Risk factors for one-year all-cause mortality in elderly multimorbid medical in-patients.

Abstract Background: Due to expansion of longevity, the proportion of elderly people with multimorbidity is increasing. Our aim was to identify risk factors for all-cause mortality in elderly multimorbid medical in-patients one year after acute hospitalization. Information regarding risk factors is important to support targeted care plans after discharge. Methods: Prospective cohort study of patients acutely admitted to a medical department in a Norwegian regional hospital. Eligible patients were community-dwelling, received home care services before hospitalization, were aged 75+, and suffered from two or more chronic conditions. Inclusion period was 1. April – 31. October 2012. Candidate variables were number of daily prescribed drugs, Cumulative Illness Rating Scale for Geriatrics score, delirium, body mass index (BMI), handgrip strength, Barthel Activities of Daily Living Index score, and the laboratory analyses haemoglobin (Hgb), sodium (Na) and estimated glomerular filtration rate (eGFR). Results: We included 227 patients; mean age 86 years, 59% women, 71% lived alone. During the year after hospitalization, 39% died. In the adjusted cox proportional hazards regression analysis, significant and independent risk factors were BMI (hazard ratio (HR) 0.93, 95% confidence interval (CI) 0.88-0.98 per kg/m2), Hgb (HR 0.87, 95% CI 0.76-0.98 per g/100 mL), Na (HR 0.94, 95% CI 0.90-0.99 per mmol/L) and eGFR < 60 mL/min/1.73 m2 (HR 1.82, 95% CI 1.07-3.08).Conclusions: In this cohort of multimorbid elderly internal medicine patients, low body mass, hyponatremia, impaired renal function and anaemia were identified as independent and significant risk factors for one-year mortality.

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Risk factors for one-year all-cause mortality in elderly multimorbid medical in-patients.

10.21203/rs.3.rs-20316/v1 ◽

2020 ◽

Author(s):

Marte Sofie Wang-Hansen ◽

Hege Kersten ◽

Torgeir Bruun Wyller

Keyword(s):

Risk Factors ◽

Body Mass ◽

Rating Scale ◽

Handgrip Strength ◽

Significant Risk ◽

Cox Proportional Hazards ◽

Community Dwelling ◽

Care Plans ◽

All Cause Mortality ◽

One Year

Abstract Background Due to expansion of longevity, the proportion of elderly people with multimorbidity is increasing. Our aim was to identify risk factors for all-cause mortality in elderly multimorbid medical in-patients one year after acute hospitalization. Information regarding risk factors is important to support targeted care plans after discharge. Methods Prospective cohort study of patients acutely admitted to a medical department in a Norwegian regional hospital. Eligible patients were community-dwelling, received home care services before hospitalization, were aged 75+, and suffered from two or more chronic conditions. Inclusion period was 1. April – 31. October 2012. Candidate variables were number of daily prescribed drugs, Cumulative Illness Rating Scale for Geriatrics score, delirium, body mass index (BMI), handgrip strength, Barthel Activities of Daily Living Index score, and the laboratory analyses haemoglobin (Hgb), sodium (Na) and estimated glomerular filtration rate (eGFR). Results We included 227 patients; mean age 86 years, 59% women, 71% lived alone. During the year after hospitalization, 39% died. In the adjusted cox proportional hazards regression analysis, significant and independent risk factors were BMI (hazard ratio (HR) 0.93, 95% confidence interval (CI) 0.88-0.98 per kg/m 2 ), Hgb (HR 0.87, 95% CI 0.76-0.98 per g/100 mL), Na (HR 0.94, 95% CI 0.90-0.99 per mmol/L) and eGFR < 60 mL/min/1.73 m 2 (HR 1.82, 95% CI 1.07-3.08). Conclusions In this cohort of multimorbid elderly internal medicine patients, low body mass, hyponatremia, impaired renal function and anaemia were identified as independent and significant risk factors for one-year mortality.

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One-year all-cause mortality for 338 patients admitted with epistaxis in a large tertiary ENT centre

The Journal of Laryngology & Otology ◽

10.1017/s0022215119000860 ◽

2019 ◽

Vol 133 (06) ◽

pp. 487-493 ◽

Cited By ~ 2

Author(s):

M J Corr ◽

T Tikka ◽

C M Douglas ◽

J Marshall

Keyword(s):

Risk Factors ◽

Rating Scale ◽

Performance Status ◽

University Hospital ◽

Retrospective Case ◽

Large Teaching Hospital ◽

All Cause Mortality ◽

One Year ◽

The One ◽

Overall Mortality

AbstractObjectiveEpistaxis is the most common ENT emergency. This study aimed to assess one-year mortality rates in patients admitted to a large teaching hospital.MethodThis study was a retrospective case note analysis of all patients admitted to the Queen Elizabeth University Hospital in Glasgow with epistaxis over a 12-month period.ResultsThe one-year overall mortality for a patient admitted with epistaxis was 9.8 per cent. The patients who died were older (mean age 77.2 vs 68.8 years; p = 0.002), had a higher Cumulative Illness Rating Scale-Geriatric score (9.9 vs 6.7; p < 0.001) and had a higher performance status score (2 or higher vs less than 2; p < 0.001). Other risk factors were a low admission haemoglobin level (less than 128 g/dl vs 128 g/dl or higher; p = 0.025), abnormal coagulation (p = 0.004), low albumin (less than 36 g/l vs more than 36 g/l; p < 0.001) and longer length of stay (p = 0.046).ConclusionThere are a number of risk factors associated with increased mortality after admission with epistaxis. This information could help with risk stratification of patients at admission and enable the appropriate patient support to be arranged.

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Long-term survival after Carpentier-Edwards Perimount aortic valve replacement in Western Denmark: a multi-centre observational study

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01506-x ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Lytfi Krasniqi ◽

Mads P. Kronby ◽

Lars P. S. Riber

Keyword(s):

Risk Factors ◽

Aortic Valve ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Significant Risk ◽

Valve Prosthesis ◽

Term Survival ◽

Long Term Survival ◽

All Cause Mortality

Abstract Background This study describes the long-term survival, risk of reoperation and clinical outcomes of patients undergoing solitary surgical aortic valve replacement (SAVR) with a Carpentier-Edwards Perimount (CE-P) bioprosthetic in Western Denmark. The renewed interest in SAVR is based on the questioning regarding the long-term survival since new aortic replacement technique such as transcatheter aortic-valve replacement (TAVR) probably have shorter durability, why assessment of long-term survival could be a key issue for patients. Methods From November 1999 to November 2013 a cohort of a total of 1604 patients with a median age of 73 years (IQR: 69–78) undergoing solitary SAVR with CE-P in Western Denmark was obtained November 2018 from the Western Danish Heart Registry (WDHR). The primary endpoint was long-term survival from all-cause mortality. Secondary endpoints were survival free from major adverse cardiovascular and cerebral events (MACCE), risk of reoperation, cause of late death, patient-prothesis mismatch, risk of AMI, stroke, pacemaker or ICD implantation and postoperative atrial fibrillation (POAF). Time-to-event analysis was performed with Kaplan-Meier curve, cumulative incidence function was performed with Nelson-Aalen cumulative hazard estimates. Cox regression was applied to detect risk factors for death and reoperation. Results In-hospital mortality was 2.7% and 30-day mortality at 3.4%. The 5-, 10- and 15-year survival from all-cause mortality was 77, 52 and 24%, respectively. Survival without MACCE was 80% after 10 years. Significant risk factors of mortality were small valves, smoking and EuroSCORE II ≥4%. The risk of reoperation was < 5% after 7.5 years and significant risk factors were valve prosthesis-patient mismatch and EuroSCORE II ≥4%. Conclusions Patients undergoing aortic valve replacement with a Carpentier-Edwards Perimount valve shows a very satisfying long-term survival. Future research should aim to investigate biological valves long-term durability for comparison of different SAVR to different TAVR in long perspective.

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GAIT SPEED AND HANDGRIP STRENGTH AS PREDICTORS OF INCIDENT DISABILITY IN MEXICAN OLDER ADULTS

Journal of Frailty & Aging ◽

10.14283/jfa.2014.10 ◽

2014 ◽

pp. 1-4

Author(s):

T. LOPEZ-TEROS ◽

L.M. GUTIERREZ-ROBLEDO ◽

M.U. PEREZ-ZEPEDA

Keyword(s):

Older Adults ◽

Gait Speed ◽

Daily Living ◽

Handgrip Strength ◽

Statistical Significance ◽

Adverse Outcomes ◽

Community Dwelling ◽

Performance Tests ◽

One Year

Physical performance tests are associated with different adverse outcomes in older people. Theobjective of this study was to test the association between handgrip strength and gait speed with incidentdisability in community-dwelling, well-functioning, Mexican older adults (age ≥70 years). Incident disability wasdefined as the onset of any difficulty in basic or instrumental activities of daily living. Of a total of 133participants, 52.6% (n=70) experienced incident disability during one year of follow-up. Significant associationsof handgrip strength (odds ratio [OR] 0.96, 95% confidence interval [95%CI] 0.93-0.99) and gait speed (OR0.27, 95%CI 0.07-0.99) with incident disability were reported. The inclusion of covariates in the models reducedthe statistical significance of the associations without substantially modifying the magnitude of them. Handgripstrength and gait speed are independently associated with incident disability in Mexican older adults.

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Abstract 13944: J Relationship of Body Mass Index of 22-year Cardiovascular Disease Mortality versus Body Mass Index

Circulation ◽

10.1161/circ.132.suppl_3.13944 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

William J Kostis ◽

Javier Cabrera ◽

Fei Wang ◽

Sara J Guterl ◽

Dhammika Amaratunga ◽

...

Keyword(s):

Risk Factors ◽

Body Mass Index ◽

Body Mass ◽

Systolic Hypertension ◽

Female Gender ◽

The Elderly ◽

Linear Term ◽

Quadratic Term ◽

All Cause Mortality ◽

Cv Disease

Introduction: J relationships of body mass index (BMI) with mortality have been described. However, little data are available on long-term follow-up in controlled clinical trials with respect to cardiovascular (CV) and all cause mortality. Hypothesis: We tested whether there is a J shape relationship between BMI with CV and all cause mortality at 22 years in the Systolic Hypertension in the Elderly Program (SHEP). Methods: SHEP was a placebo controlled, randomized clinical trial of antihypertensive therapy in patients with isolated systolic hypertension aged 60 and older. The relationship between CV and all cause mortality with baseline BMI was examined in 4,211 SHEP participants. Results: In unadjusted analyses, a J relationship was observed for all-cause mortality (linear term p=0.0318, quadratic term p=0.3217 and tricubic term p=0.0046) and for CV mortality (linear term p=0.0962, quadratic term p=0.6866 and tricubic term p=0.0908, left figure). The lowest risk was at a BMI of 25.9 for all-cause and 25.5 for CV mortality. The J shaped relationship between BMI and mortality was attenuated after adjustment for age, gender, comorbidities (e.g. diabetes, heart failure) and risk factors for CV disease (e.g. smoking and dyslipidemia, right figure). Age and gender were significant predictors of both all- cause and CV mortality: age p<0.0001, female gender p=0.0063 for all-cause mortality and p<0.0001 for age and p=0.0004 for female gender for CV mortality. <br/Conclusions: This study indicates that both very low and very high BMI are markers of high risk. The J relationship between BMI and mortality is mediated by age, female gender, comorbidities and risk factors for CV disease.

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Ethnicity and other COVID-19 death risk factors in Mexico

Archives of Medical Science ◽

10.5114/aoms.2020.101443 ◽

2020 ◽

Author(s):

Erwin Chiquete ◽

Jesus Alegre-Díaz ◽

Ana Ochoa-Guzmán ◽

Liz Nicole Toapanta-Yanchapaxi ◽

Carlos González-Carballo ◽

...

Keyword(s):

Risk Factors ◽

Proportional Hazards Model ◽

Invasive Mechanical Ventilation ◽

Significant Risk ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Chronic Obstructive ◽

Death Risk ◽

Factors Associated ◽

Risk Of Death

IntroductionPatients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may develop coronavirus disease 2019 (COVID-19). Risk factors associated with death vary among countries with different ethnic backgrounds. We aimed to describe the factors associated with death in Mexicans with confirmed COVID-19.Material and methodsWe analysed the Mexican Ministry of Health’s official database on people tested for SARS-CoV-2 infection by real-time reverse transcriptase–polymerase chain reaction (rtRT-PCR) of nasopharyngeal fluids. Bivariate analyses were performed to select characteristics potentially associated with death, to integrate a Cox-proportional hazards model.ResultsAs of May 18, 2020, a total of 177,133 persons (90,586 men and 86,551 women) in Mexico received rtRT-PCR testing for SARS-CoV-2. There were 5332 deaths among the 51,633 rtRT-PCR-confirmed cases (10.33%, 95% CI: 10.07–10.59%). The median time (interquartile range, IQR) from symptoms onset to death was nine days (5–13 days), and from hospital admission to death 4 days (2–8 days). The analysis by age groups revealed that the significant risk of death started gradually at the age of 40 years. Independent death risk factors were obesity, hypertension, male sex, indigenous ethnicity, diabetes, chronic kidney disease, immunosuppression, chronic obstructive pulmonary disease, age > 40 years, and the need for invasive mechanical ventilation (IMV). Only 1959 (3.8%) cases received IVM, of whom 1893 were admitted to the intensive care unit (96.6% of those who received IMV).ConclusionsIn Mexico, highly prevalent chronic diseases are risk factors for death among persons with COVID-19. Indigenous ethnicity is a poorly studied factor that needs more investigation.

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Risk factors for future falls among community-dwelling older adults without a fall in the previous year: A prospective one-year longitudinal study

Archives of Gerontology and Geriatrics ◽

10.1016/j.archger.2020.104161 ◽

2020 ◽

Vol 91 ◽

pp. 104161 ◽

Cited By ~ 1

Author(s):

Jaqueline Mello Porto ◽

Natália Camargo Rodrigues Iosimuta ◽

Renato Campos Freire Júnior ◽

Roberta de Matos Brunelli Braghin ◽

Érika Leitner ◽

...

Keyword(s):

Risk Factors ◽

Older Adults ◽

Longitudinal Study ◽

Community Dwelling ◽

One Year ◽

Community Dwelling Older Adults

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Concentrations of sex-hormone binding globulin and corticosteroid binding globulin in serum in relation to cardiovascular risk factors and to 12-year incidence of cardiovascular disease and overall mortality in postmenopausal women.

Clinical Chemistry ◽

10.1093/clinchem/32.1.146 ◽

1986 ◽

Vol 32 (1) ◽

pp. 146-152 ◽

Cited By ~ 80

Author(s):

L Lapidus ◽

G Lindstedt ◽

P A Lundberg ◽

C Bengtsson ◽

T Gredmark

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Body Mass Index ◽

Body Mass ◽

Significant Risk ◽

Sex Hormone ◽

Sex Hormone Binding Globulin ◽

Hormone Binding ◽

Corticosteroid Binding Globulin ◽

Overall Mortality

Abstract We determined sex-hormone binding globulin (SHBG) and corticosteroid binding globulin (CBG) by radioimmunoassay of serum samples from a group of 253 women, who were 54 or 60 years old when first studied in 1968-69. The SHBG concentration was highly significantly and inversely related to body mass, body mass index, waist-to-hip circumference ratio, and serum triglyceride concentration; CBG concentration was inversely related to body mass and body mass index. The concentration of neither protein was related to whether or not the subject smoked. Decrease in the concentration of SHBG, but not of CBG, was a significant risk factor for 12-year overall mortality. The plot of the 12-year incidence of myocardial infarction vs SHBG concentration was U-shaped. We recommend that SHBG be included when serum androgens or estrogens are being evaluated as risk factors for cardiovascular disease and death.

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Determining Risk Factors for the Development of Temporomandibular Disorders during Orthodontic Treatment

Applied Sciences ◽

10.3390/app10228216 ◽

2020 ◽

Vol 10 (22) ◽

pp. 8216

Author(s):

Alessandro Ugolini ◽

Federico Garbarino ◽

Luca Di Vece ◽

Francesca Silvestrini-Biavati ◽

Valentina Lanteri

Keyword(s):

Risk Factors ◽

Temporomandibular Disorders ◽

Orthodontic Treatment ◽

Complex Disease ◽

Myofascial Pain ◽

Significant Risk ◽

Female Gender ◽

Structured Interview ◽

Disc Displacement ◽

One Year

Temporomandibular disorders (TMD) represent a complex disease with a multifactorial etiology. Despite several studies on the subject, a causal relationship between orthodontic treatment and different forms of TMD has not been established. The aim of this study was to analyze the effect of orthodontic treatment on two aspects of TMD: myofascial pain and disc displacement. This retrospective cohort study followed 224 orthodontic adult patients at three points in time: before treatment (T0), immediately after treatment (T1), and one year after treatment (T2). Disc displacement and myofascial pain were evaluated through a clinical assessment and with a semi-structured interview, along with headache, neck, and shoulder pain parameters and behavioral and somatic accompanying symptoms. Multivariate logistic regression was used to identify risk factors that could influence the development of TMD in these patients. There was a non-significant increase in disc displacement during orthodontic treatment, which mostly resolved after completion of treatment. Myofascial pain scores worsened during treatment, but improved when compared with the baseline once treatment was complete (T0 = 51.3%, T1 = 64.6%, T2 = 44.9%). Female gender (aOR = 1.9, CI 95%, 1.23–2.36), the presence of somatic symptoms (aOR = 3.6, CI 95%, 2.01–5.84), and symptoms of anxiety or depression (aOR = 2.2, CI 95%, 1.14–4.51) were significant risk factors associated with the development of TMD. There is a low and not significant risk of TMD development during orthodontic treatment. When TMD occurred, they resolved within 1 year of the end of treatment.

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