High Nutritional-Related Risk on Admission Predicts Less Improvement of Functional Independence Measure in Geriatric Stroke Patients: A Retrospective Cohort Study

2016 ◽  
Vol 25 (6) ◽  
pp. 1335-1341 ◽  
Author(s):  
Yoji Kokura ◽  
Keisuke Maeda ◽  
Hidetaka Wakabayashi ◽  
Shinta Nishioka ◽  
Sotaro Higashi
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Stroke Patients ◽  
Related Risk

scholarly journals Reamputation in patients with diabetic-related minor amputations who underwent physical therapy during their hospitalization. A single-facility retrospective cohort study

2020 ◽  
Author(s):  
Shinsuke Imaoka ◽  
Koji Sato ◽  
Masahide Furukawa ◽  
Minoru Okita ◽  
Toshio Higashi
Keyword(s):  
Cohort Study ◽  
Physical Therapy ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Care Center ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Ankle Dorsiflexion ◽  
Factors Associated ◽  
Minor Amputation

Abstract Background: Diabetic foot lesions are a major cause of non-traumatic lower limb amputations; they can interfere with daily life, reduce physical function and lower a patient’s quality of life. Physical therapy is necessary to prevent such social disadvantage. Patients at high risk of reamputation may require physical therapy to prevent reamputation. The purpose of this study was to elucidate the factors that influence re-amputation in patients with minor amputations who were treated with physical therapy during their hospitalization.Methods: This was a retrospective cohort study of 245 consecutive hospitalized patients who presented to our Wound Care Center between January 2015 and February 2018 and received physical therapy after a minor amputation. Participants were identified from admission records (to surgical and physical therapy units) stored in the electronic medical records. We examined reamputations that occurred in the ipsilateral lower extremity during the 1-year post-discharge outpatient period. The maximum follow-up period was１year. We used Cox proportional hazards analysis to examine factors affecting the risk of reamputation.Results: Of the 129 patients enrolled, 42 patients (32.5%) underwent reamputations during an average observation period of 6.2 months (range, 2.1 to 10.9 months). The factors associated with reamputation were a requirement for hemodialysis, ankle dorsiflexion angle, and ambulation Functional Independence Measure score.Conclusions: We identified a requirement for hemodialysis, ankle dorsiflexion angle, and functional independence measure (FIM) ambulation as the factors associated with reamputation in patients with diabetes who had undergone minor amputation. In the future, developing a physical therapy program that focuses on these factors could help reduce reamputations.

scholarly journals Reamputation in patients with diabetes-related minor amputations who underwent physical therapy during their hospitalization. A single-facility retrospective cohort study

2020 ◽  
Author(s):  
Shinsuke Imaoka ◽  
Koji Sato ◽  
Masahide Furukawa ◽  
Minoru Okita ◽  
Toshio Higashi
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Physical Therapy ◽  
Retrospective Cohort Study ◽  
Lower Limb ◽  
Retrospective Cohort ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Amputation Rate ◽  
Modifiable Risk Factors

Abstract Background：Diabetes-related foot lesions are a major cause of non-traumatic lower limb amputations and are associated with a high re-amputation rate. Lesions can cause hindrance in activities of daily living, reduce physical function, and lower a patient’s quality of life. Physical therapy is necessary to prevent these limitations. Thus far, there has been limited investigation into the re-amputation rate in patients who have undergone physical therapy. This study aimed to elucidate modifiable risk factors for re-amputation in patients with minor amputations who were treated with physical therapy during their hospitalization.Methods：This was a retrospective cohort study of 245 consecutive hospitalized patients who presented to our Wound Care Center between January 2015 and February 2018 and received physical therapy after a minor amputation. Participants were identified from admission records (to surgical and physical therapy units) stored in the electronic medical records. We examined reamputations that occurred in the ipsilateral lower extremity during the 1-year post-discharge outpatient period. The maximum follow-up period was set at 1 year. We used Cox proportional hazards analysis to examine factors affecting the risk of reamputation.Results: Of the 129 patients enrolled, 42 patients (32.5%) underwent reamputations during an average observation period of 6.2 months (range, 2.1 to 10.9 months). The factors associated with reamputation were a requirement for hemodialysis, ankle dorsiflexion angle, and ambulation Functional Independence Measure score.Conclusions: In diabetes patients with minor amputations, requirement for hemodialysis, ankle dorsiflexion angle, and functional independence measure (FIM) ambulation were shown to be modifiable risk factors for re-amputation. This emphasizes that maintaining vascular endothelial function through lower limb muscle exercises for hemodialysis, improving ankle mobility, and off-loading walking are necessary to reduce the risk of reamputation. Patients with these risk factors should be encouraged to participate in physical therapy.

The Association Between Antipsychotic Drug Use and Rehabilitation Outcome in Post-Acute Hip Fractured Patients: A Retrospective Cohort Study

2020 ◽  
pp. 073346482090456
Author(s):  
Avital Hershkovitz ◽  
Ran Nissan
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Functional Independence Measure ◽  
Multiple Linear Regression Model ◽  
Functional Independence ◽  
Functional Improvement ◽  
Rehabilitation Outcome ◽  
Rehabilitation Outcomes ◽  
Functional Gain

Antipsychotic (AP) use may lead to numerous side effects which may affect rehabilitation outcomes. A retrospective cohort study was carried out on 448 hip fractured patients admitted to a post-acute geriatric rehabilitation center. Functional improvement was measured by the Functional Independence Measure (FIM), motor FIM (mFIM), and mFIM effectiveness. A multiple linear regression model and regression analysis was used to evaluate the level of association between AP use and achievement of favorable functional gain. AP users exhibited lower functional ability on admission and at discharge, achieved a significantly lower functional gain and required longer rehabilitation time compared with nonusers. AP use by post-acute hip fractured patients negatively affects their chances of achieving favorable rehabilitation outcome after adjustment for confounders.

scholarly journals Characteristics and Outcomes of Hip Fracture Patients Hospitalized in an Orthogeriatric Unit Versus an Orthopedic Department: A Retrospective Cohort Study

2021 ◽  
Vol 12 ◽  
pp. 215145932098629 ◽  
Author(s):  
Yulia Bugaevsky ◽  
Yochai Levy ◽  
Avital Hershkovitz ◽  
Irena Ocheretny ◽  
Adaya Nissenholtz ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Hip Fracture ◽  
Hip Fractures ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Functional Independence ◽  
Functional Improvement ◽  
Orthopedic Department ◽  
Successful Recovery

Introduction: Hip fractures are a significant health risk in older adults and a major cause of morbidity, functional decline and mortality. Our aim was to compare clinical outcomes of older patients hospitalized in an ortho-geriatric (OG) unit to those hospitalized in an orthopedic department (OD) for surgical treatment of a hip fracture. Methods: A retrospective cohort study of hip fractured patients hospitalized between 2015-2016 in a single tertiary university-affiliated medical center. Included were patients aged 65 and older who had undergone hip fracture surgery and were admitted to either a geriatric or orthopedic ward. Results: 441 patients met the inclusion criteria (195 in the OG unit, 246 in the OD); 257 were transferred to an affiliated geriatric center hospital (107 from the OG unit and 127 from the OD) for rehabilitation. Patients in the OG unit were older, more cognitively and functionally impaired and with more comorbidities. The 1-year mortality rate was significantly lower in the OD group (OR 0.32, CI 95% 0.19-0.53, p < 0.001), however, after propensity matching, the 30-day and 1 year mortality rates were similar in both groups. No difference was found in the rehabilitation length of stay between the groups. The functional independence measure improvement was similar in both groups, with a non-significant trend toward better functional improvement among OG unit patients. Conclusions: Despite the higher complexity of patients, worse baseline functional capacity in the OG unit, improvement after rehabilitation was similar in both groups. These results demonstrate the advantages of the OG unit in treating and stabilizing frail older adults, thus maximizing their chances for a successful recovery after hip fractures. Level of Evidence: Level IV

ROLE OF COMPUTED TOMOGRAPHY SCAN IN EVALUATION OF NEUROLOGICAL MANIFESTATIONS IN COVID 19 POSITIVE PATIENTS AND ITS CORRELATION WITH D-DIMER VALUE AND GCS: A RETROSPECTIVE COHORT STUDY IN A TERTIARY CARE HOSPITAL IN CENTRAL INDIA

2021 ◽  
pp. 17-21
Author(s):  
Debraj Saha ◽  
Aarti Anand ◽  
Jawahar Rathod ◽  
Prajwaleet Gour ◽  
Shivprasad Jaybhay ◽  
...  
Keyword(s):  
Cohort Study ◽  
Acute Stroke ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Neurological Symptoms ◽  
Government Medical College ◽  
Stroke Patients ◽  
Medical College ◽  
Neuro Imaging ◽  
D Dimer

Objective: To investigate the incidence and spectrum of neuroimaging ndings and their prognostic role in hospitalized COVID-19 patients in Government Medical College Nagpur along with their correlation with D-Dimer Values and GCS . Methods: This is a retrospective cohort study of 774 COVID-19 conrmed patients admitted to Government Medical College st st Nagpur between 1 April 2020 and 31 October 2020. Clinical data were extracted from electronic medical records, and particularly data of all neurological symptoms were extracted from the imaging reports. Four neuro-radiologists evaluated all neuroimaging studies for acute neuroimaging ndings related to COVID-19. Plasma D-dimer levels were measured using a particle-enhanced, immunoturbidimetric assay on admission in the 116 patients who came for evaluation of neurological symptoms. Moreover ,the patients were classied into different groups as mild, moderate and severe based on their GCS scores and was assessed with respect to their neuro-imaging ndings. Results: 15 % of the admitted patients suffered from neurological symptoms. Acute stroke was the most common nding in the patients with positive neuroimaging ndings resulting in 34.4% of the patients with positive neuroimaging ndings. Other ndings were subacute infarcts (13.8%), Chronic lacunar infarcts (20.6%) , Intraparenchymal hemorrhage in 10.4 %, hypertensive encephalopathy in 7 % and subarachanoid hemorrhage in 3.4 %. Plasma median D-dimer levels were signicantly (P฀ =฀ 0.000) higher in Acute stroke patients as compared to COVID 19 positive patients who had negative CT scan imaging features(0.88; interquartile range [IQR], 0.28–2.11 mg/L and 0.31; IQR, 0.17–0.74 mg/L). Patients who have positive neuroimaging ndings presented with a lower GCS whereas patients who had negative neuroimaging ndings presented with a higher GCS. Conclusions: Our study demonstrates acute stroke is the most common neuroloimaging nding in hospitalized COVID 19 Patients. Moreover D-Dimer values are highly predictive of acute ischemic stroke. Patients with positive neuro-imaging ndings have poor GCS scores.

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