141Are Older Patients At High Risk Of Adverse Health Outcomes Identified In Hospital?

Background Previous research has suggested possible sex-related differences in executive functioning among cocaine users; however, no studies specifically explain sex-related differences in neurocognitive impairment (NCI) among cocaine users receiving clinical care. Knowledge about this association can aid in the development of targeted prevention strategies to reduce adverse health outcomes. This study was designed to examine the sex-related differences in NCI among high-risk cocaine users receiving substance-abuse treatment. Methods The Neuropsychological Impairment Scale (NIS) was administered to 199 cocaine users (98 men; 101 women), receiving methadone maintainance treatment, to assess self-reported NCI by identifying the patients’ awareness of neuropsychological symptoms. We used T-test comparison to find differences in NCI between men and women and multiple regression analysis to explore the relative contribution of sex to NCI. Results Consistent with prior work, high NCI was evident within this sample, as indicated by high scores on most of the NIS subscales. Women reported greater impairment than men, as evidenced by significantly higher scores on several NIS subscales, after controlling for demographic and other confounding variables. Interestingly, cocaine craving significantly predicted NCI among men but not among women, as suggested by the significant association between cocaine craving and all except one of the NIS subscales. Conclusions These findings suggest that cocaine users enter into treatment with a range of NCI – with women having significantly more neurocognitive deficits than men – that may contribute to differential treatment outcomes. This highlights the need to include additional services such as neuropsychological screening and sex-specific treatment programs to optimally reduce adverse health outcomes in these high-risk, cognitively impaired patients.

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Medication Adherence and Adverse Health Outcomes in Community Dwelling Older Patients

Value in Health ◽

10.1016/j.jval.2013.08.077 ◽

2013 ◽

Vol 16 (7) ◽

pp. A335 ◽

Cited By ~ 1

Author(s):

C. Cahir ◽

T. Fahey ◽

C. Teljeur ◽

K. Bennett

Keyword(s):

Medication Adherence ◽

Health Outcomes ◽

Older Patients ◽

Community Dwelling ◽

Adverse Health ◽

Adverse Health Outcomes

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Predicting Adverse Health Outcomes in Older Patients Presenting to the Emergency Department: The Acutely Presenting Older Patient Study

Academic Emergency Medicine ◽

10.1111/acem.13119 ◽

2017 ◽

Vol 24 (4) ◽

pp. 505-505 ◽

Cited By ~ 2

Author(s):

Jelle de Gelder ◽

Jacinta A. Lucke ◽

Bas de Groot ◽

Anne J. Fogteloo ◽

Sander Anten ◽

...

Keyword(s):

Emergency Department ◽

Health Outcomes ◽

Older Patients ◽

Older Patient ◽

Patient Study ◽

Adverse Health ◽

Adverse Health Outcomes

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Systematic Review: Components of a Comprehensive Geriatric Assessment in Inflammatory Bowel Disease—A Potentially Promising but Often Neglected Risk Stratification

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz082 ◽

2019 ◽

Vol 13 (11) ◽

pp. 1418-1432 ◽

Cited By ~ 3

Author(s):

Vera E R Asscher ◽

Felicia V Y Lee-Kong ◽

Esther D Kort ◽

Floor J van Deudekom ◽

Simon P Mooijaart ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Risk Stratification ◽

Health Outcomes ◽

Geriatric Assessment ◽

Bowel Disease ◽

Comprehensive Geriatric Assessment ◽

Older Patients ◽

Adverse Health ◽

Adverse Health Outcomes ◽

Inflammatory Bowel

Abstract Background The population of older patients with inflammatory bowel disease [IBD] is increasing. Patient age does not fully account for poor outcomes and its clinical utility for risk stratification is limited. Comprehensive geriatric assessment [CGA], comprising a somatic, functional, mental, and social assessment or frailty, could be a predictor tool. Aims To systematically review literature on the kind of components of a CGA being used in adult IBD patients and the association of these components with adverse health outcomes. Methods An electronic literature search was performed on January 16, 2018, using PubMed, Embase, Web of Science, the Cochrane Library, CENTRAL, Emcare, and PsycINFO. Longitudinal studies relating somatic, functional, mental, and social assessment or frailty to adverse health outcomes during follow-up in IBD patients were included. The Newcastle-Ottawa scale was used to assess individual study quality. Results Of 4080 identified citations, 27 studies were included, reporting 169 associations. Median sample size was 108 patients (interquartile range [IQR] 60–704). No studies performed subgroup analyses on older patients, and the highest mean age reported was 52.7 years. Somatic and functional assessments were used in three studies, mental in 24, and social in five. No study assessed cognitive status, functional performance, or frailty. In 62 associations [36.7%], components of a CGA were significantly associated with adverse health outcome measurements. Conclusions Components of a CGA were associated with adverse health outcomes in IBD patients, but older patients were under-represented. More studies among older patients with IBD are warranted to further establish the clinical impact of a CGA.

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Strategy to reduce adverse health outcomes in subjects highly vulnerable to COVID-19: results from a population-based study in Northern Italy

BMJ Open ◽

10.1136/bmjopen-2020-046044 ◽

2021 ◽

Vol 11 (3) ◽

pp. e046044

Author(s):

Antonio Giampiero Russo ◽

Marino Faccini ◽

Walter Bergamaschi ◽

Antonio Riussi

Keyword(s):

High Risk ◽

Health Outcomes ◽

Population Based ◽

Population Based Study ◽

High Risk Patients ◽

Risk Of Death ◽

Adverse Health ◽

Adverse Health Outcomes ◽

Risk Patients ◽

Overall Mortality

ObjectivesThis study describes a new strategy to reduce the impact of COVID-19 on the elderly and other clinically vulnerable subjects, where general practitioners (GPs) play an active role in managing high-risk patients, reducing adverse health outcomes.DesignRetrospective cohort study.SettingPopulation-based study including subjects resident in the province of Milan and Lodi.Participants127 735 residents older than 70 years, with specific chronic conditions.InterventionsWe developed a predictive algorithm for overall mortality risk based on demographic and clinical characteristics. All residents older than 70 years were classified as being at low or high risk of death from COVID-19 infection according to the algorithm. The high-risk group was assigned to their GPs for telephone triage and consultation. The high-risk cohort was divided into two groups based on GP intervention: patients who were not contacted and patients who were contacted by their GPs.Outcome measuresOverall mortality, COVID-19 morbidity and hospitalisation.ResultsPatients with increased risk of death from COVID-19 were 127 735; 495 669 patients were not at high risk and were not included in the intervention. Out of the high-risk subjects, 79 110 were included but not contacted by their GPs, while 48 625 high-risk subjects were included and contacted. Overall mortality, morbidity and hospitalisation was higher in high-risk patients compared with low-risk populations. High-risk patients contacted by their GPs had a 50% risk reduction in COVID-19 mortality, and a 70% risk reduction in morbidity and hospitalisation for COVID-19 compared with non-contacted patients.ConclusionsThe study showed that, during the COVID-19 outbreak, involvement of GPs and changes in care management of high-risk groups produced a significant reduction in all adverse health outcomes.

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