Clostridium difficile infection at a geriatric acute-care hospital in Switzerland between 2008 and 2014: a retrospective cohort study

Abstract Background In several current fall prediction models, the reported predictors vary from one model to another. We developed and validated a new fall prediction model for patients admitted to an acute care hospital by identifying predictors of falls considering a combination of background factors and one crucial stratum. Methods We conducted a retrospective cohort study of patients admitted to Shizuoka General Hospital from April 2019 to September 2020, aged 20 years or older. We developed and validated a new fall prediction model by identifying predictors of falls stratified by essential activities of daily living (ADL) indicators and integrating these models. Results A total of 22,988 individuals were included in the analysis, with 653 (2.8 %) experiencing all falls and 400 (1.7 %) experiencing falls with medical resources during the study period. Multivariate analysis was performed after one stratification level, using bedridden rank (ability to move around in daily life) as a stratifying variable, a clinically important variable and highly correlated with 17 other variables. The results of multivariate analysis showed that the risk factors for falls (high risk) were age (high), sex (men), and ambulance transport (yes) for rank J (independence/autonomy); age (high),) and sex (men) for rank A (house-bound); There were no predictors for rank B (chair-bound); and there was ophthalmologic disease (no) for rank C (bed-bound). The c-index indicating the prediction model’s performance for falls within 28 days of hospitalisation was 0.705 (95 % CI, 0.664–0.746). Hosmer-Lemeshow goodness-of-fit statistics were significant (χ2 = 192.06; 8 degrees of freedom; p < 0.001). The c-index for the entire unstratified sample was 0.703 (95 % CI, 0.661–0.746), indicating that the predictive model stratified by bedriddenness rank was accurate (p < 0.001). Conclusion We identified predictors of falls using important ADLs (bedriddenness rank) and developed a more accurate prediction model in acute care hospital settings. This predictive model is an essential tool for fall prevention.

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Effectiveness of 7-day versus weekday-only rehabilitation for stroke patients in an acute-care hospital: a retrospective cohort study

Disability and Rehabilitation ◽

10.1080/09638288.2017.1367964 ◽

2017 ◽

Vol 40 (25) ◽

pp. 3050-3053 ◽

Cited By ~ 2

Author(s):

Tomoko Nakazora ◽

Konosuke Iwamoto ◽

Tetsuhito Kiyozuka ◽

Hirohiko Arimoto ◽

Toshiki Shirotani ◽

...

Keyword(s):

Cohort Study ◽

Acute Care ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Acute Care Hospital ◽

Care Hospital ◽

Stroke Patients

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The incidence of adverse events in an Italian acute care hospital: findings of a two-stage method in a retrospective cohort study

BMC Health Services Research ◽

10.1186/1472-6963-14-358 ◽

2014 ◽

Vol 14 (1) ◽

Cited By ~ 14

Author(s):

Lorenzo Sommella ◽

Chiara de Waure ◽

Anna Maria Ferriero ◽

Amalia Biasco ◽

Maria Teresa Mainelli ◽

...

Keyword(s):

Cohort Study ◽

Adverse Events ◽

Acute Care ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Acute Care Hospital ◽

Care Hospital ◽

Two Stage

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Association between the use of physical restraint and functional decline among older inpatients admitted with pneumonia in an acute care hospital: A retrospective cohort study

Archives of Gerontology and Geriatrics ◽

10.1016/j.archger.2020.104330 ◽

2020 ◽

pp. 104330

Author(s):

Shoko Soeno ◽

Toshihiko Takada ◽

Taro Takeshima ◽

Mirei Kaneyama ◽

Manami Sagawa ◽

...

Keyword(s):

Cohort Study ◽

Acute Care ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Physical Restraint ◽

Functional Decline ◽

Acute Care Hospital ◽

Care Hospital ◽

Older Inpatients

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Incidence and risk factors of a severe Clostridium difficile infection: results of a retrospective cohort study at a tertiary care hospital

10.21203/rs.2.13795/v1 ◽

2019 ◽

Author(s):

Claas Baier ◽

Simone Valentin ◽

Frank Schwab ◽

Sandra Steffens ◽

Ralf-Peter Vonberg ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Clostridium Difficile ◽

Clostridium Difficile Infection ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Tertiary Care ◽

Care Hospital ◽

Care Clinic ◽

Independent Risk Factors

Abstract Background Clostridium difficile infection (CDI) is a relevant healthcare burden worldwide and one of the leading causes for nosocomial diarrhea. Besides mild courses, the development of a severe infection can occur and has a relevant impact on healthcare costs and patient outcome.Methods We conducted a retrospective cohort study over a 4 year-long period to analyze the incidence of CDI and the contributing risk factors for a severe course at a tertiary care clinic. Independent risk factors were determined by a multivariable logistic regression analysis.Results A total of 761 CDI cases were identified in the study period, thereof 612 (80.4%) cases were nosocomially acquired. The mean incidence for a CDI was 0.42 cases per 1000 patient-days. A severe CDI occurred in 131 cases (17.2%). Independent risk factors for a severe course were pulmonary disease, a Charlson comorbidity index >3, and a preceding antibiotic therapy within three months with glycopeptides (vancomycin/teicoplanin) and/or aminoglycosides.Conclusions This study highlights the relevant burden of CDI in hospitals. Moreover, it underscores that specific knowledge of risk factors contributing to severe CDI is crucial to optimize treatment, infection prevention measures and to guide clinical monitoring and therapy strategy.

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The occurrence and timing of delirium in acute care hospitalizations in the last year of life: A population-based retrospective cohort study

Palliative Medicine ◽

10.1177/0269216320929545 ◽

2020 ◽

Vol 34 (8) ◽

pp. 1067-1077

Author(s):

Colleen Webber ◽

Christine L Watt ◽

Shirley H Bush ◽

Peter G Lawlor ◽

Robert Talarico ◽

...

Keyword(s):

Cohort Study ◽

Confidence Interval ◽

Acute Care ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Prevalence Ratio ◽

Acute Care Hospitals ◽

Population Based ◽

Care Hospital ◽

Factors Associated

Background: Delirium is a distressing neurocognitive disorder that is common among terminally ill individuals, although few studies have described its occurrence in the acute care setting among this population. Aim: To describe the prevalence of delirium in patients admitted to acute care hospitals in Ontario, Canada, in their last year of life and identify factors associated with delirium. Design: Population-based retrospective cohort study using linked health administrative data. Delirium was identified through diagnosis codes on hospitalization records. Setting/participants: Ontario decedents (1 January 2014 to 31 December 2016) admitted to an acute care hospital in their last year of life, excluding individuals age of <18 years or >105 years at admission, those not eligible for the provincial health insurance plan between their hospitalization and death dates, and non-Ontario residents. Results: Delirium was recorded as a diagnosis in 8.2% of hospitalizations. The frequency of delirium-related hospitalizations increased as death approached. Delirium prevalence was higher in patients with dementia (prevalence ratio: 1.43; 95% confidence interval: 1.36–1.50), frailty (prevalence ratio: 1.67; 95% confidence interval: 1.56–1.80), or organ failure–related cause of death (prevalence ratio: 1.23; 95% confidence interval: 1.16–1.31) and an opioid prescription (prevalence ratio: 1.17; 95% confidence interval: 1.12–1.21). Prevalence also varied by age, sex, chronic conditions, antipsychotic use, receipt of long-term care or home care, and hospitalization characteristics. Conclusion: This study described the occurrence and timing of delirium in acute care hospitals in the last year of life and identified factors associated with delirium. These findings can be used to support delirium prevention and early detection in the hospital setting.

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