Abstract P312: Sensitivity to Mental Illness and Life Enjoyment (smile) After Stroke

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Matthew Wu ◽  
Laura Solano ◽  
Christopher Degiorgio ◽  
Neal M Rao
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Length Of Stay ◽  
Statistical Significance ◽  
Health Resources ◽  
Hospital Length ◽  
County Hospital ◽  
Hospital Length Of Stay ◽  
Stroke Patients

Background: After experiencing a life changing stroke, survivors are often faced with a challenging journey back to wellness. This is particularly trying for those with depression and poor access to healthcare. In this study, we seek to assess the degree of depression and health-related quality of life (QOL) in first-time ischemic stroke patients compared to post-myocardial infarction (MI) patients in a county hospital system. Methods: Consecutive patients admitted for stroke and MI at a Los Angeles County Hospital were reviewed. Patients who meet the inclusion criteria and consented for participation were assessed for quality of life with EQ-5D-3L, depression with Patient Health Questionnaire 9 (PHQ-9) and knowledge of mental health resources. Stroke and MI severity were ranked and compared by hospital length of stay and day 90 mRS. Dichotomized variables were computed via t-test for parametric and Wilcoxon for nonparametric values. Multivariate analysis of non-parametric values was computed via Spearman correlation. Results: 61 stroke patients (mean age 59.7±13.4) and 52 MI patients (mean age 60.5±9.9) were included. Hospital length of stay did not significantly differ (mean 3.9 vs 2.5 days p=0.11). Day 90 mRS was significantly higher in the stroke group (mean 1.62 vs 0.96, p=0.004). PHQ-9 (mean 5.97 vs 6.85 p=0.13) and EQ-5D-3L (mean 7.4 vs 6.60 p=0.06) scores did not significantly differ. Among stroke patients (mean NIHSS 4.8 ±5.7), age correlated with day 90 mRS (r s =0.36 p<0.01). Initial NIHSS and stroke subtype did not correlate with either PHQ-9 or EQ-5D scores. Day 90 mRS correlated with PHQ-9 scores (r s =0.76 p<0.01, r s =0.65 p<0.01) and EQ-5D scores (r s =0.74 p<0.01, r s =0.78 p<0.01) in both groups. Only 6.5% of stroke and 15.1% of MI patients sought mental health resources. Conclusions: Stroke patients trended towards worse QOL scores, but lower depression scores than MI patients, though this did not reach statistical significance. Day 90 mRS correlated with worse QOL and depression scores in both groups. Despite high rates of depressive symptoms, very few patients had sought out mental health resources. This highlights the need to support mental health outreach, especially for vulnerable county patient populations.

Mood Disorders in Elderly Patients Hospitalized for Acute Exacerbation of COPD

2017 ◽  
Vol 41 (S1) ◽  
pp. S142-S142
Author(s):  
I. Bonfitto ◽  
G. Moniello ◽  
M. Pascucci ◽  
A. Bellomo
Keyword(s):  
Quality Of Life ◽  
Length Of Stay ◽  
Elderly Patients ◽  
Acute Exacerbation ◽  
Rating Scale ◽  
Hospital Length Of Stay ◽  
Acute Exacerbation Of Copd ◽  
Copd Exacerbations ◽  
Exacerbation Of Copd

IntroductionChronic obstructive pulmonary disease (COPD) represents the most common cause of chronic respiratory failure and it's associated with several comorbidities such as depression. Depression is about four times more frequent in elderly patients with COPD compared to peers who are not affected and its prevalence increases with the degree of disease severity.ObjectiveTo assess mood and perception of the quality of life in elderly patients hospitalized for acute exacerbation of COPD.MethodsThirty-five elderly patients hospitalized for reactivation of COPD were examined; they were subjected to spirometry test for the calculation of FEV1 and to COPD Assessment Test (CAT) and Hamilton Rating Scale for Depression (HAM-D) to evaluate impact of COPD on patients’ quality of life and depressive symptomatology, respectively. The number of COPD exacerbations in the last year prior to hospitalization and the number of recovery days required for the stabilization of patients were also recorded.ResultsThere were strongly significative correlations (P < 0.001), positive between HAM-D scores, CAT scores, number of exacerbation in the last year and hospital length of stay and negative between HAM-D scores and FEV1 values. Furthermore, females were more depressed, with lower FEV 1 (P = 0.043) and with a longer length of stay (P = 0.039) as compared to males.ConclusionsA greater severity of depressive symptoms is related to a greater severity of COPD exacerbations, disability associated with it and perceived by the patient, as well as a higher number of recovery days and annual acute exacerbations, particularly in female gender.

scholarly journals QUALITY OF LIFE OF STROKE PATIENT CAREGIVERS AT SRINAGARIND HOSPITAL, KHON KAEN PROVINCE, THAILAND

2015 ◽  
Vol 6 (3) ◽  
pp. 1123-1133
Author(s):  
Lertchai Charerntanyarak ◽  
Karnchanasri Singhpoo ◽  
Roongtiwa Chobchuen ◽  
Chananya Kasinpila ◽  
Ratchada Ngamroop ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Stroke Patient ◽  
Assessment Instrument ◽  
Life Assessment ◽  
Sources Of Information ◽  
Physical And Mental Health ◽  
Stroke Patients ◽  
Khon Kaen

Stroke is a chronic disease requiring patients to be treated for a long period of time. Patients need to been given close and attentive care, and this has an impacton the health and daily lives of caregivers. The aim of this cross-sectional descriptive study was to investigate the quality of life of stroke patient caregivers at Srinagarind Hospital, Khon Kaen Province, Thailand. The subjects were 166 caregivers of all stroke patients who received treatment at Srinagarind Hospital during the period 1 July 10 September, 2011. The research tool was a questionnaire which was intwo parts: Part 1 was designed to collect baseline data about the patients and their caregivers, and Part 2 was the Thai version of the brief WHO quality of life assessment instrument (WHOQOL-BREF-THAI). Data were collected from the patients medical histories and from interviews conducted by the researchers and were analyzed using descriptive statistics. The results showed that the overall quality of life of caregivers was at a moderate level with a mean score of92.5. In terms of each component domain of the quality of lifeinstrument, the mean scores for physical health, mental health, social relationships, and the environment were24.1, 21.3, 10.7, and 29.3 points, respectively.Even though the quality of life of caregivers was moderatelyhigh, medical professionals who provide care for stroke patients should assist and support caregivers in various ways by, for example, giving advice on sources of information which are useful to the caregivers themselves and for the physical and mental health care of the patients in. They should also provide assistance to families when they require help in continuing to care for the patients in their own homes.

scholarly journals Differences in Antibiotic and Antiviral Use in People With Confirmed Influenza: a Retrospective Comparison of Rapid Influenza PCR and Multiplex Respiratory Virus PCR Tests.

2020 ◽  
Author(s):  
Victor Au Yeung ◽  
Kiran Thapa ◽  
William Rawlinson ◽  
Andrew Georgiou ◽  
Jeffrey Post ◽  
...  
Keyword(s):  
Emergency Department ◽  
High Risk ◽  
Length Of Stay ◽  
Influenza A ◽  
Respiratory Virus ◽  
Cost Benefit Analysis ◽  
Statistical Significance ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Inpatient Hospital

Abstract BACKGROUND Influenza is a highly contagious respiratory virus with clinical impacts on patient morbidity, mortality and hospital bed management. The effect of rapid nucleic acid testing (RPCR) in comparison to standard multiplex PCR (MPCR) diagnosis in treatment decisions is unclear. This study aimed to determine whether RPCR influenza testing in comparison to standard MPCR testing was associated with differences in antibiotic and antiviral (oseltamivir) utilisation and hospital length of stay in emergency department and inpatient hospital settings. METHODS A retrospective cohort study of positive influenza RPCR and MPCR patients was performed utilising data from the 2017 influenza season. Medical records of correlating patient presentations were reviewed for data collection. An analysis of RPCR versus MPCR patient outcomes was performed examining test turnaround time, antibiotic initiation, oseltamivir initiation and hospital length of stay for both emergency department and inpatient hospital stay. Subgroup analysis was performed to assess oseltamivir use in high risk populations for influenza complications. Statistical significance was assessed using Mann-Whitney test for numerical data and Chi-squared test for categorical data. Odds ratio with 95% confidence intervals were calculated where appropriate.RESULTS Overall, 122 RPCR and 362 MPCR positive influenza patients were included in this study. Commencement of antibiotics was less frequent in the RPCR than MPCR cohorts (51% vs 67%; p <0.01, OR 0.52; 95% CI 0.34-0.79). People at high risk of complications from influenza who were tested with the RPCR were more likely to be treated with oseltamivir compared to those tested with the MPCR (76% vs 63%; p = 0.03, OR 1.81; 95% CI 1.07-3.08). Hospital length of stay was not impacted when either test was used in the emergency department and inpatient settings. CONCLUSIONS These findings suggest utilisation of RPCR testing in influenza management can improve antibiotic stewardship through reduction in antibiotic use and improvement in oseltamivir initiation in those at higher risk of complications. Further research is required to determine other factors that may have influenced hospital length of stay and a cost-benefit analysis should be undertaken to determine the financial impact of the RPCR test.

scholarly journals Predicting hospital length of stay for geriatric and adult patients with schizophrenia

2015 ◽  
Vol 4 (2) ◽  
pp. 15 ◽  
Author(s):  
Zahinoor Ismail ◽  
Tamara Arenovich ◽  
Charlotte Grieve ◽  
Peggie Willett ◽  
Donald Addington ◽  
...  
Keyword(s):  
Mental Health ◽  
Length Of Stay ◽  
Linear Models ◽  
Health Centre ◽  
Clinical Information ◽  
Hospital Length ◽  
Adult Patients ◽  
Hospital Length Of Stay ◽  
Use Of Resources ◽  
Resident Assessment

Objective: To determine predictors of psychiatric hospital length of stay (LOS) for geriatric and adult patients with schizophrenia admitted to inpatient beds, that could be determined within 72 hours of hospitalization. Methods: General linear models were used to identify and compare predictors of LOS for 187 geriatric patients and 881 general adult patients with schizophrenia admitted to a large urban mental health centre between 2005 and 2010. Demographic and clinical information were obtained from the Resident Assessment Inventory – Mental Health (RAI). Results: Increased dependence score on the Instrumental Activities of Daily Living scale predicted longer LOS in general adult but not in geriatric schizophrenia patients. Predictors of longer LOS irrespective of age group included recent psychiatric admissions, living alone and incapacity to make treatment decisions. Conclusions: Specific clinical characteristics are associated with longer hospitalization in patients with schizophrenia. Addressing these factors early on in the admission may result in shorter LOS and better use of resources.

scholarly journals Preoperative Dexamethasone Enhances Quality of Recovery after Laparoscopic Cholecystectomy

2011 ◽  
Vol 114 (4) ◽  
pp. 882-890 ◽  
Author(s):  
Glenn S. Murphy ◽  
Joseph W. Szokol ◽  
Steven B. Greenberg ◽  
Michael J. Avram ◽  
Jeffery S. Vender ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Length Of Stay ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Postanesthesia Care Unit ◽  
Control Group ◽  
Quality Of Recovery ◽  
Pain Scores ◽  
Dexamethasone Group

Background The effect of dexamethasone on quality of recovery after discharge from the hospital after laparoscopic surgery has not been examined rigorously in previous investigations. We hypothesized that preoperative dexamethasone would enhance patient-perceived quality of recovery on postoperative day 1 in subjects undergoing laparoscopic cholecystectomy. Methods One hundred twenty patients undergoing outpatient laparoscopic cholecystectomy were randomized to receive either dexamethasone (8 mg) or placebo-saline. A 40-item quality-of-recovery scoring system (QoR-40) was administered preoperatively and on postoperative day 1 to all subjects. Nausea, vomiting, fatigue, and pain scores were recorded at the time of discharge from the postanesthesia care unit and ambulatory surgical unit. Hospital length of stay was also assessed. Results Global QoR-40 scores on postoperative day 1 were higher in the dexamethasone group (median [range], 178 [130-195]) compared with the control group (161 [113-194]) (median difference [99% CI], -18 [-26 to -8]; P &lt; 0.0001). Postoperative QoR-40 scores in the dimensions of emotional state, physical comfort, and pain were all improved in the dexamethasone group compared with the control group (P &lt; 0.001). Nausea, fatigue, and pain scores were all reduced in the dexamethasone group during the hospitalization, as were postoperative analgesic requirements (P &lt; 0.05). Total hospital length of stay was also reduced in subjects administered steroids (P = 0.003). Conclusions Among patients undergoing outpatient laparoscopic cholecystectomy surgery, the use of preoperative dexamethasone enhanced postdischarge quality of recovery and reduced nausea, pain, and fatigue in the early postoperative period.

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