Aim To evaluate the prevalence and predictors of potentially inappropriate medications (PIM) and potential prescribing omissions (PPO) in hospital‐discharged older patients, according to the recently updated Screening Tool of Older People's Prescriptions and Screening Tool to Alert to Right Treatment version 2 criteria. Methods This was a multicenter prospective observational study of patients aged ≥65 years consecutively discharged from geriatric and internal medicine wards. Each patient underwent a comprehensive geriatric assessment, and PIM and PPO at discharge were determined according to the Screening Tool of Older People's Prescriptions and Screening Tool to Alert to Right Treatment version 2 criteria. A multivariate logistic regression was carried out to identify variables independently associated with PIM and PPO. Results Among 726 participants (mean age 81.5 years, 47.8% women), the prevalence of PIM and PPO were 54.4% and 44.5%, respectively. Benzodiazepines and proton‐pump inhibitors were the drugs most frequently involved with PIM, whereas PPO were often related to 5‐alpha reductase inhibitors, angiotensin‐converting enzyme inhibitors, statins and drugs for osteoporosis. The number of medications (OR 1.22, 95% CI 1.15–1.28) and discharge from geriatric units (OR 0.55, 95% CI 0.40–0.75) were associated with PIM, whereas PPO were independently associated with discharge from geriatric wards (OR 0.44, 95% CI 0.31–0.62), age (OR 1.04, 95% CI 1.02–1.07), comorbidities (OR 1.17, 95% CI 1.04–1.30) and the number of drugs (OR 1.12, 95% CI 1.05–1.18). Conclusions Inappropriate prescribing is highly prevalent among hospital‐discharged older patients, and is associated with polypharmacy and discharge from internal medicine departments. Geriatr Gerontol Int 2019; 19: 5–11.

Objectives: To evaluate whether STOPP/START v2 potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) are associated with 6-month mortality and unplanned hospitalization in hospital-discharged older patients. Design: Multicenter prospective cohort observational study Setting and participants: patients aged ≥65 years consecutively discharged from acute geriatric and internal medicine wards of two university hospitals in Northwestern Italy Methods: At discharge, a comprehensive geriatric assessment was performed in each patient, prescribed medications were recorded, and PIMs and PPOs were determined according to STOPP/START v2. Death and unplanned readmissions at 6 months were investigated through telephone interviews; variables associated with outcomes were identified in the overall sample and according to discharge setting (i.e. home vs medium/long-term care facility, MLTCF) through a multivariate logistic regression model. Results: Among 611 patients (mean age 81.6 years, 48.4% females, 34.2% MLTCFdischarged, mean number of drugs 7.7±3.2), with an inappropriate prescription (IP) prevalence at discharge of 71.7% (PIMs 54.8%, PPOs 47.3%), mortality and unplanned readmission rate were 25.0% and 30.9%. Neither PIMs nor PPOs were associated with overall mortality. A higher number of PIMs was significantly associated with unplanned readmission in the overall sample (OR 1.23, 95%CI 1.03-1.46), and in home-discharged patients (OR 1.38, 95%CI 1.13-1.68). The number of drugs at discharge was associated with readmissions in the overall sample (OR 1.11, 95%CI 1.05-1.18) and in MLTCF-discharged patients (OR 1.27, 95%CI 1.13-1.42). PPOs were not significantly associated with clinical outcomes. Conclusions and implications: In hospital-discharged polymorbid older patients, 6-month unplanned readmissions were associated with number of PIMs in home-discharged patients Commento [EB1]: Forse sia per questione di spazio che di rilevanza, mettere l'associazione dicotomica dei PPO all'univariata, come richiesto dal reviewer 1 sarebbe inappropriato? Commento [MB2]: Non ho trovato questa richiesta da parte di R1 4 and with number of drugs in MLTCF-discharged patients. This reaffirms the importance of performing a systematic and careful review of medication appropriateness in hospitaldischarged older patients.

We report data regarding kinetic of response to oral iron in 34 iron deficiency anemia children. Twenty-four/34 patients (70.5%) reached reference value of hemoglobin (Hb) concentration for age and sex at day + 30 from the beginning of treatment (complete early responders (CERs)), and 4/34 (12%) reached an Hb concentration at least 50% higher than the original (partial early responders (PERs)). CHr at T1 (within 7 days from the beginning of treatment) was significantly different in the different groups (22.95 in CERs versus 18.41 in other patients; p = 0.001; 22.42 in early responders versus 18.07 in NERs; p = 0.001). Relative increase of CHr from T0 to T1 resulted significantly higher in CERs than in other patients (0.21 versus 0.11, p = 0.042) and in early responders than in NERs (0.22 versus 0.004, p = 0.006). Multivariate logistic models revealed a higher probability of being a complete early responder due to relative increase of ARC from T0 to T1 [OR (95% CI) = 44.95 (1.54–1311.98)] and to CHr at T1 [OR (95% CI) =3.18 (1.24–8.17)]. Our preliminary data confirm CHr as early and accurate predictor of hematological response to oral iron.

Background: Long QT and use of QT-prolonging drugs are common among older patients receiving polytherapies, but real-world evidence on their impact in clinical practice is controversial. We investigated prevalence, variables associated and clinical implications of prolonged corrected QT (QTc) among patients from the Syncope and Dementia study. Methods: Observational, prospective, multicenter study. Patients≥65 years with dementia and fall suspected for syncope in the previous three months were enrolled. Several clinical variables and the complete list of medications were recorded for each patient. A 12-lead ECG was obtained and corrected QT was calculated by the Bazett's formula. One-year followup for death and recurrent syncope was performed. Results: Prolonged QTc was observed in 25% of the 432 enrolled patients (mean age 83.3), and was significantly associated with male gender (OR 2.09; 95% CI 1.34-3.26) and diuretics use (OR 1.85; 95% CI 1.18-2.90). At one-year 23.3% of patients died and 30.4% reported at least one recurrent event. Variables associated with oneyear mortality were: age, male gender, atrial fibrillation (AF), use of calcium channel blockers and prolonged QTc (OR 1.80; 95% CI 1.01-3.20). Among patients with prolonged QTc a significant interaction for mortality was found with AF. Recurrent events were associated with the use of antiplatelets, cholinesterase. inhibitors and antipsychotics, but not with prolonged QTc. Conclusions: We documented a high prevalence of prolonged QTc, that was associated with male gender and diuretics but not with psychoactive medications. Patients with prolonged QTc had higher one-year mortality, that was four-fold increased in those with concomitant AF. 1. Introduction Long QT syndrome is an electro-physiologic disorder in which the ventricular repolarization is lengthened, with an increased susceptibility to ventricular tachy-arrhythmias, potentially leading to syncope, cardiac arrest and sudden cardiac death [1]. Acquired prolonged QT interval is the most common form of long QT syndrome, and usually results from the complex interplay between several factors