scholarly journals Validating SPICES as a Screening Tool for Frailty Risks among Hospitalized Older Adults

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Harriet Udin Aronow ◽  
Jeff Borenstein ◽  
Flora Haus ◽  
Glenn D. Braunstein ◽  
Linda Burnes Bolton
Keyword(s):  
Older Adult ◽  
Older Patients ◽  
Screening Tool ◽  
Adverse Outcomes ◽  
Patient Harm ◽  
Comorbid Conditions ◽  
Care Plans ◽  
Screening Protocol ◽  
Hospitalized Older Adults ◽  
Almost All

Older patients are vulnerable to adverse hospital events related to frailty. SPICES, a common screening protocol to identify risk factors in older patients, alerts nurses to initiate care plans to reduce the probability of patient harm. However, there is little published validating the association between SPICES and measures of frailty and adverse outcomes. This paper used data from a prospective cohort study on frailty among 174 older adult inpatients to validate SPICES. Almost all patients met one or more SPICES criteria. The sum of SPICES was significantly correlated with age and other well-validated assessments for vulnerability, comorbid conditions, and depression. Individuals meeting two or more SPICES criteria had a risk of adverse hospital events three times greater than individuals with either no or one criterion. Results suggest that as a screening tool used within 24 hours of admission, SPICES is both valid and predictive of adverse events.

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

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.

scholarly journals DETERMINING THE PREVALENCE OF SARCOPENIA IN AN INPATIENT GERIATRIC POPULATION USING EWGSOP2 OR FNIH DEFINITIONS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S844-S844
Author(s):  
Matthew M Scholl ◽  
Elena Volpi ◽  
Rachel R Deer
Keyword(s):  
Physical Performance ◽  
Lean Mass ◽  
Adverse Outcomes ◽  
International Consensus ◽  
Geriatric Population ◽  
Cross Sectional ◽  
European Working ◽  
Combining Data ◽  
Hospitalized Older Adults ◽  
Almost All

Abstract Sarcopenia has been recognized as a progressive and generalized skeletal muscle disorder leading to loss of strength, muscle mass, and function. It is associated with an increased likelihood of adverse outcomes like falls, fractures, physical disability, and mortality. International consensus groups continue providing new definitions and clinical cut-off points despite over a decade of work in this area. Thus, the purpose of this research was to determine the prevalence of sarcopenia using two of the most current operational definitions (Foundation of NIH Sarcopenia Project (FNIH) and the European Working Group on Sarcopenia in Older Persons 2 (EWGSOP2)). Our cohort of acutely hospitalized older adults was formed from combining data from two randomized controlled trials and one cross-sectional observational study. Testing during hospitalization included measures of: demographics, body composition (DEXA), physical function tests, psychological wellbeing and independence questionnaires, and chart review. These were used to analyze the cohort according to three main groupings of low physical performance, low muscle strength, and low lean mass. We compared multiple tests and cutoffs for each of the three groupings under the FNIH and EWGSOP2 definitions, which varied 3% for low lean mass up to 48% for tests of low physical performance. After examining the efficacy of each cutoff, we evaluated the differences between FNIH and EWGSOP2. In our cohort, the prevalence of sarcopenia was 15.79% by EWGSOP2 and 13.59% by FNIH. The groupings within FNIH and EWGSOP2 were found to be near identical across almost all measures despite the definitions’ discrepancies in cutoff points.

scholarly journals Ambulance dispatch of older patients following primary and secondary telephone triage in metropolitan Melbourne, Australia: a retrospective cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e042351
Author(s):  
Kathryn Eastwood ◽  
Dhanya Nambiar ◽  
Rosamond Dwyer ◽  
Judy A Lowthian ◽  
Peter Cameron ◽  
...  
Keyword(s):  
Cohort Study ◽  
Older Adult ◽  
Retrospective Cohort Study ◽  
Older Patients ◽  
Retrospective Cohort ◽  
Vital Signs ◽  
Telephone Triage ◽  
Ambulance Dispatch ◽  
Emergency Ambulance ◽  
Primary Triage

BackgroundMost calls to ambulance result in emergency ambulance dispatch (direct dispatch) following primary telephone triage. Ambulance Victoria uses clinician-led secondary telephone triage for patients identified as low-acuity during primary triage to refer them to alternative care pathways; however, some are returned for ambulance dispatch (secondary dispatch). Older adult patients are frequent users of ambulance services; however, little is known about the appropriateness of subsequent secondary dispatches.ObjectivesTo examine the appropriateness of secondary dispatch through a comparison of the characteristics and ambulance outcomes of older patients dispatched an emergency ambulance via direct or secondary dispatch.DesignA retrospective cohort study of ambulance patient data between September 2009 and June 2012 was conducted.SettingThe secondary telephone triage service operated in metropolitan Melbourne, Victoria, Australia during the study period.ParticipantsThere were 90 086 patients included aged 65 years and over who had an emergency ambulance dispatch via direct or secondary dispatch with one of the five most common secondary dispatch paramedic diagnoses.Main outcome measuresDescriptive analyses compared characteristics, treatment and transportation rates between direct and secondary dispatch patients.ResultsThe dispatch groups were similar in demographics, vital signs and hospital transportation rates. However, secondary dispatch patients were half as likely to be treated by paramedics (OR 0.51; CI 0.48 to 0.55; p<0.001). Increasing age was associated with decreasing treatment (p<0.005) and increasing transportation rates (p<0.005).ConclusionSecondary triage could identify patients who would ultimately be transported to an emergency department. However, the lower paramedic treatment rates suggest many secondary dispatch patients may have been suitable for referral to alternative low-acuity transport or referral options.

scholarly journals A Midwest COVID-19 Cohort for the Evaluation of Multimorbidity and Adverse Outcomes from COVID-19

2021 ◽  
Vol 12 ◽  
pp. 215013272110109
Author(s):  
Sanjeev Nanda ◽  
Loren Toussaint ◽  
Ann Vincent ◽  
Karen M. Fischer ◽  
Ryan Hurt ◽  
...  
Keyword(s):  
Mayo Clinic ◽  
Adverse Outcomes ◽  
Chronic Obstructive ◽  
Comorbid Conditions ◽  
Prevalence Data ◽  
Obstructive Pulmonary Disease ◽  
Morbidity Score ◽  
Process And Outcome ◽  
Comorbidity Index ◽  
Risk Factor Score

Objective To describe the process and outcome of creating a patient cohort in the early stages of the COVID-19 pandemic in order to better understand the process of and predict the outcomes of COVID-19. Patients and Methods A total of 1169 adults aged 18 years of age or older who tested positive in Mayo Clinic Rochester or the Mayo Clinic Midwest Health System between January 1 and May 23 of 2020. Results Patients were on average 43.9 years of age and 50.7% were female. Most patients were white (69.0%), and Blacks (23.4%) and Asians (5.8%) were also represented in larger numbers. Hispanics represented 16.3% of the sample. Just under half of patients were married (48.4%). Common comorbid conditions included: cardiovascular diseases (25.1%), dyslipidemia (16.0%), diabetes mellitus (11.2%), chronic obstructive pulmonary disease (6.6%), asthma (7.5%), and cancer (5.1%). All other comorbid conditions were less the 5% in prevalence. Data on 3 comorbidity indices are also available including the: DHHS multi-morbidity score, Charlson Comorbidity Index, and Mayo Clinic COVID-19 Risk Factor Score. Conclusion In addition to managing the ever raging pandemic and growing death rates, it is equally important that we develop adequate resources for the investigation and understanding of COVID-19-related predictors and outcomes.

scholarly journals SPMSQ for risk stratification of older patients in the emergency department

2019 ◽  
Vol 52 (S4) ◽  
pp. 222-228 ◽  
Author(s):  
A. Schönstein ◽  
H.-W. Wahl ◽  
H. A. Katus ◽  
A. Bahrmann
Keyword(s):  
Emergency Department ◽  
Nursing Home ◽  
Risk Stratification ◽  
Predictive Validity ◽  
Older Patients ◽  
Area Under The Curve ◽  
Composite Endpoint ◽  
Adverse Outcomes ◽  
Nursing Home Admission ◽  
Initial Contact

Abstract Background Risk stratification of older patients in the emergency department (ED) is seen as a promising and efficient solution for handling the increase in demand for geriatric emergency medicine. Previously, the predictive validity of commonly used tools for risk stratification, such as the identification of seniors at risk (ISAR), have found only limited evidence in German geriatric patient samples. Given that the adverse outcomes in question, such as rehospitalization, nursing home admission and mortality, are substantially associated with cognitive impairment, the potential of the short portable mental status questionnaire (SPMSQ) as a tool for risk stratification of older ED patients was investigated. Objective To estimate the predictive validity of the SPMSQ for a composite endpoint of adverse events (e.g. rehospitalization, nursing home admission and mortality). Method This was a prospective cohort study with 260 patients aged 70 years and above, recruited in a cardiology ED. Patients with a likely life-expectancy below 24 h were excluded. Follow-up examinations were conducted at 1, 3, 6 and 12 month(s) after recruitment. Results The SPMSQ was found to be a significant predictor of adverse outcomes not at 1 month (area under the curve, AUC 0.55, 95% confidence interval, CI 0.46–0.63) but at 3 months (AUC 0.61, 95% CI 0.54–0.68), 6 months (AUC 0.63, 95% CI 0.56–0.70) and 12 months (AUC 0.63, 95% CI 0.56–0.70) after initial contact. Conclusion For longer periods of observation the SPMSQ can be a predictor of a composite endpoint of adverse outcomes even when controlled for a range of confounders. Its characteristics, specifically the low sensitivity, make it unsuitable as an accurate risk stratification tool on its own.

scholarly journals First validation of the G-8 geriatric screening tool in older patients with glioblastoma

2019 ◽  
Vol 10 (1) ◽  
pp. 159-163 ◽  
Author(s):  
Elise Deluche ◽  
Sophie Leobon ◽  
Francois Lamarche ◽  
Nicole Tubiana-Mathieu
Keyword(s):  
Older Patients ◽  
Screening Tool ◽  
Geriatric Screening

scholarly journals 246Use of The ‘Surprise Question’ in Predicting Adverse Outcomes Among Frail Older Patients after Hospital Admission

2018 ◽  
Vol 47 (suppl_5) ◽  
pp. v1-v12
Author(s):  
Laura Gaffney ◽  
Conor Judge ◽  
Laura Morrison ◽  
Maria Costello ◽  
Stephanie Robinson ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Older Patients ◽  
Adverse Outcomes ◽  
Surprise Question

scholarly journals Pharmacy Practice: Exploring the Relationship between SSRIs and Sodium Levels in an Older Adult Population

2016 ◽  
Vol 7 (4) ◽  
Author(s):  
Sonya L Anderson ◽  
Nita Johnston
Keyword(s):  
Older Patients ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Sodium Level ◽  
Screening Tool ◽  
Conflicts Of Interest ◽  
Adult Population ◽  
Pharmacy Practice ◽  
Hospital Data ◽  
Inappropriate Use ◽  
Financial Interests

I was asked to examine the presence of hyponatremia (<130 mEq/L) in older patients (>65 years) taking Selective Serotonin Reuptake Inhibitors (SSRIs) at Moses Cone Hospital. The presence of hyponatremia in older patients using SSRIs indicates potentially inappropriate use according to the STOPP (Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions) and START (Screening Tool to Alert Doctors to Right Treatment) criteria6. This study was done to assess possible risk factors for potentially inappropriate use of SSRIs by older patients at Moses Cone Hospital. Data collected included the patient’s sex, age, sodium level, and the date the sodium level was drawn. Data also included the specific SSRI and the starting date for the SSRI. The study showed no relationship between age, sex, SSRI prescribed and hyponatremia. However, patients that were prescribed an SSRI for less than a year were more at risk for hyponatremia. Therefore, in order to minimize the risk of hyponatremia, additional monitoring may need to be added at SSRI initiation, three months, six months, and one year, especially in patients with other medications that may lower sodium levels. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties.   Type: Student Project

scholarly journals Age differences in clinical features and outcomes in patients with COVID-19, Jiangsu, China: a retrospective, multi-center cohort study

2020 ◽  
Author(s):  
Huanyuan Luo ◽  
Songqiao Liu ◽  
Yuancheng Wang ◽  
Penelope A. Phillips-Howard ◽  
Yi Yang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Hospital Stay ◽  
Older Patients ◽  
Adverse Outcomes ◽  
Trend Test ◽  
Chronic Obstructive ◽  
Chi Square ◽  
Chi Square Test

Objectives To determine the age-specific clinical presentations and incidence of adverse outcomes among patients with COVID-19 in Jiangsu, China. Design and setting This is a retrospective, multi-center cohort study performed at twenty-four hospitals in Jiangsu, China. Participants From January 10 to March 15, 2020, 625 patients with COVID-19 were involved. Results Of the 625 patients (median age, 46 years; 329 [52.6%] males), 37 (5.9%) were children (18 years or less), 261 (40%) young adults (19-44 years), 248 (39.7%) middle-aged adults (45-64 years), and 79 (12.6%) elderly (65 years or more). The incidence of hypertension, coronary heart disease, chronic obstructive pulmonary disease, and diabetes comorbidities increased with age (trend test, P < .0001, P = 0.0003, P < .0001, and P < .0001 respectively). Fever, cough, and shortness of breath occurred more commonly among older patients, especially the elderly, compared to children (Chi-square test, P = 0.0008, 0.0146, and 0.0282, respectively). The quadrant score and pulmonary opacity score increased with age (trend test, both P < .0001). Older patients had significantly more abnormal values in many laboratory parameters than younger patients. Elderly patients contributed the highest proportion of severe or critically-ill cases (33.0%, Chi-square test P < 0.001), intensive care unit (ICU) (35.4%, Chi-square test P < 0.001), and respiratory failure (31.6%, Chi-square test P = 0.0266), and longest hospital stay (21 days, ANOVA-test P < 0.001). Conclusions Elderly (≥65) patients with COVID-19 had the highest risk of severe or critical illness, intensive care use, respiratory failure, and the longest hospital stay, which may be due partly to that they had higher incidence of comorbidities and poor immune responses to COVID-19.

Translation and adaption of short version of IQCODE into Hausa and its psychometric evaluation among outpatients older adults

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Tolulope Adeniji ◽  
Adetoyeje Y. Oyeyemi
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Internal Consistency ◽  
Screening Tool ◽  
Receiver Operating Curve ◽  
Cognitive Screening ◽  
Cronbach’S Alpha ◽  
Cognitive Changes ◽  
Content Type ◽  
Cronbach's Alpha

Purpose This study aims at translating and adapting a common and widely used proxy rated cognitive screening tool – Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) into Hausa language and also to evaluate the instrument’s psychometric properties. Design/methodology/approach IQCODE was translated and adapted using a qualitative process involving experts and the adapted version was then evaluated against a gold standard (Diagnostic and Statistical Manual of Mental Disorder V criteria for neurocognitive disorders) with older adults subjects (N = 100), while its reliability (internal consistency) was also evaluated. Descriptive statistics of mean and frequencies, and inferential statistic of receiver operating curve analysis and Cronbach’s alpha coefficient were used for data analysis at an alpha level set at 0.05. Findings The Hausa IQCODE has a sensitivity value of 73.3%, specificity value of 71.8% and optimal cut-off values of between 3.2 and 3.3. For his adapted instrument the area under the Curve (AUC) curve is 0.79 (95% CI: 0.663–0.919; std. err: 0.066; P = 0.000), and Cronbach’s alpha value of 0.819 was obtained indicating that the adapted instrument has good internal consistency. Research limitations/implications The adapted IQCODE is a valid and reliable proxy based cognitive screening tool for the older adult Hausa speakers in Maiduguri. However, clinician and researcher might want to consider different optimal cut-off points when using this tool to screen or to monitor cognitive changes among older adults. Originality/value This research paper translated and adapted Hausa IQCODE into Hausa language. And it gives information on the validity and reliability of the adapted tool alongside with new optimal cut-off for cognitive screening by proxy among older adult patients in Nigeria.

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