Background: Evidence regarding the relationships among high plasma triglycerides (TG), all‐cause mortality, and atherosclerotic cardiovascular disease (ASCVD) events in low‐to‐moderate risk individuals is limited. The aim of this study was to determine whether the presence of high TG levels influences the risk of all‐cause mortality and ASCVD events in a population cohort followed in the real‐world clinical setting. Methods and Results: A retrospective longitudinal cohort analysis using administrative databases of 3 Italian Local Health Units was performed. All individuals with at least one TG measurement between January 1, 2010 and December 31, 2015 were followed through December 2016. Outcome measures included incident ASCVD events and all‐cause mortality. Individuals with normal TG levels (500 mg/dL). 158 042 individuals (142 289 with normal, 15 558 with high, and 195 with very high TG) were considered. In the whole cohort, the overall incidence rates of ASCVD and all‐cause mortality were 7.2 and 17.1 per 1000 person‐years, respectively. After multivariate adjustment for potential confounders, individuals with high and very high TG showed a significantly increased risk of all‐cause mortality (hazard ratio [HR]=1.49 [95% confidence interval (CI) 1.36–1.63], P <0.001, and HR=3.08 [95% CI 1.46–6.50], P <0.01, respectively) and incident ASCVD events (HR=1.61 [95% CI 1.43–1.82], P <0.001, and HR=2.30 [95% CI 1.02–5.18], P <0.05, respectively) as compared to those with normal TG. Conclusions: Moderate‐to‐severe elevation of TG is associated with a significantly increased risk of all‐cause mortality and ASCVD events in a large cohort of low‐to‐moderate cardiovascular risk individuals in a real‐world clinical setting.
This real-world analysis evaluated the clinical and economic burden of non-dialysis-dependent CKD patients with and without secondary hyperparathyroidism (sHPT) in Italy. An observational retrospective study was conducted using administrative databases containing a pool of healthcare entities covering 2.45 million health-assisted individuals. Adult patients with hospitalization discharge diagnoses for CKD stages 3, 4, and 5 were included from 1 January 2012 to 31 March 2015 and stratified using the presence/absence of sHPT. Of the 5710 patients, 3119 were CKD-only (62%) and 1915 were CKD + sHPT (38%). The groups were balanced using Propensity Score Matching (PSM). Kaplan-Meier curves revealed that progression to dialysis and cumulative mortality had a higher incidence in the CKD + sHPT versus CKD-only group in CKD stage 3 patients and the overall population. The total direct healthcare costs/patient at one-year follow-up were significantly higher in CKD + sHPT versus CKD-only patients (EUR 8593 vs. EUR 5671, p < 0.001), mostly burdened by expenses for drugs (EUR 2250 vs. EUR 1537, p < 0.001), hospitalizations (EUR 4628 vs. EUR 3479, p < 0.001), and outpatient services (EUR 1715 vs. EUR 654, p < 0.001). These findings suggest that sHPT, even at an early CKD stage, results in faster progression to dialysis, increased mortality, and higher healthcare expenditures, thus indicating that timely intervention can ameliorate the management of CKD patients affected by sHPT.
This Italian retrospective study aimed to analyze the pharmaco-utilization of anti-VEGF drugs and health care costs among patients with wet age-related macular degeneration (wAMD) or other ocular diseases. A retrospective analysis was performed on administrative databases of Italian entities covering approximately six million individuals. Across January 2010–December 2017, patients aged ≥50 years with a prescription of intravitreal anti-VEGFs were included as “wAMD” patients [by wAMD hospitalization or intravitreal injections] or as “other ocular diseases” patients [by hospitalization for other ocular disorders or intravitreal injections, with concomitant diabetes diagnosis or dexamethasone treatment]. The date of first matching of inclusion criteria was index-date. wAMD-cohort. Overall, 3879 patients were included; at index-date, 82.2% were treated with Ranibizumab, 15.8% with Aflibercept, and 2% with Pegaptanib. During the follow-up, the mean/annual anti-VEGF prescription [3.6 (first-year)–0.8 (third-year)] and the total expenditure [5799.84 € (first-year)–3212.84 € (third-year)] decreased. Other ocular diseases-cohort. Overall, 2646 patients were enclosed; 85.9% were treated with Ranibizumab, 13.5% with Aflibercept, and 0.6% with Pegaptanib. During the follow-up, the mean/annual anti-VEGF prescription [3.3 (first-year)–0.5 (third-year)] and the total cost [7196.83 € (first-year)–5162.68 € (third-year)] decreased. This observational study highlighted a decline in anti-VEGF prescriptions over time in both cohorts, suggesting a trend of under-treatment that could worsen the patients’ clinical outcomes and increase health care resource consumption.
Background/Objectives The economic impact of respiratory syncytial virus (RSV) in Italy is not well defined. This analysis assessed the economic outcomes of RSV-hospitalized patients aged ≥ 60 years in Italy. Methods: Healthcare resource utilization and direct healthcare costs during the first RSV hospitalization and 12-month follow-up were collected from Italian administrative databases. A propensity-score-matched (PSM) analysis was performed between patients hospitalized for RSV and those hospitalized for any cause (without an RSV diagnosis). Results: Among 201 patients, an average of 1.95 hospitalizations, 19.38 prescriptions, and 7.11 outpatient services were reported during the first RSV hospitalization and the following 12 months. The mean direct healthcare costs were EUR 11,599 (related to hospitalization [79%], prescriptions [16%], and outpatient services [5%]). Following PSM analyses, direct healthcare costs were 15% higher for RSV-hospitalized patients versus those hospitalized for any cause (EUR 9369 versus EUR 8173; p < 0.05), driven by differences in hospitalizations (EUR 7477 versus EUR 6327; p < 0.05) and intensive care unit admissions (EUR 818 versus EUR 178; p = 0.001). Conclusions: Despite a limited sample size, this study reports a substantial economic burden associated with RSV-hospitalized patients aged ≥ 60 years in Italy. The results provide important evidence to inform preventative RSV strategies to reduce the economic burden on the Italian National Health Service.
Background: Invasive fungal infections (IFI), prevalent in critically ill ICU patients, have gained attention due to post‐COVID‐19 epidemiological shifts. Notably, COVID‐19‐associated aspergillosis and candidiasis pose significant risks. WHO recognises key fungal pathogens, emphasising the need for enhanced research and interventions.Methods: The CHARTER‐IFI study retrospectively examines 186,310 individuals admitted to ICUs in Italy from 01/01/2012–01/09/2023, utilising administrative databases covering around 10 million inhabitants. Adult patients were included having at least one ICU discharge diagnosis of IFI at their first IFI‐related hospitalisation and having at least 12 months of available data prior to this hospitalisation.Results: A total of 746 IFI patients discharged from ICU (incidence of 4.0 per 1000 ICU‐hospitalised patients), were included. Median age was 68 years, 63% were males, and the overall Charlson Comorbidity Index was 2.2. The top three diagnoses were candidiasis (N = 501, 2.7/1000 ICU‐hospitalised patients), aspergillosis (N = 71, 0.4/1000), and pneumocystosis (N = 55, 0.3/1000). The evaluation of the comorbidity profile in IFI patients revealed the presence of hypertension (60.5%), use of systemic GC/antibacterials (45.3% during 12 months before and 18.6% during 3 months before hospital admission), cancer (23.1%), diabetes (24.3%) and cardiovascular diseases (23.9%). The mean (±SD) length of hospitalisation in ICU was 19.9 ± 24.1 days (median 11 days), and deaths occurred in 36.1% of IFI patients (within 30 days from discharge).Conclusions: This retrospective analysis among ICU‐hospitalised patients described the burden of IFI in ICU, and its understanding could be crucial to strengthen surveillance, investments in research, and public health interventions as required by WHO.
This real-world analysis investigated patients with follicular lymphoma in Italy receiving three or more treatment lines (≥3L), focusing on therapeutic pathways with their rebounds on healthcare resource consumptions and costs. Data were retrieved from administrative databases from healthcare entities covering about 13.3 million residents. Adults diagnosed with follicular lymphoma were identified between January 2015 and June 2020, and among them 2434 patients with ≥3L of treatment during the data availability interval (January 2009 to June 2021) were included. Of them, 1318 were in 3L, 494 in 4L and 622 in ≥5L. A relevant proportion of patients (12–32%) switched to a later line within the same calendar year. At 3-year follow-up (median), 34% patients died. Total mean annual expenses were euro 14,508 in the year preceding inclusion and rose to euro 21,081 at 1-year follow-up (on average euro 22,230/patient/year for the whole follow-up), with hospitalization and drug expenses as weightiest cost items. In conclusion, the clinical and economic burden of follicular lymphoma increases along with later treatment lines. The high mortality rates indicate that further efforts are needed to optimize disease management.