Suicidal Risk Factors Associated With Opioid Analgesics Use

2019 ◽  
Author(s):  
Keyword(s):  
Risk Factors ◽  
Opioid Analgesics ◽  
Suicidal Risk ◽  
Factors Associated

Factors associated with re-presentation to emergency departments in elderly people with pain

2014 ◽  
Vol 38 (4) ◽  
pp. 461 ◽  
Author(s):  
Rebecca Howard ◽  
Andrew Hannaford ◽  
Tracey Weiland
Keyword(s):  
Risk Factors ◽  
Elderly People ◽  
Opioid Analgesics ◽  
Complex Care ◽  
Care Needs ◽  
Factors Associated ◽  
Medication Side Effects ◽  
Medication Side ◽  
Complex Care Needs

Objectives To identify medical, social and demographic factors associated with increased risk of 30-day re-presentation to the emergency department (ED) in elderly people presenting with pain. Methods We undertook a single site, prospective observational study of all patients aged >65 years discharged from the ED with pain. Data were collected on possible medical, social and demographic predictors of ED readmission. Participants were a subset of all elderly patients presenting to the ED with pain, and received follow-up case management as part of the hospital’s rapid response, assessment and care planning program for elderly people. Results Over 8 months, 356 people were eligible for inclusion in the study; of these, 189 consented to case management and to participate in the study. Three factors statistically increased odds of re-presentation to ED within 30 days: (1) prescription of opioids (P = 0.003); (2) the presence of Home and Community Care Services (P = 0.03); and (3) the absence of a gait aid (P = 0.019). Nineteen per cent of eligible patients re-presented to ED within 30 days of initial presentation. Conclusion These findings contribute to current debate about opioid prescription and effective pain management in the elderly. The study highlights the need for routine follow-up care of older people discharged from the ED with pain, particularly those discharged home with opioids or with complex care needs. What is known about the topic? Re-presentation rates within 28 days for all-comers to the emergency department (ED) are collected and reported as part of routine service monitoring and evaluation. Presentation rates for elderly people to EDs have been escalating over the past decade; however, the risk factors that lead to re-presentations for elderly people have not been documented. Similarly, increasing concern about the prescription of opioids in elderly people is documented; however, its impact on ED re-presentations has not been reported. Innovative models of care are emerging to stem the rise in ED demand; however, their role and impact on re-presentation rates are not documented for this subgroup of ED presenters. What does this paper add? This research has demonstrated that ED re-presentation rates for elderly people with pain are higher than overall ED re-presentation rates. This article has identified three risk factors that significantly increase the risk of re-presentation in this population, including the prescription of opioid analgesics. Qualitative data have identified that elderly people prescribed opioids require extensive education and support to manage the medication side effects. What are the implications for practitioners? Practitioners should be aware that elderly people with pain are a higher risk group for ED re-presentation, particularly those prescribed opioid analgesics or with complex care needs. Discharge planning and assessment of supports should be routinely instigated to manage medication side effects, and follow-up services put in place where inadequate. Improved provision of written information in multiple languages for patients who cannot read English should also be initiated.

Protective Factors and Suicidality in Members of Arab Kindred

Crisis ◽  
2012 ◽  
Vol 33 (2) ◽  
pp. 80-86 ◽  
Author(s):  
Sami Hamdan ◽  
Nadine Melhem ◽  
Israel Orbach ◽  
Ilana Farbstein ◽  
Mohammad El-Haib ◽  
...  
Keyword(s):  
Risk Factors ◽  
Protective Factors ◽  
Suicidal Behavior ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Suicidal Risk ◽  
Arab Population ◽  
Psychiatric Interview ◽  
History Of

Background: Relatively little is known about the role of protective factors in an Arab population in the presence of suicidal risk factors. Aims: To examine the role of protective factors in a subsample of in large Arab Kindred participants in the presence of suicidal risk factors. Methods: We assessed protective and risk factors in a sample of 64 participants (16 suicidal and 48 nonsuicidal) between 15 and 55 years of age, using a comprehensive structured psychiatric interview, the Composite International Diagnostic Interview (CIDI), self-reported depression, anxiety, hopelessness, impulsivity, hostility, and suicidal behavior in first-degree and second-relatives. We also used the Religiosity Questionnaire and suicide attitude (SUIATT) and multidimensional perceived support scale. Results: Suicidal as opposed to nonsuicidal participants were more likely to have a lifetime history of major depressive disorder (MDD) (68.8% vs. 22.9% χ2 = 11.17, p = .001), an anxiety disorder (87.5% vs. 22.9, χ2 = 21.02, p < .001), or posttraumatic stress disorder (PTSD) (25% vs. 0.0%, Fisher’s, p = .003). Individuals who are otherwise at high risk for suicidality have a much lower risk when they experience higher perceived social support (3.31 ± 1.36 vs. 4.96 ± 1.40, t = 4.10, df = 62, p < .001), and they have the view that suicide is somehow unacceptable (1.83 ± .10 vs. 1.89 ± .07, t = 2.76, df = 60, p = .008). Conclusions: Taken together with other studies, these data suggest that the augmentation of protective factors could play a very important role in the prevention of incidental and recurrent suicidal behavior in Arab populations, where suicidal behavior in increasing rapidly.

Risk factors associated with substance use

2014 ◽  
Author(s):  
Ariel M. Barber ◽  
Alexandra Crouch ◽  
Stephen Campbell
Keyword(s):  
Risk Factors ◽  
Substance Use ◽  
Factors Associated

A Six Year Prospective Study of Fibrinogen and Other Risk Factors Associated with Mortality in Stable Claudicants

1992 ◽  
Vol 68 (03) ◽  
pp. 261-263 ◽  
Author(s):  
A K Banerjee ◽  
J Pearson ◽  
E L Gilliland ◽  
D Goss ◽  
J D Lewis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intermittent Claudication ◽  
Fibrinogen Level ◽  
Past History ◽  
Fold Increase ◽  
Arterial Disease ◽  
Plasma Fibrinogen ◽  
Plasma Fibrinogen Level ◽  
Factors Associated ◽  
Probability Of Death

SummaryA total of 333 patients with stable intermittent claudication at recruitment were followed up for 6 years to determine risk factors associated with subsequent mortality. Cardiovascular diseases were the underlying cause of death in 78% of the 114 patients who died. The strongest independent predictor of death during the follow-up period was the plasma fibrinogen level, an increase of 1 g/l being associated with a nearly two-fold increase in the probability of death within the next 6 years. Age, low ankle/brachial pressure index and a past history of myocardial infarction also increased the probability of death during the study period. The plasma fibrinogen level is a valuable index of those patients with stable intermittent claudication at high risk of early mortality. The results also provide further evidence for the involvement of fibrinogen in the pathogenesis of arterial disease.

Risk factors associated with primary and secondary reduced libido in male patients with sexual dysfunction

2013 ◽  
Author(s):  
Giovanni Corona ◽  
Giulia Rastrelli ◽  
Emmanuele Jannini ◽  
Linda Vignozzi ◽  
Edoardo Mannucci ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sexual Dysfunction ◽  
Factors Associated ◽  
Male Patients

Population level risk factors associated with childhood obesity

2019 ◽  
Author(s):  
Claire Beynon ◽  
Nora Pashyan ◽  
Elizabeth Fisher ◽  
Dougal Hargreaves ◽  
Linda Bailey ◽  
...  
Keyword(s):  
Risk Factors ◽  
Childhood Obesity ◽  
Population Level ◽  
Factors Associated

Renal Failure after Coronary Bypass Surgery and the Associated Risk Factors

2015 ◽  
Vol 18 (1) ◽  
pp. 006
Author(s):  
Hasan Reyhanoglu ◽  
Kaan Ozcan ◽  
Murat Erturk ◽  
Fatih İslamoglu ◽  
İsa Durmaz
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Renal Failure ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Significant Risk ◽  
High Morbidity ◽  
Factors Associated

<strong>Objective:</strong> We aimed to evaluate the risk factors associated with acute renal failure in patients who underwent coronary artery bypass surgery.<br /><strong>Methods:</strong> One hundred and six patients who developed renal failure after coronary artery bypass grafting (CABG) constituted the study group (RF group), while 110 patients who did not develop renal failure served as a control group <br />(C group). In addition, the RF group was divided into two subgroups: patients that were treated with conservative methods without the need for hemodialysis (NH group) and patients that required hemodialysis (HR group). Risk factors associated with renal failure were investigated.<br /><strong>Results:</strong> Among the 106 patients that developed renal failure (RF), 80 patients were treated with conservative methods without any need for hemodialysis (NH group); while <br />26 patients required hemodialysis in the postoperative period (HR group). The multivariate analysis showed that diabetes mellitus and the postoperative use of positive inotropes and adrenaline were significant risk factors associated with development of renal failure. In addition, carotid stenosis and postoperative use of adrenaline were found to be significant risk factors associated with hemodialysis-dependent renal failure (P &lt; .05). The mortality in the RF group was determined as 13.2%, while the mortality rate in patients who did not require hemodialysis and those who required hemodialysis was 6.2% and 34%, respectively.<br /><strong>Conclusion:</strong> Renal failure requiring hemodialysis after CABG often results in high morbidity and mortality. Factors affecting microcirculation and atherosclerosis, like diabetes mellitus, carotid artery stenosis, and postoperative vasopressor use remain the major risk factors for the development of renal failure.<br /><br />

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