scholarly journals Nutritional Vulnerability: The Complexity of Preparing Older Veterans for Surgery

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 773-773
Author(s):  
Kathyrn Starr ◽  
Nancy Loyack ◽  
Shelley McDonald ◽  
Mitchell Heflin ◽  
Sandhya Lagoo-deenadayalan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Best Practices ◽  
Perioperative Period ◽  
Nutritional Risk ◽  
Interprofessional Team ◽  
Poor Nutritional Status ◽  
History Of ◽  
Risk Situation ◽  
High Risk Situation ◽  
History Of Depression

Abstract Poor nutritional status leads to postoperative complications, infections, poor healing, and increased mortality, creating a high-risk situation for older adults undergoing surgery. Psychosocial and environmental factors, including socioeconomic disadvantage, disability, social isolation and depression, are known precipitators of nutritional risk. However, these potentially modifiable concerns are rarely taken into consideration preoperatively. In 736 older Veterans preparing for surgery, we found 42% reported it was hard/somewhat hard to pay for basic needs, 6% reported sometimes/often times not having enough to eat, 24% reported living along, 47% reported needing assistance with 1 or more IADLs, and 42% reported a history of depression. Findings from older, Veterans, illustrate the prevalence of psychosocial and environmental risk factors prior to surgery. Best practices for identifying these factors, the importance of an interprofessional team for intervening, and specific resources that can be utilized throughout the perioperative period to improve outcomes will be presented.

Sleep, Pain, and Cognition: Modifiable Targets for Optimal Perioperative Brain Health

2021 ◽  
Author(s):  
Brian P. O’Gara ◽  
Lei Gao ◽  
Edward R. Marcantonio ◽  
Balachundhar Subramaniam
Keyword(s):  
Risk Factors ◽  
Best Practices ◽  
Postoperative Delirium ◽  
Strong Predictor ◽  
Perioperative Period ◽  
Multimodal Analgesia ◽  
Neurocognitive Disorders ◽  
Brain Health ◽  
Multiple Risk Factors ◽  
Preventative Approach

The prevention of perioperative neurocognitive disorders is a priority for patients, families, clinicians, and researchers. Given the multiple risk factors present throughout the perioperative period, a multicomponent preventative approach may be most effective. The objectives of this narrative review are to highlight the importance of sleep, pain, and cognition on the risk of perioperative neurocognitive disorders and to discuss the evidence behind interventions targeting these modifiable risk factors. Sleep disruption is associated with postoperative delirium, but the benefit of sleep-related interventions is uncertain. Pain is a risk factor for postoperative delirium, but its impact on other postoperative neurocognitive disorders is unknown. Multimodal analgesia and opioid avoidance are emerging as best practices, but data supporting their efficacy to prevent delirium are limited. Poor preoperative cognitive function is a strong predictor of postoperative neurocognitive disorder, and work is ongoing to determine whether it can be modified to prevent perioperative neurocognitive disorders.

scholarly journals History of Depression and Increased Risk of Sternal Wound Infection After Cardiothoracic Surgery: A Novel and Potentially Modifiable Risk Factor

2019 ◽  
Vol 6 (3) ◽  
Author(s):  
Deborah A Theodore ◽  
Renee D Goodwin ◽  
Yuan (Vivian) Zhang ◽  
Nancy Schneider ◽  
Rachel J Gordon
Keyword(s):  
Risk Factors ◽  
Wound Infection ◽  
Medical Center ◽  
Academic Medical Center ◽  
Cardiothoracic Surgery ◽  
Sternal Wound Infection ◽  
Composite Variable ◽  
Increased Risk ◽  
History Of ◽  
History Of Depression

Abstract Background Sternal wound infection (SWI) is a leading cause of postoperative disease and death; the risk factors for SWI remain incompletely understood. The goal of the current study was to investigate the relationship between a preoperative history of depression and the risk of SWI after cardiothoracic surgery. Methods Among patients undergoing cardiothoracic surgery in a major academic medical center between 2007 and 2012, those in whom SWI developed (n = 129) were matched, by date of surgery, with those in whom it did not (n = 258). Multivariable logistic regression was used to examine the strength of relationships between risk factors and development of infection. History of depression was defined as a composite variable to increase the sensitivity of detection. Results History of depression as defined by our composite variable was associated with increased risk of SWI (adjusted odds ratio, 2.4; 95% confidence interval, 1.2–4.7; P = .01). Staphylococcus aureus was the most common organism isolated. Conclusions History of depression was associated with increased risk of SWI. Future prospective studies are warranted to further investigate this relationship. Depression is highly treatable, and increased efforts to identify and treat depression preoperatively may be a critical step toward preventing infection-related disease and death.

History of Depression and Other Psychiatric Illness as Risk Factors for Alzheimer Disease in a Twin Sample

1999 ◽  
Vol 13 (1) ◽  
pp. 47-52 ◽  
Author(s):  
Julie Loebach Wetherell ◽  
Margaret Gatz ◽  
Boo Johansson ◽  
Nancy L. Pedersen
Keyword(s):  
Risk Factors ◽  
Alzheimer Disease ◽  
Psychiatric Illness ◽  
History Of ◽  
History Of Depression

Abstract 138: Characterizing Depressed Symptoms in Younger Women and Men Who Experienced an Acute Myocardial Infarction: Insights from the VIRGO Study

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Kim Smolderen ◽  
Kelly Strait ◽  
Dreyer Rachel ◽  
Gail D’Onofrio ◽  
Shengfan Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Depressive Symptoms ◽  
Cardiovascular Risk ◽  
Health Status ◽  
Symptom Burden ◽  
Prior History ◽  
Younger Women ◽  
History Of ◽  
History Of Depression

Background: This study aimed to determine the prevalence of the depressive symptom burden among younger men and women, and to better characterize those experiencing depressive symptoms in the weeks leading up to their AMI. Method: The VIRGO study enrolled 3,572 AMI patients (2:1 ratio for women: men; 67.1% women) between 2008 and 2012 (103 US hospitals, 24 in Spain and 3 in Australia) at their index AMI admission. The PHQ-9 (clinically relevant depressive symptoms = PHQ-9 scores ≥10) was administered to assess patients’ depressive symptoms. Demographic, socio-economic, cardiovascular risk, AMI risk factor, perceived stress (PSS-14), and health status information (Seattle Angina Questionnaire [SAQ], EQ-5D) was obtained through patient interviews during the index hospitalization and medical chart abstraction. Information about history of depression was also documented through interviews. Results: A total of 886 (39%) women experienced clinically relevant depressive symptoms vs. 245 (22%) men (P<0.0001). Overall, about half (n=1141, 48%) of women reported a prior history of depression vs. 1 in 4 in men (n=280, 24%) (P<0.0001). Women had higher rates of somatic depressive symptoms (10% vs. 6% in men), as well as a combination of cognitive and somatic symptoms of depression (23% vs. 11% in men) (P<0.0001). High levels of stress (mean score 32±8 vs. 21±8 for men; 34±8 vs. 23±8 for women on PSS-14) and low quality of life scores (mean SAQ Quality of Life score 50±22 vs. 63±21 for men; 45±25 vs. 61±22 for women) were noted among depressed patients, regardless of their gender (all P-values <0.0001 for depressed vs. non-depressed). In both women and men, depression was more prevalent among patients with a lower socio-economic profile (e.g. lower education, uninsured), among those with cardiovascular risk factors (e.g. diabetes, smoking). As compared with men, women had a 2.28-increased odds of experiencing depressive symptoms. This relationship persisted after adjusting for demographic, socio-economic, cardiovascular and AMI risk factors, and health status (OR=1.64; 95%CI 1.36, 1.98). Conclusions: A high depressive symptom burden and prior history of depression was observed among younger women admitted with AMI. Regardless of gender, depression affected those with a lower socio-economic status and cardiovascular risk factors; it was also accompanied with high levels of stress and worse health status. Targeted interventions and preventive strategies should consider addressing this high burden of depressive symptoms among younger depressed AMI patients.

Suicide Among Chinese Schizophrenics in Hong Kong

1989 ◽  
Vol 154 (2) ◽  
pp. 243-246 ◽  
Author(s):  
K. K. Cheng ◽  
C. M. Leung ◽  
W. H. Lo ◽  
T. H. Lam
Keyword(s):  
Risk Factors ◽  
Attempted Suicide ◽  
Descriptive Study ◽  
Time Of Death ◽  
Age At Death ◽  
Duration Of Illness ◽  
History Of ◽  
The Mean ◽  
Suicidal Ideas ◽  
History Of Depression

A descriptive study of suicides in 74 Chinese schizophrenic out-patients (43 male) is presented. The mean age at death was 31.3 years. The mean duration of illness was 8.5 years and 50 of the 74 died within ten years of onset of illness. Only five lived alone; 35 were openly employed and 20 were married at the time of death. Twenty had a history of depression, and 27 had attempted suicide previously. More females had been depressed or had attempted suicide than males. Over half were last admitted for reasons other than schizophrenic symptoms alone and ten died within one month of discharge. Eight of 71 patients followed up expressed suicidal ideas at the last psychiatric contact, but only 15 were symptomatic. Jumping was the commonest method used. Analytical studies are needed to identify risk factors in Chinese schizophrenics.

Markers for depression in Alzheimer's disease

2006 ◽  
Vol 18 (1) ◽  
pp. 25-29 ◽  
Author(s):  
Ruud van Winkel ◽  
Albert F. G. Leentjens ◽  
Frans R. J. Verhey
Keyword(s):  
Risk Factors ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
General Population ◽  
Logistic Model ◽  
Predictive Power ◽  
History Of ◽  
Independent Marker ◽  
History Of Depression ◽  
Disease Specific

Objective:The aim of this study was to evaluate whether risk factors for depression in the general population are also markers for depression in Alzheimer's disease (AD) and to identify additional disease-specific markers for depression in AD.Patients and methods:A logistic model of five risk factors for depression in the general population was constructed using the data of 217 patients with AD, of whom 63 (29%) suffered from major depressive disorder. In a next step, five potential disease-specific markers were individually added to this model to see whether the strength and predictive power of the model would improve.Results:The multivariate model of five risk factors for depression in the general population was not a good model to predict depression in AD. In this multivariate approach, only ‘a history of depression’ was an independent marker for depression. The only disease-specific variable that improved the logistic model was ‘disability due to AD’. An interaction between these two markers became apparent.Conclusions:Of the established risk factors for depression in the general population, only ‘a history of depression’ was found to be an independent marker for depression in AD. ‘Disability due to AD’ was the only disease-related marker for depression in AD, although this marker cannot be considered specific for AD. The importance of controlling for general risk factors for depression in the search for disease-specific markers for depression in AD is stressed.

Poverty, violence and depression during pregnancy: a survey of mothers attending a public hospital in Brazil

2005 ◽  
Vol 35 (10) ◽  
pp. 1485-1492 ◽  
Author(s):  
GIOVANNI MARCOS LOVISI ◽  
JOSÉ RAMON R. A. LÓPEZ ◽  
EVANDRO SILVA FREIRE COUTINHO ◽  
VIKRAM PATEL
Keyword(s):  
Risk Factors ◽  
Public Hospital ◽  
Social Deprivation ◽  
Previous History ◽  
Psychosocial Interventions ◽  
Intimate Relationship ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
History Of ◽  
History Of Depression

Background. Depression in women is associated with social deprivation and violence. We describe the prevalence and risk factors for depression during pregnancy, in particular the association with poverty and violence, in a Brazilian setting.Method. A cross-sectional survey of women in the third trimester of pregnancy attending a public hospital maternity clinic from August 2003 to July 2004 in Rio de Janeiro. Participants were interviewed about their sociodemographic status, obstetric and medical conditions, substance use, stressful life events, and social support. Depression was diagnosed through the Composite International Diagnostic Interview (CIDI).Results. A total of 230 of 240 eligible women consented to participate. The 12-month prevalence of depression was 19·1% (95% CI 14·4–24·9). On multivariate analyses, having been educated beyond primary school was protective (OR 0·5, 95% CI 0·2–0·9). Risk factors were: being divorced or widowed (OR 4·9, 95% CI 1·3–18·3); a history of depression before pregnancy (OR 7·9, 95% CI 3·1–20·5); loss of an intimate relationship (OR 8·4, 95% CI 3·3–21·4), experienced financial difficulties (OR 6·6, 95% CI 2·5–17·2) and having been exposed to violence in the previous year (OR 4·2, 95% CI 1·5–11·8).Conclusions. Depression is common during pregnancy and is associated with indicators of socio-economic deprivation, violence and the loss of an intimate relationship, and with a previous history of depression. Psychosocial interventions and appropriate social policies need to be implemented in this population to reduce the burden of maternal depression.

scholarly journals History of premorbid depression is a risk factor for COVID-related mortality: Analysis of a retrospective cohort of 1,387 COVID+ patients

2020 ◽  
Author(s):  
Sean Clouston ◽  
Benjamin J Luft ◽  
Edward Sun
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Models ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
History Of ◽  
History Of Depression ◽  
Related Mortality

Background: The goal of the present work was to examine risk factors for mortality in a 1,387 COVID+ patients admitted to a hospital in Suffolk County, NY. Methods: Data were collated by the hospital epidemiological service for patients admitted from 3/7/2020-9/1/2020. Time until final discharge or death was the outcome. Cox proportional hazards models were used to estimate time until death among admitted patients. Findings: In total, 99.06% of cases had resolved leading to 1,179 discharges and 211 deaths. Length of stay was significantly longer in those who died as compared to those who did not p=0.007). Of patients who had been discharged (n=1,179), 54 were readmitted and 9 subsequently died. Multivariable-adjusted Cox proportional hazards regression revealed that in addition to older age, male sex, and heart failure, a history of premorbid depression was a risk factor for COVI-19 mortality. Interpretation: While an increasing number of studies have shown effects linking cardiovascular risk factors with increased risk of mortality in COVID+ patients, this study reports that history of depression is a risk factor for COVID mortality.

scholarly journals Risk factors for acute otitis media in primary school children: a case-control study in Central Java, Indonesia

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Siwi Pramatama Wijayanti ◽  
Daniel Joko Wahyono ◽  
Dwi Sarwani Sri Rejeki ◽  
Devi Octaviana ◽  
Aris Mumpuni ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nutritional Status ◽  
Primary School ◽  
Otitis Media ◽  
School Children ◽  
Acute Otitis Media ◽  
Primary School Children ◽  
Central Java ◽  
Poor Nutritional Status ◽  
History Of

Background: Acute otitis media (AOM) is the most common disease in young children requiring antibiotic treatment. Information on AOM-related determinant risk factors in primary school children is still limited, particularly in Indonesia. This study aims to identify risk factors related to AOM in primary school children in Banyumas Regency, Central Java, Indonesia.Design and Methods: This is an analytical study with a case-control design in Banyumas Regency, Indonesia. 3574 children from 6 regions of the Banyumas Regency were recruited for the screening of AOM detection, and confirmation of AOM diagnosis was determined by Otolaryngologist. One hundred and twenty-five cases and 125 control were involved in this study. Data collection was carried out using a structured questionnaire focusing on several variables such as household cooking fuel, house environment, smoking exposure, knowledge of parents, and nutrition status. Univariate, bivariate using chi-square and multivariate with regression logistic was conducted for data analysis. Results: This study highlights the risk of household firewood use (p=0.003), poor nutritional status (p=0.009), and a family history of ear infections (p=0.015) with an increased risk of otitis media.Conclusions: Household firewood use, poor nutritional status and family history of ear infection are factors associated with the occurrence of acute otitis media. It is necessary to provide public health education to prevent exposure to fuel at risk for children and to improve their nutritional status.

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