scholarly journals Association of Social Determinants, Multimorbidity, and Functional Status with Mortality after Pneumonia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 627-627
Author(s):  
Chan Mi Park ◽  
Hye Chang Rhim ◽  
Eun Sik Lee ◽  
Wonsock Kim ◽  
Jong Hun Kim ◽  
...  
Keyword(s):  
Social Support ◽  
Activities Of Daily Living ◽  
Functional Status ◽  
Daily Living ◽  
Social Deprivation ◽  
University Hospital ◽  
Survival Times ◽  
Group A ◽  
Group B ◽  
Score Range

Abstract Social support, multimorbidity, and functional status are important determinants of health in older adults, but their prognostic implications remain unclear after an acute illness. We conducted a prospective cohort study of 201 patients 65 years or older who were hospitalized for pneumonia at a university hospital in Korea in 2019-2020. K-means cluster analysis was performed using social deprivation score (range: 0-5), activities of daily living (range: 0-7), instrumental activities of daily living (range: 0-7), physical limitation score (range: 0-7), and Gagne comorbidity index (range: 0-24) (higher scores indicate higher risk). Four groups were identified: 1) Group A: physically limited and non-disabled group with limited social support; 2) Group B: multimorbid but functional group with social support; 3) Group C: multimorbid and disabled group with social support; 4) Group D: multimorbid and disabled group with limited social support. For Groups A through D, the Kaplan-Meir estimates for 6-month mortality were 10.0%, 18.0%, 34.2%, and 43.6%, respectively, and the 6-month mean survival times were 166.4 days (95% CI: 156.1-176.6), 156.9 days (95% CI: 140.8-173.1), 145.2 days (95% CI: 126.6-163.8), and 125.9 days (95% CI: 107.7-144.1), respectively. After adjusting for sex, age, and pneumonia severity score, the hazard ratios for Groups B through D versus Group A were 2.07 (95% CI: 0.70-6.13), 3.14 (95% CI: 1.17-8.42), and 4.38 (95% CI: 1.73-11.04), respectively. Our results suggest that multimorbidity and disabilities were implicated in higher risk of 6-month mortality after pneumonia, and social support may mitigate this risk among those with multimorbidity and disability.

scholarly journals Changes in Functional Status Among Clusters of Older Adults After Hospitalization for Pneumonia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 595-596
Author(s):  
Chan Mi Park ◽  
Hye Chang Rhim ◽  
Eun Sik Lee ◽  
Wonsock Kim ◽  
Jong Hun Kim ◽  
...  
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Activities Of Daily Living ◽  
Functional Status ◽  
Functional Recovery ◽  
Daily Living ◽  
Social Deprivation ◽  
Group A ◽  
Group B ◽  
Group D

Abstract Little is known about how social determinants, comorbidity, and disability status are associated with functional recovery after an acute illness. A prospective cohort study was conducted between 2019-2020 at a university hospital in Korea, to investigate functional recovery after hospitalization for pneumonia in older adults with different degrees of social deprivation, disabilities, and comorbidities. K-means cluster analysis was used to identify groups of patients based on social deprivation score, activities of daily living, instrumental activities of daily living, physical limitation score, and Gagne comorbidity index. Four groups were identified: Group A: non-disabled group with limited social support (n=61 [30.3%]); Group B: multimorbid but non-disabled group with social support (n=45 [22.4%]); Group C: multimorbid and disabled group with social support (n=38 [18.9%]); Group D: multimorbid and disabled group with limited social support (n=57 [28.4%]). Functional status, defined as ability to perform 21 activities and physical tasks independently, was measured via telephone interviews at 1, 3, and 6 months after discharge. Group-based trajectory model identified four functional status trajectories: excellent (n=29 [14.4%]), good (n=51 [25.4%]), fair (n=58 [28.9%]) and poor (n=63 [31.3%]). The most common functional trajectory by four groups was good trajectory (59%) in Group A, excellent trajectory (48.9%) in Group B, fair (50%) and poor trajectory (50%) in Group C, and poor trajectory (77.2%) in Group D. Our results suggest that most patients without disability recover functional status after pneumonia, despite multimorbidity or limited social support. Social support seems to be more important for those with multimorbidity and disability.

scholarly journals Effects of lumbar corset on the patients with lumbar spondylosis

2014 ◽  
Vol 42 (2) ◽  
pp. 55-59
Author(s):  
MT Islam ◽  
MA Shakoor ◽  
MA Emran ◽  
KMT Islam ◽  
MG Nobi ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Female Ratio ◽  
Lumbar Spondylosis ◽  
End Of Treatment ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Medical University ◽  
Male To Female

This experimental study was done in the Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University to find out the effects of lumbar corset on the patients with lumbar spondylosis. Ninety seven patients were selected in the study. Out of them 40(41.24%) were male and 57(58.76%) were female. The male to female ratio was 1:1.42. The mean age was 41.22 ± 8.52 years. The patients were divided into two groups, 50 patients in group A ( Treated with NSAID, activities of daily living instructions and lumbar corset) and another 47 patients in group B (Treated with NSAID and activities of daily living instructions only ). In both the groups, patients were treated for six weeks and assessed at 7 days interval. Improvement was noticed in both the groups in every visit but there was no difference in improvement between the groups till 4th week of treatment. At the end of treatment group A showed statistically significant difference in overall improvement in comparison to group B. So, from the present study, it may be concluded that lumbar corset is beneficial to the patients with lumbar spondylosis. DOI: http://dx.doi.org/10.3329/bmj.v42i2.18987 Bangladesh Med J. 2013 May; 42 (2): 55-59

Aspects of Functional Abilities Changes in Aging

2016 ◽  
Vol 859 ◽  
pp. 236-240
Author(s):  
Elena Lupeanu ◽  
Mihaela Elena Ulmeanu ◽  
Anca Iovita ◽  
Rodica Hnidei
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Functional Limitations ◽  
Age Groups ◽  
Significant Negative Correlation ◽  
Assistive Technologies ◽  
Functional Abilities ◽  
Group A ◽  
Group B ◽  
Group D

The aim of this study is to assess functional status and prevalence of functional limitations/disabilities in aging, in order to identify possible strategies in assistive technologies. Investigations were undertaken on 138 patients, men and women, aged between 45 and 90 years, divided into four age groups: group A patients aged 50 - 59 years; group B aged 60 - 69 years; group C aged 70 - 79 years; group D aged 80 - 92 years. The results showed significant reduction in the ability to carry out basic activities of daily living (ADL) in patients aged 80 - 90+ years compared to patients aged 45-59 years (p = 0.05) and those of 60-69 years old (p = 0.043). Ability to carry out instrumental activities of daily living (IADL) was significantly reduced (p = 0.0503) in patients aged 70-79 years compared with patients aged 45-59 years and 60-69 years. Patients older than 80 years showed significant reduction ability to conduct IADLs compared to patients aged 45-59 years (p = 0.0047), aged 60-69 years (p = 0.0049) and aged 70-79 years (p = 0.029). There was a significant negative correlation of ADL (r = - 0.25, p <0.01) and IADL (r = - 0.39; p <0.01) with patients age. In conclusion, ADLs decline appears relatively late, after 80 years, while IADLs begins at about the age of 70 years. Seniors which experience decline in ADLs and IADLs can benefit from a variety of assistive technologies which promote independence and safety as they compensate for sensory, physical and cognitive impairments.

Association between baseline geriatric domains and survival in older adults with chronic lymphocytic leukemia (CLL).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 12041-12041
Author(s):  
Julia Rice ◽  
Ryan David Nipp ◽  
Daniel E Lage ◽  
Ashley M. Nelson ◽  
Richard Newcomb ◽  
...  
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Nutritional Status ◽  
Activities Of Daily Living ◽  
Functional Status ◽  
Clinical Outcomes ◽  
Daily Living ◽  
Social Activity ◽  
Psychological Status ◽  
Timed Up And Go

12041 Background: CLL is a disease that commonly affects older adults. Although the value of geriatric assessment is increasingly being recognized in older adults with cancer, few studies have examined the relationship between baseline geriatric domains and clinical outcomes in older adults with CLL. Methods: We conducted a secondary data analysis of 369 adults diagnosed with CLL and treated in a phase 3 randomized trial of patients age ≥65 with bendamustine plus rituximab versus ibrutinib plus rituximab versus ibrutinib alone. We evaluated geriatric domains of functional status (activities of daily living [ADL], instrumental activities of daily living [IADL], Timed “Up and Go,” and number of falls in last 6 months), psychological status (Mental Health Inventory), social activity (Medical Outcomes Study [MOS] Social Activity Survey), cognition (Blessed Orientation Memory Concentration Test), social support (MOS Social Support Tangible and Emotional/Informational subscales), and nutritional status ( > 5% weight loss in the preceding 6 months). We examined associations among baseline geriatric domains with overall survival (OS) and progression-free survival (PFS) using multivariable Cox regression models. Results: The median age of patients was 71 years (range: 65-89). Most were male (67.1%) and had an ECOG performance status of 0 or 1 (96.9%). In multivariable models, the following geriatric domains were significantly associated with OS: better functional status (ADL score: HR 0.67, p = 0.012; IADL score: HR 0.98, p = 0.007); social activity score (HR 0.97, p = 0.004); and nutritional status (HR 2.58, p = 0.008). Similarly, functional status (ADL score: HR 0.77, p = 0.028; IADL score: HR 0.99, p = 0.007); social activity score (HR 0.97, p < 0.001); and nutritional status (HR 2.87, p < 0.001) were all associated with PFS. Additionally, the number of impaired geriatric domains was also associated with OS (HR 1.50, p = 0.004) and PFS (HR 1.45, p < 0.001). Timed “Up and Go”, number of falls in last 6 months, psychological status, cognition, and social support were not significantly associated with clinical outcomes. Conclusions: Geriatric domains of functional status, social activity, and nutritional status were associated with OS and PFS in this cohort of older adults with CLL. These findings highlight the importance of assessing geriatric domains to identify high-risk patients with CLL who may benefit from additional support during their treatment.

scholarly journals The effect of stretching exercise in the management of lateral epicondylitis

2014 ◽  
Vol 43 (2) ◽  
pp. 61-66 ◽  
Author(s):  
Md Nuruzzaman Khandaker ◽  
Samprity Islam ◽  
Md Ali Emran ◽  
Jahidul Islam ◽  
Syed Mozzafar Ahmed ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Lateral Epicondylitis ◽  
Weekly Interval ◽  
Ultrasound Therapy ◽  
Physical Medicine ◽  
Early Recovery ◽  
Pain Frequency ◽  
Group A ◽  
Group B

This comparative study was conducted on patients of lateral epicondylitis attending at Physical Medicine and Rehabilitation Department of BSMMU, Dhaka from June to November 2010 with an aim to assess the effect of stretching exercise in patients of lateral epicondylitis of elbow. Eighty consecutive patients of lateral epicondylitis were randomly assigned to two groups. In group A, patients were treated with stretching exercise, ultrasound therapy (UST), NSAID, advice regarding activities of daily living. In group B, patients were treated with ultrasound therapy (UST), NSAID and advice regarding activities of daily living. The outcome was evaluated at weekly interval for 6 weeks in terms of pain, tenderness and frequency of pain. At 2nd week, the pain in group-A came to satisfactory level, but in group-B, it became so at 4th week. The improvement of tenderness was observed at 2nd and 3rd week in group A and group B respectively, but the improvement in pain frequency achieved at 2nd and 4th week in group-A and group-B respectively. The study concludes that stretching exercise is helpful in the early recovery from lateral epicondylitis, majority of the cases experiencing improvement in pain (both in terms intensity and frequency) and tenderness. DOI: http://dx.doi.org/10.3329/bmj.v43i2.21384 Bangladesh Med J. 2014 May; 43 (2): 61-66

Inflammation, Functional Status, and Weight Loss During Recovery From Cardiac Surgery in Older Adults

2013 ◽  
Vol 16 (3) ◽  
pp. 344-352 ◽  
Author(s):  
Rose Ann DiMaria-Ghalili ◽  
Eileen M. Sullivan-Marx ◽  
Charlene Compher
Keyword(s):  
Weight Loss ◽  
Cardiac Surgery ◽  
Activities Of Daily Living ◽  
Functional Status ◽  
Grip Strength ◽  
Daily Living ◽  
Community Dwelling ◽  
Chair Stand ◽  
Prospective Longitudinal ◽  
Over Time

Objective: To determine the nutritional, inflammatory, and functional aspects of unintentional weight loss after cardiac surgery that warrant further investigation. Research Methods and Procedures: Twenty community-dwelling adults > 65 years old undergoing cardiac surgery (coronary artery bypass graft [CABG] or CABG + valve) were recruited for this prospective longitudinal (preoperative and 4–6 weeks postdischarge) pilot study. Anthropometrics (weight, standing height, and mid-arm and calf circumference), nutritional status (Mini-Nutritional Assessment™ [MNA]), appetite, physical performance (timed chair stand), muscle strength (hand grip) and functional status (basic and instrumental activities of daily living), and inflammatory markers (plasma leptin, ghrelin, interleukin [IL]-6, high-sensitivity[hs] C-reactive protein, and serum albumin and prealbumin) were measured. Results: Participants who completed the study ( n = 11 males, n = 3 females) had a mean age 70.21 ± 4.02 years. Of these, 12 lost 3.66 ± 1.44 kg over the study period. Weight, BMI, activities of daily living, and leptin decreased over time ( p < .05). IL-6 increased over time ( p < .05). Ghrelin, hs-CRP, and timed chair stand increased over time in those who underwent combined procedures ( p < .05). Grip strength decreased in those who developed complications ( p = .004). Complications, readmission status, and lowered grip strength were found in those with low preoperative MNA scores ( p < .05). Conclusion: After cardiac surgery, postdischarge weight loss occurs during a continued inflammatory response accompanied by decreased physical functioning and may not be a positive outcome. The impacts of weight loss, functional impairment, and inflammation during recovery on disability and frailty warrant further study.

Comparison of Outcome of one Versus two Drains Insertion for Seroma Formation Following Modified Radical Mastectomy in Breast Carcinoma

2021 ◽  
Vol 17 (1) ◽  
pp. 52-55
Author(s):  
Shiraz Shaikh ◽  
Ambreen Munir ◽  
Shahnawaz Abro ◽  
Shahida Khatoon ◽  
Zameer Hussain Laghari ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
General Surgery ◽  
Stable Condition ◽  
Radical Mastectomy ◽  
Seroma Formation ◽  
University Hospital ◽  
P Value ◽  
Modified Radical Mastectomy ◽  
Group A ◽  
Group B

Objective: Comparative outcome of one versus two drains insertion for in the term of seroma formation following modified radical mastectomy in breast carcinoma. Methodology: This Prospective Interventional trial was conducted at Department of General Surgery, Liaquat University Hospital Hyderabad from February 2018 to January 2019.  Females with breast carcinoma admitted for modified radical mastectomy were included. Patients were divided into two groups.  Groups I underwent one drain placement and group II underwent two drains placement. All patients were observed to measure and record the volume of the fluid. Patients were discharged from Hospital in stable condition and after removal of drains, and followed up weekly for one month. Data was recorded on self-made proforma and analyzed by using SPSS-20. Results: Total of 80 patients were selected, 38 in group A and 42 in group B. Mean age of patients of group A was 49.08 ± 9.89 years and group B was 51.40 ± 13.59 years. , Excised Mass weight was lesser in group A as compared to group B. Mean volume of drain discharge was significantly higher in Group B 323.43 ± 158.88 ml, while it was in group A 230.29± 200.98, findings were statistically significant 0.013. Seroma formation was statistically insignificant among both groups as 8(21.1%) in group A and   10(23.8%) in group B, p-value 0.768. Conclusion: One-drain and two-drain insertion are equally effective to reduce the seroma formation after modified radical mastectomy; however, one drain insertion leads to more patient compliance and comfort with probably less morbidity and cost.

A Comparative Study of Epidemiology, Clinicopathologic Features and Outcome of Colorectal Cancer Patients between Ain Shams University Hospitals and Luxor International Hospital

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Tarek Hussein Kamel ◽  
Amr Lotfy Farag ◽  
Dr/Sherif Hassanin Ahmed ◽  
Chresteen Talaat Samy Hanna
Keyword(s):  
Colorectal Cancer ◽  
Comparative Study ◽  
Disease Free Survival ◽  
University Hospital ◽  
Treatment Modalities ◽  
Clinicopathologic Features ◽  
Free Survival ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background Colorectal cancer (CRC) is one of the leading causes of mortality and morbidity in the world. It is the third most common malignancy after lung & breast and the fourth leading cause of cancer-related deaths worldwide, accounting for approximately 1,400,000 new cases and about 700,000 deaths worldwide. Objectives The aim of this retrospective study is to compare the epidemiology, clinicopathologic features, different treatment modalities and outcomes regarding disease free survival (DFS), progression free survival (PFS) & overall survival (OS) of colorectal cancer disease between cases presented to Ain shams university hospital & to Luxor international hospital in 3 consecutive years. Patients and Methods The study is retrospective comparative study. Clinical oncology department in Ain Shams University Hospital and Luxor International Hospital. The data Collected from January 2013 to December 2015. This study analyzed hospital records of patients who diagnosed with colorectal cancer (CRC) and allocated into two groups: Group A: CRC patients presented to Ain-Shams University Hospital from January 2013 to December 2015, group B: CRC patients presented to Luxor International Hospital from January 2013 to December 2015. Results There was no statistically significant difference regarding age parameter in LIH when compared to ASU, but the study was consistent with higher incidence in patients who were aged more than forty- accounted about 70.5% in all CRC cases. Cases less than 40 years old, in group A were 35.2%, while in Group B were 23.5%. Even there was no statistically significant difference but it may be attributable to more westernization in Lower Egypt. Other explanation may be due to decreased low socioeconomic status and different lifestyle factors in more developing region what increase risk of colorectal cancer. Among our cases, there is no statistically significant difference regarding gender between the two hospitals. Both sexes almost were affected equally, females appeared to be at a slightly higher risk of developing CRC cancer with current prevalence 1.3:1 in ASU group, and 1.1:1 in LIH group. Conclusion The need to increase awareness about CRC in Egypt especially upper Egypt, is recommended. An awareness campaign should be performed to promote detection of CRC at its earliest and most curable stage by recognizing early symptoms and enabling early referrals for colonoscopy. Those at higher risk should be offered more intensive surveillance. Similarity of the data from different centers suggests that this is the picture of colorectal cancer typical of Egypt.

Social isolation, loneliness and functional disability in Chinese older women and men: a longitudinal study

2020 ◽  
Author(s):  
Lizhi Guo ◽  
Li An ◽  
Fengping Luo ◽  
Bin Yu
Keyword(s):  
Longitudinal Study ◽  
Activities Of Daily Living ◽  
Functional Status ◽  
Social Isolation ◽  
Daily Living ◽  
Functional Disability ◽  
Iadl Disability ◽  
Older Populations ◽  
New Onset

Abstract Objective This study investigated whether loneliness or social isolation is associated with the onset of functional disability over 4 years among Chinese older populations. Setting and Subjects This study used data from the China Health and Retirement Longitudinal Study (CHARLS). Functional status was assessed by activities of daily living (ADL) and instrumental activities of daily living (IADL). Analyses were conducted with data from two waves (2011 and 2015) and were restricted to those respondents aged 50 and older and free of functional disability at baseline [n = 5,154, mean age (SD) = 60.72 (7.51); male, 52.3%]. Method Social isolation, loneliness and covariates were measured at baseline. Follow-up measures of new-onset ADL and IADL disability were obtained 4 years later. We stratified the sample by gender, and then used binary logistic regressions to evaluate the associations between baseline isolation, loneliness and new-onset ADL and IADL disability. Results For women, baseline social isolation was significantly associated with new-onset ADL (OR = 1.18, 95% CI = 1.07–1.30) and IADL (OR = 1.11, 95% CI = 1.01–1.21) disability; no significant association between loneliness and ADL or IADL disability was found. For men, neither social isolation nor loneliness was found to be significantly associated with ADL or IADL disability. Conclusion This longitudinal study found that social isolation, rather than loneliness, was significantly associated with functional disability over 4 years among women (but not men) in China. These findings expand our knowledge about the association between social relationships and functional status among non-Western populations.

scholarly journals Role of SatO2, PaO2/FiO2 Ratio and PaO2 to Predict Adverse Outcome in COVID-19: A Retrospective, Cohort Study

2021 ◽  
Vol 18 (21) ◽  
pp. 11534
Author(s):  
Stefano Sartini ◽  
Laura Massobrio ◽  
Ombretta Cutuli ◽  
Paola Campodonico ◽  
Cristina Bernini ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Adverse Outcome ◽  
University Hospital ◽  
Rt Pcr ◽  
Threatening Condition ◽  
Life Threatening ◽  
Group A ◽  
Group B ◽  
The University

COVID-19 respiratory failure is a life-threatening condition. Oxygenation targets were evaluated in a non-ICU setting. In this retrospective, observational study, we enrolled all patients admitted to the University Hospital of Genoa, Italy, between 1 February and 31 May 2020 with an RT-PCR positive for SARS-CoV-2. PaO2, PaO2/FiO2 and SatO2% were collected and analyzed at time 0 and in case of admission, patients who required or not C-PAP (groups A and B) were categorized. Each measurement was correlated to adverse outcome. A total of 483 patients were enrolled, and 369 were admitted to hospital. Of these, 153 required C-PAP and 266 had an adverse outcome. Patients with PaO2 <60 and >100 had a higher rate of adverse outcome at time 0, in groups A and B (OR 2.52, 3.45, 2.01, respectively). About the PaO2/FiO2 ratio, the OR for < 300 was 3.10 at time 0, 4.01 in group A and 4.79 in group B. Similar odds were found for < 200 in any groups and < 100 except for group B (OR 11.57). SatO2 < 94% showed OR 1.34, 3.52 and 19.12 at time 0, in groups A and B, respectively. PaO2 < 60 and >100, SatO2 < 94% and PaO2/FiO2 ratio < 300 showed at least two- to three-fold correlation to adverse outcome. This may provide simple but clear targets for clinicians facing COVID-19 respiratory failure in a non ICU-setting.

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