title: ISMAR-study presentation: in-hospital epidemiology and clinical management of respiratory and cardiac comorbidities in cardiac and respiratory disease units.
abstract: BACKGROUND
  Cardiovascular and respiratory diseases are leading causes of morbidity and their co-occurrence has important implications in mortality and other outcomes. Even the most recent guidelines do not reliably address clinical, prognostic, and therapeutic concerns due to the overlap of respiratory and cardiac diseases.
  In order to evaluate in the reality of clinical practice the epidemiology and the reciprocal impact of cardio-pulmonary comorbidity on the clinical management, diagnostic workup and treatment, 1,500 cardiac and 1,500 respiratory inpatients, admitted in acute and rehabilitation units, will be enrolled in a multicenter, nationwide, prospective observational study. For this purpose, each center will enroll at least 50 consecutive patients. At discharge, data analysis will be aimed at the definition of cardiac and pulmonary inpatient comorbidity prevalence, demographic characteristics, length of hospital stay, and risk factors, taking into account also procedures, pharmacological and non-pharmacological treatment, and follow up in patients with cardio-respiratory comorbidity.
  
  
  CONCLUSIONS
  The purely observational design of the study aims to give new relevant information on the assessment and management of overlapping patients in real life clinical practice, and new insight for improvement and implementation of current guidelines on the management of individual diseases.
authors.affiliation: Division of Cardiac Rehabilitation, IRCCS Policlinico San Donato - Care and Research Institute, Piazza Malan 1, I-20097 San Donato Milanese, Milan, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Tramarin
authors.affiliation: High Specialty Provincial Pulmonologic Unit, "Scarlato" Hospital, Scafati, (SA), Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Polverino
authors.affiliation: Division of Cardiac Rehabilitation, IRCCS San Raffaele Pisana - Care and Research Inst., Rome, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Volterrani
authors.affiliation: Division of Cardiac Rehabilitation, IRCCS Policlinico San Donato - Care and Research Institute, Piazza Malan 1, I-20097 San Donato Milanese, Milan, Italy.
authors.forename: Bruna
authors.initials: B
authors.lastname: Girardi
authors.affiliation: Division of Cardiology, Sant'Anna Hospital, Brescia, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Chimini
authors.affiliation: Division of Pneumology, University Hospital Auxilium Vitae, Volterra, Italy.
authors.forename: Nicolino
authors.initials: N
authors.lastname: Ambrosino
authors.affiliation: Division of Pneumology, Ss.Annunziata Hospital, Chieti, Italy.
authors.forename: Fernando
authors.initials: F
authors.lastname: De Benedetto
authors.affiliation: Division of Cardiology, Sant'Anna Hospital, Brescia, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Proto
keywords: Comorbidity; Diagnostic procedure; Epidemiology; In-hospital; Management; Treatment