scholarly journals Mortality Following Hip Fractures in the Elderly: Relation with Timing of Fixation, Length of Hospital Stay and Comorbidities

2018 ◽  
Vol 17 (1) ◽  
Author(s):  
Khairul Mohd Khalid ◽  
Nik Mohd Fatmy Nik Mohd Najmi ◽  
Mohamad Fauzlie Yusof
Keyword(s):  
Logistic Regression ◽  
Mortality Rate ◽  
Hospital Stay ◽  
Hip Fractures ◽  
Length Of Hospital Stay ◽  
The Elderly ◽  
Significant Variable ◽  
International Studies ◽  
Cross Sectional ◽  
Phone Calls

Introduction: The incidence of hip fractures in Malaysia was 218 per 100,000 for females and 88 per 100,000 for men and they are associated with mortality rate up to 33 % at 1 year as shown by international studies. There are no local studies available in regards to mortality rate and associated factors. We aimed to determine mortality rate in elderly patient following hip fractures within 1 year. In addition, we evaluated the association of timing of fixation, length of hospital stay and number of comorbidities with mortality in these patients. Materials And Methods: This was a cross sectional study conducted in Hospital Melaka. All patients aged 65 and older who were admitted and underwent surgery for hip fractures from January 2014 to January 2017 were included. Patients or relatives were contacted via phone calls to determine their status of living. From the records, timing of fixation, length of hospital stay and number of comorbidities were recorded. Results: Mortality rate at 1 year was 10.55%. From Simple Logistic Regression analysis, all three factors of timing of fixation, length of hospital stay and number of comorbidities were found to have significant value less than 0.25. From Multiple Logistic Regression, only length of stay was found to be significant (p<0.0001). The significant variable can be interpreted as follows: a person with one day longer in hospital stay has 1.89 times the chance to be deceased at 1 year. Conclusion: This study shows 10.55% mortality rate at 1 year following hip fractures in the elderly. There were an association between mortality and timing of fixation, length of hospital stay and patients’ comorbidities.

scholarly journals Risk factors for high length of hospital stay and in-hospital mortality in hip fractures in the elderly

2021 ◽  
Vol 65 (5) ◽  
pp. 322-330
Author(s):  
J. Salvador Marín ◽  
F.J. Ferrández Martínez ◽  
C. Fuster Such ◽  
J.M. Seguí Ripoll ◽  
D. Orozco Beltrán ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Hip Fractures ◽  
Length Of Hospital Stay ◽  
The Elderly ◽  
High Length

scholarly journals Systematic review and meta-analysis of the association between frailty and outcome in surgical patients

2016 ◽  
Vol 98 (2) ◽  
pp. 80-85 ◽  
Author(s):  
K Oakland ◽  
R Nadler ◽  
L Cresswell ◽  
D Jackson ◽  
PA Coughlin
Keyword(s):  
Mortality Rate ◽  
Hospital Stay ◽  
Surgical Intervention ◽  
Discharge Rate ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
The Elderly ◽  
Surgical Patients ◽  
Step Down ◽  
One Year

Introduction Frailty is becoming increasingly prevalent in the elderly population although a lack of consensus regarding a clinical definition hampers comparison of clinical studies. More elderly patients are being assessed for surgical intervention but the effect of frailty on surgical related outcomes is still not clear. Methods A systematic literature search for studies prospectively reporting frailty and postoperative outcomes in patients undergoing surgical intervention was performed with data collated from a total of 12 studies. Random effects meta-analysis modelling was undertaken to estimate the association between frailty and mortality rates (in-hospital and one-year), length of hospital stay and the need for step-down care for further rehabilitation/nursing home placement. Results Frailty was associated with a higher in-hospital mortality rate (pooled odds ratio [OR]: 2.77, 95% confidence interval [CI]: 1.62–4.73), a higher one-year mortality rate (pooled OR: 1.99, 95% CI: 1.49–2.66), a longer hospital stay (pooled mean difference: 1.05 days, 95% CI: 0.02–2.07 days) and a higher discharge rate to further rehabilitation/step-down care (pooled OR: 5.71, 95% CI: 3.41–9.55). Conclusions The presence of frailty in patients undergoing surgical intervention is associated with poorer outcomes with regard to mortality and return to independence. Further in-depth studies are required to identify factors that can be optimised to reduce the burden of frailty in surgical patients.

scholarly journals Treatment Outcome and Associated Factors among Type 1 Diabetic Children<15 Years Admitted With DKA in Bahir Dar City Public Referral Hospital, North West, Ethiopia: A retrospective Cross Sectional Study

2021 ◽  
Author(s):  
Fentahun Meseret
Keyword(s):  
Treatment Outcome ◽  
Mortality Rate ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
North West ◽  
North West Ethiopia

Abstract Background: Length of hospital stay and overall in hospital mortality of diabetic keto acidosis during management are the foremost primary out comes that should be measured. Because, it is highly trusted on the improvement of diabetic keto acidosis related complication management. However, data associated to length of stay, mortality rate due to diabetic keto acidosis remains to be limited in Ethiopia.In addition to this, Nonfiction is much scarce in relation to factors associated with treatment outcome starting from its initial presentation and the overall management process. Objective: To assess treatment outcome of children<15 years old admitted with diabetic keto acidosis at Felege Hiwot comprehensive referral hospital, North West, Ethiopia, 2021Methods: Retrospective cross sectional study was conducted at Felege Hiwot comprehensive referral hospital among randomly selected sample of 176 children admitted with diabetic keto acidosis from 2016 to 2021.Data were collected by using data abstraction tool. Then it was coded, enter, cleaned and stored into Epi-data version 4.2 and was exported into STATA 14.0 statistical software for analysis. Categorical variables were described using proportions and compared using Chi-square test; whereas continuous parametric variables with mean and standard deviation and compared using parametric (t-test). Model goodness-of-fit and assumptions were checked. Finally, association between independent variables and length of hospital stay were assessed using binary logistics regression and Variables with p-value < 0.05 were considered as statistically significant.Result: The mean length of hospital stay was 9.5±6.2 days. About 59.3% of had long hospital stay (>7days).Majority of the clients (97.5%) were improve and discharged with 14.2% management complication and 4(2.5%) died in the hospital. Factors that affect long hospital stay were residence(AOR=4.31;95CI=1.25-14.80),family history of diabetes (AOR=0.12; 95%CI=0.02-0.64),glycaemia at admission (AOR=1.01;95%CI=1.00-1.02),insulin skipping (AOR=0.08;95%CI=0.01-0.98),abdominal pain(AOR=4.28;95%CI=1.11 -15.52), time in which the patient get out of diabetic keto acidosis(AOR=6.39;95%CI=1.09-37.50).Conclusion and Recommendation: Majority of clients were showed improvement and discharged to their home after longer hospital stay and with very low mortality rate followed by complication (14.2%).The time with in which the majority of the clients get out of DKA were found in between 24-48 hours. Thus, to achieve the intended treatment out come early in time, modification of the approach by emphasizing the above predictors is mandatory with the recommendation of multicenter study in this regard.

Budaya Kerja Petugas Panti Menurut Persepsi Lansia Dengan Kejadian Pengabaian di PSTW X

2019 ◽  
Vol 4 (3) ◽  
pp. 651
Author(s):  
Lola Felnanda Amri
Keyword(s):  
Logistic Regression ◽  
Nursing Home ◽  
Work Environment ◽  
The Elderly ◽  
Statistical Test ◽  
Nursing Personnel ◽  
Work Culture ◽  
Chi Square ◽  
Cross Sectional ◽  
Correlation Design

<p><em>Perawatan pada lansia di panti tresna werdha X dilakukan berdasarkan rutinitas kerja dan petugas belum mendapat pelatihan mengenai kebutuhan dasar lansia yang harus dipenuhi. Berdasarkan hal tersebut, peneliti ingin mengetahui hubungan budaya kerja petugas panti menurut persepsi lansia dengan kejadian pengabaian di PSTW X Sumatera Barat. Desain penelitian deskriptif korelasi, menggunakan pendekatan cross sectional. Pengambilan sampel dengan total sampling, berjumlah 75. Uji statistik digunakan chi square dan regresi logistik. Hasil yang diperoleh seluruh lansia mengalami pengabaian; ada hubungan antara sikap terhadap apa yang dikerjakan, lingkungan pekerjaan; waktu dengan pengabaian lansia; Tidak ada hubungan antara perilaku ketika mengambil keputusan dengan pengabaian lansia. Sikap terhadap apa yang dikerjakan memiliki pengaruh paling besar terhadap kejadian pengabaian lansia. Disimpulkan bahwa petugas harus lebih memahami tentang peran dan fungsinya sebagai pemberi pelayanan pada lansia. Direkomendasikan agar pejabat yang berwenang dapat menempatkan petugas panti sesuai dengan peran dan fungsi serta kewenangannya, dan merekrut perawat sesuai dengan kebutuhan panti.</em></p><p> </p><p><em>The nursing of elderly in </em><em>Tresna Werda X nursing home is mainly based on the workrout in and that the caregiver have not yet received training on the basic needs of the elderly that they should meet. Therefore, the researcher wanted to know the relations of the work culture of caregiver according to the elderly’s perception with the incidence of neglect in PSTW X West Sumatera. This study used Descriptive correlation design with cross sectional approach. The method of sampling used total sampling, which amounts to 75. The statistical test used chi square and logistic regression. The results of the study show that all of the elderly experienced neglect; there is a relation between attitude towards what is conducted, work environment, time with elderly neglect; no relation between behavior in making decisions with elderly neglect. The attitude towards what is conducted has the most impacton the incidence of elderly neglect. It is concluded that the caregiver should have a better understanding on their roles and functions as the caregivers to the elderly. Moreover, it is recommended that the authorities should put nursing personnel in accordance with the roles, functions and competence, and recruit nurses in accordance with the needs of the nursing home.</em></p>

scholarly journals Cross-Sectional Association between Hypercholesterolemia and Knee Pain in the Elderly with Radiographic Knee Osteoarthritis: Data from the Korean National Health and Nutritional Examination Survey

2021 ◽  
Vol 10 (5) ◽  
pp. 933
Author(s):  
Byung Woo Cho ◽  
Du Seong Kim ◽  
Hyuck Min Kwon ◽  
Ick Hwan Yang ◽  
Woo-Suk Lee ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Knee Pain ◽  
Logistic Regression Analysis ◽  
National Health ◽  
Large Scale ◽  
Metabolic Diseases ◽  
The Elderly ◽  
Cross Sectional ◽  
Ordinal Logistic Regression Analysis

Few studies have reported the relationship between knee pain and hypercholesterolemia in the elderly population with osteoarthritis (OA), independent of other variables. The aim of this study was to reveal the association between knee pain and metabolic diseases including hypercholesterolemia using a large-scale cohort. A cross-sectional study was conducted using data from the Korea National Health and the Nutrition Examination Survey (KNHANES-V, VI-1; 2010–2013). Among the subjects aged ≥60 years, 7438 subjects (weighted number estimate = 35,524,307) who replied knee pain item and performed the simple radiographs of knee were enrolled. Using multivariable ordinal logistic regression analysis, variables affecting knee pain were identified, and the odds ratio (OR) was calculated. Of the 35,524,307 subjects, 10,630,836 (29.9%) subjects experienced knee pain. Overall, 20,290,421 subjects (56.3%) had radiographic OA, and 8,119,372 (40.0%) of them complained of knee pain. Multivariable ordinal logistic regression analysis showed that among the metabolic diseases, only hypercholesterolemia was positively correlated with knee pain in the OA group (OR 1.24; 95% Confidence Interval 1.02–1.52, p = 0.033). There were no metabolic diseases correlated with knee pain in the non-OA group. This large-scale study revealed that in the elderly, hypercholesterolemia was positively associated with knee pain independent of body mass index and other metabolic diseases in the OA group, but not in the non-OA group. These results will help in understanding the nature of arthritic pain, and may support the need for exploring the longitudinal associations.

scholarly journals The independent patient factors that affect length of stay following hip fractures

2018 ◽  
Vol 100 (7) ◽  
pp. 556-562 ◽  
Author(s):  
T Richards ◽  
A Glendenning ◽  
D Benson ◽  
S Alexander ◽  
S Thati
Keyword(s):  
Hip Fracture ◽  
Length Of Stay ◽  
Hospital Stay ◽  
Hip Fractures ◽  
Length Of Hospital Stay ◽  
Hospital Length ◽  
Acute Hospital ◽  
Hospital Length Of Stay ◽  
Patient Factors ◽  
Mobility Status

Introduction Management of hip fractures has evolved over recent years to drive better outcomes including length of hospital stay. We aimed to identify and quantify the effect that patient factors influence acute hospital and total health service length of stay. Methods A retrospective observational study based on National Hip Fracture Database data was conducted from 1 January 2014 to 31 December 2015. A multiple regression analysis of 330 patients was carried out to determine independent factors that affect acute hospital and total hospital length of stay. Results American Society of Anesthesiologists (ASA) grade 3 or above, Abbreviated Mental Test Score (AMTS) less than 8 and poor mobility status were independent factors, significantly increasing length of hospital stay in our population. Acute hospital length of stay can be predicted as 8.9 days longer when AMTS less than 8, 4.2 days longer when ASA grade was 3 or above and 20.4 days longer when unable to mobilise unaided (compared with independently mobile individuals). Other factors including total hip replacement compared with hemiarthroplasty did not independently affect length of stay. Conclusions Our analysis in a representative and generalisable population illustrates the importance of identifying these three patient characteristics in hip fracture patients. When recognised and targeted with orthogeriatric support, the length of hospital stay for these patients can be reduced and overall hip fracture care improved. Screening on admission for ASA grade, AMTS and mobility status allows prediction of length of stay and tailoring of care to match needs.

Socioeconomic Variation of Multimorbidity in Colombian Older Adults

2021 ◽  
Author(s):  
Silvia Marcela Ballesteros ◽  
José Moreno-Montoya ◽  
Wilhelmus Johannes Andreas Grooten ◽  
Pedro Barrera-López ◽  
José A. De la Hoz-Valle
Keyword(s):  
Mortality Rate ◽  
Rural Areas ◽  
Urban Areas ◽  
Structural Equation ◽  
Strong Association ◽  
High Body Mass Index ◽  
Multidimensional Poverty ◽  
The Elderly ◽  
Cross Sectional ◽  
Multidimensional Poverty Index

Abstract BackgroundMultimorbidity prevalence in the elderly is increasing worldwide. Variations regarding the socioeconomic characteristics of the individuals and their context have been described, mostly in high-income scenarios. This study aims to assess the magnitude and the socioeconomic factors associated with variations on multimorbidity in Colombia.MethodsA cross-sectional multilevel study with a nationally representative sample of 23 694 Colombian adults aged 60 years and older was conducted. Individual socioeconomic, demographic, childhood and health related characteristics, as well as group level variables (multidimensional poverty index and infectious diseases mortality rate) were analyzed. A two-level stepwise structural equation model was used to simultaneously adjust the individual and contextual effects. ResultsMultimorbidity prevalence was 62.3% (95% CI 61.7–62.9). In the multilevel adjusted models, age, female sex, having functional limitations, non-white ethnicity, high body mass index, higher income, physical inactivity, poverty during childhood and living in urban areas were associated with multimorbidity. The mediation analysis showed that living in rural areas was significantly associated with infectious disease mortality rate and other individual associations with multimorbidity were mediated by the multidimensional poverty variable. ConclusionsThis paper demonstrates a strong association between multimorbidity and poverty in a low-middle income country. Differences in the factors involved in the etiology of multimorbidity are expected among wealthy and poor countries regarding availability and prioritization of health services.

scholarly journals Trends in the incidence and outcome of sepsis using data from a Japanese nationwide medical claims database-the Japan Sepsis Alliance (JaSA) study group-

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Taro Imaeda ◽  
Taka-aki Nakada ◽  
Nozomi Takahashi ◽  
Yasuo Yamao ◽  
Satoshi Nakagawa ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Organ Dysfunction ◽  
Length Of Hospital Stay ◽  
Annual Incidence ◽  
Claim Database ◽  
Antibiotic Administration ◽  
Electronic Health Record Data ◽  
Acute Organ Dysfunction

Abstract Background Trends in the incidence and outcomes of sepsis using a Japanese nationwide database were investigated. Methods This was a retrospective cohort study. Adult patients, who had both presumed serious infections and acute organ dysfunction, between 2010 and 2017 were extracted using a combined method of administrative and electronic health record data from the Japanese nationwide medical claim database, which covered 71.5% of all acute care hospitals in 2017. Presumed serious infection was defined using blood culture test records and antibiotic administration. Acute organ dysfunction was defined using records of diagnosis according to the international statistical classification of diseases and related health problems, 10th revision, and records of organ support. The primary outcomes were the annual incidence of sepsis and death in sepsis per 1000 inpatients. The secondary outcomes were in-hospital mortality rate and length of hospital stay in patients with sepsis. Results The analyzed dataset included 50,490,128 adult inpatients admitted between 2010 and 2017. Of these, 2,043,073 (4.0%) patients had sepsis. During the 8-year period, the annual proportion of patients with sepsis across inpatients significantly increased (slope = + 0.30%/year, P < 0.0001), accounting for 4.9% of the total inpatients in 2017. The annual death rate of sepsis per 1000 inpatients significantly increased (slope = + 1.8/1000 inpatients year, P = 0.0001), accounting for 7.8 deaths per 1000 inpatients in 2017. The in-hospital mortality rate and median (interquartile range) length of hospital stay significantly decreased (P < 0.001) over the study period and were 18.3% and 27 (15–50) days in 2017, respectively. Conclusions The Japanese nationwide data indicate that the annual incidence of sepsis and death in inpatients with sepsis significantly increased; however, the annual mortality rates and length of hospital stay in patients with sepsis significantly decreased. The increasing incidence of sepsis and death in sepsis appear to be a significant and ongoing issue.

scholarly journals One-year postoperative mortality rate among the elderly with hip fractures at a single tertiary care center

2020 ◽  
Vol 40 (4) ◽  
pp. 298-304
Author(s):  
Khalid A. Alsheikh ◽  
Firas M. Alsebayel ◽  
Faisal Abdulmohsen Alsudairy ◽  
Abdullah Alzahrani ◽  
Ali Alshehri ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Mortality Rate ◽  
Hip Fractures ◽  
Surgical Intervention ◽  
Care Center ◽  
Tertiary Care ◽  
The Elderly ◽  
Tertiary Care Center ◽  
Factors Associated ◽  
One Year

ABSTRACT BACKGROUND: Hip fractures are one of the leading causes of disability and dependency among the elderly. The rate of hip fractures has been progressively increasing due to the continuing increase in average life expectancy. Surgical intervention is the mainstay of treatment, but with an increasing prevalence of comorbid conditions and decreased functional capacity in elderly patients, more patients are prone to postoperative complications. OBJECTIVES: Assess the value of surgical intervention for hip fractures among the elderly by quantifying the 1-year mortality rate and assessing factors associated with mortality. DESIGN: Medical record review. SETTING: Tertiary care center. PATIENTS AND METHODS: All patients 60 years of age or older who sustained a hip fracture between the period of 2008 to 2018 in a single tertiary healthcare center. Data was obtained from case files, using both electronic and paper files. MAIN OUTCOME MEASURES: The 1-year mortality rate for hip fracture, postoperative complications and factors associated with mortality. SAMPLE SIZE: 802 patients. RESULTS: The majority of patients underwent surgical intervention (93%). Intra- and postoperative complications were 3% and 16%, respectively. Four percent of the sample died within 30 days, and 11% died within one year. In a multivariate analysis, an increased risk of 1-year mortality was associated with neck of femur fractures and postoperative complications ( P =.034, <.001, respectively) CONCLUSION: The 1-year mortality risk in our study reinforces the importance of aggressive surgical intervention for hip fractures. LIMITATION: Single-centered study. CONFLICT OF INTEREST: None.

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