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Hospitalized older adults

Peter Ssebutinde, Imelda T Kyamwanga, Eleanor Turyakira, Stephen Asiimwe, Francis Bajunirwe
BACKGROUND: The prevalence of HIV infection among older persons is increasing yet older age at initiation of antiretroviral therapy (ART) may be associated with poorer treatment outcomes including mortality. However, majority of these studies have been done in the western world and there is limited data in resource limited settings. Our study used routinely collected health facility data to assess trends in age at initiation of ART, the effect of age at ART initiation on mortality and immunological response at a large urban hospital in south western Uganda...
2018: PloS One
Islam I Bedaiwi, Sukayna Z Alfaraj, Jesse M Pines
BACKGROUND: We examine recent trends in U.S. emergency department (ED) and hospital care for stroke and transient ischemic attack (TIA). METHOD: We used national ED and inpatient data from the Healthcare Cost and Utilization Project 2006-14. We explored trends in care and outcomes for patients treated in U.S. hospitals with stroke and TIA using descriptive statistics, as well as intracranial hemorrhage (ICH), a complication of stroke treatment. RESULTS: From 2006 to 14, there were 3...
August 8, 2018: American Journal of Emergency Medicine
José Antonio López Trigo, Rosa López Mongil, Alberto Mariano Lázaro, Gloria Mato Chaín, Norberto Moreno Villajos, Primitivo Ramos Cordero
Influenza is a significant health problem, particularly in those persons susceptible to having associated complications, older people, children less than 2 years, patients with chronic diseases, immunocompromised patients, and pregnant women. But influenza also has a large impact on the health system, with an increase in the healthcare demand and a spectacular increase in outpatient visits, overloading the emergency and hospital services. During epidemic outbreaks, the hospital admission rates of people over 65 years are at a maximum, and the mortality notified for the 2017/2018 influenza season was 960 deaths...
August 11, 2018: Revista Española de Geriatría y Gerontología
Rima C Tarraf, Esther Suter, Mubashir Arain, Arden Birney, Omenaa Boakye, Pierre Boulanger, Cheryl A Sadowski
PURPOSE: Slow changes in older adults' health status are often not detected until they escalate. Our aim was to understand if e-technology can enhance the safety and quality of older adult care by detecting changes in health status early. METHODS: E-technology was implemented with 30 seniors in an assisted living facility. We used wireless devices to monitor blood pressure, oxygen saturation, weight, and hydration. This 1-year feasibility study included: a readiness assessment, procuring devices, developing an alert software, training staff, and weekly monitoring for several months...
August 13, 2018: Informatics for Health & Social Care
Laura Rafaela Monteiro de Almeida Maciel, Oellen Stuani Franzosi, Diego Silva Leite Nunes, Sérgio Henrique Loss, Audrey Machado Dos Reis, Bibiana de Almeida Rubin, Silvia Regina Rios Vieira
BACKGROUND: The Nutritional Risk Screening 2002 (NRS-2002) is a widely recommended nutrition risk indicator. Two cut-offs have been proposed for intensive care unit (ICU) patients to classify nutrition risk: ≥3-<5, at risk and ≥5, high risk. To date, no study has directly compared these cut-offs. The aim of this study is to compare the NRS-2002 ICU nutrition risk cut-offs as predictors of clinical outcomes including infections, ICU and hospital mortality, length of stay (LOS), duration of mechanical ventilation (MVd), weaning failure, tracheotomy for prolonged MVd, and chronic critical illness (CCI)...
August 13, 2018: Nutrition in Clinical Practice
T M Alarcon Falconi, M S Cruz, E N Naumova
According to the Centers for Disease Control and Prevention (CDC), from 2000 to 2014, reported cases of legionellosis per 100 000 population increased by 300% in the USA, although reports on disease seasonality are inconsistent. Using two national databases, we assessed seasonal patterns of legionellosis in the USA. We created a monthly time series from 1993 to 2015 of reported cases of legionellosis from the CDC, and from 1997 to 2006 of medical claims of legionellosis-related hospitalisation in older adults from the Centers for Medicaid and Medicare Services (CMS)...
August 13, 2018: Epidemiology and Infection
Annaliese Blair, Katrina Anderson, Catherine Bateman
ABSTRACTObjectives:Evaluate the clinical outcomes for patients with dementia, delirium, or at risk for delirium supported by the person-centered volunteer program in rural acute hospitals. DESIGN: A non-randomized, controlled trial. PARTICIPANTS: Older adults admitted to seven acute hospitals in rural Australia. Intervention (n = 270) patients were >65 years with a diagnosis of dementia or delirium or had risk factors for delirium and received volunteer services...
August 13, 2018: International Psychogeriatrics
Kate Gregorevic, Nancye M Peel, Wen Kwang Lim, Ruth E Hubbard
Background: Although increasing frailty is predictive of increased mortality and length of stay for hospitalised older adults, this approach ignores health assets that individuals can utilise to recover following hospital admission. Aim: To examine whether health assets mitigate the effect of frailty on outcomes for older adults admitted to hospital. Design: 1418 patients aged ≥ 70 years admitted to 11 hospitals in Australia were evaluated at admission using the interRAI assessment system for Acute Care, which surveys a large number of domains, including cognition, communication, mood and behaviour, activities of daily living, continence, nutrition, skin condition, falls, and medical diagnosis...
August 7, 2018: QJM: Monthly Journal of the Association of Physicians
Rachel Bosshard, Karl O'Reilly, Stephen Ralston, Shkun Chadda, David Cork
BACKGROUND: Acute myeloid leukemia (AML) is a rare hematologic malignancy largely affecting older adults. Comorbidities may compromise fitness and eligibility for high-intensity chemotherapy (HIC). This study presents the results of two systematic reviews (SRs) assessing (1) the impact of AML and current treatments on health-related quality of life (HRQoL), and (2) the economic burden and cost drivers of AML in patients who are ineligible for HIC. METHODS: Electronic searches (MEDLINE, EMBASE, EconLit, Cochrane library) were supplemented with manual searching of conference, utility, and HTA databases...
July 18, 2018: Cancer Treatment Reviews
Liron Sinvani, Jessy Warner-Cohen, Andrew Strunk, Travis Halbert, Ruchika Harisingani, Colm Mulvany, Michael Qiu, Andrzej Kozikowski, Vidhi Patel, Tara Liberman, Maria Carney, Renee Pekmezaris, Gisele Wolf-Klein, Corey Karlin-Zysman
OBJECTIVES: To determine whether a multicomponent intervention improves care in hospitalized older adults with cognitive impairment. DESIGN: One-year retrospective chart review with propensity score matching on critical demographic and clinical variables was used to compare individauls with cognitive impairmenet on intervention and nonintervention units. SETTING: Large tertiary medical center. PARTICIPANTS: All hospitalized individuals age 65 and older with cognitive impairment admitted to medicine who required constant or enhanced observation for behavioral and psychological symptoms...
August 11, 2018: Journal of the American Geriatrics Society
Michael Rosenbloom, Terry R Barclay, Soo Borson, Ann M Werner, Lauren O Erickson, Jean M Crow, Kamakshi Lakshminarayan, Logan H Stuck, Leah R Hanson
BACKGROUND: Alzheimer's disease, the most common cause of dementia, goes unrecognized in half of patients presenting to healthcare providers and is associated with increased acute care utilization. Routine cognitive screening of older adults in healthcare settings could improve rates of dementia diagnosis and patterns of healthcare utilization. OBJECTIVE: To evaluate the impact of screening positive for cognitive impairment on provider action in primary and specialty care practices and patient healthcare utilization...
August 10, 2018: Journal of General Internal Medicine
Tracy E Madsen, Eliza DeCroce-Movson, Morgan Hemendinger, Ryan A McTaggart, Shadi Yaghi, Shawna Cutting, Karen L Furie, Ali Saad, Matthew S Siket, Mahesh V Jayaraman
BACKGROUND: It is largely unknown whether functional outcomes after mechanical thrombectomy for large vessel occlusion (LVO) ischemic strokes differ by sex in non-clinical trial populations. We investigated sex differences in 90-day outcomes among ischemic stroke patients receiving mechanical thrombectomy. METHODS: This was a prospective cohort of adults treated with mechanical thrombectomy for LVO at a single academic comprehensive stroke center from July 2015 to April 2017...
August 10, 2018: Journal of Neurointerventional Surgery
Lisa X Deng, Kanan Patel, Christine Miaskowski, Ingrid Maravilla, Sarah Schear, Sarah Garrigues, Nicole Thompson, Andrew D Auerbach, Christine S Ritchie
OBJECTIVES: To investigate the prevalence, characteristics, and management of pain in older hospitalized medical patients. DESIGN: Medical record aggregate review. SETTING: Tertiary care hospital. PARTICIPANTS: Individuals aged 65 and older admitted to the medicine service between November 28, 2014, and May 28, 2015. MEASUREMENTS: Demographic characteristics, comorbidity burden, pain characteristics, and analgesics during index hospitalization were assessed in individuals with moderate to severe pain (≥4 on 0-10 Numeric Pain Rating Scale)...
August 10, 2018: Journal of the American Geriatrics Society
Zhenbin Jiang, Meishun Cai, Bao Dong, Yu Yan, Bing Yang, Mi Wang, Yan Wang, Xin Li, Lichao Lian, Song Li, Li Zuo
Membranous nephropathy is typically classified as idiopathic and secondary, but nowadays the number of atypical membranous nephropathy (aMN) is increasing, many of which cannot determine its etiology in China. In this study, we compared the clinical and pathological characteristics of idiopathic membranous nephropathy (iMN) with aMN with unknown etiology from a single center in China.We retrospectively reviewed the clinical data of 577 patients with iMN and aMN at Peking University People's Hospital from January 2006 to December 2015 over a 10-year period, and analyzed their clinical and pathological characteristics...
August 2018: Medicine (Baltimore)
Ruth de Francisco, Andrés Castaño-García, Susana Martínez-González, Isabel Pérez-Martínez, Ana J González-Huerta, Lucía R Morais, María S Fernández-García, Santiago Jiménez, Susana Díaz-Coto, Pablo Flórez-Díez, Adolfo Suárez, Sabino Riestra
BACKGROUND: Little is known about the impact of Epstein-Barr virus (EBV) infection on clinical outcomes in adults with inflammatory bowel disease (IBD). AIM: To evaluate seroprevalence, seroconversion rate and complications associated with EBV infection in an adult IBD cohort attending a tertiary hospital in Spain between 2006 and 2016. METHODS: EBV serological status was performed. In seronegative patients, the seroconversion rate was evaluated...
August 10, 2018: Alimentary Pharmacology & Therapeutics
D Orwig, M C Hochberg, A L Gruber-Baldini, B Resnick, R R Miller, G E Hicks, A R Cappola, M Shardell, R Sterling, J R Hebel, R Johnson, J Magaziner
BACKGROUND: Incidence of hip fractures in men is expected to increase, yet little is known about consequences of hip fracture in men compared to women. It is important to investigate differences at time of fracture using the newest technologies and methodology regarding metabolic, physiologic, neuromuscular, functional, and clinical outcomes, with attention to design issues for recruiting frail older adults across numerous settings. OBJECTIVES: To determine whether at least moderately-sized sex differences exist across several key outcomes after a hip fracture...
2018: Journal of Frailty & Aging
Juliana M Bernstein, Peter Graven, Kathleen Drago, Konrad Dobbertin, Elizabeth Eckstrom
OBJECTIVES: To design a value-driven, interprofessional inpatient geriatric consultation program coordinated with systems-level changes and studied outcomes and costs. DESIGN: Propensity-matched case-control study of older adults hospitalized at an academic medical center (AMC) who did or did not receive geriatric consultation. SETTING: Single tertiary-care AMC in Portland, Oregon. PARTICIPANTS: Adults aged 70 and older who received an inpatient geriatric consultation (n=464) and propensity-matched controls admitted before development of the consultation program (n=2,381)...
August 10, 2018: Journal of the American Geriatrics Society
Mathew J Summers, Innocenzo Rainero, Alessandro E Vercelli, Georg Aumayr, Helios de Rosario, Michaela Mönter, Ryuta Kawashima
Introduction: Frailty increases the risk of poor health outcomes, disability, hospitalization, and death in older adults and affects 7%-12% of the aging population. Secondary impacts of frailty on psychological health and socialization are significant negative contributors to poor outcomes for frail older adults. Method: The My Active and Healthy Aging (My-AHA) consortium has developed an information and communications technology-based platform to support active and healthy aging through early detection of prefrailty and provision of individually tailored interventions, targeting multidomain risks for frailty across physical activity, cognitive activity, diet and nutrition, sleep, and psychosocial activities...
2018: Alzheimer's & Dementia: Translational Research & Clinical Interventions
Beth Prusaczyk, Vanessa Fabbre, Christopher R Carpenter, Enola Proctor
Background: Health services and implementation researchers often seek to capture the implementation process of complex interventions yet explicit guidance on how to capture this process is limited. Medical record review is a commonly used methodology, especially when used as a proxy for provider behavior, with recognized benefits and limitations. The purpose of this study was to test the feasibility of chart review to measure implementation and offer recommendations for future researchers using this method to capture the implementation process...
May 25, 2018: EGEMS
Jessica Louise Roberts, Aaron W Pritchard, Michelle Williams, Nikki Totton, Val Morrison, Nafees Ud Din, Nefyn H Williams
OBJECTIVES: To describe the implementation of an enhanced rehabilitation programme for elderly hip fracture patients with mental capacity, in a randomised feasibility study compared with usual rehabilitation. To compare processes between the two and to collect the views of patients, carers and therapy staff about trial participation. DESIGN: Mixed methods process evaluation in a randomised feasibility study. SETTING: Patient participants were recruited on orthopaedic and rehabilitation wards; the intervention was delivered in the community following hospital discharge...
August 8, 2018: BMJ Open
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