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Predictive value of bleeding risk scores in elderly patients with atrial fibrillation and oral anticoagulation

Journal of Geriatric Cardiology 2023年第9期20卷 684-692页

作者： Pablo Domínguez-Erquicia Sergio Raposeiras-Roubín Emad Abu-Assi Andrea Lizancos-Castro jose a parada-barcia AndréGonzález-García Ana Ledo-Piñeiro Vanesa Noriega-Caro Carla Iglesias-Otero AndrésÍñiguez-Romo Department of Cardiology University HospitalÁlvaro CunqueiroVigoSpain Health Research Institute Galicia Sur VigoSpain

BACKGROUND The predictive value of bleeding risk scores for atrial fibrillation in older patients is not as well *** goal of this study was to evaluate the predictive value of HASBLED,ORBIT and ATRIA for major bleeding(MB)and intracranial hemorrhage(ICH)in patients≥75 years with atrial fibrillation and oral anticoagulation(OAC).METHODS A retrospective unicenter study including patients≥75 years with atrial fibrillation(AF)and OAC.A total of 7613 patients≥75 years with AF and OAC included between 2014 and 2018(registry:NCT04364516).We analyzed the discriminative value of HASBLED,ATRIA and ORBIT scores for bleeding endpoints(major bleeding as primary endpoint and intracerebral hemorrhage as secondary).Cox regression was used to predict major bleeding with each scale and also for searching other variables potentially predictor of major *** discrimination was assessed using Harrell’s *** was assessed with goodness-of-fit test proposed by Gronnesby and *** During a mean follow up of 4.0 years(IQR:2.4–5.7 years),729 patients developed MB(2.61 per 100 patients/year)and 243 patients developed ICH(0.85 per 100 patients/year).Three scores showed a low discrimination for major bleeding,being ORBIT the best(HASBLED C statistic=0.557;ATRIA C statistic=0.568;ORBIT C statistic=0.595)and also a low discrimination for ICH(HASBLED C statistic=0.509;ATRIA C statistic=0.522;ORBIT C statistic=0.526).Among the variables that are part of the scores and other baseline characteristics,after multivariable adjustment only sex(male),dementia,prior admission for bleeding,anemia and liver disease were found as a predictors of *** In older patients under oral anticoagulation with atrial fibrillation,the risk scores HASBLED,ATRIA and ORBIT showed a weak discrimination for major bleeding and intracranial ***,other better alternatives should be evaluated for this purpose.

关键词： patients bleeding fibrillation

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Proposal for a Project of Integration of IT Tools With Focus on Planning and Control of Operations on the Shop Floor

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Management Studies 2016年第3期4卷 111-130页

作者： Walther Azzolini Junior jose Luis Garcia Hermosila Antonio Marcos Vitoreli Rubens parada Neto State University of Sao Paulo Sao Carlos Brazil University Center of Araraquara Araraquara Brazil

Manufacturing system, with high level of complexity and with a mix of semi-repetitive and repetitive products, to become productive, should seek the standardization of products and processes to obtain the optimization of use of production resources. However, it is necessary to measure the productivity, so that the system of measurement and control of manufacturing processes are an element critical as to ensure greater visibility of the flow＇s restrictions, minimized when detected properly. In this case, the automation of factory＇s measurement process can effectively contribute to ensuring the effectiveness of the function control of a manufacturing system. It is important to consider that the automation of the system of measurement and control of manufacturing processes, of complex environment, is heavily dependent of IT tools applied directly in the interface computational between the operation systems and the corporate systems. This heavy reliance, if exploited technically properly, allows that automation of the system of measurement and control of production makes the access to time real of availability of manufacturing process＇s data, such as processing time and setup time that it can export to a specialist software in programming production, for example, feasible. In this paper, the automation of the system of measurement and control of production is approached, in order to identify the main possibilities of the design of an information system capable to integrate the flow of information in an environment internal on manufacturing organizations, with emphasis in the digital manufacturing paradigm.

关键词： advanced planning system operations management sales and operations planning shop floor control,supply chain planning

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