scholarly journals Malnutrition and cachexia among cancer out-patients in Nairobi, Kenya

2017 ◽  
Vol 6 ◽  
Author(s):  
L. U. Kaduka ◽  
Z. N. Bukania ◽  
Y. Opanga ◽  
R. Mutisya ◽  
A. Korir ◽  
...  
Keyword(s):  
At Risk ◽  
Screening Tool ◽  
Point Of Care ◽  
Cross Sectional Study ◽  
Fat Free Mass ◽  
Assessment Tools ◽  
Correct Identification ◽  
Cross Sectional ◽  
Cancer Management ◽  
Patients At Risk

AbstractCancer is the third leading cause of death in Kenya. However, there is scarce information on the nutritional status of cancer patients to guide in decision making. The present study sought to assess the risk of malnutrition, and factors associated with malnutrition and cachexia, among cancer out-patients, with the aim of informing nutrition programmes for cancer management in Kenya and beyond. This was a facility-based cross-sectional study performed at Kenyatta National Hospital and Texas Cancer Centre in Nairobi, Kenya. The risk of malnutrition was assessed using the Malnutrition Universal Screening Tool (MUST). Diagnoses of malnutrition and cachexia were done using the European Society of Clinical Nutrition and Metabolism (ESPEN) and Fearon criteria, respectively. A total of 512 participants were assessed. Those at risk of malnutrition were 33·1 % (12·5 % at medium risk, 20·6 % at high risk). Prevalence of malnutrition was 13·4 %. The overall weight loss >5 % over 3 months was 18·2 % and low fat-free mass index was 43·1 %. Prevalence of cachexia was 14·1 % compared with 8·5 % obtained using the local criteria. Only 18·6 % participants had received any form of nutrition services. Age was a predictor of malnutrition and cachexia in addition to site of cancer for malnutrition and cigarette smoking for cachexia. The use of the MUST as a screening tool at the first point of care should be explored. The predictive value of current nutrition assessment tools, and the local diagnostic criteria for malnutrition and cachexia should be reassessed to inform the development of appropriate clinical guidelines and future capacity-building initiatives that will ensure the correct identification of patients at risk for timely care.

scholarly journals Sarcopenia and Malnutrition Screening in Female Osteoporosis Patients—A Cross-Sectional Study

2021 ◽  
Vol 10 (11) ◽  
pp. 2344
Author(s):  
Franca Genest ◽  
Dominik Rak ◽  
Elisa Bätz ◽  
Kerstin Ott ◽  
Lothar Seefried
Keyword(s):  
At Risk ◽  
Risk Groups ◽  
Cross Sectional Study ◽  
Mineral Density ◽  
Cross Sectional ◽  
Functional Deficits ◽  
Complementary Approach ◽  
Study Results ◽  
Patients At Risk ◽  
Not At Risk

Sarcopenia and malnutrition are important determinants of increased fracture risk in osteoporosis. SARC-F and MNA-SF are well-established questionnaires for identifying patients at risk for these conditions. We sought to evaluate the feasibility and potential added benefit of such assessments as well as the actual prevalence of these conditions in osteoporosis patients. We conducted a cross-sectional, single-center study in female osteoporosis patients ≥ 65 years (SaNSiBaR-study). Results of the sarcopenia (SARC-F) and malnutrition (MNA-SF) screening questionnaires were matched with a functional assessment for sarcopenia and data from patients’ medical records. Out of 107 patients included in the analysis, a risk for sarcopenia (SARC-F ≥ 4 points) and a risk for malnutrition (MNA-SF ≤ 11 points) was found in 33 (30.8%) and 38 (35.5%) patients, respectively. Diagnostic overlap with coincident indicative findings in both questionnaires was observed in 17 patients (16%). As compared to the respective not-at-risk groups, the mean short physical performance battery (SPPB) score was significantly reduced in both patients at risk for sarcopenia (7.0 vs. 10.9 points, p < 0.001) and patients at risk for malnutrition (8.7 vs. 10.5 points, p = 0.005). Still, confirmed sarcopenia according to EWGSOP2 criteria was present in only 6 (6%) of all 107 patients, with only 3 of them having an indicative SARC-F score. Bone mineral density was not significantly different in any of the at-risk groups at any site. In summary, applying SARC-F and MNA-SF in osteoporosis patients appears to be a complementary approach to identify individuals with functional deficits.

Drug-related problems in a clinical setting: a literature review and cross-sectional study evaluating factors to identify patients at risk

2015 ◽  
Vol 22 (4) ◽  
pp. 229-235 ◽  
Author(s):  
Carli Michèle Wilmer ◽  
Victor Johan Bernard Huiskes ◽  
Stephanie Natsch ◽  
Alexander Johannes Maria Rennings ◽  
Bartholomeus Johannnes Frederikus van den Bemt ◽  
...  
Keyword(s):  
At Risk ◽  
Literature Review ◽  
Clinical Setting ◽  
Cross Sectional Study ◽  
Drug Related Problems ◽  
Sectional Study ◽  
Cross Sectional ◽  
Patients At Risk

scholarly journals Advance preferences regarding thrombolysis in patients at risk for stroke: a cross-sectional study: Table 1

QJM ◽  
2014 ◽  
Vol 108 (1) ◽  
pp. 27-31 ◽  
Author(s):  
T. Ó Flatharta ◽  
A. Khan ◽  
T. Walsh ◽  
M. O’Donnell ◽  
S.T. O’Keefe
Keyword(s):  
At Risk ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Patients At Risk

Acceptability of blood-based HIV self-testing among adolescents aged 15–19 years at risk of HIV acquisition in Bangkok

2021 ◽  
pp. 095646242110037
Author(s):  
Pongpak Phongphiew ◽  
Wipaporn N Songtaweesin ◽  
Nantika Paiboon ◽  
Panyaphon Phiphatkhunarnon ◽  
Patchareeyawan Srimuan ◽  
...  
Keyword(s):  
At Risk ◽  
Point Of Care ◽  
Cross Sectional Study ◽  
Hiv Treatment ◽  
Cross Sectional ◽  
Sex With Men ◽  
Finger Stick ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition ◽  
Antibody Tests

Introduction: Young men who have sex with men (YMSM) and young transgender women (YTGW) in Thailand are at high HIV risk. HIV self-tests (HIVSTs) are rapidly administrable and prompt linkage to HIV treatment or prevention services. This study assesses the acceptability and feasibility of blood-based HIVST use in adolescents. Methods: A cross-sectional study was conducted among YMSM and YTGW aged 15–19 years with HIV acquisition risk. Participants completed questionnaires on the HIVST and then administered INSTI® independently, an HIVST immunoassay detecting gp41 and gp36 antibodies from finger-stick blood. Confirmatory HIV antibody tests were performed. Results: Between July and September 2020, 90 adolescents were enrolled. Mean (SD) age was 17.6 (1.1) years. Half ( N = 45) were YMSM. Forty-six (51%) were first-time HIV testers, and 32 (36%) had “ever used” HIV pre-exposure prophylaxis (PrEP). Two (2.2%, 95% CI: 0.0–5.3) tested positive, 21 (23.4%) invalid, and 67 (74.4%) negative. Invalidity causes included 17 (81%) insufficient blood, 3 (14%) buffer spillage, and 1 (5%) procedural missteps; all had negative HIV antibody tests. HIV self-test acceptability was 87.8% (95% CI: 81.0–94.5). Most (79%) preferred HIVST performance in hospital rather than at home. Conclusions: HIVSTs are acceptable in HIV at-risk adolescents. Blood-based HIVSTs should be positioned as rapid point-of-care tests with real-time linkage to HIV services.

scholarly journals A predictive model for identifying patients at risk of delayed transfer of care: a retrospective, cross-sectional study of routinely collected data

2021 ◽  
Vol 33 (3) ◽  
Author(s):  
Andrew Davy ◽  
Thomas Hill ◽  
Sarahjane Jones ◽  
Alisen Dube ◽  
Simon c Lea ◽  
...  
Keyword(s):  
At Risk ◽  
Predictive Model ◽  
Cross Sectional Study ◽  
Early Warning Score ◽  
Sectional Study ◽  
Cross Sectional ◽  
Transfer Of Care ◽  
Routinely Collected Data ◽  
Patients At Risk ◽  
Transfers Of Care

Abstract Background Delays to the transfer of care from hospital to other settings represent a significant human and financial cost. This delay occurs when a patient is clinically ready to leave the inpatient setting but is unable to because other necessary care, support or accommodation is unavailable. The aim of this study was to interrogate administrative and clinical data routinely collected when a patient is admitted to hospital following attendance at the emergency department (ED), to identify factors related to delayed transfer of care (DTOC) when the patient is discharged. We then used these factors to develop a predictive model for identifying patients at risk for delayed discharge of care. Objective To identify risk factors related to the delayed transfer of care and develop a prediction model using routinely collected data. Methods This is a single centre, retrospective, cross-sectional study of patients admitted to an English National Health Service university hospital following attendance at the ED between January 2018 and December 2020. Clinical information (e.g. national early warning score (NEWS)), as well as administrative data that had significant associations with admissions that resulted in delayed transfers of care, were used to develop a predictive model using a mixed-effects logistic model. Detailed model diagnostics and statistical significance, including receiver operating characteristic analysis, were performed. Results Three-year (2018–20) data were used; a total of 92 444 admissions (70%) were used for model development and 39 877 (30%) admissions for model validation. Age, gender, ethnicity, NEWS, Glasgow admission prediction score, Index of Multiple Deprivation decile, arrival by ambulance and admission within the last year were found to have a statistically significant association with delayed transfers of care. The proposed eight-variable predictive model showed good discrimination with 79% sensitivity (95% confidence intervals (CIs): 79%, 81%), 69% specificity (95% CI: 68%, 69%) and 70% (95% CIs: 69%, 70%) overall accuracy of identifying patients who experienced a DTOC. Conclusion Several demographic, socio-economic and clinical factors were found to be significantly associated with whether a patient experiences a DTOC or not following an admission via the ED. An eight-variable model has been proposed, which is capable of identifying patients who experience delayed transfers of care with 70% accuracy. The eight-variable predictive tool calculates the probability of a patient experiencing a delayed transfer accurately at the time of admission.

scholarly journals Involvement of Tunisian General Practitioners in the Management of Patients at Risk of Infective Endocarditis: A Cross-Sectional Study

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Malek Lagha ◽  
Mehdi Khemiss ◽  
Ines Kallel ◽  
Asma Araissia ◽  
Chems Belkhir ◽  
...  
Keyword(s):  
At Risk ◽  
Infective Endocarditis ◽  
Antibiotic Prophylaxis ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Patients At Risk ◽  
Spss Software ◽  
General Dentists ◽  
The Right ◽  
Real Practice

Objectives. This work aimed to estimate the knowledge and practice of general dentists in the governorate of Manouba regarding the management of patients at risk of infective endocarditis. Materials and Methods. A survey involving private sector general dentists in the governorate of Manouba was performed. It contained 21 questions, and it was addressed to 111 dentists. Only 82 dentists responded. To carry out the descriptive study, we used the SPSS software version 21.0. Results. Our results proved the lack of knowledge among dentists in the governorate of Manouba with regard to the management of patients at risk of infective endocarditis. An overestimation of the risk and an overprescription of antibiotic were found in order to ensure an over-protection for the patients as well as the dentist. In fact, 85.4% of these dentists prescribed antibiotic prophylaxis for the two groups of patients (high risk and moderate risk). Only 9.8% followed the right modality of antibiotic prophylaxis prescription; 4.9% of the dentists prescribed antibiotic only 1 hour before the act and 4.9% of them prescribed antibiotic 1 hour before the act and continued the treatment in case of the presence of an infectious site. Conclusion. A discrepancy towards an over-estimation of risk and overprescription of antibiotic was found between the recommendations and real practice. Similar studies in the other governorates of Tunisia are recommended in order to better understand the problem.

scholarly journals Associação entre ferramenta de triagem e avaliação nutricional entre pacientes hospitalizados no município de Porto Alegre

2020 ◽  
Vol 2 (35) ◽  
pp. 144-148
Author(s):  
Camila Weschenfelder ◽  
Luciane Vieira Figueira ◽  
Talita Sthephanie Scotta Cabral ◽  
Jacqueline Schaurich dos Santos
Keyword(s):  
Predictive Value ◽  
Screening Tool ◽  
Nutritional Assessment ◽  
Cross Sectional Study ◽  
The Body ◽  
Assessment Tools ◽  
Nutritional Risk ◽  
Porto Alegre ◽  
Cross Sectional ◽  
Hospital Malnutrition

Introduction: Hospital malnutrition is associated with the worsening of the patient’s general condition and its early diagnosis allows the reduction of related complications. The aim of this study was to verify the agreement of the Short Nutritional Assessment Questionnaire (SNAQ) screening tool and the Subjective Global Assessment (SGA). Methods: Cross-sectional study, carried out in a general hospital in the city of Porto Alegre (RS). The SNAQ was applied by previously trained nutritionists and nurses, and the patient was considered at nutritional risk when the score was ≥2. SGA was applied by nutritionists in all patients and considered the gold standard for comparison. The Kappa coefficient was used to assess the degree of agreement between the screening and nutritional assessment tools. Kappa values between 0.21-0.60 were considered as low agreement, 0.61-0.8 as moderate agreement and greater than 0.81, as strong agreement. Results: Between January and March 2017, 186 patients were evaluated, of them 115 (62%) were women. The mean age was 65.7 ± 16.6 years and the body mass index (BMI) mean was 26.5 ± 5.5 kg/ m². According to SGA classification, 73.7% of the sample was considered to be well nourished, 14% moderately malnourished and 12.4% severely malnourished. Low agreement was observed between the nutritional risk diagnosed by nursing vs. nutrition through SNAQ (Kappa=0.58) and good agreement of SNAQ applied by the nutrition team with the nutritional diagnosis of SGA (Kappa=0.73). The SNAQ presented sensitivity of 85.7% (95% CI 73.3 - 92.9) and specificity of 90.5% (95% CI 84.4 - 94.4); positive predictive value of 76.4% (95% CI 65.7 - 84.5) and negative predictive value of 94.7% (95% CI 90 - 97.2). Conclusion: We conclude that the screening tool SNAQ when conducted by nutritionists can be used for early detection of hospital malnutrition.

Symptom Burden in Patients With Home Care Who Are at Risk for Malnutrition: A Cross-Sectional Study

2019 ◽  
Vol 35 (2) ◽  
pp. 103-109
Author(s):  
Erika Berggren ◽  
Peter Strang ◽  
Ylva Orrevall ◽  
Ann Ödlund Olin ◽  
Lena Törnkvist
Keyword(s):  
Primary Care ◽  
At Risk ◽  
Home Care ◽  
Older Patients ◽  
Symptom Burden ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Significance Level ◽  
Patients At Risk

In Sweden, patients in early palliative stages of illness are cared for in primary care and often offered home care. Many are older and at risk for malnutrition, but little is known about their symptom burden and nutritional problems. This cross-sectional study divided older patients in home care into those with and without risk for malnutrition and compared symptom burden in the 2 groups. Participants were patients in Stockholm County (n = 121) in early palliative stages of disease cared for at home by primary care professionals from 10 health-care centers. The Mini Nutritional Assessment (MNA) was used to identify risk for malnutrition. Symptoms and/or nutritional status in patients with and without risk were assessed with the Functional Assessment of Anorexia/Cachexia Therapy (FAACT), Patient-Generated Subjective Global Assessment Short Form (PG-SGA), and Edmonton Symptom Assessment System (ESAS). Forty-two percent of the patients were at risk for malnutrition (MNA). Appetite ( P = .012), tiredness ( P = .003), and anxiety ( P = .008) were worse in these patients than in those without risk (ESAS; significance level, P ≤ .015). Patients at risk were also more concerned about how thin they looked ( P = .006), agreed more strongly that their family or friends were pressuring them to eat ( P = .000; FAACT; significance level, P ≤ .029), had a higher symptom burden ( P = .005), had lower physical activity ( P = .000), and more lost weight over time ( P = .032; PG-SGA; significance level, P ≤ .040). This study adds a more detailed picture of the symptom burden in older patients at risk for malnutrition. Such information is needed to identify risk for malnutrition earlier and improve patients’ health.

Anticholinergic Exposure in Elderly Complex Chronic Patients: A Cross-Sectional Study

2021 ◽  
Vol 27 ◽  
Author(s):  
Ángela Tristancho-Pérez ◽  
Ángela Villalba-Moreno ◽  
María Dolores Santos-Rubio ◽  
María Dolores López-Malo ◽  
Bernardo Santos-Ramos ◽  
...  
Keyword(s):  
At Risk ◽  
Adverse Effects ◽  
Cross Sectional Study ◽  
Multiple Chronic Conditions ◽  
Anticholinergic Drugs ◽  
Chronic Patients ◽  
Cross Sectional ◽  
Anticholinergic Activity ◽  
Patients At Risk ◽  
Anticholinergic Burden

Background: Elderly patients with multiple chronic conditions are closely linked to polymedication, a condition that is also highly associated with the presence of adverse effects, such as those observed by anticholinergic activity. Anticholinergic burden is defined in a very variable way and is described inconsistently using different scores and providing different interpretations of the risk of suffering from anticholinergic adverse effects Objective: the objective is to analyse the anticholinergic risk exposure in elderly complex chronic patients. Methods: A observational multicentre study was performed for a cohort of complex chronic patients over 65 years who received treatment with at least one drug with anticholinergic activity. Anticholinergic exposure was assessed using ten scales included in the Anticholinergic Burden Calculator. Results: 473 patients were recruited, being 67.7% with excessive polypharmacy. 80 was the total number of anticholinergic drugs with any scale, with a median of 2 drugs with anticholinergic activity per patient (IQR=2). Three scales evaluated more than 70% of the patients (Chew:79.1%; Drug Burden Index (DBI):77.8%; Anticholinergic Cognitive Burden (ACB):75.9%). The percentage of different drugs with anticholinergic properties evaluated ranged from 13.8% (Anticholinergic Burden Classification (ABC)) to 57.5% (DBI) and anticholinergic drugs prescriptions oscillated from 14% (Anticholinergic Risk Scale (ARS)) to 53.3%(DBI). 71.1% of patients were at risk (moderate and high risk) according to DBI vs. 9.7% by ARS at the opposite side. Important differences of anticholinergic risk in patients with excessive polypharmacy were in ACB, ABC and DBI scales. Conclusions: This study has highlighted clear differences between the scales used. DBI seems to be the scale that identifies a higher number of elderly chronic complex patients at risk of developing anticholinergic adverse effects.

scholarly journals Nursing care mapping for patients at risk of falls in the Nursing Interventions Classification

2014 ◽  
Vol 48 (4) ◽  
pp. 632-640 ◽  
Author(s):  
Melissa de Freitas Luzia ◽  
Miriam de Abreu Almeida ◽  
Amália de Fátima Lucena
Keyword(s):  
At Risk ◽  
Nursing Care ◽  
Cross Sectional Study ◽  
Mapping Method ◽  
University Hospital ◽  
Nursing Interventions ◽  
Cross Sectional ◽  
Nursing Diagnosis ◽  
Risk Of Falls ◽  
Patients At Risk

Objective: Identifying the prescribed nursing care for hospitalized patients at risk of falls and comparing them with the interventions of the Nursing Interventions Classifications (NIC). Method: A cross-sectional study carried out in a university hospital in southern Brazil. It was a retrospective data collection in the nursing records system. The sample consisted of 174 adult patients admitted to medical and surgical units with the Nursing Diagnosis of Risk for falls. The prescribed care were compared with the NIC interventions by the cross-mapping method. Results: The most prevalent care were the following: keeping the bed rails, guiding patients/family regarding the risks and prevention of falls, keeping the bell within reach of patients, and maintaining patients’ belongings nearby, mapped in the interventions Environmental Management: safety and Fall Prevention. Conclusion: The treatment prescribed in clinical practice was corroborated by the NIC reference.


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