consisted of 842 patient records, with more than 50% over 75 years of age and consisting mainly of men. The results of the ASGO and the BI were more correlated at discharge (rho = -0.79) than at admission (rho = -0.59). Furthermore, sensitivity and specificity, calculated with reference to the optimal cut-off point (Youden index), demonstrated the highest reliability of the test at discharge (sensitivity: 0.87; specificity: 0.78) compared to admission (sensitivity: 0.77; specificity: 0.72). This result was confirmed by the analysis of the ROC curve: The area under the curve was greater at discharge (89%) than at admission (82%). Analysis of the results obtained from assessments created with the ASGO demonstrates the applicability of this model in the context of hospital care and how well it can represent functional dependence. This study was not registered.

Design and validation of a "Peristomal Lesion Scale" for peristomal skin assessment.

Many people in Italy undergo ostomy because of illness, and this can have negative psychological and physical effects. It is estimated that 15%-43% of ostomates suffer from skin complications in the peristomal area. During their life, many ostomates experience at least one peristomal lesion, and they turn to stomal therapy centres where trained nurses provide patient care and manage skin complications. To ensure a good quality of life for patients, and to take prompt action for the prevention and treatment of stomal lesions, it is essential to use appropriate assessment tools. The aim of this study was to develop a reliable peristomal skin assessment tool (Peristomal Lesion Scale [PLS]) for classifying lesions based on their severity; and to compare its validity with the most widely used peristomal tool in Italy, SACS. The new tool was designed by a team of experts, focusing on patients' demographics, clinical characteristics, and classification of the lesions by severity and topography. The results of this comparative validation study indicate that the PLS better discriminates lesions by their severity because of its level of detail, using a standardised terminology, and its completeness. The PLS is a valid tool for use in the daily work of stomal therapists.

[Assessment of an algorithm to identify paediatric-onset celiac disease cases through administrative healthcare databases]. / Valutazione di un algoritmo per l'identificazione dei casi di celiachia a insorgenza pediatrica utilizzando fonti sanitarie correnti.

OBJECTIVES: to assess the role of four administrative healthcare databases (pathology reports, copayment exemptions, hospital discharge records, gluten-free food prescriptions) for the identification of possible paediatric cases of celiac disease. DESIGN: population-based observational study with record linkage of administrative healthcare databases. SETTING AND PARTICIPANT S: children born alive in the Friuli Venezia Giulia Region (Northern Italy) to resident mothers in the years 1989-2012, identified using the regional Medical Birth Register. MAIN OUTCOME MEASURES: we defined possible celiac disease as having at least one of the following, from 2002 onward: 1. a pathology report of intestinal villous atrophy; 2. a copayment exemption for celiac disease; 3. a hospital discharge record with ICD-9-CM code of celiac disease; 4. a gluten-free food prescription. We evaluated the proportion of subjects identified by each archive and by combinations of archives, and examined the temporal relationship of the different sources in cases identified by more than one source. RESULT S: out of 962 possible cases of celiac disease, 660 (68.6%) had a pathology report, 714 (74.2%) a copayment exemption, 667 (69.3%) a hospital discharge record, and 636 (66.1%) a gluten-free food prescription. The four sources coexisted in 42.2% of subjects, whereas 30.2% were identified by two or three sources and 27.6% by a single source (16.9% by pathology reports, 4.2% by hospital discharge records, 3.9% by copayment exemptions, and 2.6% by gluten-free food prescriptions). Excluding pathology reports, 70.6% of cases were identified by at least two sources. A definition based on copayment exemptions and discharge records traced 80.5% of the 962 possible cases of celiac disease; whereas a definition based on copayment exemptions, discharge records, and gluten-free food prescriptions traced 83.1% of those cases. The temporal relationship of the different sources was compatible with the typical diagnostic pathway of subjects with celiac disease. CONCLUSIONS: the four sources were only partially consistent. A relevant proportion of all possible cases of paediatric celiac disease were identified exclusively by pathology reports.