Preoperative Falls and Their Association with Functional Dependence and Quality of Life

Abstract Background No study has rigorously explored the characteristics of surgical patients with recent preoperative falls. Our objective was to describe the essential features of preoperative falls and determine whether they are associated with preoperative functional dependence and poor quality of life. Methods This was an observational study involving 15,060 surveys from adult patients undergoing elective surgery. The surveys were collected between January 2014 and August 2015, with a response rate of 92%. Results In the 6 months before surgery, 26% (99% CI, 25 to 27%) of patients fell at least once, and 12% (99% CI, 11 to 13%) fell at least twice. The proportion of patients who fell was highest among patients presenting for neurosurgery (41%; 99% CI, 36 to 45%). At least one fall-related injury occurred in 58% (99% CI, 56 to 60%) of those who fell. Falls were common in all age groups, but surprisingly, they did not increase monotonically with age. Middle-aged patients (45 to 64 yr) had the highest proportion of fallers (28%), recurrent fallers (13%), and severe fall-related injuries (27%) compared to younger (18 to 44 yr) and older (65+ yr) patients (P < 0.001 for each). A fall within 6 months was independently associated with preoperative functional dependence (odds ratio, 1.94; 99% CI, 1.68 to 2.24) and poor physical quality of life (odds ratio, 2.18; 99% CI, 1.88 to 2.52). Conclusions Preoperative falls might be common and are possibly often injurious in the presurgical population, across all ages. A history of falls could enhance the assessment of preoperative functional dependence and quality of life.

Download Full-text

P645 Mental health, work presenteeism and exercise in IBD patients

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab076.765 ◽

2021 ◽

Vol 15 (Supplement_1) ◽

pp. S577-S577

Author(s):

M Sciberras ◽

C Nascimento ◽

T Tabone ◽

K Karmiris ◽

P Nikolaou ◽

...

Keyword(s):

Quality Of Life ◽

Demographic Data ◽

International Study ◽

Poor Quality ◽

Psychiatric Medication ◽

Active Involvement ◽

Significant Difference ◽

Previous Medication ◽

History Of

Abstract Background IBD has been shown to increase the rates of anxiety and depression amongst diagnosed individuals, with a prevalence rate of approximately 15- 20%. Chronic diseases such as IBD can have a significant impact on productivity at work (presenteeism). This can lead to emotional distress, poor quality of life and cost effects on employers. The primary aim of the study was to assess the prevalence of psychological problems, exercise levels and presenteeism at work among IBD patients. Methods This was a multicentre international study whereby IBD patients (>18 years) in clinical remission over the last year, were asked to answer an anonymous questionnaire. Demographic data, type of IBD, current and previous medication, admissions to hospital, history of psychiatric referrals, Stanford Presenteeism Scale (SPS-6), Godin Score (exercise related score) were collected. Exclusion criteria included patients with IBD flares requiring corticosteroids in the previous 12 months. Results 573 patients (CD: n=318) from 8 European Centres and Israel participated in the study. The mean patient age was 39.9 years (SD+/- 13.0). 21.6% were smokers and 48.5% were non-smokers. The rest were ex-smokers. 10.9% of patients had a diagnosis of depression/anxiety prior to the diagnosis of IBD, whereas this increased to 20.6% post-IBD diagnosis, this being significantly commoner in the CD cohort (23.0%, p<0.05) and in females (55.8%, p<0.05). 37.7% of patients had been to a psychiatrist or a psychologist (41% of CD, p<0.05) with 11.7% of patients being on psychiatric medication (14.5% of CD, p<0.05). Low presenteeism at work was evident in 34.7%, with no statistically significant difference between UC and CD patients (p=0.5). 39.9% had a Godin Exercise Score being in the active range, 38.8% had a sedentary/insufficient exercise score. The rest were moderately active. Patients diagnosed with depression/anxiety had a more sedentary lifestyle. Conclusion In our study 37.7% of patients were referred for psychological help. This can have several effects including poor presenteeism at work (34.7%) and reduced efficiency. These issues are commoner in patients with CD than in UC. Active involvement of a psychologist/ psychiatrist as part of the IBD team should be routine as to improve the patient’s quality of life.

Download Full-text

Association between Diabetes Consequences and Quality of Life among Patients with Diabetes Mellitus in the Aseer Province of Saudi Arabia

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2020.4107 ◽

2020 ◽

Vol 8 (E) ◽

pp. 325-330

Author(s):

Sultan M. Alshahrani ◽

Moferrah Alzahran ◽

Khaled Alakhali ◽

Easwaran Vigneshwaran ◽

Mir Javid Iqbal ◽

...

Keyword(s):

Quality Of Life ◽

Diabetes Mellitus ◽

Saudi Arabia ◽

Age Groups ◽

Cross Sectional ◽

Health Care Burden ◽

Patients With Diabetes ◽

History Of

BACKGROUND: Diabetes mellitus (DM) is a major health-care burden worldwide. AIM: The aim of the study was to explore how the quality of life (QoL) of DM patients could be affected in the Aseer Province of the Kingdom of Saudi Arabia (KSA). METHODS: A cross-sectional, multicenter study in DM patients of both sexes and all age groups in Aseer Province were done using a validated self-administered questionnaire. The study was conducted between April 1, 2018 and November 25, 2018. RESULTS: A total of 418 patients completed our questionnaire, of which 240 (58%) were male and 178 (42%) were female. Furthermore, 50.23% were married and 104 (24.16%) were illiterate. We found that 403 (96.42%) respondents had type-2 DM and 315 (75.35%) had a family history of DM. In addition, 132 (31.57%) respondents were on monotherapy whereas only 61 (14.59%) were using combination therapy. Hypertension was the most prevalent comorbidity (166, 39.71%) and peripheral neuropathy the most prevalent complication of DM (157, 37.56%). CONCLUSION: DM had a significant impact on QoL among patients from Aseer Province in KSA. Our study underscores the importance of generating data on QoL among DM patients.

Download Full-text

Protocol for evaluation of perioperative risk in patients aged over 75 years: Aged Patient Perioperative Longitudinal Evaluation–Multidisciplinary Trial (APPLE-MDT study)

BMC Geriatrics ◽

10.1186/s12877-020-01956-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yanhong Zhang ◽

◽

Lina Ma ◽

Tianlong Wang ◽

Wei Xiao ◽

...

Keyword(s):

Quality Of Life ◽

Decision Making ◽

Elective Surgery ◽

Aged Patient ◽

Aged Patients ◽

Surgical Decision ◽

Longitudinal Evaluation ◽

Non Local ◽

Surgical Decision Making

Abstract Background With the extended life expectancy of the Chinese population and improvements in surgery and anesthesia techniques, the number of aged patients undergoing surgery has been increasing annually. However, safety, effectiveness, and quality of life of aged patients undergoing surgery are facing major challenges. In order to standardize the perioperative assessment and procedures, we have developed a perioperative evaluation and auxiliary decision-making system named “Aged Patient Perioperative Longitudinal Evaluation–Multidisciplinary Trial (APPLE-MDT)”. Methods We will conduct a perioperative risk evaluation and targeted intervention, with follow-ups at 1, 3, and 6 months after surgery. The primary objective of the study is to evaluate the effectiveness of the “Aged Patient Perioperative Longitudinal Evaluation-Multiple Disciplinary Trial Path” (hereinafter referred to as the APPLE-MDT path) in surgical decision-making for aged patients (≥75 years) undergoing elective surgery under non-local anesthesia in the operating room. The secondary objectives of the study are to evaluate the postoperative outcome and health economics of the APPLE-MDT path applied to the surgical decision-making of aged patients (≥75 years) undergoing elective surgery under non-local anesthesia and to optimize intervention strategies for aged patients undergoing surgery to reduce the occurrence of postoperative complications and improve the quality of life after surgery. Discussion It is necessary to formulate a reliable, effective, and concise evaluation tool, which can effectively predict the perioperative complications and mortality of aged patients, support targeted intervention strategies, and allow for a more comprehensive risk and benefit analysis, thereby forming an effective senile perioperative surgery management path. It is expected that the implementation of this protocol can reduce the occurrence of postoperative complications, improve the postoperative quality of life, shorten hospital stay, reduce hospitalization expenses, reduce social burden, and allow the elderly to have a good quality of life after surgery. Trial registration ChiCTR, ChiCTR1800020363, Registered 15 December 2018.

Download Full-text

Efficacy of galcanezumab in patients with migraine and history of failure to 3–4 preventive medication categories: subgroup analysis from CONQUER study

The Journal of Headache and Pain ◽

10.1186/s10194-021-01322-7 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Rose Okonkwo ◽

Antje Tockhorn-Heidenreich ◽

Chad Stroud ◽

Marie-Ange Paget ◽

Manjit S. Matharu ◽

...

Keyword(s):

Quality Of Life ◽

Subgroup Analysis ◽

Migraine Headache ◽

Response Rate ◽

Maximum Tolerated Dose ◽

Episodic Migraine ◽

Patient Functioning ◽

Preventive Medication ◽

History Of

Abstract Background Chronic migraine (CM) and episodic migraine (EM) are associated with substantial headache-related disability, poor quality of life and global societal burden. In this subgroup analysis from the CONQUER study, we report efficacy outcomes from a pre-specified analysis of galcanezumab versus placebo in patients with CM or EM and 3–4 prior preventive medication category failures due to inadequate efficacy (after at least 2 months at maximum tolerated dose), or safety or tolerability reasons. The patient population is of particular interest due to evidence of decreased quality of life and increased economic burden among patients with migraine that is inadequately managed and is of interest to decision-makers globally. Methods Key outcomes included overall mean change from baseline in monthly migraine headache days and proportions of patients achieving ≥30% (CM), ≥50%, and ≥ 75% reduction (response rates) in monthly migraine headache days across Months 1–3. Patient functioning and disability were evaluated at Month 3. Results Of the 462 randomized patients, 186 (40.3%) had a history of 3–4 preventive category failures. Galcanezumab versus placebo resulted in significantly (P ≤ .001) larger overall mean reduction in monthly migraine headache days (total: − 5.49 versus − 1.03; CM: − 6.70 versus − 1.56; EM: − 3.64 versus − 0.65). Similarly, the ≥50% response rate was significantly (P ≤ .001) higher with galcanezumab versus placebo (total: 41.0 versus 12.7; CM: 41.5 versus 8.4; EM: 41.1 versus 16.5). In the CM group, the ≥30% response rate was significantly higher in the galcanezumab group than the placebo group (CM, 57.5 versus 19.8, P ≤ .0001) as was the ≥75% response rate (13.3 versus 2.6, P ≤ .05). Galcanezumab also resulted in significant (P < .0001) improvements in patient functioning and reductions in disability. Conclusions Galcanezumab was effective in a difficult-to-treat population of patients with CM or EM who had failed 3–4 prior preventive medication categories. Trial registration CONQUER. Clinicaltrials.gov identifier: NCT03559257.

Download Full-text

The Relationship between Non-Communicable Diseases History and Health-Related Quality of Life

Jurnal Kesehatan Masyarakat ◽

10.15294/kemas.v12i1.4853 ◽

2016 ◽

Vol 12 (1) ◽

Author(s):

Ajeng Tias Endarti ◽

Agus Handito

Keyword(s):

Quality Of Life ◽

Poor Quality ◽

Communicable Diseases ◽

Joint Disease ◽

Shortness Of Breath ◽

Non Communicable Diseases ◽

Related Quality ◽

Health Related ◽

History Of

Disaster-prone population is vulnerable for suffering non-communicable diseases (NCDs) which become risk factors for poor quality of life (QoL). The study aims at investigating the effect of history of NCDs to the QoL. QoL was measured by WHODAS. NCDs with prevalence more than 1% were involved in analysis. Those NCDs included shortness of breath, diabetes, hypertension, joint disease and stroke. Among 1,872 respondents of Riskesdas, 7.7% of them have a poor QoL, suffering hypertension (8.7%), shortness of breath (7.3%) and asthma (6.9%). Risks of poor QoL six times higher among those with a history of PTM (PORadj 5.987; 95% CI 4.210-8.514) after adjusted by age, gender, education, socioeconomic status and region of residence. Stroke gives the greatest impact with POR 25.00 (95% CI 10.406 to 60.063). We recommend that the promotion and prevention of NCDs should be integrated with both mitigation-related and community resilience activities to disasters.

Download Full-text

Predictors of Poor Quality of Life 1 Year After Subarachnoid Hemorrhage

Neurosurgery ◽

10.1227/neu.0000000000001042 ◽

2015 ◽

Vol 78 (2) ◽

pp. 256-264 ◽

Cited By ~ 29

Author(s):

Zahrah Taufique ◽

Teresa May ◽

Emma Meyers ◽

Cristina Falo ◽

Stephan A. Mayer ◽

...

Keyword(s):

Quality Of Life ◽

Subarachnoid Hemorrhage ◽

Cognitive Rehabilitation ◽

Sickness Impact Profile ◽

Multivariable Analysis ◽

Population Based ◽

Poor Quality ◽

History Of ◽

Grade 3

ABSTRACT BACKGROUND: Risk factors for poor quality of life (QOL) after subarachnoid hemorrhage (SAH) remain poorly described. OBJECTIVE: To identify the frequency and predictors of poor QOL 1 year after SAH. METHODS: We studied 1-year QOL in a prospectively collected cohort of 1181 consecutively admitted SAH survivors between July 1996 and May 2013. Patient clinical, radiographic, surgical, and acute clinical course information was recorded. Reduced QOL (overall, physical, and psychosocial) at 1 year was assessed with the Sickness Impact Profile and defined as 2 SD below population-based normative Sickness Impact Profile values. Logistic regression leveraging multiple imputation to handle missing data was used to evaluate reduced QOL. RESULTS: Poor overall QOL was observed in 35% of patients. Multivariable analysis revealed that nonwhite ethnicity, high school education or less, history of depression, poor clinical grade (Hunt-Hess Grade ≥3), and delayed infarction were predictors of poor overall and psychosocial QOL. Poor physical QOL was additionally associated with older age, hydrocephalus, pneumonia, and sepsis. At 1 year, patients with poor QOL had increased difficulty concentrating, cognitive dysfunction, depression, and reduced activities of daily living. More than 91% of patients with poor QOL failed to fully return to work. These patients frequently received physical rehabilitation, but few received cognitive rehabilitation or emotional-behavioral support. CONCLUSION: Reduced QOL affects as many as one-third of SAH survivors 1 year after SAH. Delayed infarction is the most important in-hospital modifiable factor that affects QOL. Increased attention to cognitive and emotional difficulties after hospital discharge may help patients achieve greater QOL.

Download Full-text

Metabolic Syndrome and Military Policemen’s Quality of Life

American Journal of Men s Health ◽

10.1177/1557988314526750 ◽

2014 ◽

Vol 8 (6) ◽

pp. 503-509 ◽

Cited By ~ 4

Author(s):

Romário Teixeira Braga Filho ◽

Argemiro D’Oliveira Júnior

Keyword(s):

Quality Of Life ◽

Metabolic Syndrome ◽

Police Officers ◽

Age Groups ◽

Poor Quality ◽

Multiple Risk Factor ◽

Men Health ◽

Health Quality ◽

Main Activity

Men generally have a lower life expectancy and higher mortality than women in nearly all age groups. Military police, whose main activity in Brazil is the maintenance of public order and the prevention of crimes and transgressions of the laws, is mostly composed of men; it is also a risky and stressful profession generally related to poor quality of life. Considering that risk factors for disease and death from cardiovascular causes—including the multiple risk factor metabolic syndrome—are mostly related to lifestyle and associated with impaired quality of life, this study aims to provide a theoretical basis for other studies about the prevalence of metabolic syndrome among police officers. In a theoretical study, the authors present an interdisciplinary review based on studies on the health and quality of life of men in general and policemen in their specificity; published studies were selected according to the key words: men, health, quality of life, police, metabolic syndrome; they should also have been published in the past 15 years and available in the Scientific Electronic Library Online—SciELO—and in the Public Medline—PubMed. In conclusion, military policemen have a risky profession, whose conditions may contribute to low quality of life, illness, and mortality from cardiovascular causes; these conditions indicate a need for the characterization of metabolic syndrome in this population as an important element for promotion of health. Studying these conditions may contribute to the adoption of comprehensive and continuing care for military policemen’s integral health.

Download Full-text

Addicted

Cinema, MD ◽

10.1093/med/9780190685799.003.0007 ◽

2020 ◽

pp. 149-170

Author(s):

Eelco F.M. Wijdicks

Keyword(s):

Quality Of Life ◽

Alcohol Consumption ◽

Drug Use ◽

20Th Century ◽

Poor Quality ◽

Therapeutic Drugs ◽

Morality Plays ◽

History Of

Cinema has a terrible reputation in its portrayal of drug use, alcohol consumption, and smoking. Early to mid-20th-century films frequently glamorized smoking and drinking. Drunkenness could also be milked for humor. Organizations that provide ratings for films have been continuously challenged by advocates of moderation. For responsible screenwriters, portraying the abuse of these substances creates great “morality plays.” They can show the downward trajectory and consequently poor quality of life of people with addictions. This chapter discusses how cinema has depicted drug use and smoking but also places it into the history of addiction throughout the decades of the 20th century. Filmmakers have used addiction to great effect. In the dreamed-up world of medicine in cinema, the physician is often blamed for prescribing therapeutic drugs that the patient goes on to abuse.

Download Full-text

Adherence with psychotherapy and treatment outcomes for psychogenic nonepileptic seizures

Neurology ◽

10.1212/wnl.0000000000006848 ◽

2019 ◽

Vol 92 (7) ◽

pp. e675-e679 ◽

Cited By ~ 13

Author(s):

Benjamin Tolchin ◽

Barbara A. Dworetzky ◽

Steve Martino ◽

Hal Blumenfeld ◽

Lawrence J. Hirsch ◽

...

Keyword(s):

Quality Of Life ◽

Childhood Abuse ◽

Odds Ratio ◽

Care Center ◽

Medium Effect ◽

Psychogenic Nonepileptic Seizures ◽

History Of ◽

Nonepileptic Seizures

ObjectiveWe conducted a prospective cohort study of patients with psychogenic nonepileptic seizures (PNES) to examine the association between adherence with psychotherapy and outcomes, including significant (≥50%) reduction in PNES frequency, PNES freedom, improvement in quality of life, and reduction in emergency department (ED) utilization.MethodsA total of 105 participants were referred to receive psychotherapy either at Brigham and Women's Hospital or with a local therapist. We called participants at 12–24 months follow-up and obtained detailed follow-up data from 93 participants (89%). Participants were considered adherent with psychotherapy if they attended at least 8 sessions within a 16-week period starting at the time of referral.ResultsAdherence with psychotherapy was associated with reduction in seizure frequency (84% in adherent group vs 61% in nonadherent, p = 0.021), improvement in quality of life (p = 0.044), and reduction in ED utilization (p = 0.040), with medium effect sizes; there was no difference in PNES freedom. The association between adherence and ≥50% reduction in PNES frequency persisted when controlling for potential confounders in a multivariate model. Psychotherapy nonadherence was associated with baseline characteristics of self-identified minority status (odds ratio 7.47, p = 0.019) and history of childhood abuse (odds ratio 3.30, p = 0.023).ConclusionsOur study is limited in that it cannot establish a causal relationship between adherence with psychotherapy and outcomes, and the results may not generalize beyond the single quaternary care center study site. Among participants with documented PNES, adherence with psychotherapy was associated with reduction in PNES frequency, improvement in quality of life, and decrease in ED visits.

Download Full-text