Browsing by Author "Davidović, Goran (14008112400)"

Background/Aim. Patients with pneumonia who require mechanical ventilation (MV) are associated with several poor outcomes such as prolonged hospitalization, higher rate of mortality and increased spread of antibioticsresistant pathogens. MV in patients with communityacquired pneumonia (CAP) could cause development of psychological symptoms, often neglected in the Intensive Care Units (ICU) as well as decreased quality of life after the withdrawal of the MV. The aim of the study was to evaluate the quality of life in patients with CAPs treated with MV in ICU. Methods. The study was designed as a cohort study of hospital-treated patients with CAP with prospective data collection. The quality of life was defined as the primary outcome, while the use of MV was assumed as the primary prognostic factor that adversely affected the outcome. The patients were recruited from the population of patients with CAPs who were hospitalized at the ICU, Clinical Center Kragujevac, Serbia, from January 2013 to January 2014. The experimental group consisted of patients who were on MV while the control group included patients who were treated for CPAs in the ICU, but were not subjected to MV. The quality of life was assessed by using patient-rated Euro Quality of Life (EuroQoL) Group-EQ-5D index. The calculation of the total EQ-5D-5L score values was performed by using the predefined, validated mapping key according to response combinations. Statistical analysis was performed by using χ2 test, Student's t-test, univariate and multivariate logistic regression analyses. Results. The patients with MV had worse EQ5D-5L values in comparison to the control group for all 5 domains. Mobility, self-care and usual activities were negatively affected during the whole follow-up period. Pain or discomfort and anxiety or depression differed significantly between the study group and the control group at days 7 and 30. Conclusion. Patients with MV tend to have poorer quality of life, especially in 3 domains. The main reasons are the presence of chronic comorbidities in the population that require MV. © 2018, Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Introduction Adherence to proposed lifestyle changes and prescribed medication in patients with stable coronary artery disease (SCAD) is poor. Objective We sought to investigate the influence of adjusting guideline proposed medications on relief of angina in a large group of patients with SCAD in Serbia. Methods The study included a total of 3,490 patients from 15 cardiology clinics with symptoms of stable angina and at least one of the following criteria: abnormal electrocardiogram (ECG), history of myocardial infarction (MI), positive stress test, significant coronary artery disease on coronary angiogram or previous revascularization. All the patients underwent comprehensive evaluation at initial visit and after two months. The relief of angina was study end-point defined as any reduction in Canadian Cardiology Society (CCS) class, number of angina attacks per week and/or number of tablets of short-acting nitrates per week. Results Most patients were included based on abnormal ECG (48.4%). At Visit 1, the average number of prescribed classes of medications to a single patient increased from 4.16 ± 1.29 to 4.63 ± 1.57 (p < 0.001). At the follow-up, the patients had significantly lower blood pressure (141 ± 19/85 ± 11 vs. 130 ± 12/80 ± 8 mmHg; p < 0.001) and most of them reported CCS class I (63.3%). The average weekly number of angina attacks was reduced from 2.82 ± 2.50 at Visit 1 to 1.72 0 ± 1.66 at Visit 2, as well as average weekly use of short-acting nitrates to treat these attacks (2.69 ± 2.53 to 1.74 ± 1.47 tablets; p < 0.001 for all). Conclusion Adjustment of prescribed medications to guideline recommendations in a large Serbian patient population with prevalent risk factors led to significant relief of angina. ©2016, Serbia Medical Society. All rights reserved.