Dementia and the risk of short-term readmission and mortality after a pneumonia admission

Background At time of discharge after a pneumonia admission, care planning for older persons with dementia is essential. However, care planning is limited by lack of knowledge on the short-term prognosis. Aim To investigate 30-day mortality and readmission after hospital discharge for pneumonia in persons with versus without dementia, and to investigate how these associations vary with age, time since discharge, and medication use. Methods Using the Danish registries, we investigated 30-day mortality and readmission in persons (+65 years) discharged after pneumonia in 2000–2016 (N = 298,872). Adjusted mortality rate ratios (aMRRs) and incidence rate ratios (aIRRs) were calculated for persons with versus without dementia, and we investigated if these associations varied with use of benzodiazepines, opioids, and antipsychotics, and with age and time since discharge. Results Among 25,948 persons with dementia, 4,524 died and 5,694 were readmitted within 30 days. The risk of 30-day mortality was 129% higher (95% CI 2.21–2.37) in persons with versus without dementia after adjustment for sociodemographic characteristics, admission-related factors, and comorbidities. Further, the highest mortality risk was found in persons with both dementia and use of antipsychotics (aMRR: 3.39, 95% CI 3.19–3.59); 16% of deaths in this group could not be explained by the independent effect of each exposure. In those with dementia, the highest aMRRs were found for the youngest and for the first days after discharge. The risk of 30-day readmission was 7% higher (95% CI 1.04–1.10) in persons with versus without dementia. In those with dementia, the highest aIRRs were found for the first days after discharge. Conclusions Dementia was associated with higher short-term mortality after pneumonia, especially in users of antipsychotics, and with slightly higher readmission, especially in the first days after discharge. This is essential knowledge in the care planning for persons with dementia who are discharged after a pneumonia admission.

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Association between multimorbidity and socioeconomic deprivation on short-term mortality among patients with diffuse large B-cell or follicular lymphoma in England: a nationwide cohort study

BMJ Open ◽

10.1136/bmjopen-2021-049087 ◽

2021 ◽

Vol 11 (11) ◽

pp. e049087

Author(s):

Matthew James Smith ◽

Edmund Njeru Njagi ◽

Aurelien Belot ◽

Clémence Leyrat ◽

Audrey Bonaventure ◽

...

Keyword(s):

Follicular Lymphoma ◽

B Cell ◽

Mortality Risk ◽

Population Based ◽

Socioeconomic Deprivation ◽

Short Term ◽

English Population ◽

Short Term Mortality ◽

Rate Ratios ◽

Large B Cell

ObjectivesWe aimed to assess the association between multimorbidity and deprivation on short-term mortality among patients with diffuse large B-cell (DLBCL) and follicular lymphoma (FL) in England.SettingThe association of multimorbidity and socioeconomic deprivation on survival among patients diagnosed with DLBCL and FL in England between 2005 and 2013. We linked the English population-based cancer registry with electronic health records databases and estimated adjusted mortality rate ratios by multimorbidity and deprivation status. Using flexible hazard-based regression models, we computed DLBCL and FL standardised mortality risk by deprivation and multimorbidity at 1 year.ResultsOverall, 41 422 patients aged 45–99 years were diagnosed with DLBCL or FL in England during 2005–2015. Most deprived patients with FL with multimorbidities had three times higher hazard of 1-year mortality (HR: 3.3, CI 2.48 to 4.28, p<0.001) than least deprived patients without comorbidity; among DLBCL, there was approximately twice the hazard (HR: 1.9, CI 1.70 to 2.07, p<0.001).ConclusionsMultimorbidity, deprivation and their combination are strong and independent predictors of an increased short-term mortality risk among patients with DLBCL and FL in England. Public health measures targeting the reduction of multimorbidity among most deprived patients with DLBCL and FL are needed to reduce the short-term mortality gap.

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Short-term mortality among older persons hospitalized for pneumonia: Influence of baseline patient characteristics beyond severity of illness

Journal of Hospital Medicine ◽

10.1002/jhm.985 ◽

2011 ◽

Vol 7 (3) ◽

pp. 211-217 ◽

Cited By ~ 6

Author(s):

Yew Y. Ding ◽

John Abisheganaden ◽

Wai F. Chong ◽

Bee H. Heng ◽

T. K. Lim

Keyword(s):

Older Persons ◽

Severity Of Illness ◽

Patient Characteristics ◽

Short Term ◽

Short Term Mortality

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The Impact of Penicillin Resistance on Short-Term Mortality in Hospitalized Adults with Pneumococcal Pneumonia: A Systematic Review and Meta-Analysis

Yearbook of Pulmonary Disease ◽

10.1016/s8756-3452(08)70418-3 ◽

2007 ◽

Vol 2007 ◽

pp. 202-203

Author(s):

J.R. Maurer

Keyword(s):

Systematic Review ◽

Pneumococcal Pneumonia ◽

Meta Analysis ◽

Penicillin Resistance ◽

Short Term ◽

Short Term Mortality ◽

The Impact

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Faculty Opinions recommendation of Association between waiting times and short term mortality and hospital admission after departure from emergency department: population based cohort study from Ontario, Canada.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.11812956.12909054 ◽

2011 ◽

Author(s):

Patrick Ray

Keyword(s):

Emergency Department ◽

Cohort Study ◽

Hospital Admission ◽

Waiting Times ◽

Population Based ◽

Short Term ◽

Short Term Mortality

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Faculty Opinions recommendation of Myocardial injury after noncardiac surgery and its association with short-term mortality.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718009625.793494600 ◽

2014 ◽

Author(s):

Roberta Hines ◽

Natalie Holt

Keyword(s):

Myocardial Injury ◽

Noncardiac Surgery ◽

Short Term ◽

Short Term Mortality

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Faculty Opinions recommendation of Influence of high-dose highly efficient statins on short-term mortality in patients undergoing percutaneous coronary intervention with stenting for acute coronary syndromes.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718251807.793508014 ◽

2015 ◽

Author(s):

Wilbert Aronow

Keyword(s):

Percutaneous Coronary Intervention ◽

Acute Coronary Syndromes ◽

Coronary Intervention ◽

High Dose ◽

Short Term ◽

Highly Efficient ◽

Percutaneous Coronary ◽

Short Term Mortality ◽

Coronary Syndromes

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Faculty Opinions recommendation of Association between extracellular matrix expansion quantified by cardiovascular magnetic resonance and short-term mortality.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718250476.793491392 ◽

2014 ◽

Author(s):

Gerald Maurer ◽

Georg Goliasch

Keyword(s):

Extracellular Matrix ◽

Cardiovascular Magnetic Resonance ◽

Magnetic Resonance ◽

Short Term ◽

Matrix Expansion ◽

Short Term Mortality ◽

Extracellular Matrix Expansion

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Older persons and relatives’ experience of coordinated care planning via a video meeting

Nursing Open ◽

10.1002/nop2.600 ◽

2020 ◽

Vol 7 (6) ◽

pp. 2047-2055

Author(s):

Ann‐Therese Hedqvist ◽

Sandra Pennbrant ◽

Margareta Karlsson

Keyword(s):

Older Persons ◽

Care Planning ◽

Coordinated Care ◽

Video Meeting

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Association of early glycemic change with short-term mortality in lobar and non-lobar intracerebral hemorrhage

Scientific Reports ◽

10.1038/s41598-021-95453-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Paola Forti ◽

Fabiola Maioli ◽

Marco Zoli

Keyword(s):

Intracerebral Hemorrhage ◽

Continuous Variable ◽

Serum Glucose ◽

Diabetic Patients ◽

Short Term ◽

Cox Models ◽

Short Term Mortality ◽

Glucose Test ◽

Acute Intracerebral Hemorrhage ◽

Persistent Hyperglycemia

AbstractThe association between early glycemic change and short-term mortality in non-diabetic patients with acute intracerebral hemorrhage (ICH) is unclear. We retrospectively investigated non-diabetic patients with lobar (n = 262) and non-lobar ICH (n = 370). Each patient had a random serum glucose test on hospital admission and a fasting serum glucose test within the following 48 h. Hyperglycemia was defined as serum glucose ≥ 7.8 mmol/l. Four patterns were determined: no hyperglycemia (reference category), persistent hyperglycemia, delayed hyperglycemia, and decreasing hyperglycemia. Associations with 30-day mortality were estimated using Cox models adjusted for major features of ICH severity. Persistent hyperglycemia was associated with 30-day mortality in both lobar (HR 3.00; 95% CI 1.28–7.02) and non-lobar ICH (HR 4.95; 95% CI 2.20–11.09). In lobar ICH, 30-day mortality was also associated with delayed (HR 4.10; 95% CI 1.77–9.49) and decreasing hyperglycemia (HR 2.01, 95% CI 1.09–3.70). These findings were confirmed in Cox models using glycemic change (fasting minus random serum glucose) as a continuous variable. Our study shows that, in non-diabetic patients with ICH, early persistent hyperglycemia is an independent predictor of short-term mortality regardless of hematoma location. Moreover, in non-diabetic patients with lobar ICH, both a positive and a negative glycemic change are associated with short-term mortality.

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Avoidance of Healthcare Utilization in South Korea during the Coronavirus Disease 2019 (COVID-19) Pandemic

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18084363 ◽

2021 ◽

Vol 18 (8) ◽

pp. 4363

Author(s):

Minjung Lee ◽

Myoungsoon You

Keyword(s):

General Population ◽

South Korea ◽

Healthcare Utilization ◽

Online Survey ◽

Negative Impact ◽

Sociodemographic Characteristics ◽

Related Factors ◽

First Case ◽

Significant Difference ◽

Health Related

Avoidance of healthcare utilization among the general population during pandemic outbreaks has been observed and it can lead to a negative impact on population health. The object of this study is to examine the influence of socio-demographic and health-related factors on the avoidance of healthcare utilization during the global outbreak of a novel coronavirus (COVID-19) in 2020. Data were collected through an online survey four weeks after the Korea Centers for Disease Control and Prevention (KCDC) confirmed the first case in South Korea; 1000 subjects were included in the analysis. The logit model for regression was used to analyze the associations between sociodemographic and health-related factors regarding the avoidance of healthcare utilization. Among the participants, 73.2% avoided healthcare utilization, and there was no significant difference in the prevalence of healthcare avoidance between groups with (72.0%) and without (74.9%) an underlying disease. Sociodemographic characteristics (e.g., gender, age, income level, and residential area) were related to healthcare avoidance. Among the investigated influencing factors, residential areas highly affected by COVID-19 (i.e., Daegu/Gyeoungbuk region) had the most significant effect on healthcare avoidance. This study found a high prevalence of healthcare avoidance among the general population who under-utilized healthcare resources during the COVID-19 outbreak. However, the results reveal that not all societal groups share the burden of healthcare avoidance equally, with it disproportionately affecting those with certain sociodemographic characteristics. This study can inform healthcare under-utilization patterns during emerging infectious disease outbreaks and provide information to public health emergency management for implementing strategies necessary to improve the preparedness of the healthcare system.

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