The effect of malnutrition at admission on length of hospital stay among adult patients in developing country: A prospective cohort study

2021 ◽  
Vol 41 ◽  
pp. 217-224
Author(s):  
Yakob Desalegn Nigatu ◽  
Seifu Hagos Gebreyesus ◽  
Johane P. Allard ◽  
Bilal Shikur Endris
Keyword(s):  
Cohort Study ◽  
Hospital Stay ◽  
Developing Country ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Length Of Hospital Stay ◽  
Adult Patients

Preventable hospitalizations among older patients with cognitive impairments and dementia

2018 ◽  
Vol 31 (3) ◽  
pp. 383-391 ◽  
Author(s):  
Dominik Wolf ◽  
Carolin Rhein ◽  
Katharina Geschke ◽  
Andreas Fellgiebel
Keyword(s):  
Cohort Study ◽  
Hospital Stay ◽  
Ambulatory Care ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Older Patients ◽  
Hospital Admissions ◽  
Cognitive Impairments ◽  
Length Of Hospital Stay ◽  
Complication Rates

ABSTRACTObjectives:Dementia and cognitive impairment are associated with higher rates of complications and mortality during hospitalization in older patients. Moreover, length of hospital stay and costs are increased. In this prospective cohort study, we investigated the frequency of hospitalizations caused by ambulatory care-sensitive conditions (ACSCs), for which proactive ambulatory care might prevent the need for a hospital stay, in older patients with and without cognitive impairments.Design:Prospective cohort study.Setting:Eight hospitals in Germany.Participants:A total of 1,320 patients aged 70 years and older.Measurements:The Mini-Cog test has been used to assess cognition and to categorize patients in the groups no/moderate cognitive impairments (probably no dementia) and severe cognitive impairments (probable dementia). Moreover, lengths of hospital stay and complication rates have been assessed, using a binary questionnaire (if occurred during hospital stay or not; behavioral symptoms were adapted from the Cohen-Mansfield Agitation Inventory). Data have been acquired by the nursing staff who received a special multi-day training.Results:Patients with severe cognitive impairments showed higher complication rates (including incontinence, disorientation, irritability/aggression, restlessness/anxiety, necessity of Tranquilizers and psychiatric consults, application of measures limiting freedom, and falls) and longer hospital stays (+1.4 days) than patients with no/moderate cognitive impairments. Both groups showed comparably high ACSC-caused admission rates of around 23%.Conclusions:The study indicates that about one-fourth of hospital admissions of cognitively normal and impaired older adults are caused by ACSCs, which are mostly treatable on an ambulatory basis. This implies that an improved ambulatory care might reduce the frequency of hospitalizations, which is of particular importance in cognitively impaired elderly due to increased complication rates.

scholarly journals Length of Hospital Stay Is Associated with a Decline in Activities of Daily Living in Hemodialysis Patients: A Prospective Cohort Study

2019 ◽  
Author(s):  
Tsukasa Kamitani ◽  
Shingo Fukuma ◽  
Sayaka Shimizu ◽  
Tadao Akizawa ◽  
Shunichi Fukuhara
Keyword(s):  
Cohort Study ◽  
Activities Of Daily Living ◽  
Hospital Stay ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Daily Living ◽  
Length Of Hospital Stay ◽  
Hemodialysis Patients ◽  
Cumulative Length ◽  
The Impact

Abstract Background The impact of length of hospital stay on activities of daily living (ADLs) has not specifically been investigated among dialysis patients. Therefore, we attempt to verify the association between the length of hospital stay and the decline in ADLs among hemodialysis patients. Methods This prospective cohort study used data from the Japanese Dialysis Outcomes and Practice Patterns Study (J-DOPPS). We included 2,442 hemodialysis patients aged ³ 40 years from the J-DOPPS phase V (2012–2015) and subsequently excluded those who had already lost basic activities of daily living (BADLs) as demonstrated by dependency in at least three of the five BADLs at baseline and for whom changes in ADLs had been evaluated for less than 90 days. The main exposure was the cumulative length of hospital stay during the follow-up period. The primary outcomes were a decline in at least one of the five BADLs and eight instrumental activities of daily living (IADLs). We compared risk ratios (RRs) for 30-day increments for hospital stays with 10-year increments for age and having diabetes. Results A total of 849 patients were included in the statistical analysis. The cumulative length of hospital stay was significantly associated with a risk of decline in ADLs (adjusted RRs [95% confidence intervals] per 30-day increments: 1.42 [1.15 to 1.75] for BADLs, 1.38 [1.13 to 1.68] for IADLs). The adjusted RRs [95% CI] for 10-year increments in age were 1.20 [0.96 to 1.50] and 1.21 [1.00 to 1.47]. The adjusted RRs [95% CI] for having diabetes were 1.36 [0.97 to 1.91] for BADLs and 1.38 [1.04 to 1.84] for IADLs. Conclusion The impact of a 30-day increment in the cumulative length of hospital stay on the decline in ADLs was comparable to that of a 10-year increase in age and having diabetes.

scholarly journals Length of Hospital Stay Is Associated with a Decline in Activities of Daily Living in Hemodialysis Patients: A Prospective Cohort Study

2020 ◽  
Author(s):  
Tsukasa Kamitani ◽  
Shingo Fukuma ◽  
Sayaka Shimizu ◽  
Tadao Akizawa ◽  
Shunichi Fukuhara
Keyword(s):  
Cohort Study ◽  
Activities Of Daily Living ◽  
Hospital Stay ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Daily Living ◽  
Length Of Hospital Stay ◽  
Hemodialysis Patients ◽  
Cumulative Length ◽  
The Impact

Abstract Background The impact of length of hospital stay on activities of daily living (ADLs) has not specifically been investigated among dialysis patients. Therefore, we attempt to verify the association between the length of hospital stay and the decline in ADLs among hemodialysis patients. Methods This prospective cohort study used data from the Japanese Dialysis Outcomes and Practice Patterns Study (J-DOPPS). We included 2,442 hemodialysis patients aged ³ 40 years from the J-DOPPS phase V (2012–2015) and subsequently excluded those who had already lost basic activities of daily living (BADLs) as demonstrated by dependency in at least three of the five BADLs at baseline and for whom changes in ADLs had been evaluated for less than 90 days. The main exposure was the cumulative length of hospital stay during the follow-up period. The primary outcomes were a decline in at least one of the five BADLs and eight instrumental activities of daily living (IADLs). We compared risk ratios (RRs) for 30-day increments for hospital stays with 10-year increments for age and having diabetes. Results A total of 849 patients were included in the statistical analysis. The cumulative length of hospital stay was significantly associated with a risk of decline in ADLs (adjusted RRs [95% confidence intervals] per 30-day increments: 1.42 [1.15 to 1.75] for BADLs, 1.38 [1.13 to 1.68] for IADLs). The adjusted RRs [95% CI] for 10-year increments in age were 1.20 [0.96 to 1.50] and 1.21 [1.00 to 1.47]. The adjusted RRs [95% CI] for having diabetes were 1.36 [0.97 to 1.91] for BADLs and 1.38 [1.04 to 1.84] for IADLs. Conclusion The impact of a 30-day increment in the cumulative length of hospital stay on the decline in ADLs was comparable to that of a 10-year increase in age and having diabetes.

scholarly journals Determinants of in-hospital mortality in COVID-19; a prospective cohort study from Pakistan

2021 ◽  
Author(s):  
Samreen Sarfaraz ◽  
Quratulain Shaikh ◽  
Syed Ghazanfar Saleem ◽  
Anum Rahim ◽  
Fivzia Farooq Herekar ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hospital Mortality ◽  
Oxygen Saturation ◽  
Hospital Stay ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Length Of Hospital Stay ◽  
List Type ◽  
Invasive Ventilation ◽  
Icu Admission

SummaryA prospective cohort study was conducted at the Indus Hospital Karachi, Pakistan between March and June 2020 to describe the determinants of mortality among hospitalized COVID-19 patients. 186 adult patients were enrolled and all-cause mortality was found to be 36% (67/186). Those who died were older and more likely to be males (p<0.05). Temperature and respiratory rate were higher among non-survivors while Oxygen saturation was lower (p<0.05). Serum CRP, D-dimer and IL-6 were higher while SpO2 was lower on admission among non-survivors (p<0.05). Non-survivors had higher SOFA and CURB-65 scores while thrombocytopenia, lymphopenia and severe ARDS was more prevalent among them (p<0.05). Use of non-invasive ventilation in emergency room, ICU admission and invasive ventilation were associated with mortality in our cohort (p<0.05). Length of hospital stay and days of intubation were longer in non-survivors (p<0.05). Use of azithromycin, hydroxychloroquine, steroids, tocilizumab, antibiotics, IVIG or anticoagulation showed no mortality benefit (p>0.05). Multivariable logistic regression showed that age > 60 years, oxygen saturation <93% on admission, pro-calcitonin > 2 ng/ml, unit rise in temperature and SOFA score, ICU admission and sepsis during hospital stay were associated with higher odds of mortality. Larger prospective studies are needed to further strengthen these findings.Key FindingsAge greater than 60 years is associated with in-hospital mortality among COVID-19 patientsOxygen saturation less than 93% and ICU admission are associated with higher odds of mortalityInflammatory markers including CRP, Ferritin and IL-6 were significantly higher among non-survivorsSerum pro-calcitonin greater than 2 ng/ml and sepsis during hospital stay are associated with higher odds of mortality among COVID-19 patients

scholarly journals Length of Hospital Stay Is Associated with a Decline in Activities of Daily Living in Hemodialysis Patients: A Prospective Cohort Study

2019 ◽  
Author(s):  
Tsukasa Kamitani ◽  
Shingo Fukuma ◽  
Sayaka Shimizu ◽  
Tadao Akizawa ◽  
Shunichi Fukuhara
Keyword(s):  
Cohort Study ◽  
Activities Of Daily Living ◽  
Hospital Stay ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Daily Living ◽  
Length Of Hospital Stay ◽  
Hemodialysis Patients ◽  
Cumulative Length ◽  
The Impact

Abstract Background The impact of length of hospital stay on activities of daily living (ADLs) has not specifically been investigated among dialysis patients. Therefore, we attempt to verify the association between the length of hospital stay and decline in ADLs among hemodialysis patients. Methods This prospective cohort study used data from the Japanese Dialysis Outcomes and Practice Patterns Study (J-DOPPS). We included 2,442 hemodialysis patients aged more than or equal to 40 years from the J-DOPPS phase V (2012–2015) and then excluded those who were not independent in more than three of the five basic activities of daily living (BADLs) and for whom changes in ADLs were evaluated for less than 90 days. The main exposure was the cumulative length of hospital stay during the follow-up period. The main outcomes were a decline in at least one of the five BADLs and eight instrumental activities of daily living (IADLs). We compared risk ratios (RRs) for 30-day increments in hospital stay with 10-year increments in age and having diabetes. Results A total of 960 patients were included in the statistical analysis. The cumulative length of hospital stay was significantly associated with a risk of decline in ADLs (adjusted RRs [95% confidence intervals] per 30-day increments: 1.42 [1.17 to 1.73] for BADLs, 1.30 [1.10 to 1.54] for IADLs). The adjusted RRs [95% CI] for 10-year increments in age were 1.20 [0.96 to 1.50] and 1.27 [1.05 to 1.54]. The adjusted RRs [95% CI] for having diabetes were 1.46 [1.06 to 2.02] for BADLs and 1.38 [1.05 to 1.81] for IADLs. Conclusion The impact of a 30-day increment in the cumulative length of hospital stay on the decline in ADLs was comparable to that of a 10-year increase in age and having diabetes.

scholarly journals Admission Hyperglycemia and Length of Hospital Stay in Patients With Diabetes and Heart Failure: A Prospective Cohort Study

2008 ◽  
Vol 14 (3) ◽  
pp. 117-120 ◽  
Author(s):  
Yohannes Gebreegziabher ◽  
Peter A McCullough ◽  
Chard Bubb ◽  
Lesel Loney-Hutchinson ◽  
John N. Makaryus ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Hospital Stay ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Length Of Hospital Stay ◽  
Patients With Diabetes

scholarly journals Length of hospital stay is associated with a decline in activities of daily living in hemodialysis patients: a prospective cohort study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Tsukasa Kamitani ◽  
Shingo Fukuma ◽  
Sayaka Shimizu ◽  
Tadao Akizawa ◽  
Shunichi Fukuhara
Keyword(s):  
Cohort Study ◽  
Activities Of Daily Living ◽  
Hospital Stay ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Daily Living ◽  
Length Of Hospital Stay ◽  
Hemodialysis Patients ◽  
Cumulative Length ◽  
The Impact

Abstract Background The impact of length of hospital stay on activities of daily living (ADLs) has not specifically been investigated among dialysis patients. Therefore, we attempt to verify the association between the length of hospital stay and the decline in ADLs among hemodialysis patients. Methods This prospective cohort study used data from the Japanese Dialysis Outcomes and Practice Patterns Study (J-DOPPS). We included 2442 hemodialysis patients aged ≥40 years from the J-DOPPS phase V (2012–2015) and subsequently excluded those who had already lost basic activities of daily living (BADLs) as demonstrated by dependency in at least three of the five BADLs at baseline and for whom changes in ADLs had been evaluated for less than 90 days. The main exposure was the cumulative length of hospital stay during the follow-up period. The primary outcomes were a decline in at least one of the five BADLs and eight instrumental activities of daily living (IADLs). We compared risk ratios (RRs) for 30-day increments for hospital stays with 10-year increments for age and having diabetes. Results A total of 849 patients were included in the statistical analysis. The cumulative length of hospital stay was significantly associated with a risk of decline in ADLs (adjusted RRs [95% confidence intervals] per 30-day increments: 1.42 [1.15 to 1.75] for BADLs, 1.38 [1.13 to 1.68] for IADLs). The adjusted RRs [95% CI] for 10-year increments in age were 1.20 [0.96 to 1.50] and 1.21 [1.00 to 1.47]. The adjusted RRs [95% CI] for having diabetes were 1.36 [0.97 to 1.91] for BADLs and 1.38 [1.04 to 1.84] for IADLs. Conclusion The impact of a 30-day increment in the cumulative length of hospital stay on the decline in ADLs was comparable to that of a 10-year increase in age and having diabetes.

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