Edouard Battegay

University of Zurich | UZH · Innovation Hub International Center for Multimorbidity and Complexity in Medicine (ICMC)

Patients with multimorbidity increasingly impact healthcare systems, both in primary care and in hospitals. This is particularly true in Internal Medicine. This population associates with higher mortality rates, polypharmacy, hospital readmissions, post-discharge syndrome, anxiety, depression, accelerated age-related functional decline, and develop...

Introduction: Intravenous iron formulations have been approved in Europe and North America for the treatment of iron deficiency if oral iron is not tolerated or not efficacious. Recently-developed intravenous iron formulations exhibit specific physicochemical and immunological properties, with distinct bioavailability, efficacy and safety profiles....

Background Multimorbidity increases healthcare resource utilization. Little is known on specific comorbidity combinations.AimsTo identify comorbidities associated with increased resource utilization among inpatients admitted for gastrointestinal bleeding (GIB).Methods This retrospective cross-sectional study, 1/2010–5/2018 at the University Hospita...

The neural response in the human visual system is composed of magno-, parvo- and koniocellular input from the retina. Signal differences from functional imaging between health and individuals with a cognitive weakness are attributed to a dysfunction of a specific retinal input. Yet, anatomical interconnections within the human visual system obscure...

Aims Several diseases are linked to increased risk of Coronavirus disease 19 (COVID-19). Our aim was to investigate whether depressive and anxiety symptoms predict subsequent risk of COVID-19, as has been shown for other respiratory infections. Methods We based our analysis on UK Biobank participants providing prospective data to estimate temporal...

Background: Multimorbidity, defined as the co-occurrence of ≥2 chronic conditions, is clinically diverse. Such complexity hinders the development of integrated/collaborative care for multimorbid patients. In addition, the universality of multimorbidity patterns is unclear given scarce research comparing multimorbidity profiles across populations. T...

Objective Nosocomial transmission of influenza is a major concern for infection control. We aimed to dissect transmission dynamics of influenza, including asymptomatic transmission events, in acute care. Design Prospective surveillance study during 2 influenza seasons. Setting Tertiary-care hospital. Participants Volunteer sample of inpatients o...

Objective To assess influenza symptoms, adherence to mask use recommendations, absenteesm and presenteeism in acute care healthcare workers (HCWs) during influenza epidemics. Methods The TransFLUas influenza transmission study in acute healthcare prospectively followed HCWs prospectively over 2 consecutive influenza seasons. Symptom diaries asking...

Background The health aspects, disease frequencies, and specific health interests of prisoners and refugees are poorly understood. Importantly, access to the health care system is limited for this vulnerable population. There has been no systematic investigation to understand the health issues of inmates in Switzerland. Furthermore, little is known...

Clinical prediction scores support the assessment of patients in the emergency setting to determine the need for further diagnostic and therapeutic steps. During the current COVID-19 pandemic, physicians in emergency rooms (ER) of many hospitals have a considerably higher patient load and need to decide within a short time frame whom to hospitalize...

Background: Little is known about risk factors upon hospital admission that are associated with in-hospital death of patients hospitalized for bacterial pneumonia. Identifying such factors may help to optimize the treatment and lower the mortality of these patients. Objectives: The aim of the study was to characterize baseline characteristics of...

Background: Physician well-being has an impact on productivity and quality of care. Residency training is a particularly stressful period. Objective: To assess the well-being of general internal medicine (GIM) residents and its association with personal and work-related factors. Methods: We conducted an anonymous electronic survey among GIM re...

Clinical prediction scores support the assessment of patients in the emergency setting to determine the need for further diagnostic and therapeutic steps. During the current COVID-19 pandemic, physicians in emergency rooms (ER) of many hospitals have a considerably higher patient load and need to decide within a short time frame whom to hospitalize...

New and changing patterns of multimorbidity (MM), i.e., multiple concurrent acute or chronic diseases in a person, are emerging in low- and middle-income countries (LMICs). The interplay of underlying population-specific factors and lifestyle habits combined with the colliding epidemics of communicable and non-communicable diseases presents new dis...

Background: Working in a hospital can be both rewarding and stressful. Whether one or the other is dominant depends on a number of factors ranging from shift work, physical demands, responsibilities and time pressure to job autonomy, work climate and leisure time. Aim: This study aimed to examine associations between temporal work stressors and...

Background Multimorbidity is challenging not only for the patient but also for the romantic partner. Strategies for interpersonal emotion regulation like disclosing to the partner are supposed to play a major role in the psychosocial adjustment to multimorbidity. Research has often focused on disease-related disclosure, even though disclosing thoug...

Background: The Wetterling alcohol withdrawal syndrome (AWS) scale determines withdrawal severity and guides treatment. We investigated associations between maximum AWS scores and clinical outcomes. Methods: This retrospective cohort study considered AWS assessments measured from 8/2015-8/2017. We used multivariable linear and logistic regressio...

Background: Little is known about the impact of depression across a broad range of multimorbid patients hospitalized for reasons other than depression. The objective of the study was to investigate in a large sample of multimorbid inpatients whether ancillary depression is associated with increased length of stay (LOS) and readmissions, two import...

Background: Caregivers encounter serious and substantial challenges in managing hypertension in patients with subclinical or clinical borderline personality disorder (BPD). These challenges include therapeutic conflicts resulting from harmful drug-drug, and drug-disease interactions. Current guidelines provide no recommendations for concurrent psy...

Aims of the study: Iron deficiency (ID) and iron deficiency anaemia (IDA) are important conditions affecting a large proportion of the general population, causing the patients physical and psychosomatic symptoms, particularly fatigue, and significantly affecting their quality of life. General practitioners (GPs) are frequently consulted with nonsp...

Objectives: What is the most effective pharmacological intervention for glycaemic control in known type 2 diabetes mellitus (DM) without prior insulin treatment and newly started on systemic glucocorticoid therapy? Design: We conducted a systematic literature review. Data sources: We searched MEDLINE, Embase and Cochrane Library databases and...

Abstract Background Detailed knowledge about viral respiratory disease transmission dynamics within healthcare institutions is essential for effective infection control policy and practice. In the quest to study viral transmission pathways, we aimed to investigate recruitment rates and adherence of healthcare workers (HCWs) and hospital inpatients...

Internet usage has grown dramatically since the early years of its inception. The rich field of data provided by internet users in interaction with digital media content can provide insight into web-based navigation behaviour and underlying psychological dimensions. Human-Computer Interaction in the web is an underutilized source of data for unders...

Aims: A new generation of physicians, millennials (also known as Generation Y), are entering residency programmes in internal medicine, and these young men and women learn and work in ways that are different from those of past generations. The aim of the present study was to investigate aspects contributing to the attractiveness to young residents...

Background: Autopsies are a crucial source of medical knowledge. Unfortunately, autopsy rates have decreased markedly in Switzerland and many other countries. Communication between clinicians and the deceased’s sceptical relatives is crucial to obtain autopsy permission. This survey investigates the personal views of multimorbid patients and their...

Multimorbidität (das gleichzeitige Vorliegen zweier oder mehrerer Langzeiterkrankungen) und die oftmals damit einhergehende Polypharmazie (Einnahme von fünf und mehr Medikamenten) sind u.a. aufgrund ihrer Interaktionen mit Ernährungsfaktoren eine Herausforderung, insbesondere für die bedarfsgerechte Ernährung und Nährstoffversorgung von älteren Men...

Entscheidungsträger haben Mühe, die Rationale einer «Allgemeinen» Inneren Medizin (AIM) am hochspezialisierten Universitätsspital zu verstehen und monieren deren «Profilunschärfe». Zudem konzentrieren sich auf der AIM multimorbide, oft unrentable Patienten. Folgen sind die Benachteiligung in Bezug auf Priorisierung und Ressourcen. Daraus wiederum r...

Background andAims Vitamin and iron deficiencies are common in patients with inflammatory bowel disease (IBD) as a result of chronic intestinal inflammation, increase in demand, or dietary restrictions. Here, we assessed the frequency of complications in relation to deficiency of iron, folate acid, and vitamin B12 in patients enrolled in the nation...

Diagnose- und Behandlungsfehler finden in der Medizin zunehmend Beachtung. Zu deren Verständnis ist die Betrachtung der zugrunde liegenden kognitiven Prozesse notwendig. Klinisches Denken und Entscheiden ist durch die gleichzeitige Aktivierung von zwei unterschiedlichen kognitiven Systemen charakterisiert, einem schnellen, intuitiven (System 1) und...

Some medical diagnostic and therapeutic interventions are non-beneficial or even harmful. The Choosing Wisely campaign has encouraged the generation of "top five" lists of unnecessary low-value services in different specialist areas. In the USA alone, where the campaign was launched, these lists include a total of 450 evidence-based recommendations...

Background: Health behavior change theories usually claim to be universally and individually applicable. Most research has tested behavior change theories at the interindividual level and within young-to-middle-aged populations. However, associations at the interindividual level can differ substantially from associations at the intraindividual lev...

Background Gallstones and kidney stones are known complications of inflammatory bowel diseases (IBD). Risk factors have been insufficiently studied and explanatory studies date back up to 30 years. It remains unclear, whether improved treatment options also influenced risk factors for these complications. Objectives Identifying risk factors for ga...

Multivariate analysis of risk factors for gallstone disease considering UC patients only. UC: Ulcerative colitis; NSAID: Non-steroidal anti-inflammatory drugs; MTWAI: Modified truelove and witts activity index. (DOCX)

Kidney stones and previous hospitalization in the last 12 months in all patients. OR: 13.90 (95% CI: 8.75–22.10; p < 0.001). Subgroup analysis; CD patients: OR 13.40 (95% CI: 7.58–23.69; p < 0.001); UC patients: OR 13.96 (95% CI: 6.26–31.14; p < 0.001) (DOCX)

Multivariate analysis of risk factors for kidney stones considering CD patients only. CD: Crohn`s disease; CDAI: Crohn`s disease activity index. (DOCX)

Multivariate analysis of risk factors for gallstones in CD patients. CD: Crohn`s disease; EIM: Extraintestinal manifestation; CDAI: Crohn`s disease activity index. (DOCX)

Gallstones and previous hospitalization in the last 12 months in all patients. OR: 12.63 (95% CI: 8.54–18.67; p < 0.001); Subgroup analysis; CD patients: OR 9.85 (95% CI: 6.11–15.87; p < 0.001); UC patients: OR 19.42 (95% CI: 9.75–38.69; p < 0.001). (DOCX)

Multivariate analysis of risk factors for kidney stones considering UC patients only. UC: Ulcerative colitis; NSAID: Non-steroidal anti-inflammatory drugs; MTWAI: Modified truelove and witts activity index. (DOCX)

Introduction: Whether clinical prediction rules for pulmonary embolism are accepted and used among general internal medicine residents remains uncertain. We therefore evaluated the frequency of use and acceptability of the Revised Geneva Score (RGS) and the Pulmonary Embolism Severity Index (PESI), and explored which factors were associated with r...

Patients with acute exacerbated chronic obstructive pulmonary disease (AECOPD) and concurrent depression suffer significant psychological stress and decreased quality of life. The aim of this study was to collate data, guidelines and recommendations from publications on the screening and management of depressive mood disorders in patients hospitali...

Etwa 20–25 % aller Personen und etwa 90 % aller akut in einer Klinik für Innere Medizin hospitalisierten Patienten weisen gleichzeitig mehrere akute oder chronische Erkrankungen auf. Sie sind multimorbid. Die Begegnung mit multimorbiden Patienten ist die häufigste Situation im Gesundheitssystem geworden. Theoretisch besteht bei Multimorbidität eine...

Therapeutic decision-making for patients with multimorbidity (MM) is challenging. Clinical practice guidelines inadequately address harmful interactions and resulting therapeutic conflicts within and among diseases. A patient-specific measure of MM severity that takes account of this conflict is needed. As a proof of concept, we evaluated whether t...

Background Chronic pain is common in multimorbid patients. However, little is known about the implications of chronic pain and analgesic treatment on multimorbid patients. This study aimed to assess chronic pain therapy with regard to the interaction potential in a sample of inpatients with multiple chronic conditions. Methods and Findings We cond...

Objective: Chronic conditions often require multiple medication intake. However, past research has focused on assessing overall adherence or adherence to a single index medication only. This study explored adherence measures for multiple medication intake, and in daily life, among patients with multiple chronic conditions (i.e. multimorbidity). Des...

Background Vitamin D deficiency is frequent and has been associated with fatigue in uncontrolled trials. Methods This is the first double-blind placebo-controlled clinical trial to investigate the efficacy of per os vitamin D3 (cholecalciferol) in treating fatigue among otherwise healthy persons with low serum 25-hydroxyvitamin D (25(OH)D) levels....

Background Decision-making processes in a medical setting are complex, dynamic and under time pressure, often with serious consequences for a patient’s condition. Objective The principal aim of the present study was to trace and map the individual diagnostic process of real medical cases using a Decision Process Matrix [DPM]). Methods The naturalis...

We investigated the relations of self-rated omission errors (i.e., forgetting to take one’s medication) and commission errors (i.e., unnecessary repetitions of medication intake because of forgetting that it has already been taken) in medication adherence in multimorbidity to prospective and retrospective memory performance. Moreover, we examined w...

In adipose tissue mTOR complex 2 (mTORC2) contributes to the regulation of glucose/lipid metabolism and inflammatory molecule expression. Both processes display diurnal variations during the course of the day. RICTOR and mSIN1 are unique and essential components of mTORC2, which is activated by growth factors including insulin. To assess whether mT...

To explore the general requirement of endothelial mTORC2 during embryonic and adolescent development, we knocked out the essential mTORC2 component Rictor in the mouse endothelium in the embryo, during adolescence and in endothelial cells in vitro. During embryonic development, Rictor knockout resulted in growth retardation and lethality around emb...