The Elderly Patient in the Coronary Care Unit: III. Factors Affecting Long-term Prognosis

In long-term care facilities, elderly mistreatment occurs routinely and frequently. However, few studies have empirically explored the multifaceted risk factor of mistreatment. The purpose of this paper was to explore the factors affecting elderly mistreatment by care workers in Japanese long-term care facilities and to examine the relationship between these factors and mistreatment. This analysis was based on a sample of 1473 care workers from long-term care facilities and used multiple regression analyses. The results revealed that the nursing care level, work period, resilience, and attitude towards mistreatment among residents and staff were factors significantly associated with the degree of mistreatment. Facility size, an institutional environment that does not limit the behavior of residents, and family and community support for the elderly were among the institutional environment factors that had significant relationships with mistreatment. Staff gender, care-related qualifications, and workload were not associated with mistreatment. These findings suggest that strengthening the staff’s attitude and coping skills to prevent mistreatment, as well as interventions for changes in the institutional environment, are needed to prevent and reduce the prevalence of mistreatment in Japan. In addition, raising staff resilience to stress situations and building a resident-centered facility care environment is an important measure to reduce mistreatment.

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SEVERE RIGHT VENTRICULAR FUNCTION DETERMINED BY VISUAL ASSESSMENT IN THE CORONARY CARE UNIT SETTING PREDICTS LONG-TERM MORTALITY

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(15)60981-0 ◽

2015 ◽

Vol 65 (10) ◽

pp. A981

Author(s):

Niyada Naksuk ◽

Charat Thongprayoon ◽

Jae Park ◽

Sithu Win ◽

Sunita Sharma ◽

...

Keyword(s):

Right Ventricular ◽

Ventricular Function ◽

Right Ventricular Function ◽

Coronary Care Unit ◽

Visual Assessment ◽

Coronary Care ◽

Long Term Mortality

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Factors Affecting Admission to a Coronary Care Unit

BMJ ◽

10.1136/bmj.4.5780.153 ◽

1971 ◽

Vol 4 (5780) ◽

pp. 153-156 ◽

Cited By ~ 7

Author(s):

I. C. Gilchrist

Keyword(s):

Coronary Care Unit ◽

Factors Affecting ◽

Coronary Care

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64 STATISTICAL ANALYSIS OF PROGNOSTIC FACTORS AFFECTING LONG-TERM PROGNOSIS AFTER ENDOSCOPIC TREATMENT OF ESOPHAGEAL VARICES

Diseases of the Esophagus ◽

10.1093/dote/doaa087.10 ◽

2020 ◽

Vol 33 (Supplement_1) ◽

Author(s):

T Nishimura

Keyword(s):

Prognostic Factors ◽

Esophageal Varices ◽

Endoscopic Treatment ◽

Survival Period ◽

Term Survival ◽

Gastroesophageal Varices ◽

Long Term Survival ◽

Factors Affecting ◽

Long Term Prognosis

Abstract Gastroesophageal varices are present in approximately 50% of patients with cirrhosis, and their rupture is a life-threatening complication. However, mortality rates have declined due to the progress in the management of these patients. Especially advances in endoscopic treatment have contributed to the improved survival rates. In this study, we investigated the prognostic factors associated with long-term survival after endoscopic treatment for esophageal varices. Methods The subjects were 260 patients who underwent initial endoscopic treatment for esophageal varices in our hospital between January 1997 and June 2019. Among them, 160 successfully followed up. The patients’ characteristics were: mean age, 65.4 years (29–85); 109 men and 51 women; and median survival period, 53 months. For analysis, subjects were divided into long-term survival and non-long-term survival groups (n = 59 for each) with a 53-month survival period as a cut-off value. Results The long-term/non-long-term survival group had a preoperative Child-Pugh score of 6.2 ± 1.1/7.4 ± 2.0 (p < 0.01) and hepatocellular carcinoma (HCC) presence rate was 25.4%/55.9% (p < 0.01), significantly higher in the non-long-term group. Analysis of the factors affecting survival period using Cox proportional hazards model showed that Child-Pugh score B or C [hazard ratio(HR):2.0143, p < 0.05], total bilirubin value≧ 2 [HR:2.5573, p < 0.05], and presence of HCC [HR:2.2450, p < 0.01] were noted as significant factors. Only presence of HCC was found to be a significant factor affecting the long-term survival using multiple logistic regression analysis [odds ratio:0.3463, p < 0.05]. Conclusion Our study revealed that liver function and the presence of HCC affect long-term prognosis after endoscopic treatment for esophageal varices.

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Anti-NMDAR encephalitis

Neurology Neuroimmunology & Neuroinflammation ◽

10.1212/nxi.0000000000000633 ◽

2019 ◽

Vol 7 (1) ◽

pp. e633 ◽

Cited By ~ 13

Author(s):

Xiaolu Xu ◽

Qiang Lu ◽

Yan Huang ◽

Siyuan Fan ◽

Lixin Zhou ◽

...

Keyword(s):

Ovarian Teratoma ◽

Long Term Outcomes ◽

First Line ◽

Factors Affecting ◽

First Line Therapy ◽

Nmdar Encephalitis ◽

Clinical Presentations ◽

Long Term Prognosis

ObjectiveTo describe the detailed clinical characteristics, immunotherapy, and long-term outcomes of patients with anti-NMDA receptor (NMDAR) encephalitis in China.MethodsA single-center, prospective study. Patients who met the diagnostic criteria were enrolled from 2011 to 2017 and followed up. The clinical features, treatment, and long-term outcomes were collected prospectively. Factors affecting the long-term prognosis were analyzed.ResultsThe study included 220 patients. The most common clinical presentations were psychosis (82.7%) and seizures (80.9%). Of the patients, 19.5% had an underlying neoplasm; of which ovarian teratoma was 100% of tumors in females and only one male had lung cancer. Most patients (99.5%) received first-line therapy (glucocorticoids, IV immunoglobulin, or plasmapheresis alone or combined), and only 7.3% received second-line immunotherapy (rituximab, cyclophosphamide alone, or combined). Long-term immunotherapy (mycophenolate mofetil or azathioprine >1 year) was administered to 53.2% of patients. During the first 12 months, 207 (94.1%) patients experienced improvement, and 5 (2.3%) died, whereas 38 (17.3%) experienced relapses. At 12-month follow-up, 92.7% had favorable clinical outcomes (modified Rankin Scale score ≤2).ConclusionsPatients in China present with psychosis and seizure frequently but have a low percentage of underlying neoplasms. Re-enforced first-line immunotherapy is effective in managing anti-NMDAR encephalitis in the acute phase. Although relapse is relatively common, with combined first-line and long-term immunotherapy, most patients reached favorable outcomes.

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