Hospitalisation of multiethnic older patients with AECOPD: exploration of the occurrence of anxiety, depression and factors associated with short-term hospital readmission

Background: Influenza is a common viral condition, but factors related to short-term mortality have not been fully studied in older adults. Our objective was to determine whether there is an association between geriatric factors and 30-day mortality. Methods: This was a retrospective cohort design. All patients aged 75 years and over, with a diagnosis of influenza confirmed by a positive RT-PCR, were included. The primary endpoint was death within the 30 days after diagnosis. Results: 114 patients were included; 14 (12.3%) patients died within 30 days. In multivariate analysis these patients were older (OR: 1.37 95% CI (1.05, 1.79), p = 0.021), and had a lower ADL score (OR: 0.36 95% CI (0, 17; 0.75), p = 0.006), and a higher SOFA score (OR: 2.30 95% CI (1.07, 4.94), p = 0.03). Oseltamivir treatment, initiated within the first 48 h, was independently associated with survival (OR: 0.04 95% CI (0.002, 0.78), p = 0.034). Conclusions: Identification of mortality risk factors makes it possible to consider specific secondary prevention measures such as the rapid introduction of antiviral treatment. Combined with primary prevention, these measures could help to limit the mortality associated with influenza in older patients.

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COVID-19 in Pediatric Inpatients: A Multi-Center Observational Study of Factors Associated with Negative Short-Term Outcomes

Children ◽

10.3390/children8110951 ◽

2021 ◽

Vol 8 (11) ◽

pp. 951

Author(s):

Sara Rubenstein ◽

Emily Grew ◽

Katharine Clouser ◽

Alexander Kwok ◽

Aravindhan Veerapandiyan ◽

...

Keyword(s):

Older Patients ◽

Severe Disease ◽

Laboratory Data ◽

The United States ◽

Medical Conditions ◽

Rt Pcr ◽

Short Term ◽

Factors Associated ◽

Number Of Individuals ◽

To Receive

Most cases of COVID-19 in children and adolescents are mild or asymptomatic, but a small number of individuals may develop severe disease, requiring PICU admission and/or mechanical ventilation. We assessed the factors associated with negative short-term outcomes of COVID-19 in 82 pediatric patients at three hospitals within the United States during the spring and summer of 2020 using medical records, laboratory data, and imaging studies of all patients admitted with a positive RT-PCR test for SARS-CoV-2. We found that older patients were more likely to have an extended hospital stay, and those with high BMIs (over 25) were more likely to be admitted to the PICU during the early pandemic. In addition, older patients, those with high BMIs, and those with underlying medical conditions, were more likely to receive respiratory support. Given the association of age, BMI, and underlying medical conditions with more severe COVID-19, clinicians should keep these factors in mind when treating patients.

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Influence of age and shock severity on short-term survival in patients with cardiogenic shock

European Heart Journal Acute Cardiovascular Care ◽

10.1093/ehjacc/zuaa035 ◽

2021 ◽

Author(s):

Jacob C Jentzer ◽

Benedikt Schrage ◽

David R Holmes ◽

Salim Dabboura ◽

Nandan S Anavekar ◽

...

Keyword(s):

Cardiogenic Shock ◽

Mayo Clinic ◽

Older Patients ◽

Cox Proportional Hazards ◽

Circulatory Support ◽

Short Term ◽

Term Survival ◽

Risk Of Death ◽

Coronary Syndrome ◽

Short Term Survival

Abstract Aims Cardiogenic shock (CS) is associated with poor outcomes in older patients, but it remains unclear if this is due to higher shock severity. We sought to determine the associations between age and shock severity on mortality among patients with CS. Methods and results Patients with a diagnosis of CS from Mayo Clinic (2007–15) and University Clinic Hamburg (2009–17) were subdivided by age. Shock severity was graded using the Society for Cardiovascular Angiography and Intervention (SCAI) shock stages. Predictors of 30-day survival were determined using Cox proportional-hazards analysis. We included 1749 patients (934 from Mayo Clinic and 815 from University Clinic Hamburg), with a mean age of 67.6 ± 14.6 years, including 33.6% females. Acute coronary syndrome was the cause of CS in 54.0%. The distribution of SCAI shock stages was 24.1%; C, 28.0%; D, 33.2%; and E, 14.8%. Older patients had similar overall shock severity, more co-morbidities, worse kidney function, and decreased use of mechanical circulatory support compared to younger patients. Overall 30-day survival was 53.3% and progressively decreased as age or SCAI shock stage increased, with a clear gradient towards lower 30-day survival as a function of increasing age and SCAI shock stage. Progressively older age groups had incrementally lower adjusted 30-day survival than patients aged <50 years. Conclusion Older patients with CS have lower short-term survival, despite similar shock severity, with a high risk of death in older patients with more severe shock. Further research is needed to determine the optimal treatment strategies for older CS patients.

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Psychopathological Factors Associated With Burnout in Intensive Care Nurses: A Cross-Sectional Study

Journal of the American Psychiatric Nurses Association ◽

10.1177/1078390321999725 ◽

2021 ◽

pp. 107839032199972

Author(s):

Erman Yıldız

Keyword(s):

Intensive Care ◽

Emotional Exhaustion ◽

Cross Sectional Study ◽

Personal Accomplishment ◽

University Hospital ◽

Sectional Study ◽

Cross Sectional ◽

Factors Associated ◽

Anxiety Depression ◽

The Relationship

BACKGROUND: Although previous studies have separately revealed that parameters such as anxiety, depression, and secondary traumatic stress (STS) are associated with burnout, there is still a limited understanding of the relationship between anxiety, depression, and STS and burnout in intensive care unit (ICU) nurses. AIMS: To investigate the relationship between levels of burnout, anxiety, depression, and STS in ICU nurses. METHOD: A cross-sectional study was conducted with ICU nurses ( N = 164) from a university hospital in eastern Turkey. The participants completed the anxiety, depression, STS, and burnout scales along with the descriptive characteristics form. The data were analyzed using descriptive statistics, correlation, and logistic regression analysis. RESULTS: The mean scores for STS, anxiety, depression, and burnout were 40.60 ± 13.77, 17.14 ± 12.90, 13.28 ± 9.75 and 41.39 ± 14.87, respectively. The results showed that, in the ICU nurses, anxiety, depression, and STS components explained 61% of emotional exhaustion, 38% of depersonalization, and 13% of personal accomplishment. CONCLUSIONS: While the present findings supported the paradigm that burnout in ICU nurses is associated with STS, anxiety, and depression, they also revealed some details about the psychopathological factors associated with burnout. These details were as follows: (1) individuals who resorted to avoidance as a component of STS on a high level were more likely to experience emotional exhaustion and depersonalization, (2) individuals with severe depressive symptoms were more likely to experience a decrease in their personal accomplishment, and (3) individuals with anxiety symptoms were more likely to experience both emotional exhaustion and personal accomplishment.

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Susceptibility to Residual Inhibition Is Associated With Hearing Loss and Tinnitus Chronicity

Trends in Hearing ◽

10.1177/2331216520986303 ◽

2021 ◽

Vol 25 ◽

pp. 233121652098630

Author(s):

S. Hu ◽

L. Anschuetz ◽

D. A. Hall ◽

M. Caversaccio ◽

W. Wimmer

Keyword(s):

Hearing Loss ◽

Narrow Band ◽

Acoustic Stimulation ◽

Normal Hearing ◽

Short Term ◽

Factors Associated ◽

Band Noise ◽

Comparator Group ◽

Residual Inhibition ◽

Subject Comparison

Residual inhibition, that is, the temporary suppression of tinnitus loudness after acoustic stimulation, is a frequently observed phenomenon that may have prognostic value for clinical applications. However, it is unclear in which subjects residual inhibition is more likely and how stable the effect of inhibition is over multiple repetitions. The primary aim of this work was to evaluate the effect of hearing loss and tinnitus chronicity on residual inhibition susceptibility. The secondary aim was to investigate the short-term repeatability of residual inhibition. Residual inhibition was assessed in 74 tinnitus subjects with 60-second narrow-band noise stimuli in 10 consecutive trials. The subjects were assigned to groups according to their depth of suppression (substantial residual inhibition vs. comparator group). In addition, a categorization in normal hearing and hearing loss groups, related to the degree of hearing loss at the frequency corresponding to the tinnitus pitch, was made. Logistic regression was used to identify factors associated with susceptibility to residual inhibition. Repeatability of residual inhibition was assessed using mixed-effects ordinal regression including poststimulus time and repetitions as factors. Tinnitus chronicity was not associated with residual inhibition for subjects with hearing loss, while a statistically significant negative association between tinnitus chronicity and residual inhibition susceptibility was observed in normal hearing subjects (odds ratio: 0.63; p = .0076). Moreover, repeated states of suppression can be stably induced, reinforcing the use of residual inhibition for within-subject comparison studies.

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Immunological variability associated with experimentally-induced positive and negative affective states

Psychological Medicine ◽

10.1017/s003329170003289x ◽

1992 ◽

Vol 22 (1) ◽

pp. 231-238 ◽

Cited By ~ 24

Author(s):

Ann D. Futterman ◽

Margaret E. Kemeny ◽

David Shapiro ◽

William Polonsky ◽

John L. Fahey

Keyword(s):

Healthy Subjects ◽

Affective States ◽

Short Term ◽

Immunological Parameters ◽

Neutral State ◽

Negative Affective States ◽

Anxiety Depression ◽

Experimentally Induced

SYNOPSISFunctional and phenotypic immunological parameters were examined immediately before, after, and 30 minutes after experimentally-induced short-term positive (happiness) and negative (anxiety, depression) affective states and a neutral state, in five healthy subjects. Results indicated that all affective states induced more immune fluctuations (regardless of the direction) than the neutral state. Furthermore, among the affective states, anxiety induced the most immunological variability and depression the least.

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Sex Differences in the Association between Atrial Fibrillation and 90-Day Adverse Outcomes among Older Adults with Heart Failure: A Retrospective Cohort Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052237 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2237

Author(s):

Youn-Jung Son ◽

Da-Young Kim ◽

Mi Hwa Won

Keyword(s):

Heart Failure ◽

Atrial Fibrillation ◽

Older Adults ◽

Sex Differences ◽

Older Adult ◽

Hospital Readmission ◽

Older Patients ◽

Adverse Outcomes ◽

Prognostic Impact ◽

Male And Female

Sex differences in the prognostic impact of coexisting atrial fibrillation (AF) in older patients with heart failure (HF) have not been well-studied. This study, therefore, compared sex differences in the association between AF and its 90-day adverse outcomes (hospital readmissions and emergency room (ER) visits) among older adults with HF. Of the 250 older adult patients, the prevalence rates of coexisting AF between male and female HF patients were 46.0% and 31.0%, respectively. In both male and female older patients, patients with AF have a significantly higher readmission rate (male 46.0%, and female 34.3%) than those without AF (male 6.8%, and female 12.8%). However, there are no significant differences in the association between AF and ER visits in both male and female older HF patients. The multivariate logistic analysis showed that coexisting AF significantly increased the risk of 90-day hospital readmission in both male and female older patients. In addition, older age in males and longer periods of time after an HF diagnosis in females were associated with an increased risk of hospital readmission. Consequently, prospective cohort studies are needed to identify the impact of coexisting AF on short- and long-term outcomes in older adult HF patients by sex.

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