scholarly journals Can I Discharge My Stroke Patient Home After Inpatient Neurorehabilitation? LIMOS Cut-Off Scores for Stroke Patients “Living Alone” and “Living With Family”

2020 ◽  
Vol 11 ◽  
Author(s):  
Beatrice Ottiger ◽  
Dirk Lehnick ◽  
Tobias Pflugshaupt ◽  
Tim Vanbellingen ◽  
Thomas Nyffeler
Keyword(s):  
Cohort Study ◽  
Nursing Home ◽  
Group Living ◽  
Living Alone ◽  
Single Center ◽  
Operating Characteristics ◽  
Odds Ratios ◽  
Stroke Patients ◽  
Age And Gender ◽  
And Gender

Background: Discharge planning of stroke patients during inpatient neurorehabilitation is often difficult since it depends both on the patient's ability to perform activities of daily living (ADL) and the social context. The aim of this study was to define ADL cut-off scores using the Lucerne ICF-based multidisciplinary observation scale (LIMOS) that allow the clinicians to decide whether stroke patients who “live alone” and “live with a family” can be discharged home or must enter a nursing home. Additionally, we investigated whether age and gender factors influence these cut-off scores.Methods: A single-center retrospective cohort study was conducted to establish cut-off discharge scores for the LIMOS. Receiver-operating-characteristics curves were calculated for both patient groups “living alone” and “living with family” to illustrate the prognostic potential of the LIMOS total score with respect to their discharge goals (home alone or nursing home; home with family or nursing home). A logistic regression model was used to determine the (age- and gender-adjusted) odds ratios of being released home if the LIMOS total score was above the cut-off. A single-center prospective cohort study was then conducted to verify the adequacy of the cut-off values for the LIMOS total score.Results: A total of 687 stroke inpatients were included in both studies. For the group “living alone” a LIMOS total score above 158 indicated good diagnostic accuracy in predicting discharge home (sensitivity 93.6%; specificity 95.4%). A LIMOS total cut-off score above 130 points was found for the group “living with family” (sensitivity 92.0%; specificity 88.6%). The LIMOS total score odds ratios, adjusted for age and gender, were 292.5 [95% CI: (52.0–1645.5)] for the group “living alone” and were 89.4 [95% CI: (32.3–247.7)] for the group “living with family.”Conclusion: Stroke survivors living alone needed a higher ADL level to return home than those living with a family. A LIMOS total score above 158 points allows a clinician to discharge a patient that lives alone, whereas a lower LIMOS score above 130 points can be sufficient in a patient that lives with a family. Neither age nor gender played a significant role.

1603-P: Changes in Age- and Gender-Specific All-Cause Mortality Rates and Ratios in People with T2DM in Hungary between 2001-2016: A Nationwide Cohort Study

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1603-P
Author(s):  
GYORGY JERMENDY ◽  
ZOLTAN KISS ◽  
GYÖRGY ROKSZIN ◽  
IBOLYA FÁBIÁN ◽  
ISTVAN WITTMANN ◽  
...  
Keyword(s):  
Cohort Study ◽  
Mortality Rates ◽  
Age And Gender ◽  
All Cause Mortality ◽  
And Gender ◽  
Gender Specific

Incidence and predictors of left atrium thrombus in acute ischemic stroke patients without atrial fibrillation: a single center cohort study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Cinar ◽  
M.I Hayiroglu ◽  
V Cicek ◽  
S Asal ◽  
M.M Atmaca ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cohort Study ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Left Atrium ◽  
Characteristic Curve ◽  
Multivariate Logistic Regression Analysis ◽  
Single Center ◽  
Stroke Patients ◽  
Previous Diagnosis

Abstract Introduction The present study aimed to determine independent predictors of left atrial thrombus (LAT) in acute ischemic stroke patients without atrial fibrillation (AF) using transesophageal echocardiography (TEE). Material and methods In this single center, retrospective cohort study, we enrolled 149 consecutive acute ischemic stroke patients. All of the patients underwent TEE examination to detect LAT within 10 days following admission. Multivariate logistic regression analysis was performed to assess independent predictors of LAT. Results Among all cases, 14 patients (9.3%) had a diagnosis of LAT on TEE examination. In a multivariate analysis; a previous diagnosis of cerebrovascular accident, elevated mean platelet volume (MPV), low left ventricle ejection fraction (EF) and a reduced left atrium appendix (LAA) peak emptying velocity were independent predictors of LAT. The area of MPV under the receiver operating characteristic curve analysis was 0.70 (95% CI: 0.57–0.83; p=0.011). With the optimal cut-off value of 9.45, MPV had a sensitivity of 71.4% and a specificity of 63% to predict LAT. Conclusion Patients with low ventricle EF and elevated MPV should undergo further TEE examination for the possibility of cardio-embolic source. In addition, this research may provide novel information with respect to the applicability of MPV to predict LAT in acute ischemic stroke patients without AF. Figure 1 Funding Acknowledgement Type of funding source: None

Epidemiology, morbidity and mortality in Behçet’s disease: a cohort study using The Health Improvement Network (THIN)

Rheumatology ◽  
2020 ◽  
Vol 59 (10) ◽  
pp. 2785-2795 ◽  
Author(s):  
Tom Thomas ◽  
Joht Singh Chandan ◽  
Anuradhaa Subramanian ◽  
Krishna Gokhale ◽  
George Gkoutos ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Cohort Study ◽  
Heart Disease ◽  
General Population ◽  
Venous Thrombosis ◽  
Ischaemic Heart Disease ◽  
Thromboembolic Disease ◽  
Age And Gender ◽  
Increased Risk ◽  
And Gender

Abstract Objectives The epidemiology of Behçet’s disease (BD) has not been well characterized in the UK. Evidence on the risk of cardiovascular disease, thromboembolic disease and mortality in patients with BD compared with the general population is scarce. Methods We used a large UK primary care database to investigate the epidemiology of BD. A retrospective matched cohort study was used to assess the following outcomes: risk of cardiovascular, thromboembolic disease and mortality. Controls were selected at a 1:4 ratio (age and gender matched). Cox proportional hazard models were used to derive adjusted hazard ratios (aHR). Results The prevalence of BD was 14.61 (95% CI 13.35–15.88) per 100 000 population in 2017. A total of 1281 patients with BD were compared with 5124 age- and gender-matched controls. There was significantly increased risk of ischaemic heart disease [aHR 3.09 (1.28–7.44)], venous thrombosis [aHR 4.80 (2.42–9.54)] and mortality [aHR 1.40 (1.07–1.84)] in patients with BD compared with corresponding controls. Patients with BD were at higher risk of pulmonary embolism compared with corresponding controls at baseline [adjusted odds ratio 4.64 (2.66–8.09), P < 0.0001]. The majority of patients with pulmonary embolism and a diagnosis of BD had pulmonary embolism preceding the diagnosis of BD, not after (87.5%; n = 28/32). Conclusion BD has a higher prevalence than previously thought. Physicians should be aware of the increased risk of developing ischaemic heart disease, stroke/transient ischaemic attack and deep venous thrombosis in patients with BD at an earlier age compared with the general population. Risk of embolism in patients with BD might vary across the disease course.

scholarly journals Outcome of stroke patients on clopidogrel plus proton-pump inhibitors: a single-center cohort study

2019 ◽  
Vol 39 (2) ◽  
pp. 82-86
Author(s):  
Rahaf A. Alghamdi ◽  
Sina Marzoughi ◽  
Muath S. Alghamdi ◽  
Aisha Alghamdi ◽  
Mohammed Almekhlafi
Keyword(s):  
Cohort Study ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Single Center ◽  
Stroke Patients

Impact of Thrombophilia and Incidence of Symptomatic Thromboembolism in First Degree Family Members (FM) of Pediatric Index Cases: a Prospective Cohort Study in FM > 14 Years of Age.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 2977-2977
Author(s):  
Ulrike Nowak-Gottl ◽  
Monika Stoll ◽  
Rolf Mesters ◽  
Sabine Thedieck ◽  
Susan Halimeh ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Family Members ◽  
Age And Gender ◽  
Lipoprotein A ◽  
Off Label ◽  
Healthy Family ◽  
And Gender ◽  
Index Cases

Abstract Abstract 2977 Poster Board II-957 Background: Venous thrombosis is a multifactorial disease and inherited genetic traits (IT) constitute a major risk factor. The aim of the present prospective cohort study was to determine i) the relative and absolute risks of first symptomatic thromboembolism [TE] in previously healthy family members of children with venous thromboembolism, and ii) whether to screen family members in a high risk population. Methods: In 205 patients (neonate to 18 years) and 526 FM followed over a total person-time of 14157 years /1000 units [person-time] a comprehensive IT screening was performed along with recording of family histories of preexisting cardiovascular diseases. FM were followed until July 2009: study endpoint was cumulative time to first TE within FM. Survival analysis (Cox regression: hazard ratio (HR/95% Confidence intervals (CIs)] adjusted for age and gender and number of new cases divided by the total population at risk (incidence rate) were calculated (events (%) per 1000 person-years [CIs]). Results: The final study population included 526 FM with 462 subjects > 14 years. The cumulative TE –free survival in FM with IT was significantly lower compared to those without: HR/CI: 6.6/ 3.3-13.5. The overall rate of symptomatic TEs was 2.9%[2.07-3.9]. The hazard adjusted for age and gender in the group of antithrombin(AT)-/protein C[PC)-/protein S(PS)-deficient FM was 29.4%[13.3-62.5], and for carriers of factor (F) V G1691A, F II G202010A mutations or elevated lipoprotein (a) it was found to be 3.3%[1.3-8.3], 1.96% [0.4- 9.0] and 2.1%[1.04-3.8]. Corresponding annual incidence rates in FM > 14 years were 4.8% for AT-/PC- or PS-deficiency states, 0.72% in subjects carrying the FV mutation, 0.36 % in FII carriers, and 0.20% for subjects with elevated lipoprotein (a) compared with 0.19% in FM with no IT. Thus, compared to adult data from the view of adult index cases [Lijfering W et al. Blood 2009] i) the risk of TE in family members of pediatric index cases with TE depends on IT, ii) the age at TE in the index patient as well as in the family members has a strong effect on TE incidence, and iii) the first symptomatic TE in primary healthy family members > 14 years of age with respect to the IT investigated is comparable to or exceeds adult data. Conclusions: i) Adult family members of pediatric index patients with an early onset of symptomatic thrombosis should be considered for IT testing, ii) primary thromboprophylaxis in family members derived from pediatric index patients should be considered in risk situations in adult carriers of AT/PC/PS-deficiencies & FV mutation. In addition, iii) larger prospective studies are needed to investigate the effects of multiple ITs and its interactions to take into account whether events are provoked or not to investigate the effect of screening. Disclosures: Off Label Use: Enoxaparin (LMWH) is used off-label in children to prevent symptomatic thromboembolism.

Comparison of outcome in stroke patients admitted during working hours vs. off-hours; a single-center cohort study

2018 ◽  
Vol 266 (3) ◽  
pp. 782-789 ◽  
Author(s):  
M. P. Tuinman ◽  
E. G. A. van Golde ◽  
R. P. Portier ◽  
I. L. H. Knottnerus ◽  
J. van der Palen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Working Hours ◽  
Single Center ◽  
Stroke Patients

scholarly journals Nursing Home Satisfaction Surveys: Differences by Race, Age, and Gender

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 71-71
Author(s):  
Nicholas Castle ◽  
John Harris ◽  
David Wolf
Keyword(s):  
Quality Improvement ◽  
Nursing Home ◽  
Nursing Home Resident ◽  
Quality Indicator ◽  
Case Mix ◽  
Age And Gender ◽  
Quality Metric ◽  
Case Mix Adjustment ◽  
And Gender ◽  
Satisfaction Measures

Abstract Nursing home satisfaction information has gained substantial traction as a quality indicator representing the consumers perspective. However, very little research has examined differences in satisfaction related to race, age and gender. As a quality metric, satisfaction measures are variously used for quality improvement, benchmarking, public reporting, and for adjustment to payments. As such, valid comparisons among facilities are important. To our knowledge, no adjustment to satisfaction scores are currently used for nursing homes. However, in many other settings this is a common practice. In this research, nursing home resident, family, and discharge satisfaction scores were examined from >4,000 participants. The data were collected in 2020 and come from 420 facilities. Satisfaction information came from the CoreQ surveys, which include 23 individual questions four of which can be combined to produce an overall satisfaction score. These CoreQ nursing home surveys are endorsed by NQF. Generally lower overall satisfaction scores were found for family members compared to current residents or discharged residents. Minorities (Black, Asian, Hispanic) had lower overall satisfaction scores compared to whites; however, the differences were not significant at conventional levels. Participants of the lowest age (<65 years) were significantly (p=<.05) less satisfied than older participants (>75 years) and males were significantly (p=<.05) less satisfied than females. The findings indicate that some case-mix adjustment may be applicable for nursing home satisfaction scores.

scholarly journals Age and gender specific association between obesity and depressive symptoms: a large-scale cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Wei Liao ◽  
Zhicheng Luo ◽  
Yitan Hou ◽  
Ningning Cui ◽  
Xiaotian Liu ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Cohort Study ◽  
Depressive Symptoms ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Age And Gender ◽  
Specific Association ◽  
And Gender ◽  
Gender Specific

Abstract Background This is a cross-sectional study to explore the age and gender specific association between obesity and depression in Chinese rural adults. Methods A total of 29,900 eligible participants from the Henan Rural Cohort Study were included. Standard anthropometric measurements were undertaken to obtain data on body mass index (BMI) and waist circumference (WC). The Patient Health Questionnaire-2 (PHQ-2) was utilized to discover depressive symptoms. Logistic regression was performed to explore the association between obesity (independent variable) and depressive symptoms (dependent variable). Results There were 1777 subjects with depressive symptoms, accounting for 5.94%. After multivariable adjustment, compared with normal weight group, the odds ratios (ORs) [95% confidence interval (CI)] for depressive symptoms in underweight, overweight and general obese groups were 1.41 (1.08–1.84), 0.87 (0.78–0.97) and 0.86 (0.74–0.99), respectively. Similarly, the OR (95% CI) of abdominal obesity group was 0.84 (0.76–0.93). Besides, there was linear decreasing trend of WC with depressive symptoms, but not BMI. Moreover, the inverse association between obesity and depressive symptoms was stronger in men and the elderly than that in women and the young. Conclusion Underweight was associated with a higher prevalence of depressive symptoms, which indicated that health care should pay attention to underweight as well as obesity, especially for women and the young. Clinical trial registration The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 2015-07-06.

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