Prevalence and associations of frailty in residents of Australian aged care facilities: findings from a retrospective cohort study

2019 ◽  
Vol 32 (9) ◽  
pp. 1849-1856 ◽  
Author(s):  
R. C. Ambagtsheer ◽  
J. Beilby ◽  
C. Seiboth ◽  
E. Dent
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Aged Care ◽  
Care Facilities ◽  
Aged Care Facilities

scholarly journals Impact of B.1.351 (beta) SARS-CoV-2 variant on BNT162b2 mRNA vaccine effectiveness in long-term care facilities of eastern France: a retrospective cohort study

2021 ◽  
Author(s):  
Benjamin Lefevre ◽  
Laura Tondeur ◽  
Yoann Madec ◽  
Rebecca Grant ◽  
Bruno Lina ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Long Term Care ◽  
Multivariable Analysis ◽  
Winter Season ◽  
Vaccine Effectiveness ◽  
Term Care ◽  
Care Facilities

Abstract Background: We aimed to assess the effectiveness of the BNT162b2 mRNA vaccine against B.1.351 (beta) variant among residents of long-term care facilities (LCTFs) in eastern France. Methods: We used routinely collected surveillance and COVID-19 vaccination data to conduct a retrospective cohort study of SARS-CoV-2 B.1.351 infection incidence and vaccine effectiveness among LCTFs residents in eastern France between 15 January and 19 May 2021. Data from secondary RT-PCR screening were used to identify B.1.351 variants. Findings: Included in our analysis were 378 residents from five LCTFs: 287 (76%) females, with median (IQR) age of 89 (83-92) years. Two B.1.351 outbreaks took place in LTCFs in which more than 70% of residents had received two doses of BNT162b2 mRNA vaccine, which included 11 cases of severe disease and six deaths among those who had received two doses. Vaccine effectiveness (95% CI) seven days after the second dose of vaccine was 49% (14-69) against any infection with B.1.351 and 86% (67-94) against severe forms of COVID-19. In multivariable analysis, females were less likely to develop severe forms of disease (IRR = 0.35, 95% CI = 0.20-0.63). Interpretation: We observed reduced vaccine effectiveness associated with B.1.351, as well as B.1.351 outbreaks in two LTCFs among individuals who had received two doses of vaccine. Our findings highlight the need to maintain SARS-CoV-2 surveillance in these high-risk settings beyond the current COVID-19 mass vaccination campaign, and advocate for a booster vaccine dose prior to the next winter season.

The effect of timing of oseltamivir chemoprophylaxis in controlling influenza A H3N2 outbreaks in long-term care facilities in Manitoba, Canada, 2014-2015: a retrospective cohort study

2018 ◽  
Vol 39 (8) ◽  
pp. 955-960 ◽  
Author(s):  
Davinder Singh ◽  
Depeng Jiang ◽  
Paul Van Caeseele ◽  
Carla Loeppky
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Influenza A ◽  
Long Term Care ◽  
Secondary Infection ◽  
Symptomatic Infection ◽  
Term Care ◽  
Care Facilities

ObjectiveThis study examined the effect of the timing of administration of oseltamivir chemoprophylaxis for the control of influenza A H3N2 outbreaks among residents in long-term care facilities (LTCFs) in Manitoba, Canada, during the 2014–2015 influenza season.MethodsA retrospective cohort study was conducted of all LTCF influenza A H3N2 outbreaks (n=94) using a hierarchical logistic regression analysis. The main independent variable was how many days passed between the start of the outbreak and commencement of oseltamivir chemoprophylaxis. The dependent variable was whether each person in the institution developed influenza-like illness (yes or no).ResultsDelay of oseltamivir chemoprophylaxis was associated with increased odds of infection in both univariate (t=5·41; df=51; P<·0001) and multivariable analyses (t=6·04; df=49; P<·0001) with an adjusted odds ratio of 1.3 (95% confidence interval [CI], 1·2–1·5) per day for influenza A H3N2.ConclusionsThe sooner chemoprophylaxis is initiated, the lower the odds of secondary infection with influenza in LTCFs during outbreaks caused by influenza A H3N2 in Manitoba. For every day that passed from the start of the outbreak to the initiation of oseltamivir, the odds of a resident at risk of infection in the facility developing symptomatic infection increased by 33%.

scholarly journals Predictors of hospitalisations and emergency department presentations shortly after entering a residential aged care facility in Australia: a retrospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e057247
Author(s):  
Maria C Inacio ◽  
Robert N Jorissen ◽  
Steve Wesselingh ◽  
Janet K Sluggett ◽  
Craig Whitehead ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Care Facility ◽  
Aged Care ◽  
Residential Aged Care ◽  
Aged Care Facility ◽  
Related System ◽  
Residential Aged Care Facility

ObjectivesTo: (1) examine the 90-day incidence of unplanned hospitalisation and emergency department (ED) presentations after residential aged care facility (RACF) entry, (2) examine individual-related, facility-related, medication-related, system-related and healthcare-related predictors of these outcomes and (3) create individual risk profiles.DesignRetrospective cohort study using the Registry of Senior Australians. Fine-Gray models estimated subdistribution HRs and 95% CIs. Harrell’s C-index assessed risk models’ predictive ability.Setting and participantsIndividuals aged ≥65 years old entering a RACF as permanent residents in three Australian states between 1 January 2013 and 31 December 2016 (N=116 192 individuals in 1967 RACFs).Predictors examinedIndividual-related, facility-related, medication-related, system and healthcare-related predictors ascertained at assessments or within 90 days, 6 months or 1 year prior to RACF entry.Outcome measures90-day unplanned hospitalisation and ED presentation post-RACF entry.ResultsThe cohort median age was 85 years old (IQR 80–89), 62% (N=71 861) were women, and 50.5% (N=58 714) had dementia. The 90-day incidence of unplanned hospitalisations was 18.0% (N=20 919) and 22.6% (N=26 242) had ED presentations. There were 34 predictors of unplanned hospitalisations and 34 predictors of ED presentations identified, 27 common to both outcomes and 7 were unique to each. The hospitalisation and ED presentation models out-of-sample Harrell’s C-index was 0.664 (95% CI 0.657 to 0.672) and 0.655 (95% CI 0.648 to 0.662), respectively. Some common predictors of high risk of unplanned hospitalisation and ED presentations included: being a man, age, delirium history, higher activity of daily living, behavioural and complex care needs, as well as history, number and recency of healthcare use (including hospital, general practitioners attendances), experience of a high sedative load and several medications.ConclusionsWithin 90 days of RACF entry, 18.0% of individuals had unplanned hospitalisations and 22.6% had ED presentations. Several predictors, including modifiable factors, were identified at the time of care entry. This is an actionable period for targeting individuals at risk of hospitalisations.

scholarly journals Prevalence And Predictors Of Diabetes Mellitus Among Persons Living With HIV: A Retrospective Cohort Study Conducted In 4 Public Healthcare Facilities In Kwazulu-Natal

2020 ◽  
Author(s):  
David Mohammed Umar ◽  
Panjasaram Naidoo
Keyword(s):  
Diabetes Mellitus ◽  
Health Care ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Health Care Facilities ◽  
Persons Living With Hiv ◽  
Kwazulu Natal ◽  
Care Facilities ◽  
Living With Hiv

Abstract Background: Diabetes mellitus is a chronic non-infectious medical condition which is evident by raised levels of glucose in the blood, because the body cannot produce any or enough of the hormone insulin or use insulin effectively. Diabetes, if not well managed leads to complications such as neuropathy, retinopathy, nephropathy which can be fatal. Some of the factors that predisposes to diabetes include older age, higher body mass index, heredity and hypertension. With the availability of HAART for managing HIV/AIDS infection, life span of persons living with HIV (PLWHIV) has increased significantly. With increased longevity, the aging population of PLWHIV also face chronic diseases such as diabetes in addition to HIV. The burden of both HIV and diabetes is high in South Africa, particularly in KwaZulu-Natal. Nevertheless, the prevalence of diabetes among PLWHIV in KwaZulu-Natal and its predictors is not well understood. Therefore, this study was conducted to determine the prevalence, predictors of diabetes and the outcome of managing diabetes among PLWHIV.Methods: This retrospective cohort study was conducted in four public health care facilities in KwaZulu-Natal with a total sample size of 1203 after ethical approval and informed consent were obtained. A pretested questionnaire and hospital patient charts were used to collect data. SPSS version 26 was used to analyze the data using descriptive statistics and logistic regression. Results: The prevalence of diabetes among PLWHIV was 9%. Just over 47% of those who had diabetes, had uncontrolled blood sugar, with a mean fasting blood sugar (FBS) of 11.7 mmol/L. The predictors of diabetes among PLWHIV were, male gender and older age. Male PLWHIV had 65% less chances of having diabetes and those who were between the ages of 18 and 48 years were 88% less probable to have diabetes compared to those who were older than 48 years. Conclusion: Public sector health care facilities in KwaZulu-Natal need to do much more to manage diabetes in PLWHIV in order to prevent diabetic complications and possible negative impact on the outcome of HIV management.

scholarly journals Feasibility of Using a Risk Assessment Tool to Predict Hospital Transfers or Death for Older People in Australian Residential Aged Care. A Retrospective Cohort Study

Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 284
Author(s):  
Meidelynn Ooi ◽  
Ebony T Lewis ◽  
Julianne Brisbane ◽  
Evalynne Tubb ◽  
Tom McClean ◽  
...  
Keyword(s):  
Cohort Study ◽  
End Of Life ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Assessment Tool ◽  
Aged Care ◽  
Initial Assessment ◽  
Residential Aged Care ◽  
Composite Outcome ◽  
Predictive Tool

Residents of Aged Care Facilities (RACF) experience burdensome hospital transfers in the last year of life, which may lead to aggressive and potentially inappropriate hospital treatments. Anticipating these transfers by identifying risk factors could encourage end-of-life discussions that may change decisions to transfer. The aim was to examine the feasibility of identifying an end-of-life risk profile among RACF residents using a predictive tool to better anticipate predictors of hospital transfers, death or poor composite outcome of hospitalisation and/or death after initial assessment. A retrospective cohort study of 373 permanent residents aged 65+ years was conducted using objective clinical factors from records in nine RACFs in metropolitan Sydney, Australia. In total, 26.8% died and 34.3% experienced a composite outcome. Cox proportional hazard regression models confirmed the feasibility of estimating the level of risk for death or a poor composite outcome. Knowing this should provide opportunities to initiate advance care planning in RACFs, facilitating decision making near the end of life. We conclude that the current structure of electronic RACF databases could be enhanced to enable comprehensive assessment of the risk of hospital re-attendance without admission. Automation tools to facilitate the risk score calculation may encourage the adoption of prediction checklists and evaluation of their association with hospital transfers.

scholarly journals Prevalence And Predictors Of Diabetes Mellitus Among Persons Living With HIV: A Retrospective Cohort Study Conducted In 4 Public Healthcare Facilities In Kwazulu-Natal

2021 ◽  
Author(s):  
David Mohammed Umar ◽  
Panjasaram Naidoo
Keyword(s):  
Diabetes Mellitus ◽  
Health Care ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Health Care Facilities ◽  
Persons Living With Hiv ◽  
Kwazulu Natal ◽  
Care Facilities ◽  
Living With Hiv

Abstract Background: Diabetes mellitus is a chronic non-infectious medical condition which is evident by raised levels of glucose in the blood, because the body cannot produce any or enough of the hormone insulin or use insulin effectively. Diabetes, if not well managed leads to complications such as neuropathy, retinopathy, nephropathy which can be fatal. Some of the factors that predisposes to diabetes include older age, higher body mass index, heredity and hypertension. With the availability of HAART for managing HIV/AIDS infection, life span of persons living with HIV (PLWHIV) has increased significantly. With increased longevity, the aging population of PLWHIV also face chronic diseases such as diabetes in addition to HIV. The burden of both HIV and diabetes is high in South Africa, particularly in KwaZulu-Natal. Nevertheless, the prevalence of diabetes among PLWHIV in KwaZulu-Natal and its predictors is not well understood. Therefore, this study was conducted to determine the prevalence, predictors of diabetes and the outcome of managing diabetes among PLWHIV.Methods: This retrospective cohort study was conducted in four public health care facilities in KwaZulu-Natal with a total sample size of 1203 after ethical approval and informed consent were obtained. A pretested questionnaire and hospital patient charts were used to collect data. SPSS version 26 was used to analyze the data using descriptive statistics and logistic regression. Results: The prevalence of diabetes among PLWHIV was 9%. Just over 47% of those who had diabetes, had uncontrolled blood sugar, with a mean fasting blood sugar (FBS) of 11.7 mmol/L. The predictors of diabetes among PLWHIV were male gender and older age. Male PLWHIV had 65% less chances of having diabetes and those who were between the ages of 18 and 48 years were 88% less probable to have diabetes compared to those who were older than 48 years. Conclusion: Public sector health care facilities in KwaZulu-Natal need to do much more to manage diabetes in PLWHIV in order to prevent diabetic complications and possible negative impact on the outcome of HIV management.

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