Pain induced by investigations and procedures commonly administered to older adults in the emergency department: a prospective cohort study

2021 ◽  
pp. emermed-2020-210535
Author(s):  
Laurence Baril ◽  
Elisabeth Nguyen ◽  
Lauralee Dufresne-Santerre ◽  
Virginie Émond ◽  
Marcel Émond ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Severe Pain ◽  
Rating Scale ◽  
Quebec City ◽  
X Rays ◽  
Convenience Sample ◽  
Median Level ◽  
Observational Cohort ◽  
Urinary Catheterisation

BackgroundThis study aimed to assess the level of pain induced by common interventions performed in older adults consulting to the ED.MethodsWe conducted a prospective multicentre observational cohort study in two academic EDs (Quebec City, Canada) between June 2018 and December 2019. A convenience sample of well-oriented and haemodynamically stable older adults (≥65 years old) who underwent at least two interventions during their ED stay was recruited. The level of pain was assessed using an 11-point Numerous Rating Scale (NRS) and is presented using median and IQR or categorised as no pain (0), mild (1–3), moderate (4–6) or severe pain (7–10).ResultsA total of 318 patients were included. The mean age was 77.8±8.0 years old and 54.4% were female . The number of pain assessments per intervention ranged between 22 (urinary catheterisation) and 240 (intravenous catheter). All imaging investigations (X-rays, CT and bedside ultrasound) were associated with a median level of pain of 0. The median level of pain for other interventions was as follows: blood samplings (n=231, NRS 1 (IQR 0–3)), intravenous catheters (n=240, NRS 2 (IQR 0–4)), urinary catheterisations (n=22, NRS 4.5 (IQR 2–6)), cervical collars (n=50, NRS 5 (IQR 0–8)) and immobilisation mattresses (n=34, NRS 5 (IQR 0–8)). Urinary catheterisations (63.8%), cervical collars (56.0%) and immobilisation mattresses (52.9%) frequently induced moderate or severe pain.ConclusionsMost interventions administered to older adults in the ED are associated with no or low pain intensity. However, urinary catheterisation and spinal motion restriction devices are frequently associated with moderate or severe pain.

scholarly journals Inequalities in primary care management of knee pain and disability in older adults: an observational cohort study

Rheumatology ◽  
2011 ◽  
Vol 50 (10) ◽  
pp. 1869-1878 ◽  
Author(s):  
C. Jinks ◽  
K. Vohora ◽  
J. Young ◽  
J. Handy ◽  
M. Porcheret ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Cohort Study ◽  
Knee Pain ◽  
Care Management ◽  
Observational Cohort Study ◽  
Observational Cohort ◽  
Primary Care Management

Fecal Incontinence Is Associated With Mortality Among Older Adults With Complex Needs: An Observational Cohort Study

2017 ◽  
Vol 112 (9) ◽  
pp. 1431-1437 ◽  
Author(s):  
Hamish A Jamieson ◽  
Philip J Schluter ◽  
Juno Pyun ◽  
Ted Arnold ◽  
Richard Scrase ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Fecal Incontinence ◽  
Observational Cohort Study ◽  
Complex Needs ◽  
Observational Cohort

scholarly journals Prospective observational cohort study on epidemiology, treatment and outcome of patients with traumatic brain injury (TBI) in German BG hospitals

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e045771
Author(s):  
Peter Schwenkreis ◽  
Andreas Gonschorek ◽  
Florian Berg ◽  
Ullrich Meier ◽  
Witold Rogge ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Cohort Study ◽  
Brain Injury ◽  
Large Scale ◽  
Telephone Interview ◽  
Observational Cohort Study ◽  
X Rays ◽  
Mild Tbi ◽  
Initial Care ◽  
Observational Cohort

ObjectivesSince 2000/2001, no large-scale prospective studies addressing traumatic brain injury (TBI) epidemiology in Germany have been published. Our aim was to look for a possible shift in TBI epidemiology described in other European countries, to look for possible changes in TBI management and to identify predictors of 1-year outcome especially in patients with mild TBI.DesignObservational cohort study.SettingAll patients suffering from a TBI of any degree between 1 October 2014 and 30 September 2015, and who arrived in one of the seven participating BG hospitals within 24 hours after trauma, were included.ParticipantsIn total, 3514 patients were included.Outcome measuresInitial care, acute hospital care and rehabilitation were documented using standardised documentation forms. A standardised telephone interview was conducted 3 and 12 months after TBI in order to obtain information on outcome.ResultsPeaks were identified in males in the early 20s and mid-50s, and in both sexes in the late 70s, with 25% of all patients aged 75 or older. A fall was the most frequent cause of TBI, followed by traffic accidents (especially bicyclists). The number of head CT scans increased, and the number of conventional X-rays of the skull decreased compared with 2000/2001. Besides, more patients were offered rehabilitation than before. Though most TBI were classified as mild, one-third of the patients participating in the telephone interview after 12 months still reported troubles attributed to TBI. Negative predictors in mild TBI were female gender, intracranial bleeding and Glasgow Coma Scale (GCS) 13/14.ConclusionThe observed epidemiologic shift in TBI (ie, elderly patients, more falls, more bicyclists) calls for targeted preventive measures. The heterogeneity behind the diagnosis ‘mild TBI’ emphasises the need for defining subgroups not only based on GCS.

Evaluation of a digital health gamification platform with older adults: An observational cohort study with a pre-test/post-test design

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Hurmuz ◽  
S M Jansen-Kosterink ◽  
L van Velsen
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Cohort Study ◽  
User Experience ◽  
Perceived Health ◽  
Observational Cohort Study ◽  
Test Design ◽  
Post Test ◽  
Observational Cohort

Abstract Background Older adults are usually less physically active than younger adults. Physical inactivity can lead to frailty, which can increase the possibility of being admitted in a hospital and, being functional limited. To handle frailty Stranded is developed. Within this platform the user will be shipwrecked and has to build a boat to leave an uninhibited island. The user can leave the island by executing physical exercises and playing cognitive games. The primary aim focussed on differences in quality of life and perceived health status after using Stranded (TRL7). The secondary aim focussed on the usability of and user experience with Stranded. This study was conducted within the FRAIL-project (Eurostars-2 10.824). Methods An observational cohort study with a pre-test/post-test design was carried out. The pre-test measurements were performed before the use of Stranded, and the post-test measurements after using it for four weeks. The study population consisted of older adults, 55 years of age or older and each subject signed an informed consent form. Results One hundred and eleven older adults were included in this study (64.9% female and 35.1% male) and 91 participants started using Stranded. In total, 59 subjects dropped out. Two health variables significantly increased (n = 52), the subjects' perceived health state on a visual analogue scale and the subjects' quality of life viewed from the positive health perspective. Stranded's usability scored an average of 61.3 (SD = 21.6). The average scores on the user experience domains were all between 3.3 and 3.9 on a 7-point scale. The subjects did not have a strong negative or positive opinion about these domains. Conclusions The average quality of life increased slightly. It is hard to find an appropriate population to investigate the effects of these innovations, because of not willing to include too frail older adults for whom participating could be intensive. The usability was perceived as acceptable.

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