Abstract
The dramatic demographic changes that are occurring in the third millennium are modifying the mission of generalist professionals such as primary care physicians and internists. Multiple chronic diseases and the related prescription of multiple medications are becoming typical problems and present many challenges. Unfortunately, the available evidence regarding the efficacy of medications has been generated by clinical trials involving patients completely different from those currently admitted to internal medicine: much younger, affected by a single disease and managed in a highly controlled research environment. Because only registries can provide information on drug effectiveness in real-life conditions, REPOSI started in 2008 with the goal of acquiring data on elderly people acutely admitted to medical or geriatric hospital wards in Italy. The main goals of the registry were to evaluate drug prescription appropriateness, the relationship between multimorbidity/polypharmacy and such cogent outcomes as hospital mortality and re-hospitalization, and the identification of disease clusters that most often concomitantly occur in the elderly. The findings of 3-yearly REPOSI runs (2008, 2010, 2012) suggest the following pertinent tasks for the internist in order to optimally handle their elderly patients: the management of multiple medications, the need to become acquainted with geriatric multidimensional tools, the promotion and implementation of a multidisciplinary team approach to patient health and care and the corresponding involvement of patients and their relatives and caregivers. There is also a need for more research, tailored to the peculiar features of the multimorbid elderly patient.
| Original language | English |
|---|---|
| Pages (from-to) | 723-734 |
| Number of pages | 12 |
| Journal | Internal and Emergency Medicine |
| Volume | 9 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - Oct 2 2014 |
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Keywords
- Adverse drug effects
- Aging
- Drug prescription
- Multidimensional evaluation
- Multimorbidity
- Polypharmacy
ASJC Scopus subject areas
- Emergency Medicine
- Internal Medicine
Cite this
Multimorbidity and polypharmacy in the elderly : Lessons from REPOSI. / Mannucci, Pier Mannuccio; Nobili, Alessandro; Mannucci, Pier Mannuccio; Nobili, Alessandro; Tettamanti, Mauro; Pasina, Luca; Franchi, Carlotta; Sparacio, Eleonora; Alborghetti, Stefania; Di Costanzo, Rosa; Eldin, Tarek Kamal; Tettamanti, Mauro; Djade, Codjo Djignefa; Salerno, Francesco; Corrao, Salvatore; Marengoni, Alessandra; Marcucci, Maura; Prisco, Domenico; Silvestri, Elena; Cenci, Caterina; Barnini, Tommaso; Delitala, Giuseppe; Carta, Stefano; Atzori, Sebastiana; Guarnieri, Gianfranco; Zanetti, Michela; Spalluti, Annalisa; Serra, Maria Grazia; Bleve, Maria Antonietta; Vanoli, Massimo; Grignani, Giulia; Casella, Gianluca; Gasbarrone, Laura; Maniscalco, Giorgio; Gunelli, Massimo; Tirotta, Daniela; Brucato, Antonio; Ghidoni, Silvia; Di Corato, Paola; Bernardi, Mauro; Bassi, Silvia Li; Santi, Luca; Agnelli, Giancarlo; Iorio, Alfonso; Marcucci, Maura; Marchesini, Emanuela; Mannarino, Elmo; Lupattelli, Graziana; Rondelli, Pamela; Paciullo, Francesco; Fabris, Fabrizio; Carlon, Michela; Turatto, Francesca; Baroni, Maria Cristina; Zardo, Marianna; Manfredini, Roberto; Molino, Christian; Pala, Marco; Fabbian, Fabio; Nuti, Ranuccio; Valenti, Roberto; Ruvio, Martina; Cappelli, Silvia; Paolisso, Giuseppe; Rizzo, Maria Rosaria; Laieta, Maria Teresa; Salvatore, Teresa; Sasso, Ferdinando Carlo; Utili, Riccardo; Mangoni, Emanuele Durante; Pinto, Daniela; Olivieri, Oliviero; Stanzial, Anna Maria; Fellin, Renato; Volpato, Stefano; Fotini, Sioulis; Barbagallo, Mario; Dominguez, Ligia; Plances, Lidia; D’Angelo, Daniela; Rini, Giovanbattista; Mansueto, Pasquale; Pepe, Ilenia; Licata, Giuseppe; Calvo, Luigi; Valenti, Maria; Borghi, Claudio; Strocchi, Enrico; Rinaldi, Elisa Rebecca; Zoli, Marco; Fabbri, Elisa; Magalotti, Donatella; Auteri, Alberto; Pasqui, Anna Laura; Puccetti, Luca; Pasini, Franco Laghi; Capecchi, Pier Leopoldo; Bicchi, Maurizio; Sabbà, Carlo; Vella, Francesco Saverio; Marseglia, Alessandro; Luglio, Chiara Valentina; Palasciano, Giuseppe; Modeo, Maria Ester; Aquilino, Annamaria; Raffaele, Pallante; Pugliese, Stefania; Capobianco, Caterina; Postiglione, Alfredo; Barbella, Maria Rosaria; De Stefano, Francesco; Fenoglio, Luigi; Brignone, Chiara; Bracco, Christian; Giraudo, Alessia; Musca, Giuseppe; Cuccurullo, Olga; Cricco, Luigi; Fiorentini, Alessandra; Cappellini, Maria Domenica; Fabio, Giovanna; Seghezzi, Sonia; De Amicis, Margherita Migone; Fargion, Silvia; Bonara, Paola; Bulgheroni, Mara; Lombardi, Rosa; Magrini, Fabio; Massari, Ferdinando; Tonella, Tatiana; Peyvandi, Flora; Tedeschi, Alberto; Rossio, Raffaella; Moreo, Guido; Ferrari, Barbara; Roncari, Luisa; Monzani, Valter; Savojardo, Valeria; Folli, Christian; Magnini, Maria; Mari, Daniela; Rossi, Paolo Dionigi; Damanti, Sarah; Prolo, Silvia; Lilleri, Maria Sole; Cricco, Luigi; Fiorentini, Alessandra; Micale, Giuliana; Podda, Mauro; Selmi, Carlo; Meda, Francesca; Salerno, Francesco; Accordino, Silvia; Conca, Alessio; Monti, Valentina; Corazza, Gino Roberto; Miceli, Emanuela; Lenti, Marco Vincenzo; Padula, Donatella; Balduini, Carlo L.; Bertolino, Giampiera; Provini, Stella; Quaglia, Federica; Murialdo, Giovanni; Bovio, Marta; Dallegri, Franco; Ottonello, Luciano; Quercioli, Alessandra; Barreca, Alessandra; Secchi, Maria Beatrice; Ghelfi, Davide; Chin, Wu Sheng; Carassale, Laura; Caporotundo, Silvia; Anastasio, Luigi; Sofia, Lucia; Carbone, Maria; Traisci, Giancarlo; De Feudis, Lucrezia; Di Carlo, Silvia; Davì, Giovanni; Guagnano, Maria Teresa; Sestili, Simona; Bergami, Elisabetta; Rizzioli, Emanuela; Cagnoni, Carlo; Bertone, Luca; Manucra, Antonio; Buratti, Alberto; Tognin, Tiziana; Liberato, Nicola Lucio; Bernasconi, Giordano; Nardo, Barbara; Bianchi, Giovanni Battista; Ospedale, Sabrina Giaquinto; Benetti, Giampiero; Quagliolo, Michela; Centenaro, Giuseppe Riccardo; Purrello, Francesco; Di Pino, Antonino; Piro, Salvatore; Mancuso, Gerardo; Calipari, Daniela; Bartone, Mosè; Gullo, Francesco; Cortellaro, Michele; Magenta, Marina; Perego;, Francesca; Meroni, Maria Rachele; Cicardi, Marco; Gidaro, Antonio; Magenta, Marina; Sacco, Andrea; Bonelli, Antonio; Dentamaro, Gaetano; Rozzini, Renzo; Falanga, Lina; Giordano, Alessandro; Perin, Paolo Cavallo; Lorenzati, Bartolomeo; Gruden, Gabriella; Bruno, Graziella; Montrucchio, Giuseppe; Greco, Elisabetta; Tizzani, Pietro; Fera, Giacomo; Di Luca, Maria Loreta; Renna, Donatella; Perciccante, Antonio; Coralli, Alessia; Tassara, Rodolfo; Melis, Deborah; Rebella, Lara; Menardo, Giorgio; Bottone, Stefania; Sferrazzo, Elsa; Ferri, Claudio; Striuli, Rinaldo; Scipioni, Rosa; Salmi, Raffaella; Gaudenzi, Piergiorgio; Gamberini, Susanna; Ricci, Franco; Morabito, Cosimo; Fava, Roberto; Semplicini, Andrea; Gottardo, Lucia; Delitala, Giuseppe; Carta, Stefano; Atzori, Sebastiana; Vendemiale, Gianluigi; Serviddio, Gaetano; Forlano, Roberta; Bolondi, Luigi; Rasciti, Leonardo; Serio, Ilaria; Masala, Cesare; Mammarella, Antonio; Raparelli, Valeria; Fanelli, Filippo Rossi; Delfino, Massimo; Amoroso, Antonio; Violi, Francesco; Basili, Stefania; Perri, Ludovica; Serra, Pietro; Fontana, Vincenzo; Falcone, Marco; Landolfi, Raffaele; Grieco, Antonio; Gallo, Antonella; Zuccalà, Giuseppe; Franceschi, Francesco; De Marco, Guido; Chiara, Cordischi; Marta, Sabbatini; Bellusci, Martino; Setti, Donatella; Pedrazzoli, Filippo; Romanelli, Giuseppe; Pirali, Caterina; Amolini, Claudia; Rosei, Enrico Agabiti; Rizzoni, Damiano; Castoldi, Luana; Picardi, Antonio; Gentilucci, Umberto Vespasiani; Mazzarelli, Chiara; Gallo, Paolo; Guasti, Luigina; Castiglioni, Luana; Maresca, Andrea; Squizzato, Alessandro; Contini, Sara; Molaro, Marta; Annoni, Giorgio; Corsi, Maurizio; Zazzetta, Sara; Bertolotti, Marco; Mussi, Chiara; Scotto, Roberto; Ferri, Maria Alice; Veltri, Francesca; Arturi, Franco; Succurro, Elena; Sesti, Giorgio; Gualtieri, Umberto; Perticone, Francesco; Sciacqua, Angela; Quero, Michele; Bagnato, Chiara; Loria, Paola; Becchi, Maria Angela; Martucci, Gianfranco; Fantuzzi, Alessandra; Maurantonio, Mauro; Corinaldesi, Roberto; De Giorgio, Roberto; Serra, Mauro; Grasso, Valentina; Ruggeri, Eugenio; Carozza, Lorenzo Mauro; Pignatti, Fabio.
In: Internal and Emergency Medicine, Vol. 9, No. 7, 02.10.2014, p. 723-734.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Multimorbidity and polypharmacy in the elderly
T2 - Lessons from REPOSI
AU - Mannucci, Pier Mannuccio
AU - Nobili, Alessandro
AU - Mannucci, Pier Mannuccio
AU - Nobili, Alessandro
AU - Tettamanti, Mauro
AU - Pasina, Luca
AU - Franchi, Carlotta
AU - Sparacio, Eleonora
AU - Alborghetti, Stefania
AU - Di Costanzo, Rosa
AU - Eldin, Tarek Kamal
AU - Tettamanti, Mauro
AU - Djade, Codjo Djignefa
AU - Salerno, Francesco
AU - Corrao, Salvatore
AU - Marengoni, Alessandra
AU - Marcucci, Maura
AU - Prisco, Domenico
AU - Silvestri, Elena
AU - Cenci, Caterina
AU - Barnini, Tommaso
AU - Delitala, Giuseppe
AU - Carta, Stefano
AU - Atzori, Sebastiana
AU - Guarnieri, Gianfranco
AU - Zanetti, Michela
AU - Spalluti, Annalisa
AU - Serra, Maria Grazia
AU - Bleve, Maria Antonietta
AU - Vanoli, Massimo
AU - Grignani, Giulia
AU - Casella, Gianluca
AU - Gasbarrone, Laura
AU - Maniscalco, Giorgio
AU - Gunelli, Massimo
AU - Tirotta, Daniela
AU - Brucato, Antonio
AU - Ghidoni, Silvia
AU - Di Corato, Paola
AU - Bernardi, Mauro
AU - Bassi, Silvia Li
AU - Santi, Luca
AU - Agnelli, Giancarlo
AU - Iorio, Alfonso
AU - Marcucci, Maura
AU - Marchesini, Emanuela
AU - Mannarino, Elmo
AU - Lupattelli, Graziana
AU - Rondelli, Pamela
AU - Paciullo, Francesco
AU - Fabris, Fabrizio
AU - Carlon, Michela
AU - Turatto, Francesca
AU - Baroni, Maria Cristina
AU - Zardo, Marianna
AU - Manfredini, Roberto
AU - Molino, Christian
AU - Pala, Marco
AU - Fabbian, Fabio
AU - Nuti, Ranuccio
AU - Valenti, Roberto
AU - Ruvio, Martina
AU - Cappelli, Silvia
AU - Paolisso, Giuseppe
AU - Rizzo, Maria Rosaria
AU - Laieta, Maria Teresa
AU - Salvatore, Teresa
AU - Sasso, Ferdinando Carlo
AU - Utili, Riccardo
AU - Mangoni, Emanuele Durante
AU - Pinto, Daniela
AU - Olivieri, Oliviero
AU - Stanzial, Anna Maria
AU - Fellin, Renato
AU - Volpato, Stefano
AU - Fotini, Sioulis
AU - Barbagallo, Mario
AU - Dominguez, Ligia
AU - Plances, Lidia
AU - D’Angelo, Daniela
AU - Rini, Giovanbattista
AU - Mansueto, Pasquale
AU - Pepe, Ilenia
AU - Licata, Giuseppe
AU - Calvo, Luigi
AU - Valenti, Maria
AU - Borghi, Claudio
AU - Strocchi, Enrico
AU - Rinaldi, Elisa Rebecca
AU - Zoli, Marco
AU - Fabbri, Elisa
AU - Magalotti, Donatella
AU - Auteri, Alberto
AU - Pasqui, Anna Laura
AU - Puccetti, Luca
AU - Pasini, Franco Laghi
AU - Capecchi, Pier Leopoldo
AU - Bicchi, Maurizio
AU - Sabbà, Carlo
AU - Vella, Francesco Saverio
AU - Marseglia, Alessandro
AU - Luglio, Chiara Valentina
AU - Palasciano, Giuseppe
AU - Modeo, Maria Ester
AU - Aquilino, Annamaria
AU - Raffaele, Pallante
AU - Pugliese, Stefania
AU - Capobianco, Caterina
AU - Postiglione, Alfredo
AU - Barbella, Maria Rosaria
AU - De Stefano, Francesco
AU - Fenoglio, Luigi
AU - Brignone, Chiara
AU - Bracco, Christian
AU - Giraudo, Alessia
AU - Musca, Giuseppe
AU - Cuccurullo, Olga
AU - Cricco, Luigi
AU - Fiorentini, Alessandra
AU - Cappellini, Maria Domenica
AU - Fabio, Giovanna
AU - Seghezzi, Sonia
AU - De Amicis, Margherita Migone
AU - Fargion, Silvia
AU - Bonara, Paola
AU - Bulgheroni, Mara
AU - Lombardi, Rosa
AU - Magrini, Fabio
AU - Massari, Ferdinando
AU - Tonella, Tatiana
AU - Peyvandi, Flora
AU - Tedeschi, Alberto
AU - Rossio, Raffaella
AU - Moreo, Guido
AU - Ferrari, Barbara
AU - Roncari, Luisa
AU - Monzani, Valter
AU - Savojardo, Valeria
AU - Folli, Christian
AU - Magnini, Maria
AU - Mari, Daniela
AU - Rossi, Paolo Dionigi
AU - Damanti, Sarah
AU - Prolo, Silvia
AU - Lilleri, Maria Sole
AU - Cricco, Luigi
AU - Fiorentini, Alessandra
AU - Micale, Giuliana
AU - Podda, Mauro
AU - Selmi, Carlo
AU - Meda, Francesca
AU - Salerno, Francesco
AU - Accordino, Silvia
AU - Conca, Alessio
AU - Monti, Valentina
AU - Corazza, Gino Roberto
AU - Miceli, Emanuela
AU - Lenti, Marco Vincenzo
AU - Padula, Donatella
AU - Balduini, Carlo L.
AU - Bertolino, Giampiera
AU - Provini, Stella
AU - Quaglia, Federica
AU - Murialdo, Giovanni
AU - Bovio, Marta
AU - Dallegri, Franco
AU - Ottonello, Luciano
AU - Quercioli, Alessandra
AU - Barreca, Alessandra
AU - Secchi, Maria Beatrice
AU - Ghelfi, Davide
AU - Chin, Wu Sheng
AU - Carassale, Laura
AU - Caporotundo, Silvia
AU - Anastasio, Luigi
AU - Sofia, Lucia
AU - Carbone, Maria
AU - Traisci, Giancarlo
AU - De Feudis, Lucrezia
AU - Di Carlo, Silvia
AU - Davì, Giovanni
AU - Guagnano, Maria Teresa
AU - Sestili, Simona
AU - Bergami, Elisabetta
AU - Rizzioli, Emanuela
AU - Cagnoni, Carlo
AU - Bertone, Luca
AU - Manucra, Antonio
AU - Buratti, Alberto
AU - Tognin, Tiziana
AU - Liberato, Nicola Lucio
AU - Bernasconi, Giordano
AU - Nardo, Barbara
AU - Bianchi, Giovanni Battista
AU - Ospedale, Sabrina Giaquinto
AU - Benetti, Giampiero
AU - Quagliolo, Michela
AU - Centenaro, Giuseppe Riccardo
AU - Purrello, Francesco
AU - Di Pino, Antonino
AU - Piro, Salvatore
AU - Mancuso, Gerardo
AU - Calipari, Daniela
AU - Bartone, Mosè
AU - Gullo, Francesco
AU - Cortellaro, Michele
AU - Magenta, Marina
AU - Perego;, Francesca
AU - Meroni, Maria Rachele
AU - Cicardi, Marco
AU - Gidaro, Antonio
AU - Magenta, Marina
AU - Sacco, Andrea
AU - Bonelli, Antonio
AU - Dentamaro, Gaetano
AU - Rozzini, Renzo
AU - Falanga, Lina
AU - Giordano, Alessandro
AU - Perin, Paolo Cavallo
AU - Lorenzati, Bartolomeo
AU - Gruden, Gabriella
AU - Bruno, Graziella
AU - Montrucchio, Giuseppe
AU - Greco, Elisabetta
AU - Tizzani, Pietro
AU - Fera, Giacomo
AU - Di Luca, Maria Loreta
AU - Renna, Donatella
AU - Perciccante, Antonio
AU - Coralli, Alessia
AU - Tassara, Rodolfo
AU - Melis, Deborah
AU - Rebella, Lara
AU - Menardo, Giorgio
AU - Bottone, Stefania
AU - Sferrazzo, Elsa
AU - Ferri, Claudio
AU - Striuli, Rinaldo
AU - Scipioni, Rosa
AU - Salmi, Raffaella
AU - Gaudenzi, Piergiorgio
AU - Gamberini, Susanna
AU - Ricci, Franco
AU - Morabito, Cosimo
AU - Fava, Roberto
AU - Semplicini, Andrea
AU - Gottardo, Lucia
AU - Delitala, Giuseppe
AU - Carta, Stefano
AU - Atzori, Sebastiana
AU - Vendemiale, Gianluigi
AU - Serviddio, Gaetano
AU - Forlano, Roberta
AU - Bolondi, Luigi
AU - Rasciti, Leonardo
AU - Serio, Ilaria
AU - Masala, Cesare
AU - Mammarella, Antonio
AU - Raparelli, Valeria
AU - Fanelli, Filippo Rossi
AU - Delfino, Massimo
AU - Amoroso, Antonio
AU - Violi, Francesco
AU - Basili, Stefania
AU - Perri, Ludovica
AU - Serra, Pietro
AU - Fontana, Vincenzo
AU - Falcone, Marco
AU - Landolfi, Raffaele
AU - Grieco, Antonio
AU - Gallo, Antonella
AU - Zuccalà, Giuseppe
AU - Franceschi, Francesco
AU - De Marco, Guido
AU - Chiara, Cordischi
AU - Marta, Sabbatini
AU - Bellusci, Martino
AU - Setti, Donatella
AU - Pedrazzoli, Filippo
AU - Romanelli, Giuseppe
AU - Pirali, Caterina
AU - Amolini, Claudia
AU - Rosei, Enrico Agabiti
AU - Rizzoni, Damiano
AU - Castoldi, Luana
AU - Picardi, Antonio
AU - Gentilucci, Umberto Vespasiani
AU - Mazzarelli, Chiara
AU - Gallo, Paolo
AU - Guasti, Luigina
AU - Castiglioni, Luana
AU - Maresca, Andrea
AU - Squizzato, Alessandro
AU - Contini, Sara
AU - Molaro, Marta
AU - Annoni, Giorgio
AU - Corsi, Maurizio
AU - Zazzetta, Sara
AU - Bertolotti, Marco
AU - Mussi, Chiara
AU - Scotto, Roberto
AU - Ferri, Maria Alice
AU - Veltri, Francesca
AU - Arturi, Franco
AU - Succurro, Elena
AU - Sesti, Giorgio
AU - Gualtieri, Umberto
AU - Perticone, Francesco
AU - Sciacqua, Angela
AU - Quero, Michele
AU - Bagnato, Chiara
AU - Loria, Paola
AU - Becchi, Maria Angela
AU - Martucci, Gianfranco
AU - Fantuzzi, Alessandra
AU - Maurantonio, Mauro
AU - Corinaldesi, Roberto
AU - De Giorgio, Roberto
AU - Serra, Mauro
AU - Grasso, Valentina
AU - Ruggeri, Eugenio
AU - Carozza, Lorenzo Mauro
AU - Pignatti, Fabio
PY - 2014/10/2
Y1 - 2014/10/2
N2 - The dramatic demographic changes that are occurring in the third millennium are modifying the mission of generalist professionals such as primary care physicians and internists. Multiple chronic diseases and the related prescription of multiple medications are becoming typical problems and present many challenges. Unfortunately, the available evidence regarding the efficacy of medications has been generated by clinical trials involving patients completely different from those currently admitted to internal medicine: much younger, affected by a single disease and managed in a highly controlled research environment. Because only registries can provide information on drug effectiveness in real-life conditions, REPOSI started in 2008 with the goal of acquiring data on elderly people acutely admitted to medical or geriatric hospital wards in Italy. The main goals of the registry were to evaluate drug prescription appropriateness, the relationship between multimorbidity/polypharmacy and such cogent outcomes as hospital mortality and re-hospitalization, and the identification of disease clusters that most often concomitantly occur in the elderly. The findings of 3-yearly REPOSI runs (2008, 2010, 2012) suggest the following pertinent tasks for the internist in order to optimally handle their elderly patients: the management of multiple medications, the need to become acquainted with geriatric multidimensional tools, the promotion and implementation of a multidisciplinary team approach to patient health and care and the corresponding involvement of patients and their relatives and caregivers. There is also a need for more research, tailored to the peculiar features of the multimorbid elderly patient.
AB - The dramatic demographic changes that are occurring in the third millennium are modifying the mission of generalist professionals such as primary care physicians and internists. Multiple chronic diseases and the related prescription of multiple medications are becoming typical problems and present many challenges. Unfortunately, the available evidence regarding the efficacy of medications has been generated by clinical trials involving patients completely different from those currently admitted to internal medicine: much younger, affected by a single disease and managed in a highly controlled research environment. Because only registries can provide information on drug effectiveness in real-life conditions, REPOSI started in 2008 with the goal of acquiring data on elderly people acutely admitted to medical or geriatric hospital wards in Italy. The main goals of the registry were to evaluate drug prescription appropriateness, the relationship between multimorbidity/polypharmacy and such cogent outcomes as hospital mortality and re-hospitalization, and the identification of disease clusters that most often concomitantly occur in the elderly. The findings of 3-yearly REPOSI runs (2008, 2010, 2012) suggest the following pertinent tasks for the internist in order to optimally handle their elderly patients: the management of multiple medications, the need to become acquainted with geriatric multidimensional tools, the promotion and implementation of a multidisciplinary team approach to patient health and care and the corresponding involvement of patients and their relatives and caregivers. There is also a need for more research, tailored to the peculiar features of the multimorbid elderly patient.
KW - Adverse drug effects
KW - Aging
KW - Drug prescription
KW - Multidimensional evaluation
KW - Multimorbidity
KW - Polypharmacy
UR - http://www.scopus.com/inward/record.url?scp=84918514930&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84918514930&partnerID=8YFLogxK
U2 - 10.1007/s11739-014-1124-1
DO - 10.1007/s11739-014-1124-1
M3 - Article
C2 - 25164413
AN - SCOPUS:84918514930
VL - 9
SP - 723
EP - 734
JO - Internal and Emergency Medicine
JF - Internal and Emergency Medicine
SN - 1828-0447
IS - 7
ER -