Functional mobility trajectories of hospitalized older adults admitted to acute geriatric wards: A retrospective observational study in an English university hospital

Abstract Background Various factors are related to self-management of medication. However, few reports comprehensively examine the factors related to patients, medication levels, and other factors related to the recuperative environment, such as family support. The aim of this study was to investigate factors affecting the continuation of medication self-management among hospitalized older adults receiving convalescent rehabilitation. Methods We conducted a retrospective observational study with 274 consecutive patients newly admitted to the convalescent rehabilitation wards at a single hospital in Japan between January 2017 and May 2018. Participants who were assessed for their ability to take their medication using the Japanese Regimen Adherence Capacity Tests, were deemed to be self-manageable, and were able to successfully continue to self-manage their medication from admission to discharge were categorized as the “continuation group,” and those who were not able to continue were categorized as the “non-continuation group.” We analyzed the groups’ demographic data, laboratory data, and Functional Independence Measure. The primary outcome was the continuation of medication self-management from admission to discharge. Results After enrollment, 134 patients (median age 82 years; 62.7% women) were included in the final analysis. Some 60.4% of eligible patients were able to maintain medication self-management during their hospitalization. The multiple logistic regression analysis for the continuation of medication self-management during hospitalization after adjusting for confounding factors revealed that pharmacist medication instructions were independently and positively correlated with successful continuation of medication self-management (odds ratio: 1.378; 95% confidence interval 1.085–1.831; p = 0.0076). Conclusion Successful continuation of medication self-management is associated with pharmacist medication instructions among hospitalized older adults undergoing rehabilitation. Trail registration The Ethics Committee’s registration number is “TGE01216–066”.

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Frailty and Mortality in Hospitalized Older Adults With COVID-19: Retrospective Observational Study

Journal of the American Medical Directors Association ◽

10.1016/j.jamda.2020.06.008 ◽

2020 ◽

Vol 21 (7) ◽

pp. 928-932.e1 ◽

Cited By ~ 27

Author(s):

Robert De Smet ◽

Bea Mellaerts ◽

Hannelore Vandewinckele ◽

Peter Lybeert ◽

Eric Frans ◽

...

Keyword(s):

Older Adults ◽

Observational Study ◽

Retrospective Observational Study ◽

Hospitalized Older Adults

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Clinical Features, Inpatient Trajectories and Frailty in Older Inpatients With COVID-19: A Retrospective Observational Study.

10.20944/preprints202101.0128.v1 ◽

2021 ◽

Author(s):

Christopher N Osuafor ◽

Catriona Davidson ◽

Alistair J Mackett ◽

Marie Goujon ◽

Lelane Van Der Poel ◽

...

Keyword(s):

Older Adults ◽

Observational Study ◽

Clinical Features ◽

Proportional Hazards ◽

Patient Characteristics ◽

Cox Proportional Hazards ◽

University Hospital ◽

Retrospective Observational Study ◽

Clinical Frailty Scale ◽

Frail Patients

Introduction: We describe the clinical features and inpatient trajectories of older adults hospitalized with COVID-19, and explore relationships with frailty. Methods: This retrospective observational study included older adults admitted as an emergency to a University Hospital who were diagnosed with COVID-19. Patient characteristics and hospital outcomes, primarily inpatient death or death within 14 days of discharge, were described for the whole cohort and by frailty status. Associations with mortality were further evaluated using Cox Proportional Hazards Regression (Hazard Ratio [HR], 95% Confidence Interval). Results: 214 patients (94 women) were included of whom 142 (66.4%) were frail with a median Clinical Frailty Scale (CFS) score of 6. Frail compared to non-frail patients were more likely to present with atypical symptoms including new or worsening confusion (45.1% vs 20.8%, p<0.001) and were more likely to die (66% vs 16%, p=0.001). Older age, being male, presenting with high illness acuity and high frailty were independent predictors of death and a dose-response association between frailty and mortality was observed (CFS 1-4: reference; CFS 5-6: HR 1.78, 95% CI 0.90, 3.53; CFS 7-8: HR 2.57, 95% CI 1.26, 5.24). Conclusions: Clinicians should have a low threshold for testing for COVID-19 in older and frail patients during periods of community viral transmission and diagnosis should prompt early advanced care planning.

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Clinical features and inpatient trajectories of older inpatients with COVID-19: a retrospective observational study.

10.21203/rs.3.rs-61056/v1 ◽

2020 ◽

Cited By ~ 1

Author(s):

Christopher N Osuafor ◽

Catriona Davidson ◽

Alistair J Mackett ◽

Marie Goujon ◽

Lelane Van Der Poel ◽

...

Keyword(s):

Older Adults ◽

Observational Study ◽

Clinical Features ◽

University Hospital ◽

Retrospective Observational Study ◽

Clinical Frailty Scale ◽

Atypical Symptoms ◽

Risk Of Death ◽

Frail Patients ◽

Older Inpatients

Abstract Background: A comprehensive description of the clinical characteristics, inpatient trajectory and relationship with frailty of older inpatients admitted with COVID-19 is essential in the management of older adults during the COVID-19 pandemic. The aim of this study was to describe the clinical features and inpatient trajectory of older inpatients with confirmed COVID -19.Methods: This was a retrospective observational study of hospitalised older adults. Subjects include unscheduled medical admissions of older inpatients to a University Hospital with laboratory and clinically confirmed COVID-19. The primary outcome was death during the inpatient stay or within 14 days of discharge after a maximum follow up time of 45 days. The characteristics of the cohort were described in detail as a whole and by frailty status.Results: 214 patients were included in this study with a mean length of stay of 11 days (Range 6 to 18 days), of whom 140 (65.4%) patients were discharged and 74 (34.6%) patients died in hospital. 142 (66.4%) patients were frail with median Clinical Frailty Scale (CFS) score of 6. Frail patients were more likely to present with atypical symptoms including new or worsening confusion compared to non-frail patients (20.8% vs 45.1%, p<0.001) and were more likely to die in hospital or within 14 days of discharge (66% vs 16%, p=0.001). Older age, being male, presenting with high illness acuity and high frailty were all independently associated with higher risk of death and a dose response association between higher frailty and higher mortality was observed.Conclusions: Older adult inpatients with COVID-19 infection are likely to present with atypical symptoms, experience delirium and have a high mortality, especially if they are also living with frailty. Clinicians should have a low threshold for testing for COVID-19 in older and frail patients presenting to hospital as an emergency during periods when there is community transmission of COVID-19 and, when diagnosed, this should prompt early advanced care planning with the patient and family.

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Clinical frailty and functional trajectories in hospitalized older adults: A retrospective observational study

Geriatrics and Gerontology International ◽

10.1111/ggi.12827 ◽

2016 ◽

Vol 17 (7) ◽

pp. 1063-1068 ◽

Cited By ~ 17

Author(s):

Peter Hartley ◽

Jennifer Adamson ◽

Carol Cunningham ◽

Georgina Embleton ◽

Roman Romero-Ortuno

Keyword(s):

Older Adults ◽

Observational Study ◽

Retrospective Observational Study ◽

Hospitalized Older Adults

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Clinical Features, Inpatient Trajectories and Frailty in Older Inpatients with COVID-19: A Retrospective Observational Study

Geriatrics ◽

10.3390/geriatrics6010011 ◽

2021 ◽

Vol 6 (1) ◽

pp. 11

Author(s):

Christopher N. Osuafor ◽

Catriona Davidson ◽

Alistair J. Mackett ◽

Marie Goujon ◽

Lelane Van Der Poel ◽

...

Keyword(s):

Older Adults ◽

Observational Study ◽

Clinical Features ◽

Proportional Hazards ◽

Patient Characteristics ◽

Cox Proportional Hazards ◽

University Hospital ◽

Retrospective Observational Study ◽

Clinical Frailty Scale ◽

Frailty Status

Introduction: We describe the clinical features and inpatient trajectories of older adults hospitalized with COVID-19 and explore relationships with frailty. Methods: This retrospective observational study included older adults admitted as an emergency to a University Hospital who were diagnosed with COVID-19. Patient characteristics and hospital outcomes, primarily inpatient death or death within 14 days of discharge, were described for the whole cohort and by frailty status. Associations with mortality were further evaluated using Cox Proportional Hazards Regression (Hazard Ratio (HR), 95% Confidence Interval). Results: 214 patients (94 women) were included of whom 142 (66.4%) were frail with a median Clinical Frailty Scale (CFS) score of 6. Frail compared to nonfrail patients were more likely to present with atypical symptoms including new or worsening confusion (45.1% vs. 20.8%, p < 0.001) and were more likely to die (66% vs. 16%, p = 0.001). Older age, being male, presenting with high illness acuity and high frailty were independent predictors of death and a dose–response association between frailty and mortality was observed (CFS 1–4: reference; CFS 5–6: HR 1.78, 95% CI 0.90, 3.53; CFS 7–8: HR 2.57, 95% CI 1.26, 5.24). Conclusions: Clinicians should have a low threshold for testing for COVID-19 in older and frail patients during periods of community viral transmission, and diagnosis should prompt early advanced care planning.

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P237 Annual incidence and prevalence of ulcerative colitis and Crohn’s disease from 2010 to 2017 in four Nordic countries: Results from the TRINordic study

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.366 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S261-S262

Author(s):

M Lördal ◽

J Burisch ◽

E Langholz ◽

T Knudsen ◽

M Voutilainen ◽

...

Keyword(s):

Ulcerative Colitis ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Observational Study ◽

Nordic Countries ◽

Annual Incidence ◽

University Hospital ◽

Retrospective Observational Study ◽

Western World ◽

The Impact

Abstract Background Incidence and prevalence of inflammatory bowel diseases (IBD) have been increasing for the past decades in the western world, however with an emerging trend of incidence stabilisation in recent years. There is an indication of higher IBD incidence and prevalence in northern Europe, especially in the Nordic region, compared with southern Europe. Methods This retrospective observational study collected data from the National Patient Registries and National Prescription Registries (Sweden [SWE], Norway [NOR], Denmark [DEN]) and one university hospital database (Turku, Finland [FIN]) during 2010–2017 to investigate the annual incidence and prevalence of ulcerative colitis (UC) and Crohn’s disease (CD). Patients with ≥2 ICD-10 diagnosis codes for UC (K51) or CD (K50) from 2010 or later and no K51 or K50 codes prior to 2010 were included; patients were classified according to their last code. The look-back period for SWE was until 2000, for NOR until 2008, for DEN until 1995, and for FIN until 2004. Incidence proportions highlight results through 2016, as 2017 patients had less than 1-year follow-up. Results In total, 69,876 patients were included (SWE n = 27,902, NOR n = 20,761, FIN n = 2,118, DEN n = 19,095), of which 44 367 patients were diagnosed with UC and 25,509 with CD. In 2016, the annual incidence of UC was 28 patients per 100,000 persons in NOR, 32 patients per 100,000 persons in DEN, 25 patients per 100,000 persons in SWE, and 44 patients per 100,000 in FIN. The corresponding results for the annual incidence of CD per 100,000 persons were 22 in NOR, 16 in DEN, 16 in SWE, and 21 in FIN. The prevalence per 100,000 persons of both UC and CD was the highest in DEN, followed by SWE and NOR, and lowest in FIN. Prevalence estimates increased in all four Nordic countries during 2010–2017: for UC, from 409 to 488 patients in SWE, from 256 to 428 in NOR, from 129 to 375 in FIN, and from 577 to 798 in DEN. For CD, it increased from 261 to 313 patients in SWE, from 164 to 258 in NOR, from 54 to 164 in FIN, and from 280 to 400 in DEN. Conclusion This retrospective observational study showed that during 2016, the annual incidence of UC ranged from 25–44 patients per 100,000 persons across the evaluated Nordic countries, whereas the annual incidence of CD was 16–22 patients per 100,000 persons. Prevalence of both UC and CD increased during 2010–2017 in all four countries. Estimates of UC and CD incidence and prevalence in this analysis are greater than reported in the published literature. Additional analyses are underway to further explore the impact of methodological decisions on the estimates of UC and CD annual incidence and prevalence.

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Telemedicine in Patients With an Ostomy During the COVID-19 Pandemic: A Retrospective Observational Study

Wound Management & Prevention ◽

10.25270/wmp.2021.1.1217 ◽

2021 ◽

Vol 67 (1) ◽

pp. 12-17

Author(s):

Vincenza Dinuzzi ◽

Giuseppe Palomba ◽

Maria Minischetti ◽

Alfonso Amendola ◽

Pierluigi Aprea ◽

...

Keyword(s):

Observational Study ◽

Health Care Services ◽

Irrigation System ◽

Care Center ◽

Mechanical Bowel Preparation ◽

University Hospital ◽

Retrospective Observational Study ◽

Care Services ◽

Group B ◽

Stoma Care

BACKGROUND: Italy instituted a lockdown from March 10 to May 3, 2020, due to the coronavirus disease-19 pandemic. All nonessential businesses were closed during this time, and health care services were reorganized. On March 11, the Stoma Care Center started providing telehealth services for patients with a stoma. PURPOSE: This retrospective observational study describes the experience of the Stoma Care Center of the University Hospital Federico II, Naples, Italy, before and during the lockdown. METHODS: Consultation records from January 1 through April 29 were retrieved, patient demographics and reasons for consultation abstracted, and pre-lockdown (January 1 to February 29) and lockdown (March 1 to April 29) information was compared. Patients who used telehealth services were also asked to rate their satisfaction with these services on a scale of 0 (extremely dissatisfied) to 4 (extremely satisfied). The authors analyzed all consultations provided from January to April 2020 and evaluated the use of telemedicine services for patients with an ostomy. Consultations were divided into 2 groups. Group A included consultations provided from January 1 to February 29. Group B included consultations provided from March 1 to April 29, which included the lockdown period. Group B included both in-person and telemedicine consultations. RESULTS: During the pre-lockdown period, 240 in-person consultations were provided. During the lockdown period, 181 in-person and 99 telemedicine consultations were provided. The number of in-person consultations for mechanical bowel preparation and transanal irrigation system training was lower (12.5% vs 6.6% [P = .046] and 3.3% vs 0% [P = .03]), whereas the number of consults for stoma care follow-up and stoma complications was higher (202 [84.1%] vs 266 [95%]). Of the 65 patients who completed the questionnaire, 82% indicated being extremely satisfied. CONCLUSIONS: The reorganization of stoma care services, including the availability of telemedicine, did not result in a decrease in the number of consultations provided. The results suggest that stoma care services using telemedicine may provide valid support for patients with an ostomy in the future.

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