Atypical Presentations of Acute Infections in Hospitalized Older Adults: The Prevalence, Predictors, and Outcomes

Influenza vaccination is annually recommended for specific populations at risk, such as older adults. We estimated the 2018/2019 influenza vaccine effectiveness (IVE) overall, by influenza subtype, type of vaccine, and by time elapsed since vaccination among subjects 65 years old or over in a multicenter prospective study in the Valencia Hospital Surveillance Network for the Study of Influenza and other Respiratory Viruses (VAHNSI, Spain). Information about potential confounders was obtained from clinical registries and/or by interviewing patients and vaccination details were only ascertained by registries. A test-negative design was performed in order to estimate IVE. As a result, IVE was estimated at 46% (95% confidence interval (CI): (16%, 66%)), 41% (95% CI: (−34%, 74%)), and 45% (95% CI: (7%, 67%)) against overall influenza, A(H1N1)pdm09 and A(H3N2), respectively. An intra-seasonal not relevant waning effect was detected. The IVE for the adjuvanted vaccine in ≥75 years old was 45% (2%, 69%) and for the non-adjuvanted vaccine in 65–74 years old was 59% (−16%, 86%). Thus, our data revealed moderate vaccine effectiveness against influenza A(H3N2) and not significant against A(H1N1)pdm09. Significant protection was conferred by the adjuvanted vaccine to patients ≥75 years old. Moreover, an intra-seasonal not relevant waning effect was detected, and a not significant IVE decreasing trend was observed over time.

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Orthostatic Hypotension and Falls in Hospitalized Older Adults

Clinical Nursing Research ◽

10.1177/1054773820986682 ◽

2021 ◽

pp. 105477382098668

Author(s):

Kathleen Schell ◽

Denise Lyons ◽

Barry Bodt

Keyword(s):

Older Adults ◽

Orthostatic Hypotension ◽

Electronic Medical Records ◽

Fall Prevention ◽

Medical Records ◽

The Elderly ◽

Chi Square ◽

Convenience Sample ◽

Chi Square Test ◽

Hospitalized Older Adults

The aim of this retrospective study was to determine the prevalence of orthostatic hypotension (OH) among a convenience sample of older adults on two Acute Care of the Elderly (ACE) units of the ChristianaCare™ in Delaware. Another aim was to determine if subjects with documented OH experienced falls. Retrospective de-identified data was obtained from electronic medical records for the years 2015 to 2018. Among all patients who had valid first orthostatic vital sign (OVS) readings ( n = 7,745), 39.2% had orthostatic hypotension on the first reading. Among the patients, 42.8% were found to be hypotensive during OVS. Thirty-one (0.9%) of those with OH fell at some point during their stay. The odds ratio for falls in the presence of OH was 1.34 with a 95% confidence interval (0.82, 2.21), but a chi-square test failed to find significance ( p = .2494). The results could not determine if OVS should be mandatory in fall prevention protocols.

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Factors Associated with Step Numbers in Acutely Hospitalized Older Adults: The Hospital-Activities of Daily Living Study

Journal of the American Medical Directors Association ◽

10.1016/j.jamda.2020.06.027 ◽

2020 ◽

Author(s):

Daisy Kolk ◽

Jesse J. Aarden ◽

Janet L. MacNeil-Vroomen ◽

Lucienne A. Reichardt ◽

Rosanne van Seben ◽

...

Keyword(s):

Older Adults ◽

Activities Of Daily Living ◽

Daily Living ◽

Factors Associated ◽

Hospitalized Older Adults

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Enhancing Our Understanding of Transitional Care Programs

Innovation in Aging ◽

10.1093/geroni/igaa057.448 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 136-137

Author(s):

Katherine McGilton ◽

Shirin Vellani ◽

Alexandra Krassikova ◽

Alexia Cumal ◽

Sheryl Robertson ◽

...

Keyword(s):

Older Adults ◽

Transitional Care ◽

Discharge Planning ◽

Grey Literature ◽

Occupational Therapists ◽

Community Dwelling ◽

Bibliographic Databases ◽

Multidisciplinary Teams ◽

Term Care ◽

Hospitalized Older Adults

Abstract Many hospitalized older adults experience delayed discharge. Transitional care programs (TCPs) provide short-term care to these patients to prepare them for transfer to nursing homes or back to the community. There are knowledge gaps related to the processes and outcomes of TCPs. We conducted a scoping review following Arksey & O’Malley’s framework to identify the: 1) characteristics of older patients served by TCPs, 2) services provided within TCPs, and 3) outcomes used to evaluate TCPs. We searched bibliographic databases and grey literature. We included papers and reports involving community-dwelling older adults aged ≥ 65 years and examined the processes and/or outcomes of TCPs. The search retrieved 4828 references; 38 studies and 2 reports met the inclusion criteria. Most studies were conducted in Europe (n=19) and America (n=13). Patients admitted to TCPs were 59-86 years old, had 2-10 chronic conditions, 26-74% lived alone, the majority were functionally dependent and had mild cognitive impairment. Most TCPs were staffed by nurses, physiotherapists, occupational therapists, social workers and physicians, and support staff. The TCPs provided 5 major types of services: assessment, care planning, treatment, evaluation/care monitoring and discharge planning. The outcomes most frequently assessed were discharge destination, mortality, hospital readmission, length of stay, cost and functional status. TCPs that reported significant improvement in older adults’ functions (which was the main goal of the TCPs) included multiple services delivered by multidisciplinary teams. There is a wide variation in the operationalization of TCPs within and between countries.

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