scholarly journals Association of anemia with rehabilitation outcomes for subacute geriatric rehabilitation patients in a secondary hospital in malaysia

2021 ◽  
Vol 3 (4) ◽  
Author(s):  
Mann Leon Chin ◽  
Keyword(s):  
Barthel Index ◽  
Elderly Population ◽  
Geriatric Rehabilitation ◽  
Simple Linear Regression ◽  
Barthel Index Score ◽  
Clinical Frailty Scale ◽  
P Values ◽  
Rehabilitation Outcomes ◽  
Comorbidity Index ◽  
Secondary Hospital

Background: To evaluate the effects of anemia on rehabilitation outcomes for geriatric subjects in the Taiping Hospital subacute geriatric rehabilitation ward. Methods: This was a retrospective study with 126 subjects that compared the change in the modified Barthel Index score of anemic and non-anemic subjects. Results: In the study, 43.7% of subjects were anemic. Among anemic subjects, 45.5% were Malay, 38.2% were Chinese, 14.5% were Indian, and 1% were others. The median (Interquartile (IQR)) modified Barthel Index (MBI) on admission for anemic and non-anemic subjects was insignificantly different, at 47 (29, 63) and 36 (21, 59), respectively (P = 0.059). The median (IQR) of MBI improvement for non-anemic subjects was found to be significantly higher than for anemic subjects, which were 14 (5, 26) and 8 (1, 18; P = 0.021). Subjects with hemoglobin (hb) ≥ 9 g/dL were significantly associated with MBI improvement of more than 20, P = 0.009. Simple linear regression found that the P-values were not significant for albumin, creatinine, the Charlson comorbidity index, or the clinical frailty scale; hence, they were not significantly associated with rehabilitation outcome. Conclusions: The study suggested that non-anemic subjects showed significant MBI improvement. Our study also suggested that judicious practices to target a hb threshold of 9 g/dL might be able to improve a subject’s functional outcome. These results should encourage further research with a larger elderly population to provide insights and awareness for the need to treat anemia in rehabilitation subjects. Keywords: Geriatric, anemia, rehabilitation, modified barthel index

scholarly journals Association of Anemia with Rehabilitation Outcome for Subacute Geriatric Rehabilitation Patients in a Secondary Hospital in Malaysia

2021 ◽  
Author(s):  
Mann Leon Chin ◽  
Christopher WS Chan ◽  
Huey Ee Chong ◽  
Wee Kooi Cheah
Keyword(s):  
Barthel Index ◽  
Geriatric Rehabilitation ◽  
Mean Corpuscular Hemoglobin ◽  
Corpuscular Hemoglobin ◽  
Barthel Index Score ◽  
Rehabilitation Outcome ◽  
Score Improvement ◽  
The Mean ◽  
Secondary Hospital ◽  
Hemoglobin Threshold

Abstract Objective: To evaluate the effect of Anemia on Rehabilitation Outcome for Geriatric Subjects in Taiping Hospital Subacute Geriatric Rehabilitation Ward.Methodology: This was a retrospective study, with 126 subjects to compare the change in modified Barthel Index score of anemic and non anemic subjects.Results: 44% of subjects were anemic and the Mean corpuscular hemoglobin and Mean corpuscular volume for anemic subjects were 85.4pg and 29.8fL. Among anemic subjects 45.5% were Malay, 38.2% were Chinese, 14.5% were Indian and 1% were others. The Median(IQR) Modified Barthel Index (MBI) on admission for anemic subjects and non anemic subjects were insignificantly difference which were 47 (29, 63) and 36 (21, 59) respectively, (p=0.059). The median(IQR) of MBI improvement for non anemic subjects was found to be significantly higher than anemic subjects which were 14 (5, 26) and 8 (1, 18) (p=0.021). Subject with hemoglobin (hb) ≥ 9g/dL were significantly associated with MBI improvement of more than 20, p=0.014. Multiple linear regression revealed a significant linear relationship between age and MBI score improvement (p=0.010). Subjects 10 years younger showed a 3.55 score improvement in MBI.Conclusion: The study suggested that non-anemic subjects showed significant MBI improvement. Our study also suggested judicious transfusion practices to maintain a hemoglobin threshold of 9 g/dL might be able to improve subject’s functional outcome. These results should encourage further research with a larger elderly subject population to provide insights and awareness for the need to correct anemia in rehabilitation subjects.

scholarly journals The Difference of Barthel Index Score Based on Stroke Severity, Weakness Side, and Onset of Physiotherapy in Ischemic Stroke Patients at Atma Jaya Hospital

2017 ◽  
Vol 6 (02) ◽  
pp. 15
Author(s):  
Agustina Novita Putri Soegiarto ◽  
Linda Suryakusuma ◽  
Jane Pelealu
Keyword(s):  
Ischemic Stroke ◽  
Barthel Index ◽  
Daily Living ◽  
Index Score ◽  
Stroke Severity ◽  
Activity Of Daily Living ◽  
Stroke Patients ◽  
Barthel Index Score ◽  
Cross Sectional ◽  
Stroke Registry

Background: Stroke is the third cause of disability that can affect the Activity of Daily Living (ADL). Ischemicstroke had higher incidence compared to hemorrhagic strokes. Rehabilitation in the form of physiotherapy canreduce the level of ADL dependencies, that is be measured by Barthel Index Score. Stroke severity, weaknessside, and physiotherapy onset can be factors that influence the success of physiotherapy to reducing the levelof ADL dependencies.Methods:A descriptive analytic study with a cross-sectional design in ischemic stroke patients using secondarydata from the Stroke Registry and medical records at Atma Jaya Hospital for the period of January 2016 toDecember 2017. The data were analyzed using Chi-Square.Results: Study on 110 subjects, consisted of 62 men(56.4%), aged divided by under of 58 years, and above of 58years were 52(47.3%) and 58 (52.7%). While subjects divided by stroke severity, i.e. minor, moderate, moderateto severe, and severe; 44 (40%), 58 (52.7%), 5 (4.5%), and 3 (2.7%) respectively. There were 77 participants(70%) had right side weakness and 33 participants (30%) were left side weakness. The changes of Barthel Indexof ADL score, were 73 (66.4%) improvement, 6 (5.5%) deterioration, and 31 (28.2%) remained. The study hasshown relationship between severity of stroke (p=0.008), weakness side (p=0.000), and physiotherapy onset(p=0.039) with the changes of Barthel Indexscore after treatment.Conclusion: There was a relationship between stroke severity, the weakness side of stroke, and physiotherapyonset with the better result of Barthel Index of ADL score after the physiotherapy.Keywords: Activity of Daily Living (ADL), Barthel Index, ischemic stroke, physiotherapy onset, stroke severity,Weakness side

Sarcopenia and Frailty in PD: Impact on Mortality, Malnutrition, and Inflammation

2018 ◽  
Vol 38 (6) ◽  
pp. 447-454 ◽  
Author(s):  
Yuka Kamijo ◽  
Eiichiro Kanda ◽  
Yoshitaka Ishibashi ◽  
Masayuki Yoshida
Keyword(s):  
Muscle Mass ◽  
Secondary Outcome ◽  
Related Factors ◽  
Clinical Frailty Scale ◽  
Risk Of Mortality ◽  
All Cause Mortality ◽  
Comorbidity Index ◽  
The Relationship ◽  
Worse Prognosis

Background It is known that sarcopenia is related to malnutrition-inflammation-atherosclerosis (MIA) syndrome and is an important problem in dialysis patients. The notion of frailty includes various physical, psychological, and social aspects. Although it has been reported that sarcopenia is associated with poor prognosis in patients with hemodialysis, reports on peritoneal dialysis (PD) patients are rare. In this study, we examined the morbidity and mortality of sarcopenia and frailty in PD patients. We also investigated the MIA-related factors. Methods We evaluated 119 patients cross-sectionally and longitudinally. The Asian Working Group for Sarcopenia criteria and the Clinical Frailty Scale (CFS) were used to diagnose sarcopenia and frailty. The primary outcome is all-cause mortality with sarcopenia and frailty. The secondary outcome is the relationship between various MIA-related factors. Results Morbidity of sarcopenia and frailty in PD patients was 8.4% and 10.9%, respectively. Old age, high values of Barthel Index, Charlson Comorbidity Index, CFS, and low values of body mass index (BMI), muscle strength, muscle mass, and slow walking were associated with sarcopenia. Interleukin-6, albumin, and prealbumin were significantly correlated with muscle mass. During follow-up, the presence of sarcopenia or frailty was associated with the risk of mortality. In multivariate analysis, CFS was related to the mortality rate of PD patients. Conclusions The presence of sarcopenia or frailty was associated with a worse prognosis.

Assembling a Toolkit to Measure Geriatric Rehabilitation Outcomes

2005 ◽  
Vol 84 (6) ◽  
pp. 460-472 ◽  
Author(s):  
Louise Demers ◽  
Johanne Desrosiers ◽  
Bernadette Ska ◽  
Christina Wolfson ◽  
Rossitza Nikolova ◽  
...  
Keyword(s):  
Geriatric Rehabilitation ◽  
Rehabilitation Outcomes

Evaluating anticoagulation sensitivity among elderly patients managed with an institution’s heparin protocol using initial anti-factor Xa levels

2020 ◽  
Vol 77 (Supplement_1) ◽  
pp. S13-S18
Author(s):  
Adley Lemke ◽  
Jean Kohs ◽  
Lynn Weber
Keyword(s):  
Elderly Patients ◽  
Retrospective Cohort ◽  
Elderly Population ◽  
Factor Xa ◽  
The Elderly ◽  
Target Level ◽  
P Values ◽  
Vein Thrombosis ◽  
Coronary Syndrome ◽  
Deep Vein

Abstract Purpose The purpose of this study was to assess an institution’s heparin protocols in elderly and nonelderly adult populations to see if a response difference was observed. Methods This was a retrospective cohort study of hospitalized adults who were prescribed unfractionated heparin due to surgery, acute coronary syndrome (ACS), or deep vein thrombosis/pulmonary embolism (DVT/PE) from February 11, 2016, through August 1, 2017. Patients were divided into nonelderly adults 18 to 69 years of age and elderly patients 70 years of age or older. The anti-factor Xa (anti-Xa) level after protocol initiation was compared to the institution’s goal range of 0.3 to 0.7 IU/mL. Outcomes of each protocol in the elderly population were compared to outcomes in their nonelderly counterparts to determine if there was a difference in heparin response. Results A total of 325 patients were included in the analysis, comprising 150 elderly and 175 nonelderly adults. Elderly patients had a higher initial anti-Xa levels than did their nonelderly adult counterparts in the ACS, DVT/PE, and surgery protocols, with P values of 0.02, <0.001, and 0.01, respectively. Only the ACS protocol demonstrated increased frequency of above-target-level anti-Xa levels in the elderly (P = 0.03). Conclusion Elderly patients had significantly higher initial anti-Xa levels than did nonelderly adult patients across all protocols. This study identifies the need to further study elderly patients’ increased heparin sensitivity to determine if a separate dosing protocol is needed.

scholarly journals 537 AGE, FRAILTY AND COMORBIDITY IN COVID-19 INPATIENTS 65 AND OLDER

2021 ◽  
Vol 50 (Supplement_2) ◽  
pp. ii14-ii18
Author(s):  
N Obiechina ◽  
A Michael ◽  
R R A Khan ◽  
M Ali ◽  
M Zainudin ◽  
...  
Keyword(s):  
Charlson Comorbidity Index ◽  
Demographic Data ◽  
Descriptive Analysis ◽  
District General Hospital ◽  
Clinical Frailty Scale ◽  
Cross Sectional ◽  
Positive Correlation ◽  
Hospital Patients ◽  
Comorbidity Index ◽  
Sectional Analysis

Abstract Introduction Higher incidence of COVID-19 and poorer outcomes have been shown to be associated with age, frailty and comorbidity. Older people have more risk of severe COVID 19; hospitalization, ITU admission, ventilation and mortality. Aim To assess the correlation between age, frailty and comorbidity in COVID-19 inpatients 65 years and older. Methods A retrospective, cross-sectional analysis was carried out on COVID 19 inpatients 65 and older in a UK district general hospital. Patients with no microbiological evidence of COVID-19 and patients with incomplete data were excluded from the study. Demographic data, frailty score and comorbidity index were extracted from the electronic records of patients. SPSS 27 statistical software was used to perform descriptive analysis and linear regression coefficient. Results 357 COVID-19 patients 65 and over were assessed; 207 males and 150 females. Mean age was 81.9 +/− 9.31. Frailty scores were measured using the Rockwood Clinical Frailty Scale (CFS) and comorbidity was calculated using the Charlson Comorbidity Index (CCI). There was positive correlation between age and Clinical Frailty Scale (r=. 436; p<. 001), between age and Charlson Comorbidity Index (r=. 448; p<. 001, and between frailty and comorbidity (r=. 429; p<. 001). Conclusion In COVID-19 inpatients 65 and older, there was positive correlation between age and Clinical Frailty Scale, between age and Charlson Comorbidity Index and between frailty and comorbidity. More studies are needed to explore the interaction between age, frailty and comorbidity and COVID 19 morbidity and mortality.

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