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Acute care for elders

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https://www.readbyqxmd.com/read/28918667/poor-outcomes-among-elderly-patients-hospitalized-for-influenza-like-illness
#1
Mine Durusa Tanriover, Tülay Bagci Bosi, Lale Ozisik, Emre Bilgin, Özlem Güzel Tunçcan, Özge Özgen, Necla Tülek, Metin Özsoy, Hasan Tezer, Tugba Bedir Demirdağ, Ates Kara, Sevgen Tanir Basaranoglu, Kubra Aykac, Aslinur Ozkaya-Parlakay, Belgin Gulhan, Serhat Unal
BACKGROUND AND OBJECTIVE: Global Influenza Hospital Surveillance Network is a worldwide initiative that aims to document the burden of influenza infections among acute admissions and the vaccine effectiveness in particular countries. As a partner of this platform, we aimed to determine the frequency of influenza infections among acute admissions with influenza like illness and the outcomes of the enrolled patients during the 2015-2016 influenza season in selected hospitals in Turkey. PATIENTS AND METHODS: The investigators screened the hospital admission registries, chart review or available records, and screened all patients hospitalized in the previous 24-48 hours or overnight in the predefined wards or emergency room...
September 18, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28911996/accessibility-to-tertiary-stroke-centers-in-hokkaido-japan-use-of-novel-metrics-to-assess-acute-stroke-care-quality
#2
Kensuke Fujiwara, Toshiya Osanai, Eiichi Kobayashi, Takumi Tanikawa, Ken Kazumata, Kikutaro Tokairin, Kiyohiro Houkin, Katsuhiko Ogasawara
BACKGROUND: Both the accessibility and availability of stroke specialists are major determinants of patient outcomes following acute ischemic stroke (AIS). The purpose of this study was to implement novel metrics to assess the accessibility of tertiary stroke centers as well as to evaluate regional disparities in stroke specialists. METHODS: Using network analysis in a geographic information system, we calculated areas within 30- and 60-minute travel times to facilities providing intravenous recombinant tissue-type plasminogen activator and mechanical thrombectomy...
September 11, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28906260/effectiveness-of-a-post-emergency-department-discharge-multidisciplinary-bundle-in-reducing-acute-hospital-admissions-for-the-elderly
#3
Colin Ong, Marxengel Asinas-Tan, Lit-Sin Quek, Michael de Dios, Xue-Ting Cai, Beng-Leong Lim
OBJECTIVE: We evaluated the effectiveness of the Subacute Ambulatory care for the Functionally challenged and Elderly (SAFE) programme, a post-emergency department (ED) discharge intervention for elderly and functionally challenged patients, in reducing acute hospital admissions. METHODS: This study was a 32-month retrospective quasi-experimental study comparing patients with at least one of six diagnostic classifications who underwent SAFE intervention with those who were eligible but declined and received usual ED care (control)...
September 12, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28905273/early-to-long-term-alterations-of-cns-barriers-after-traumatic-brain-injury-considerations-for-drug-development
#4
Beatriz Rodriguez-Grande, Aleksandra Ichkova, Sighild Lemarchant, Jerome Badaut
Traumatic brain injury (TBI) is one of the leading causes of death and disability, particularly amongst the young and the elderly. The functions of the blood-brain barrier (BBB) and blood-cerebrospinal fluid barrier (BCSFB) are strongly impaired after TBI, thus affecting brain homeostasis. Following the primary mechanical injury that characterizes TBI, a secondary injury develops over time, including events such as edema formation, oxidative stress, neuroinflammation, and alterations in paracelullar and transcellular transport...
September 13, 2017: AAPS Journal
https://www.readbyqxmd.com/read/28899447/shifting-care-from-community-hospitals-to-intensive-community-support-a-mixed-method-study
#5
Kate S Williams, Stoyan Kurtev, Kay Phelps, Emma Regen, Simon Conroy, Andrew Wilson
Aim To examine how the introduction of intensive community support (ICS) affected admissions to community hospital (CH) and to explore the views of patients, carers and health professionals on this transition. BACKGROUND: ICS was introduced to provide an alternative to CH provision for patients (mostly very elderly) requiring general rehabilitation. METHOD: Routine data from both services were analysed to identify the number of admissions and length of stay between September 2012 and September 2014...
September 13, 2017: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/28893575/clinical-characteristics-and-outcomes-of-intracerebral-hemorrhage-in-very-elderly
#6
Yasuteru Inoue, Fumio Miyashita, Kazuo Minematsu, Kazunori Toyoda
BACKGROUND: Intracerebral hemorrhage (ICH) incidences increase with age. Patients of advanced age may have limitations during acute care and recovery. We investigated baseline characteristics, hematoma features, and outcomes of very elderly ICH patients (≥80 years old) and compared them with those of younger ICH patients (<80 years old). METHODS: We studied 377 patients (122 women; 69 ± 11 years old) admitted within 24 hours of ICH onset. Outcome measures included hematoma volumes, National Institutes of Health Stroke Scale scores on admission, and vital and functional prognoses at 30 days...
September 8, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28890528/association-between-economic-status-and-discharge-destination-among-elderly-patients-from-acute-care-hospitals
#7
Nobuo Sakata, Yasuyuki Okumura, Yasuyuki Shirakawa
Objective The aim of this study was to investigate the association between economic status and discharge destination of elderly patients from acute care hospitals.Method We conducted a case-control study using data from a survey of elderly discharged patients conducted under the subsidy program of the Japanese Ministry of Health, Labour and Welfare. The questionnaires were mailed to 1,068 acute care hospitals located in the Kanto and Kansai region. The survey asked medical social workers or nurses, who were responsible for the discharge planning, to answer questions about the discharge of elderly patients from their hospitals...
2017: [Nihon Kōshū Eisei Zasshi] Japanese Journal of Public Health
https://www.readbyqxmd.com/read/28890165/reduction-of-the-anticholinergic-burden-makes-it-possible-to-decrease-behavioral-and-psychological-symptoms-of-dementia
#8
Yacine Jaïdi, Vignon Nonnonhou, Lukshe Kanagaratnam, Laurie Anne Bertholon, Sarah Badr, Vivien Noël, Jean-Luc Novella, Rachid Mahmoudi
OBJECTIVE: The aim of this study was to evaluate the impact of a reduction of the anticholinergic burden (AB) on the frequency and severity of behavioral and psychological symptoms of dementia (BPSD) and their repercussions on the care team (occupational disruptiveness). METHODS: In this prospective, single-center study in an acute care unit for Alzheimer disease (AD) and related disorders, 125 elderly subjects (mean age: 84.4 years) with dementia presented with BPSD...
August 14, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28878434/incidence-and-characteristics-of-accidental-falls-in-hospitalizations
#9
Kazuyoshi Kobayashi, Shiro Imagama, Yuko Inagaki, Yusuke Suzuki, Kei Ando, Yoshihiro Nishida, Yoshimasa Nagao, Naoki Ishiguro
Aging of the patient population has led to increased occurrence of accidental falls in acute care settings. The aim of this study is to survey the annual occurrence of falls in a university hospital, and to examine procedures to prevent fall. A total of 49,059 inpatients were admitted to our hospital from April 2015 to March 2016. A fall assessment scale was developed to estimate the risk of fall at admission. Data on falls were obtained from the hospital incident reporting system. There were fall-related incidents in 826 patients (1...
August 2017: Nagoya Journal of Medical Science
https://www.readbyqxmd.com/read/28872035/prevalence-and-severity-of-peripheral-arterial-disease-among-patient-with-heel-pressure-ulcer-a-retrospective-study-of-42-patients
#10
Guillaume Tisserand, Nora Zenati, Christophe Seinturier, Sophie Blaise, Gilles Pernod
Heel pressure ulcer is a major complication in elderly hospitalized patients. The association with peripheral arterial disease (PAD) which is also a frequent disease in this population is poorly known. The aim of this study was to assess the prevalence of PAD and critical limb ischemia (CLI) in patients with heel pressure ulcer. Patients referred to the vascular medicine department for heel pressure ulcer from October 2014 to June 2015 were included in the study. The assessment of peripheral arterial disease was made with the results of ankle brachial index and/or doppler ultra sound of lower limb arteries...
September 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/28869885/development-and-validation-of-a-prognostic-index-for-6-and-12-month-mortality-in-hospitalized-older-adults
#11
Eva Gallego González, Francisco Javier Ortiz Alonso, Maria Teresa Vidán Astiz, Selene Soria Felix, Verónica García Cárdenas, John Omonte Guzmán, Pedro Abizanda, Maria Isabel Valadés Malagón, Silvia Oreja Sevilla, José Antonio Serra Rexach
BACKGROUND/AIM: Estimation of mortality in elderly patients is difficult yet very important when planning care. Previous tools are complicated or do no take into account some major determinants of mortality (i.e., frailty). We designed a simple, accurate, and non-disease-specific tool to predict individual mortality risk after hospital discharge in older adults. METHODS: Patients admitted to the Acute Geriatric Unit were assessed at adission and at discharge and contacted 6 and 12 months later...
July 23, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28868074/update-on-pharmacological-treatment-of-acute-coronary-syndrome-without-persistent-st-segment-elevation-myocardial-infarction-in-the-elderly
#12
REVIEW
Coşkun Usta, Aslı Bedel
The increase in cardiovascular disease prevalence with ageing has been attributed to several age-related changes such as changes in the vascular wall elasticity, the coagulation and haemostatic system and endothelial dysfunction, among other causes. There is a 50% increased mortality risk per 10-year increase in age starting at 65 years old. Here, we aimed to discuss pharmacological treatment in acute coronary syndrome (ACS) without persistent ST segment elevation myocardial infarction in the elderly. The main aim of ACS treatment in elderly people is at preventing ischemia, myocardial damage and complications...
July 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28866906/end-of-life-care-for-advanced-dementia-patients-in-residential-care-home-a-hong-kong-perspective
#13
James K H Luk, Felix H W Chan
Dementia will become more common as the population ages. Advanced dementia should be considered as a terminal illnesses and end-of-life (EOL) care is very much needed for this disease group. Currently, the EOL services provided to this vulnerable group in Hong Kong, especially those living in residential care homes, is limited. The usual practice of residential care homes is to send older residents with advanced dementia to acute hospitals when they are sick, irrespective of their wish, premorbid status, diagnoses and prognosis...
August 28, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28866898/olanzapine-induced-delirium-a-probable-adverse-drug-reaction
#14
David MacKintosh
Olanzapine is an atypical antipsychotic indicated for the treatment of schizophrenia and known to be effective in the management of delirium. In addition to its use for these indications olanzapine has also been used in the management of chemotherapy induced nausea and vomiting and otherwise difficult to control nausea and vomiting in palliative care settings. Although considered to be well tolerated with a lower incidence of extrapyramidal effects than first generation antipsychotics there are a small number of reports of olanzapine inducing delirium...
June 19, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28866896/hospitalizations-in-elderly-glioblastoma-patients
#15
Claire Moroney, James R Perry, Derek S Tsang, Denise Bilodeau, Chris Mueller, Hany Soliman, Sten Myrehaug, Arjun Sahgal, Chia-Lin Tseng, May N Tsao
BACKGROUND: Elderly glioblastoma (GB) patients are at risk of hospitalizations due to the morbidity of the disease and possible treatment toxicity. METHODS: In this observational cohort study, 255 newly diagnosed GB patients age 65 years and older were included. Survival, emergency room visits and admissions to an acute care hospital were determined. Mean and median total health care costs were calculated. Risk factors for Emergency room visits and acute care hospital admissions were determined...
August 11, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28864878/self-rated-health-as-a-predictor-of-mid-term-and-long-term-mortality-in-older-afro-caribbeans-hospitalised-via-the-emergency-department
#16
Lidvine Godaert, C Godard-Sebillotte, L Allard Saint-Albin, L Bousquet, I Bourdel-Marchasson, J-L Fanon, M Dramé
PURPOSE: To determine whether self-rated health (SRH) is an independent predictor for mortality in older Afro-Caribbean patients hospitalised for an acute condition. METHODS: Prospective cohort of patients recruited from the University Hospitals of Martinique Acute Care for Elders unit. Patients aged 75 or older and hospitalised for an acute condition were eligible. The outcome was time to death within the 36-week follow-up. SRH was the explanatory variable of interest...
September 1, 2017: Quality of Life Research
https://www.readbyqxmd.com/read/28863353/predicting-3-year-mortality-and-admission-to-acute-care-hospitals-skilled-nursing-facilities-and-long-term-care-facilities-in-medicare-beneficiaries
#17
Jibby E Kurichi, Hillary R Bogner, Joel E Streim, Dawei Xie, Pui L Kwong, Debra Saliba, Sean Hennessy
PURPOSE: The ability to predict mortality and admission to acute care hospitals, skilled nursing facilities (SNFs), and long-term care (LTC) facilities in the elderly and how it varies by activity of daily living (ADL) and instrumental ADL (IADL) status could be useful in measuring the success or failure of economic, social, or health policies aimed at disability prevention and management. We sought to derive and assess the predictive performance of rules to predict 3-year mortality and admission to acute care hospitals, SNFs, and LTC facilities among Medicare beneficiaries with differing ADL and IADL functioning levels...
August 24, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28860862/early-rehospitalizations-of-frail-elderly-patients-the-role-of-medications-a-clinical-prospective-observational-trial
#18
Niklas Ekerstad, Kristoffer Bylin, Björn W Karlson
BACKGROUND AND OBJECTIVE: Early readmissions of frail elderly patients after an episode of hospital care are common and constitute a crucial patient safety outcome. Our purpose was to study the impact of medications on such early rehospitalizations. PATIENTS AND METHODS: This is a clinical, prospective, observational study on rehospitalizations within 30 days after an acute hospital episode for frail patients over the age of 75 years. To identify adverse drug reactions (ADRs), underuse of evidence-based treatment and avoidability of rehospitalizations, the Naranjo score, the Hallas criteria and clinical judgment were used...
2017: Drug, Healthcare and Patient Safety
https://www.readbyqxmd.com/read/28858968/what-wait-time-in-a-soiled-pad-is-acceptable-to-older-patients-and-their-direct-caregivers
#19
Judith Fernando, Adrian Wagg
PURPOSE: We sought to establish views on wait times and hypothesized that they may vary depending upon perspective, circumstance, and incontinence type. DESIGN: Cross-sectional, descriptive survey. SUBJECTS AND SETTING: Eligible patients were inpatients, 65 years and older, in a single tertiary acute care hospital. Eligible staff were regulated (licensed) and unregulated providers of direct care to patients. Patients may or may not have used absorbent continence products prior to their admission...
August 30, 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28844513/outcomes-of-nonagenarians-admitted-to-the-cardiac-intensive-care-unit-by-the-elders-risk-assessment-score-for-long-term-mortality-risk-stratification
#20
Andrew N Rosenbaum, Niyada Naksuk, Shahyar M Gharacholou, Jorge A Brenes-Salazar
There are limited data on outcomes of older adults admitted to cardiac intensive care units (CICU), and there are no data on outcomes after admission to the CICU in nonagenarians. Our purpose was to identify whether the Elders Risk Assessment (ERA) index could risk stratify older adults after CICU admission. We retrospectively identified 453 nonagenarians admitted to the CICU between 2004 and 2013. End points included mortality, length of stay, incidence of delirium, and discharge disposition. Average age of the cohort was 92 ± 2 years, and the average ERA score was 13 ± 6...
July 31, 2017: American Journal of Cardiology
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