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elderly inpatients

William Beedham, George Peck, Simon E Richardson, Kevin Tsang, Michael Fertleman, David Jh Shipway
Head injury is a common cause for hospital admission and additionally 250,000 UK inpatients fall during hospital admissions annually. Head injury most commonly occurs as a result of falls from standing height in older adults. Older adults are frequently frail and multi-morbid; many have indications for anticoagulation and antiplatelet agents. The haemorrhagic complications of head injury occur in up to 16% of anticoagulated patients sustaining a head injury. These patients suffer adverse outcomes from surgery as a result of medical complications...
March 2019: Clinical Medicine: Journal of the Royal College of Physicians of London
Anh Trung Nguyen, Thanh Xuan Nguyen, Tu N Nguyen, Thu Hoai Thi Nguyen, Thang Pham, Robert Cumming, Sarah N Hilmer, Huyen Thi Thanh Vu
Aims: To investigate the impact of frailty on outcomes in older hospitalized patients, including prolonged length of stay and all-cause mortality 6 months after admission, using both the frailty phenotype and the Reported Edmonton Frail Scale (REFS). Patients and methods: This study is the follow-up phase of a study designed to investigate the prevalence of frailty and its impact on adverse outcomes in older hospitalized patients at the National Geriatric Hospital in Hanoi, Vietnam...
2019: Clinical Interventions in Aging
Yan Li, Si Zheng, Yunxia Wu, Xiaoguang Liu, Gengding Dang, Yu Sun, Zhongqiang Chen, Jiayang Wang, Jiao Li, Zhongjun Liu
Purpose: Given the aging Chinese population and the inevitable degenerative process of the spine, more elderly patients with spinal degenerative disease (SDD) are surgical candidates, placing a significant burden on health care resources. Few studies have investigated recent trends in hospital admissions and procedures for SDD in China. This study aimed to identify the trends, if any, in the number of surgical procedures undertaken for SDD in a large patient cohort. Materials and methods: This retrospective cohort analysis used data from inpatient medical records at Peking University Third Hospital between 2003 and 2016...
2019: Clinical Interventions in Aging
Peng Song, Jingcheng Zhang, Congcong Shang, Li Zhang
To summarize the therapeutic effects of PD-1/PD-L1 inhibitors on patients with advanced non-small cell lung cancer (NSCLC) in a real-world setting, we attempted to identify potential molecular biomarkers or clinical factors that reflected the therapeutic effect. The medical records of patients with non-small cell lung cancer who were treated with PD-1/PD-L1 inhibitors were obtained from the outpatient department or inpatient department of Peking Union Medical College Hospital from August 1, 2015, to January 1, 2018...
March 12, 2019: Scientific Reports
Phu Sabei Shwe, Stephanie A Ward, Paul M Thein, Ralph Junckerstorff
BACKGROUND: Poor nutritional status is a risk factor for the development of frailty. Likewise, oral health is independently associated with nutrition. The potential association between oral health and frailty in hospitalised elderly adults has, however, not previously been investigated. OBJECTIVE: To investigate the relationship between oral health and frailty in hospitalised elderly adults and to identify the predictors of frailty. METHOD: A cross-sectional study of 168 geriatric inpatients >65 years old was performed from August to December 2016...
March 12, 2019: Gerodontology
Gitte Bunkenborg, Ingrid Poulsen, Karin Samuelson, Steen Ladelund, Jonas Akeson
PURPOSE: The purpose of this paper is to determine associations between initially recorded deviations in individual bedside vital parameters that contribute to total Modified Early Warning Score (MEWS) levels 2 or 3 and further clinical deterioration (MEWS level=4). DESIGN/METHODOLOGY/APPROACH: This was a prospective study in which 27,504 vital parameter values, corresponding to a total MEWS level⩾2, belonging to 1,315 adult medical and surgical inpatient patients admitted to a 90-bed study setting at a university hospital, were subjected to binary logistic and COX regression analyses to determine associations between vital parameter values initially corresponding to total MEWS levels 2 or 3 and later deterioration to total MEWS level ⩾4, and to evaluate corresponding time intervals...
February 11, 2019: International Journal of Health Care Quality Assurance
Y Huang, P Meyer, L Jin
OBJECTIVES: Ambulatory care sensitive condition (ACSC) admission rates have been widely used as indicators of access to and quality of primary care as well as the efficiency of health systems. This study examines associations of spatial access to health care with both inpatient hospital admissions and emergency department (ED) visits for ACSCs for older adults. This study also compares inpatient hospitalization admissions and ED visits for elderly ACSCs by spatial access to health care...
February 27, 2019: Public Health
Jorja Collins, Judi Porter, Helen Truby, Catherine E Huggins
Understanding older patients' dietary intake patterns may improve the timing of strategies to address hospital malnutrition. The aims of this study were to explore longitudinally the change in daily energy (kJ/day) and protein (g/day) intake, and associated factors. Data were derived using a 5-point scale to visually estimate plate waste, and known nutrient composition data. Analyses determined the change in intake between admission and day 14, and admission, day 14 and day 28, respectively. Data were available for 39 participants between admission and day 14 (median (interquartile range) age 82 (78⁻87) years; 54% male) and 12 participants between admission, day 14 and day 28 (median (IQR) age 79 (69⁻84) years; 58% male)...
February 22, 2019: Nutrients
Shintaro Takenoshita, Seishi Terada, Etsuko Oshima, Megumi Yamaguchi, Satoshi Hayashi, Kenji Hinotsu, Satoru Esumi, Takayoshi Shinya, Norihito Yamada
BACKGROUND: Recently, depression with Lewy body pathology before the appearance of parkinsonism and cognitive dysfunction has been drawing attention. Low cardiac metaiodobenzylguanidine (MIBG) uptake is helpful for early differentiation of Lewy body disease (LBD) from late-onset psychiatric disorders even before parkinsonism or dementia appears. In this study, we used MIBG uptake as a tool in suspected LBD, and evaluated the relationship of MIBG results to clinical characteristics and depressive symptoms...
February 27, 2019: Psychogeriatrics: the Official Journal of the Japanese Psychogeriatric Society
Antonio Caronni, Michela Picardi, Evdoxia Aristidou, Paola Antoniotti, Giuseppe Pintavalle, Valentina Redaelli, Irma Sterpi, Massimo Corbo
BACKGROUND: The timed up and go (TUG) test is widely used for assessing treatments effectiveness on elderly mobility. Although the TUG test consists of different tasks (e.g. walking and turning), the total TUG duration (TTD) is usually the only outcome measure, with TTD shortening indicating the patient's improvement. RESEARCH QUESTION: Does TTD shortening reflect the improvement of each TUG tasks or does it reflect the improvement of only some of them? METHODS: This retrospective study recruited 120 elderly patients (mean, SD: 76...
February 15, 2019: Gait & Posture
Steven M Kurtz, Edmund Lau, Doruk Baykal, Susan M Odum, Bryan D Springer, Thomas K Fehring
BACKGROUND: We analyzed whether the total hospital cost in a 90-day bundled payment period for ceramic-on-polyethylene (C-PE) and ceramic-on-ceramic (COC) total hip arthroplasty (THA) bearings was changing over time, and whether the cost differential between ceramic bearings and metal-on-polyethylene (M-PE) bearings was approaching the previously published tipping point for cost-effectiveness of US$325. METHODS: A total of 245,077 elderly Medicare patients (65+) who underwent primary THA between 2010 and 2015 were identified from the United States Medicare 100% national administrative hospital claims database...
February 5, 2019: Journal of Arthroplasty
Sankalp Dwivedi, Jaya Edukulla, Sindhu Rajendra, Sandesh Murali, Serge A Sorser, Marc S Piper, Michael Piper, Bradley J Warren, Harsha Ramchandani
Background : Inappropriate use of acid suppression (AST) therapy may lead to unnecessary harms, especially in the geriatric population. Despite this, AST remains one of the most commonly prescribed medications in the hospital. Therefore, we aimed to assess its prevalence and create educational intervention to improve the appropriateness of inpatient acid suppression therapy. Methods : Using a time-series design, we established a historical control by performing a retrospective chart. Accepted indications for AST were based on those endorsed by the USA Food and Drug Administration and literature review...
2019: Journal of Community Hospital Internal Medicine Perspectives
Ishveen Chopra, Malcolm D Mattes, Patricia Findley, Xi Tan, Nilanjana Dwibedi, Usha Sambamoorthi
Background: Healthcare spending for coronary artery disease (CAD)-related services is higher than for other chronic conditions. Diagnosis of incident cancer may impede management of CAD, thereby increasing the risk of CAD-related complications and associated healthcare expenditures. This study examined the relationship between incident cancer and CAD-related expenditures among elderly Medicare beneficiaries. Patients and Methods: A retrospective longitudinal study was conducted using the SEER-Medicare linked registries and a 5% noncancer random sample of Medicare beneficiaries...
February 2019: Journal of the National Comprehensive Cancer Network: JNCCN
Agnus M Kim, Sungchan Kang, Jong Heon Park, Tae Ho Yoon, Yoon Kim
BACKGROUND: The incidence of pneumonia in Korea started to increase in the 1990's after a period of decrease and stabilization, and the mortality and hospitalization rates for pneumonia in Korea are alarmingly high. This study was performed to examine geographic variation and factors associated with hospitalization for bacterial pneumonia in Korea. METHODS: Data were acquired from the inpatient claims of the 2015 period of the National Health Insurance Service. The age- and sex-standardized hospitalization rates for bacterial pneumonia were calculated for three age groups...
February 20, 2019: BMC Pulmonary Medicine
Xibei Liu, Jay J Shen, Pearl Kim, Sun Jung Kim, Johnson Ukken, Younseon Choi, In Choel Hwang, Jae-Hoon Lee, Sung-Youn Chun, Jinwook Hwang, Haneul Choi, Hyeyoung Yeom, Yong-Jae Lee, Ji Won Yoo
AIM: Pancreas cancer continues to carry a poor prognosis. Hospitalized patients with advanced chronic pancreatic illnesses increasingly receive palliative care due to its perceived clinical benefits. Meanwhile, a growing proportion of elderly patients are reportedly receiving life-sustaining procedures. Temporal trends in the utilization of life-sustaining procedures and palliative care consultation among dying patients with advanced chronic pancreatic illnesses in US hospitals were examined...
February 15, 2019: Journal of Palliative Care
Katja Dierich, Maria-Theresia Nicolai, Henrieke Franzen
In accordance with Prevention Act law and the associated new prevention mandate of the nursing care funds, more preventive and health promoting activities have been taking place in inpatient care facilities since 2016. The Lübeck model of themed movement activities as a part of the program "Grow older in Balance" of the Federal Center for Health Education was developed as a physical, mental, and socially activating prevention program for elderly people with physical and cognitive impairments.The regional implementation of the Lübeck model in inpatient care facilities, facilities for age-appropriate living, as well as in day-care, serves the Berlin project "Adaptation and implementation of the Lübeck model of themed movement activities in the model region of Pankow - Low threshold exercise offers in nursing facilities for the elderly...
February 13, 2019: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
Oksana Zolotar, Norbert Schrage
The demographic change in Germany has led to an increasing number of elderly and dependent persons being cared for in nursing homes. Additionally, public health insurance has tried to save money on home visits made by general practitioners and specialists. This has led to significant deficits in ophthalmic care. To relieve the stress on the health care system, we tested the ACTO eye test as part of our study. This test can be performed after a short introduction; even by laypeople. For our study, we assessed the vision of 218 persons, aged 60 or above, in four nursing homes in Germany...
February 8, 2019: Klinische Monatsblätter Für Augenheilkunde
Panagiota Voukelatou, Ioannis Vrettos, Georgia Emmanouilidou, Konstantinos Dodos, Georgia Skotsimara, Dimitra Kontogeorgou, Andreas Kalliakmanis
Introduction. Overutilization of Proton Pump Inhibitors (PPIs) both in ambulatory care and in the inpatient setting possesses economic implications and increases the risk for adverse drug reactions. This study was undertaken to identify factors associated with inappropriate PPI use among consecutively unplanned admissions of elderly patients at the time of admission. Materials and Methods. In 758 patients (54.2% women), mean age 80.3±8.0 (M±1SD), demographic characteristics, and medical and medication history were recorded...
2019: Current Gerontology and Geriatrics Research
Rachel L Groves
BACKGROUND: Delirium is a neurological disorder with correlations to increased hospital length of stays and higher morbidity and mortality rates, particularly in the growing elderly population, making prevention strategies key in improving patient outcomes and health care systems. OBJECTIVES: Does increased exposure to light, by artificial or natural means, decrease the incidence of delirium? METHODS: A systematic review was conducted of 4 revered databases, CINAHL, PubMed, PsycINFO, and Scopus, for articles related to key words "delirium" and "lighting" or "daylight" or "natural light" or "bright light" or "sunlight...
March 2019: Dimensions of Critical Care Nursing: DCCN
Jinjiao Wang, Mary S Dietrich, Susan P Bell, Cathy A Maxwell, Sandra F Simmons, Sunil Kripalani
OBJECTIVES: (1) To compare changes in vulnerability after hospital discharge among older patients with cardiovascular disease who were discharged home with self-care versus a home healthcare (HHC) referral and (2) to examine factors associated with changes in vulnerability in this period. DESIGN: Secondary analysis of longitudinal data from a cohort study. PARTICIPANTS AND SETTING: 834 older (≥65 years) patients hospitalised for acute coronary syndromes and/or acute decompensated heart failure who were discharged home with self-care (n=713) or an HHC referral (n=121)...
January 29, 2019: BMJ Open
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