Assessing frailty index and correlation with crp and serum albumin and clinical outcome in terms of length of hospital stay

2021 ◽  
Vol 8 (1) ◽  
pp. 15-21
Author(s):  
Shilpa Avarebeel ◽  
Akash Durgakar ◽  
Pratibha Pereira ◽  
Tandure Varsha ◽  
Mahesh Poojari ◽  
...  

Frailty is defined as “a clinically recognizable state of increased vulnerability, resulting from aging associated decline in reserve and function across multiple A Hospital based descriptive cross-sectional study in tertiary care hospital. Atotal of 294 patients admitted in the Medicine/Geriatric Ward, were included in stressors is compromised”. It is a robust and powerful risk factor for disability. With this background, study was conducted at a tertiary centre with objectives to assess the frailty in elderly patients and to assess the correlation of frailty with Serum Albumin and CRP physiologic systems, such that the ability to cope with every day or acute and evaluate the clinical outcome in terms of length of hospital stay. The study. Demographic details and details of known comorbidities were recorded. Cognition score of all patients were assessed using mini mental scale examination. Investigations like Serum Albumin and CRP were done. The data was analyzed using statistical software.Our results show that in hospitalized patients frailty is seen in both gender. The presence of co-morbidities worsens the frailty. 30 second chair test is very good indicator for frailty and risk of fall and we observed reduced duration in the Pre-Frail group. The cognition score decreased along with the increase in age groups. When compared with the Frailty index, it was more in the Pre-Frail group. The duration of hospital stay was more in Frail group. The mean serum albumin level is important marker to identify early frailty.Assessment of frailty in elderly patients is necessary and identifying Pre-Frailgroup is very important. 30 second chair stand test and serum albumin are very important early markers in the assessment of frailty. Cognitive function is also very important to identify early frailty. Our study shows that the length of hospital stay is more in the Frail group. Frailty is important aspect of elderly. It should be included in routine clinical assessment of all elderly patients.

2021 ◽  
Vol 59 (236) ◽  
Author(s):  
Pramod Joshi

Introduction: Orthopedic conditions includes a range of condition varying from traumatic injuries, congenital anomalies, chronic back pain, arthritis, rheumatologic conditions, and other. Length of hospital stay is determined by a number of factors such as symptom severity, patient co morbidity and hospital availability. Our study aims to study the length of hospital stay of the patients admitted in a provincial hospital. Methods: A descriptive cross-sectional study was conducted in Seti Provincial Hospital in the month of January among 800 cases. The record of each orthopedic cases admitted in the hospital was retrospectively collected from the medical record section after receiving ethical approval from Institutional Review Committee of Seti Provincial Hospital. Whole sampling technique was used. Data were analyzed by Statistical Package for the Social Sciences version 20. The descriptive statistical analysis was done. Results: The average length of hospital stay was 2.87 days with the maximum length of the stay of 10 days and the minimum stay of zero days (discharged on the same day). Forearm bone fracture was the main reason for admission in the hospital 325 (40.62%). Conclusions: Length of the hospital stay was found to shorter than the previous study done in similar settings.


2019 ◽  
Vol 31 (2) ◽  
pp. 98-101
Author(s):  
Md Saidur Rahman ◽  
Md Abdul Mannan ◽  
Md Anower Hossain ◽  
Md Tozammel Hoque ◽  
AKM Ahsan Habib

Introduction: Skin disorders are common in elderly people. Systemic diseases promote the development of dermatological conditions. Various systemic diseases contribute to the presence of cutaneous disorders, indicating the possibility that a skin abnormality may sometimes be the first and only symptom of a much more serious medical problem. The aim of the study to determine the frequency of skin diseases in elderly patients. Materials & Methods: This was a cross-sectional study and non-probability convenient sampling technique was used. Patients were recruited from attending the Dermatology Out-patient Department of SZMCH during the study from January’2018 to July’2018. Patients included in the study having skin diseases aged between 60-80 years, including all those who were diabetic and hypertensive because diabetes and hypertension are the most common comorbid conditions among these elderly patients. Patients were included having skin diseases including pruritus, dermatitis, xerosis, eczema, psoriasis, scabies, bacterial infection, and fungal infections. Results: More than half (53.0%) patients belonged to age 71-80 years. Three fourth (75.0%) patients had pruritus followed by 37(37.0%) had dermatitis, 24(24.0%) had xerosis, 23(23.0%) had eczema and 12(12.0%) had bacterial infections. Pruritis, dermatitis, eczema and bacterial infections were statistically significant (p<0.05) among three groups. Conclusion: More than half of the patients belonged to age more than 70 years of age. Most common (three fourth) skin patients had pruritis, followed by more common skin patients were found dermatitis, xerosis, eczema and bacterial infection. Pruritis, dermatitis, eczema and bacterial infections were statistically significant in different age groups. Medicine Today 2019 Vol.31(2): 98-101


Background: Epilepsy is fairly a frequent occurrence in the elderly. It is commonly diagnosed after the episode of two or more unprovoked seizures. Unprovoked seizures in elderly are recurrent rather than younger individuals. This study was designed to estimate the concrete burden of frequent causes of epilepsy. Methods: A descriptive cross-sectional study with a total of 153 patients diagnosed case of epilepsy were included in this study at Jinnah Medical College Hospital from February 2018-August 2018. Mean was calculated for age, duration of disease of the patients. Causes of epilepsy, gender, and education was calculated and presented as percentages. Electrolyte readings were taken i.e., Sodium, Calcium and Magnesium levels and imaging was planned to rule out stroke, primary neurodegenerative disorders and tumors. Post stratification Chi square test was applied and p-value less than or equal to 0.05 was considered significant. Results: The mean age of the patients was 63.91±5.68 years and mean duration of the disease was 4.61± 1.07 months. The common causes of epilepsy were found to be cerebrovascular disease 56.9%, cryptogenic 54.2%, neurodegenerative disorder 20.3%, traumatic head injury 11.8%, metabolic abnormalities or electrolyte disturbances 10.5% and brain tumor 7.8%. Conclusion: Elderly patients with first seizure should present to a facility designed in a way that neurologist, cardiologist, rehabilitation and geriatrics work together to identify and treat the condition in a better way. Keywords: Epilepsy; Seizures; Cerebrovascular Disease; Neurodegenerative Disorder.


2021 ◽  
Vol 12 ◽  
pp. 215013272110002
Author(s):  
Gayathri Thiruvengadam ◽  
Marappa Lakshmi ◽  
Ravanan Ramanujam

Background: The objective of the study was to identify the factors that alter the length of hospital stay of COVID-19 patients so we have an estimate of the duration of hospitalization of patients. To achieve this, we used a time to event analysis to arrive at factors that could alter the length of hospital stay, aiding in planning additional beds for any future rise in cases. Methods: Information about COVID-19 patients was collected between June and August 2020. The response variable was the time from admission to discharge of patients. Cox proportional hazard model was used to identify the factors that were associated with the length of hospital stay. Results: A total of 730 COVID-19 patients were included, of which 675 (92.5%) recovered and 55 (7.5%) were considered to be right-censored, that is, the patient died or was discharged against medical advice. The median length of hospital stay of COVID-19 patients who were hospitalized was found to be 7 days by the Kaplan Meier curve. The covariates that prolonged the length of hospital stay were found to be abnormalities in oxygen saturation (HR = 0.446, P < .001), neutrophil-lymphocyte ratio (HR = 0.742, P = .003), levels of D-dimer (HR = 0.60, P = .002), lactate dehydrogenase (HR = 0.717, P = .002), and ferritin (HR = 0.763, P = .037). Also, patients who had more than 2 chronic diseases had a significantly longer length of stay (HR = 0.586, P = .008) compared to those with no comorbidities. Conclusion: Factors that are associated with prolonged length of hospital stay of patients need to be considered in planning bed strength on a contingency basis.


2013 ◽  
Vol 2013 ◽  
pp. 1-6
Author(s):  
Raheela Mohsin Rizvi ◽  
Munnazza Akhtar ◽  
Nadeem Faiyaz Zuberi

Objective. The study was performed to review the complications of surgery for POP with or without surgery for SUI. This included the need for second procedure two years after the primary surgery.Study Design. We conducted a retrospective cross-sectional comparative study at the Aga Khan University, Karachi, Pakistan. International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) was used to identify women who underwent vaginal hysterectomy with anterior/posterior repair alone and those with concomitant tension-free vaginal tape surgery for urodynamic stress incontinence.Results. The 28 cases of VH/repair combined with TVT were compared for complications with 430 cases of VH with repair alone. The basic characteristics like age, BMI, and degree of prolapse showed no statistical difference among two groups. The main comorbidities in both groups were hypertension, diabetes, and bronchial asthma. We observed no significant differences in intraoperative and postoperative complications except for cuff abscess, need for medical intervention, and readmission following discharge from hospital, which were higher in cases with vaginal hysterectomy with concomitant TVT.Conclusions. Vaginal hysterectomy is an efficient treatment for uterovaginal prolapse with a swift recovery, short length of hospital stay, and rare serious complications. The addition of surgery for USI does not appear to increase the morbidity.


2012 ◽  
Vol 19 (01) ◽  
pp. 011-014
Author(s):  
RANA MUHAMMAD ADNAN ◽  
Muhammad Irfan ZIA ◽  
JAHANZAIB AMIN ◽  
Rafya Khan ◽  
Saleem Ahmed ◽  
...  

Background: To compare the frequency of various types of fractures of femur in patients less than and more than 40 years ofage in a tertiary care hospital. Design: Descriptive cross-sectional study. Setting: Emergency department. Period: January 2009 to April 2011.Method: A total of 1756 patients were divided into two groups with respect to age. Then they were further categorized according to the part offemur involved, and compared in both age groups. Results: The study was conducted on a total number of 1756 patients over a period of 2 yearsfrom 2009 to 2011. 51.1% patients were less than 40 years of age and 48.9% patients were more than 40 years of age. In patients more than 40years of age, pertrochanteric fracture was most common (86.40%). In patients less than 40 years of age, mid shaft of femur was most commonregion involved (87.02%). Conclusions: The incidence of proximal femur fractures is high in elderly patients because of several factors likeosteoporosis, visual impairment and cognitive disability. Whereas incidence of fractures of mid-shaft of femur is more common in youngpatients.


Author(s):  
Sandhya Mishra ◽  
Deepak Chopra ◽  
Nidhi Jauhari ◽  
Ausaf Ahmad

Background: Dengue virus infection is a growing health problem and is prevalent throughout India. Research focusing on length of hospital stay and its predictors is scarce from India. This is important considering the burden of the disease during epidemics and impact on hospital admissions. Hence the study was conducted with the objectives to find out the factors influencing the length of stay in hospital of dengue patients.Methods: A cross sectional retrospective observational study conducted at a tertiary care hospital from August 2016 to October 2016. Data was retrieved from case sheets at Medical Record Department of 350 lab confirmed adult dengue patients admitted in the hospital.Results: The majority of patients admitted were of economically productive age group of 18-45 years and males indicating the occupational exposure to the vector of dengue. The study found that majority had length of stay of less than a week and as age increases the length of stay also increases (statistically significant). The nil case fatality and lesser number of mean days of symptoms before admission possibly indicate that early arrival of patients to hospital can lead to very low fatality rates. Further research required to find out the other predictors of length of stay.Conclusions: The study concludes that the dengue affects the economically productive age group and more males thereby indicating occupational exposure to the vector. The age of the patient can be used as an indicator to the length of stay in the hospital.


2018 ◽  
Vol 16 (1) ◽  
pp. 15-19
Author(s):  
Maimoona Qadir ◽  
Sohail Amir ◽  
Samina Jadoon ◽  
Muhammad Marwat

Background: Perinatal mortality rate indicates quality of care provided during pregnancy and delivery to the mother and to the neonate in its early neonatal period. The objective of this study was to determine the frequency and causes of perinatal mortality in a tertiary care hospital in Peshawar, Pakistan. Materials & Methods: This cross-sectional study was conducted at Department of Gynaecology & Obstetrics, Khyber Teaching Hospital, Peshawar, Pakistan from 1st January 2016 to 31st December 2016. The inclusion criteria was all singleton gestation with gestational age of at least 24 weeks presenting with perinatal mortality. Data was collected for the following variables; age groups (up to 20 years, 21-30 years, 31-40 years and > 40 years), booking status (yes/ no), period of gestation (24-31+6, 32-36+6, 37-39+6 and > 40 weeks), Foetal weight ( 3.5 kg) and cause of perinatal mortality. Results: Out of 4508 deliveries there were 288 perinatal deaths, including 228 stillbirths and 60 neonatal deaths, so perinatal mortality rate was 63.8/1000 births. 90.28% women were unbooked. Most common cause was hypertensive disorders of pregnancy (27.78%) followed by antepartum haemorrhage (25.71%) and then mechanical causes (13.88%). Congenital anomalies comprised 11.8% cases, neonatal problems 10.07% and maternal medical disorders for 4.16% cases. Cause of 4.16% cases remained unexplained. Conclusion: Appropriate strategies like control of identifiable causes, proper antenatal and postnatal care, healthy delivery practices and availability of emergency neonatal care facilities can bring down perinatal mortality rates.


2019 ◽  
Vol 53 ◽  
pp. 65
Author(s):  
Samire Lopes Pereira ◽  
Thales Philipe Rodrigues da Silva ◽  
Alexandra Dias Moreira ◽  
Taiane Gonçalves Novaes ◽  
Milene Cristine Pessoa ◽  
...  

OBJECTIVE: To evaluate whether age group, complications or comorbidities are associated with the length of hospitalization of women undergoing cesarean section. METHODS: A cross-sectional study was carried out between June 2012 and July 2017, with 64,437 women undergoing cesarean section and who did not acquire conditions during their hospital stay. Hospital discharge data were collected from national health institutions, using the Diagnosis-Related Groups system (DRG Brasil). The DRG referring to cesarean section with additional complications or comorbidities (DRG 765) and cesarean section without complications or associated comorbidities (DRG 766) were included in the initial diagnosis. The influence of age group and comorbidities or complications present at admission on the length of hospital stay was assessed based on the means of the analysis of variance. The size of the effect was verified by Cohen’s D, which allows evaluating clinical relevance. The criticality levels were identified using the Duncan test. RESULTS: The longest length of hospital stay was observed in the age group from 15 to 17 years old and among those aged 45 years old or more. The hospital stay of women with complications or comorbidities at the time of admission was also longer. Moreover, it was noted that the increase in criticality level was associated with an increase in the mean length of hospital stay. CONCLUSIONS: The length of hospital stay of women is higher among those belonging to the age group ranging from 15 to 17 years old and for those aged 45 years old or more. The presence of associated comorbidities, such as eclampsia, pre-existing hypertensive disorder with superimposed proteinuria and gestational hypertension (induced by pregnancy) with significant proteinuria increase the length of hospital stay. This study enabled the construction of distinct criticality level profiles based on the combination of age groups and the main comorbidities, which were directly related to the length of hospital stay.


2020 ◽  
Vol 18 (1) ◽  
pp. 24-27
Author(s):  
Niraj Parajuli ◽  
Laila Lama ◽  
Anupama Karki ◽  
Rushma Shrestha ◽  
Sumida Tiwari ◽  
...  

Introduction: Cutaneous blisters can occur in variety of conditions. They are broadly classified as immunobullous or non-immunobullous. Immunobullous blistering diseases can further classify as intraepidermal or subepidermal. Non-immunobullous blistering disease are commonly due to infections, drugs among others. Some of the blistering disease carry significant mortality and morbidity. There are only limited data on blistering diseases from Nepal, so this study will provide details on the prevalence of this rare dermatological disease from one of the tertiary care referral hospital in the country. Objective: To assess the clinical pattern and prevalence of various blistering diseases in a tertiary care referral hospital. Materials and Methods: All of the data were obtained from the admission register maintained at department of dermatology and venereology, National Academy of Medical Sciences. All the patients admitted with blistering disease from year April 2008 till March 2018 were included. The details including age, sex, type of blistering disease and length of hospital stay were recorded.  Results: A total of 710 patients were admitted in the dermatology ward over the period of 10 years.  There were a total of 193 blistering disease admitted during this period. Autoimmune blistering disease was diagnosed in 59 patients whereas 100 patients had non-immunobullous disease. The age grouped range from 4- 93 years with the mean age of 43± 19.71 years. The average number of hospital stay of all blistering diseases was 11.73±11.36 days. Conclusion: Blistering diseases are one of the most common conditions requiring admission in dermatology ward. Some of these diseases carry a significant morbidity and mortality. So, prompt diagnosis and treatment is of utmost importance.


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