The impact of functional status on LOS and readmission in older patients in geriatrics department: a cohort study

ObjectivesThis study aims to investigate the prevalence of impairment of activities of daily living (ADLs) in older patients with heart failure (HF), and to examine the impact of ADL impairment on readmission after discharge.Design and settingsA prospective cohort study was conducted in patients aged ≥65 years with HF admitted to a tertiary hospital in Vietnam from August 2016 to June 2017. Difficulties with six ADLs were assessed by a questionnaire. Participants were classified into two categories (with and without ADL impairment). The associations of ADL impairment with 3-month readmission were examined using logistic regression models.ResultsThere were 180 participants (mean age 80.6±8.2, 50% female) and 26.1% were classified as having ADL impairment. The most common impaired activity was bathing (21.1%), followed by transferring (20.0%), toileting (12.2%), dressing (8.9%), eating (3.3%), and continence (2.8%). During 3-month follow-up, 32.8% of the participants were readmitted to hospitals (55.3% in participants with ADL impairment, 24.8% in those without ADL impairment, p<0.001). ADL impairment significantly increased the risk of 3-month readmission (adjusted OR 2.75, 95% CI 1.25 to 6.05, p=0.01).ConclusionsIn summary, ADL impairment was common in older hospitalised patients with HF and was associated with increased readmission. These findings suggest further studies on ADL assessment and intervention during transition care for older patients with HF after discharge to prevent readmission.

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The effect of ageing on presentation, management and outcomes in degenerative cervical myelopathy: a systematic review

Age and Ageing ◽

10.1093/ageing/afaa236 ◽

2020 ◽

Author(s):

Ben Grodzinski ◽

Rory Durham ◽

Oliver Mowforth ◽

Daniel Stubbs ◽

Mark R N Kotter ◽

...

Keyword(s):

Systematic Review ◽

Functional Status ◽

Cervical Myelopathy ◽

Older Patients ◽

Meta Analysis ◽

Current Evidence ◽

Clinical Aspects ◽

Similar Amount ◽

Degenerative Cervical Myelopathy ◽

The Impact

Abstract Objective Degenerative cervical myelopathy (DCM) is a disabling neurological condition. The underlying degenerative changes are known to be more common with age, but the impact of age on clinical aspects of DCM has never been synthesised. The objective of this study is to determine whether age is a significant predictor in three domains—clinical presentation, surgical management and post-operative outcomes of DCM. Methods a systematic review of the Medline and Embase databases (inception to 12 December 2019), registered with PROSPERO (CRD42019162077) and reported in accordance with preferred reporting items of systematic reviews and meta-analysis (PRISMA) guidelines, was conducted. The inclusion criteria were full text articles in English, evaluating the impact of age on clinical aspects of DCM. Results the initial search yielded 2,420 citations, of which 206 articles were eventually included. Age was found to be a significant predictor in a variety of measures. Within the presentation domain, older patients have a worse pre-operative functional status. Within the management domain, older patients are more likely to undergo posterior surgery, with more levels decompressed. Within the outcomes domain, older patients have a worse post-operative functional status, but a similar amount of improvement in functional status. Because of heterogenous data reporting, meta-analysis was not possible. Conclusion the current evidence demonstrates that age significantly influences the presentation, management and outcomes of DCM. Although older patients have worse health at all individual timepoints, they experience the same absolute benefit from surgery as younger patients. This finding is of particular relevance when considering the eligibility of older patients for surgery.

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The impact of hip fracture (HF) on the functional status (FS) of older persons in Rio de Janeiro, Brazil: Results of a prospective cohort study

Archives of Gerontology and Geriatrics ◽

10.1016/j.archger.2009.08.007 ◽

2010 ◽

Vol 51 (1) ◽

pp. e28-e35 ◽

Cited By ~ 4

Author(s):

Silvia R.M. Pereira ◽

Martine T.E. Puts ◽

Margareth C. Portela ◽

Mario A. Sayeg

Keyword(s):

Cohort Study ◽

Hip Fracture ◽

Functional Status ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Rio De Janeiro ◽

Older Persons ◽

The Impact

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Functional status decline in older patients with breast and colorectal cancer after cancer treatment: A prospective cohort study

Journal of Geriatric Oncology ◽

10.1016/j.jgo.2017.01.003 ◽

2017 ◽

Vol 8 (3) ◽

pp. 176-184 ◽

Cited By ~ 22

Author(s):

Doris van Abbema ◽

Arnée van Vuuren ◽

Franchette van den Berkmortel ◽

Marjan van den Akker ◽

Laura Deckx ◽

...

Keyword(s):

Colorectal Cancer ◽

Cohort Study ◽

Cancer Treatment ◽

Functional Status ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Older Patients ◽

After Cancer

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Interrelationship of Postoperative Delirium and Cognitive Impairment and Their Impact on the Functional Status in Older Patients Undergoing Orthopaedic Surgery: A Prospective Cohort Study

PLoS ONE ◽

10.1371/journal.pone.0110339 ◽

2014 ◽

Vol 9 (11) ◽

pp. e110339 ◽

Cited By ~ 26

Author(s):

Chih-Kuang Liang ◽

Chin-Liang Chu ◽

Ming-Yueh Chou ◽

Yu-Te Lin ◽

Ti Lu ◽

...

Keyword(s):

Cohort Study ◽

Cognitive Impairment ◽

Functional Status ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Older Patients ◽

Orthopaedic Surgery ◽

Postoperative Delirium

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The Impact of Functional Status of Arteriovenous Fistula On Kidney Graft Outcome: a National Cohort Study.

Transplantation Journal ◽

10.1097/00007890-201407151-02156 ◽

2014 ◽

Vol 98 ◽

pp. 637

Author(s):

Vajdic B. Trampuz ◽

M. Arnol ◽

R. Ponikvar ◽

A. Kandus ◽

J. Buturovic-Ponikvar

Keyword(s):

Cohort Study ◽

Functional Status ◽

Arteriovenous Fistula ◽

Kidney Graft ◽

Graft Outcome ◽

National Cohort ◽

The Impact

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007 The impact of demographic changes on the presentation and outcome of stroke: experiences of the oldest old in the murrumbidgee region

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2018-anzan.7 ◽

2018 ◽

Vol 89 (6) ◽

pp. A4.2-A4

Author(s):

Alice Powell ◽

Paul Finucane ◽

Martin Jude ◽

Jenna Mewburn ◽

Katherine Mohr ◽

...

Keyword(s):

Functional Status ◽

Older Patients ◽

Oldest Old ◽

Residential Aged Care ◽

Ageing Population ◽

Demographic Changes ◽

Stroke Treatment ◽

Demographic Groups ◽

The Future ◽

The Impact

IntroductionDemographic changes are leading to an ageing population with a disproportionate increase in the oldest old. Stroke is a leading cause of death and disability in Australia and is particularly prevalent in the elderly. The Murrumbidgee region has a population profile that is 14 years ahead of national Australia and therefore data from this population portends how stroke may present nationally in the future. Existing research suggests that stroke risk factors, subtype, treatment provided and outcomes differ between younger and older demographic groups. This study seeks to build a profile of the experiences of stroke in the oldest old and compare variables with two younger cohorts to test a number of hypotheses about background, treatment and outcomes.MethodsData was collected retrospectively from the electronic medical records of 100 stroke patients consecutively admitted to the Wagga Wagga Rural Referral Hospital Acute Stroke Unit. They were split into three demographic groups; young old, 65–74 old (75 to 84) and oldest old (85 and older) and comparisons were made of baseline functional status and risk factor profile, stroke type, stroke treatment and outcomes.ResultsOlder people admitted with stroke were more likely to be female with poorer premorbid functional status and higher numbers living in residential care. Atrial fibrillation (p=0.008) and hypertension (p=0.01) were significantly more common with advancing age while rates of smoking (p=0.006) were higher in younger patients. Stroke mechanism was predominantly cardioembolic in older patients and embolic stroke of undetermined source (ESUS) in the youngest group. Stroke severity and stroke treatment did not vary according to age. However, outcomes were poorer with rates of dependency (p=0.03) and residential aged care facility placement (p=0.06) increased among older patients post stroke.ConclusionThese data provide an indication of how stroke may manifest in our ageing population in the future.

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Three-month functional outcomes following endovascular thrombectomy during the first wave of the COVID-19 pandemic: a Canadian single-center cohort study

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2021-017664 ◽

2021 ◽

pp. neurintsurg-2021-017664

Author(s):

Joel Neves Briard ◽

Gabrielle Dufort ◽

Grégory Jacquin ◽

Walid Alesefir ◽

Olena Bereznyakova ◽

...

Keyword(s):

Cohort Study ◽

Acute Stroke ◽

Functional Status ◽

Functional Outcomes ◽

High Volume ◽

Stroke Care ◽

Single Center ◽

Acute Stroke Care ◽

Baseline Characteristics ◽

The Impact

BackgroundThe COVID-19 pandemic has disrupted acute stroke care logistics, including delays in hyperacute management and decreased monitoring following endovascular therapy (EVT). We aimed to assess the impact of the pandemic on 90-day functional outcome among patients treated with EVT.MethodsThis is an observational cohort study including all patients evaluated for an acute stroke between March 30, 2020 and September 30, 2020 (pandemic cohort) and 2019 (reference cohort) in a high-volume Canadian academic stroke center. We collected baseline characteristics, acute reperfusion treatment and management metrics. For EVT-treated patients, we assessed the modified Rankin score (mRS) at 90 days. We evaluated the impact of the pandemic on a 90-day favourable functional status (defined as mRS 0–2) and death using multivariable logistic regressions.ResultsAmong 383 and 339 patients included in the pandemic and reference cohorts, baseline characteristics were similar. Delays from symptom onset to evaluation and in-house treatment were longer during the early first wave, but returned to reference values in the subsequent months. Among the 127 and 136 EVT-treated patients in each respective cohort, favourable 90-day outcome occurred in 53/99 (53%) vs 52/109 (48%, p=0.40), whereas 22/99 (22%) and 28/109 (26%, p=0.56) patients died. In multivariable regressions, the pandemic period was not associated with 90-day favourable functional status (aOR 1.27, 95% CI 0.60 to 2.56) or death (aOR 0.74, 95% CI 0.33 to 1.63).ConclusionIn this single-center cohort study conducted in a Canadian pandemic epicenter, the first 6 months of the COVID-19 pandemic did not impact 90-day functional outcomes or death among EVT-treated patients.

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Adherence to Recommendations from Comprehensive Geriatric Assessment of Older Individuals with HIV

Journal of the International Association of Providers of AIDS Care (JIAPAC) ◽

10.1177/2325958218821656 ◽

2019 ◽

Vol 18 ◽

pp. 232595821882165 ◽

Cited By ~ 5

Author(s):

Christiana Bitas ◽

Sian Jones ◽

Harjot Kaur Singh ◽

Mildred Ramirez ◽

Eugenia Siegler ◽

...

Keyword(s):

Cohort Study ◽

Social Workers ◽

Geriatric Assessment ◽

Comprehensive Geriatric Assessment ◽

Retrospective Cohort Study ◽

Medical Records ◽

Older Patients ◽

Retrospective Cohort ◽

Older Individuals ◽

The Impact

This retrospective cohort study sought to assess the effectiveness of comprehensive geriatric assessment (CGA) for older patients at an HIV clinic in a large US city. We systematically reviewed medical records of all patients who underwent CGA from June 2013 to July 2017. In addition, physicians and social workers completed an anonymous survey about the impact of CGA on their patients. For the 76 patients (median age 67.2; Q1, Q3 = 60.9, 72.6) seen by geriatricians at the clinic, there were 184 recommendations, 54 instances of counseling, and 11 direct actions. Overall adherence to recommendations was 32.8%, 34.9% for patient-directed, and 31.7% for provider-directed recommendations. No demographic or CGA variables were associated with adherence. Despite this lack of adherence, surveyed providers reported that they usually or always followed recommendations; the most frequently cited barrier to implementation was lack of feasibility. Further research will be needed to determine how CGA can improve outcomes for this population.

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