scholarly journals Heart failure as a predictor of functional dependence in hospitalized elderly

2015 ◽  
Vol 49 (5) ◽  
pp. 790-796 ◽  
Author(s):  
Sara de Oliveira Xavier ◽  
Renata Eloah de Lucena Ferretti-Rebustini ◽  
Eduesley Santana-Santos ◽  
Paola Alves de Oliveira Lucchesi ◽  
Karine Generoso Hohl
Keyword(s):  
Heart Failure ◽  
Medical Records ◽  
Daily Living ◽  
Functional Dependence ◽  
Functional Decline ◽  
University Hospital ◽  
Geriatric Ward ◽  
Hospitalized Elderly ◽  
Katz Index ◽  
Functional Deterioration

AbstractOBJECTIVEIdentify whether Heart Failure (HF) is a predictor of functional dependence for Basic Activities of Daily Living (BADL) in hospitalized elderly.METHODSWe investigated medical records and assessed dependence to BADL (by the Katz Index) of 100 elderly admitted to a geriatric ward of a university hospital. In order to verify if HF is a predictor of functional dependence, linear regression analyzes were performed.RESULTSThe prevalence of HF was 21%; 95% of them were dependent for BADLs. Bathing was the most committed ADL. HF is a predictor of dependence in hospitalized elderlies, increasing the chance of functional decline by 5 times (95% CI, 0.94-94.48), the chance of functional deterioration by 3.5 times (95% CI, 1.28-11.66; p <0.02) and reducing 0.79 points in the Katz Index score (p <0.05).CONCLUSIONHF is a dependency predictor of ADL in hospitalized elderly, who tend to be more dependent, especially for bathing.

scholarly journals Prevalence of Systolic Heart Failure in Patients with Dementia in Saudi Arabia: Single-center retrospective data review

2021 ◽  
Vol 19 (2) ◽  
Author(s):  
Mazen Basheikh ◽  
Ayman AlQayidi ◽  
Mohammed Addas ◽  
Mohammed Al-Zanbaqi ◽  
Abdulaziz Abumelha
Keyword(s):  
Heart Failure ◽  
Saudi Arabia ◽  
Medical Records ◽  
Chart Review ◽  
Critical Role ◽  
Systolic Heart Failure ◽  
University Hospital ◽  
Inclusion Criteria ◽  
Dominant Type ◽  
Diagnosis Of Dementia

Background: Dementia is one of the most common neurological diagnoses in older patients. Previous reports have proposed that heart failure could be a risk factor for dementia. Other studies have suggested that cardiovascular function could have a critical role in the pathogenesis of dementia. Aim: This study aimed to identify the prevalence of heart failure in patients diagnosed with dementia. Method: This was a chart review of medical records of patients followed at King Abdul-Aziz University Hospital and diagnosed with dementia with at least one echocardiogram completed after the diagnosis of dementia. Demographic variations and comorbidities of these patients were collected. Result: A total of 200 patients met the inclusion criteria, with a mean age of 76.28 years. In 10.5% of the participants, the ejection fraction was less than 40%. The dominant type of dementia in the participants was mixed/unspecified type (78.5%). Conclusion: The prevalence of systolic heart failure seems to be higher in patients with dementia when compared to similar age group populations reported in other studies. Multiple limitations are present in this study, and additional research is needed to further assess this possible correlation. Key words: Systolic heart failure, dementia, Saudi Arabia

scholarly journals Relationship between Activities of Daily Living and Readmission within 90 Days in Hospitalized Elderly Patients with Heart Failure

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Masahiro Kitamura ◽  
Kazuhiro P. Izawa ◽  
Hiroki Taniue ◽  
Yumi Mimura ◽  
Keita Imamura ◽  
...  
Keyword(s):  
Heart Failure ◽  
Body Mass Index ◽  
Elderly Patients ◽  
Activities Of Daily Living ◽  
Roc Curve ◽  
Daily Living ◽  
Cutoff Value ◽  
Hospitalized Elderly ◽  
Patients With Heart Failure ◽  
Hospitalized Elderly Patients

Aims. To examine the relationship between activities of daily living (ADL) and readmission within 90 days and assess the cutoff value of ADL to predict readmission in hospitalized elderly patients with heart failure (HF). Methods. This cohort study comprised 589 consecutive patients with HF aged ≥65 years, who underwent cardiac rehabilitation from May 2012 to May 2016 and were discharged home. We investigated patients’ characteristics, basic attributes, and ADL (motor and cognitive Functional Independence Measure [FIM]). We analyzed the data using the unpaired t-test, χ2 test, Cox proportional hazard model, receiver operating characteristic (ROC) curve, and Kaplan-Meier method. Results. Of 589 patients, 113 met the criteria, and they were divided into the nonreadmission (n=90) and readmission groups (n=23). Age, body mass index, New York Heart Association class, hemoglobin level, and motor FIM score were significantly different between the two groups (p<0.05). The body mass index (hazard ratio [HR]: 0.87; p<0.05) and motor FIM score (HR: 0.94; p<0.01) remained statistically significant. The cutoff value for the motor FIM score determined by ROC curve analysis was 74.5 points (area under the curve = 0.78; p<0.001). Conclusion. The motor FIM score in elderly patients with HF was an independent predictor of rehospitalization within 90 days.

Dependence Level in Basic and Instrumental Activities of Daily Living in Older Adults

2021 ◽  
Vol 4 (3) ◽  
Author(s):  
Ramona Armida Medina Barragán
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Negative Impact ◽  
Functional Dependence ◽  
Human Beings ◽  
Functional Changes ◽  
Instrumental Activities ◽  
Katz Index ◽  
Dependence Level

During the life cycle of human beings, various evolutionary processes take place in a constant and irreversible way, aging is characterized by a progressive loss of functionality and adaptability; this process involves functional changes and a greater degree of dependence, gradually affecting their health and performance of daily activities, leaving a negative impact in the lives of older people. Objective: Evaluate the dependence level in basic and instrumental activities of daily living in older adults. Materials and Methods: A descriptive, cross-sectional study with a quantitative approach and simple random sampling, the sample size consisted of 84 older adults, residents of Tepic Nayarit. Mexico. The Katz Index instruments were used to assess the functional dependence of the basic activities of daily living and the Lawton-Brody Instrumental Activities of Daily Living (IADL) scale to measure the level of independence in the instrumental activities of daily living. Results: The mean age of older adults was 74.58 ± 12.4 years. In regards to gender, 58% were female and 42% were male. The dependency classification according to the Katz index for basic activities of daily living determined that 50% had a significant prevalence of mild disability, 35.72% had moderate disability and 14.28% had severe disability. The Lawton-Brody (IADL) scale contributed evaluating the dependence level in instrumental activities of daily living, the results showed that 17% of older adults were independent, 21% had mild dependence, 25% had moderate dependence, 29% had severe dependence, and 5.9% had total dependence. Conclusions: The level of dependence is related to the health and age of persons and they are a constraint to be self-sufficient in managing the care they require daily, therefore, it is important to carry out interventions to promote independence and functionality in older adults.

scholarly journals Endoscopic retrograde cholangiopancreatography in infants and children

2021 ◽  
Vol 09 (03) ◽  
pp. E292-E296
Author(s):  
Tone Lise Åvitsland ◽  
Lars Aabakken
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Medical Records ◽  
Pediatric Patients ◽  
Biliary Stricture ◽  
Infants And Children ◽  
University Hospital ◽  
Older Children ◽  
Endoscopic Retrograde ◽  
Procedure Codes ◽  
In Infants And Children

Abstract Background and study aims Previous reports have suggested that endoscopic retrograde cholangiopancreatography (ERCP) in pediatric patients are safe. However, the total number of cases presented in the literature remains small. We present results regarding safety and outcomes in pediatric patients undergoing ERCP at Oslo University Hospital. Patients and methods Patients < 18 years who underwent ERCP between April 1999 and November 2017 were identified using procedure codes. Medical records were examined for age, gender, diagnosis, indications, type of sedation, findings, interventions, and complications. Results A total of 244 procedures were performed in 158 patients. Fifty-six of these were in 53 infants (age ≤ 1 year). Mean age was 8.8 years. The youngest patient was 8 days old. Mean weight was 5.0 kg in infants, the smallest weighing 2.9 kg. Cannulation failed in 19 (7.8 %). The main indication in infants was suspicion of biliary atresia (n = 38). Six of the procedures (10.7 %) were therapeutic. In children the main indications were biliary stricture (n = 64) and investigation of primary sclerosing cholangitis (PSC) (n = 45). 119 (63.2 %) of these procedures were therapeutic.Complications were uncommon in infants; only two episodes of infection were registered. In children (> 1 year) post-ERCP pancreatitis were seen in 10.4 %. Conclusions Our retrospective series of ERCP procedures includes 56 procedures in infants, which is one of the largest series presented. Complications in infants are rare and post-ERCP pancreatitis was not seen. In older children 10.4 % experienced post-ERCP pancreatitis. In expert hands, ERCP was shown to be acceptably feasible and safe in infants and children.

scholarly journals A retrospective study on the usefulness of the JJ risk engine for predicting the incidence rate of coronary heart disease in type 2 diabetes patients

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Yasunari Yamashita ◽  
Rina Kitajima ◽  
Kiyoshi Matsubara ◽  
Gaku Inoue ◽  
Hajime Matsubara
Keyword(s):  
Type 2 Diabetes ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Medical Records ◽  
Low Frequency ◽  
University Hospital ◽  
Diabetes Treatment ◽  
C Statistic ◽  
Risk Engine

Abstract Objective In 2018, we conducted a retrospective survey using the medical records of 484 patients with type 2 diabetes. The observed value of coronary heart disease (CHD) incidence after 5 years and the predicted value by the JJ risk engine as of 2013 were compared and verified using the discrimination and calibration values. Results Among the total cases analyzed, the C-statistic was 0.588, and the calibration was p < 0.05; thus, the JJ risk engine could not correctly predict the risk of CHD. However, in the group expected to have a low frequency of hypoglycemia, the C-statistic was 0.646; the predictability of the JJ risk engine was relatively accurate. Therefore, it is difficult to accurately predict the complication rate of patients using the JJ risk engine based on the diabetes treatment policy after the Kumamoto Declaration 2013. The JJ risk engine has several input items (variables), and it is difficult to satisfy them all unless the environment is well-equipped with testing facilities, such as a university hospital. Therefore, it is necessary to create a new risk engine that requires fewer input items than the JJ risk engine and is applicable to several patients.

scholarly journals Impairment in activities of daily living and readmission in older patients with heart failure: a cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e044416
Author(s):  
Tan Van Nguyen ◽  
Huyen Thanh Dang ◽  
Mason Jenner Burns ◽  
Hiep HH Dao ◽  
Tu Ngoc Nguyen
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Older Patients ◽  
Tertiary Hospital ◽  
Logistic Regression Models ◽  
Hospitalised Patients ◽  
Patients With Heart Failure ◽  
The Impact

ObjectivesThis study aims to investigate the prevalence of impairment of activities of daily living (ADLs) in older patients with heart failure (HF), and to examine the impact of ADL impairment on readmission after discharge.Design and settingsA prospective cohort study was conducted in patients aged ≥65 years with HF admitted to a tertiary hospital in Vietnam from August 2016 to June 2017. Difficulties with six ADLs were assessed by a questionnaire. Participants were classified into two categories (with and without ADL impairment). The associations of ADL impairment with 3-month readmission were examined using logistic regression models.ResultsThere were 180 participants (mean age 80.6±8.2, 50% female) and 26.1% were classified as having ADL impairment. The most common impaired activity was bathing (21.1%), followed by transferring (20.0%), toileting (12.2%), dressing (8.9%), eating (3.3%), and continence (2.8%). During 3-month follow-up, 32.8% of the participants were readmitted to hospitals (55.3% in participants with ADL impairment, 24.8% in those without ADL impairment, p<0.001). ADL impairment significantly increased the risk of 3-month readmission (adjusted OR 2.75, 95% CI 1.25 to 6.05, p=0.01).ConclusionsIn summary, ADL impairment was common in older hospitalised patients with HF and was associated with increased readmission. These findings suggest further studies on ADL assessment and intervention during transition care for older patients with HF after discharge to prevent readmission.

scholarly journals Left ventricular systolic function decreases in lamin a/c cardiomyopathy wihout concomitant ventricular dilatation

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
ES Eystein Skjolsvik ◽  
OL Oyvind Haugen Lie ◽  
MC Monica Chivulescu ◽  
MR Margareth Ribe ◽  
AIC Anna Isotta Castrini ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricular ◽  
University Hospital ◽  
Lv Function ◽  
Lamin A ◽  
Age Related ◽  
End Stage Heart Failure ◽  
Lv Volumes ◽  
End Stage

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): This work was supported by the Norwegian Research Council [203489/030] onbehalf Department of Cardiology, Research group for genetic cardiac diseases and sudden cardiac death, Oslo University Hospital, Rikshospitalet, Oslo, Norwa Background Lamin A/C disease is an inheritable cardiomyopathy characterized by conduction abnormalities, ventricular arrhythmias and end stage heart failure with complete age-related penetrance. Purpose To assess left ventricular structural and functional progression in patients with lamin A/C cardiomyopathy. Methods We included and followed consecutive lamin A/C genotype positive patients with clinical examination and echocardiography at every visit. We evaluated progression of left- ventricular size and function by mixed model statistics. Results We included 101 consecutive lamin A/C genotype positive patients (age 44 [29-54] years, 39% probands, 51%female) with 576 echocardiographic exams during 4.9 (IQR 2.5-8.1) years of follow-up. LV ejection fraction (LVEF) declined from 50 ± 12% to 47 ± 13%, p &lt; 0.001 (rate -0.5%/year). LV end diastolic volumes (LVEDV) remained stationary with no significant dilatation in the total population (136 ± 45ml to 138 ± 43ml, p = 0.60), (Figure). In the subgroup of patients &gt;58 years, we observed a decline in LV volumes 148, SE 9 ml to 140, SE 9 ml p &lt; 0.001 (rate -2.7 ml/year) towards end stage heart failure. Conclusions LVEF deteriorated, while LV size remained unchanged during 4.9 years of follow-up in patients with lamin A/C cardiomyopathy. In patients &lt;58 years, we observed a reduction in LV volumes. These findings represent loss of LV function without the necessary compensatory dilation to preserve stroke volume indicating high risk of decompensated end stage heart failure in lamin A/C. Abstract Figure.

scholarly journals 53. Incidence of Bloodstream Infections and Outcomes in Patients with Severe COVID-19 Pneumonia

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S156-S157
Author(s):  
Aikaterini Papamanoli ◽  
Jeanwoo Yoo ◽  
Azad Mojahedi ◽  
Robin Jacob ◽  
Prabhjot Grewal ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Medical Records ◽  
Bloodstream Infections ◽  
Blood Stream ◽  
Blood Cultures ◽  
High Flow ◽  
University Hospital ◽  
Skin Microbiota ◽  
Prolonged Recovery ◽  
The Impact

Abstract Background Coronavirus disease 19 (COVID-19) leading to acute respiratory distress syndrome is associated with need for intensive care (IC), mechanical ventilation (MV), and prolonged recovery. These patients are thus predisposed to blood stream infections which can worsen outcomes. This risk may be aggravated by adjunctive therapies. Methods We reviewed the medical records of all adults admitted to Stony Brook University Hospital, NY, from March 1 to April 15, 2020 with severe COVID-19 pneumonia (requiring high-flow O2). Patients who received MV or died within 24h were excluded. Patients were followed until death or hospital discharge. We reviewed positive blood cultures (PBC) for pathogenic microorganisms, and calculated the incidence of bacteremia, rates of infective endocarditis (IE), and impact on mortality. Microbes isolated only once and belonging to groups defined as commensal skin microbiota were labelled as contaminants. We also examined the impact of adjunctive therapies with immunosuppressive potential (steroids and tocilizumab), on bacteremia. Results A total of 469 patients with severe COVID-19 pneumonia were included (Table 1). Of these, 199 (42.4%) required IC and 172 (36.7%) MV. Median length of stay was 13 days (8–22) and 94 (20.0%) had PBC. Of these, 43 were considered true pathogens (bacteremia), with predominance of E. faecalis and S. epidermidis, and 51 were considered contaminants (Table 2). The incidence of bacteremia (43/469, 9.2%) was 5.1 per 1000 patient-days (95%CI 3.8–6.4). An echocardiogram was performed in 21 patients, 1 had an aortic valve vegetation (IE) by methicillin sensitive S. aureus. Bacteremia rates were nonsignificantly higher with steroids (5.9 vs 3.7 per 1000 patient-days; P=0.057). Use of tocilizumab was not associated with bacteremia (5.8 vs 4.8 per 1000 patient-days; P=0.28). Mortality was nonsignificantly higher in patients with (15/43, 34.9%) vs. without (108/426, 25.4%) bacteremia (P=0.20). Length of stay was the strongest predictor of bacteremia, with risk increasing by 7% (95%CI 6%-9%, P&lt; 0.001) per additional day. Cohort Characteristics of Patients with Severe COVID-19 Pneumonia on High-Flow O2 (N= 469) All Microorganisms Isolated from Blood Cultures Conclusion The incidence of bacteremia was relatively low and IE was uncommon in this study of severe COVID-19 patients. Risk of bacteremia increased with longer hospital stay and with steroids use, but not with tocilizumab. Disclosures All Authors: No reported disclosures

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