scholarly journals Risk Factors for Aspiration Pneumonia among Elderly Patients in a Community-Based Integrated Care Unit: A Retrospective Cohort Study

Geriatrics ◽  
2021 ◽  
Vol 6 (4) ◽  
pp. 113
Author(s):  
Isao Uno ◽  
Takaaki Kubo
Keyword(s):  
Cohort Study ◽  
Integrated Care ◽  
Aspiration Pneumonia ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Functional Independence ◽  
Physical Factors ◽  
Community Based ◽  
Factors Associated ◽  
Oral Environment

We aimed to clarify the physical factors associated with the incidence of aspiration pneumonia in a community-based integrated care unit. This retrospective cohort study included 412 patients aged 65 years or older admitted to a community-based integrated care unit. A new diagnosis of aspiration pneumonia made by the attending physician based on physical examination, imaging findings, and blood test data after 48 h of admission was considered as an incidence of aspiration pneumonia. Basic patient information, activities of daily living, swallowing function, nutritional status, cognitive function, oral health-related factors, and energy intake were retrospectively investigated. We classified the patients into a pneumonia group and a non-pneumonia group, and examined the factors associated with the development of aspiration pneumonia. The mean age was 86.9 ± 8.1 years, and the pneumonia group comprised 49 participants. Comparison between the groups showed significant differences in oral environment, denture use, cognitive functional independence measure, and discharge to home. In multivariate logistic regression analysis, oral environment (odds ratio (OR) = 0.229, 95% confidence interval (CI): 0.070–0.753, p = 0.015) and use of dentures (OR = 0.360, 95% CI: 0.172–0.754, p = 0.007) were independently associated with aspiration pneumonia. Oral care and the use of dentures may be effective in preventing aspiration pneumonia.

scholarly journals Reamputation in patients with diabetic-related minor amputations who underwent physical therapy during their hospitalization. A single-facility retrospective cohort study

2020 ◽  
Author(s):  
Shinsuke Imaoka ◽  
Koji Sato ◽  
Masahide Furukawa ◽  
Minoru Okita ◽  
Toshio Higashi
Keyword(s):  
Cohort Study ◽  
Physical Therapy ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Care Center ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Ankle Dorsiflexion ◽  
Factors Associated ◽  
Minor Amputation

Abstract Background: Diabetic foot lesions are a major cause of non-traumatic lower limb amputations; they can interfere with daily life, reduce physical function and lower a patient’s quality of life. Physical therapy is necessary to prevent such social disadvantage. Patients at high risk of reamputation may require physical therapy to prevent reamputation. The purpose of this study was to elucidate the factors that influence re-amputation in patients with minor amputations who were treated with physical therapy during their hospitalization.Methods: This was a retrospective cohort study of 245 consecutive hospitalized patients who presented to our Wound Care Center between January 2015 and February 2018 and received physical therapy after a minor amputation. Participants were identified from admission records (to surgical and physical therapy units) stored in the electronic medical records. We examined reamputations that occurred in the ipsilateral lower extremity during the 1-year post-discharge outpatient period. The maximum follow-up period was１year. We used Cox proportional hazards analysis to examine factors affecting the risk of reamputation.Results: Of the 129 patients enrolled, 42 patients (32.5%) underwent reamputations during an average observation period of 6.2 months (range, 2.1 to 10.9 months). The factors associated with reamputation were a requirement for hemodialysis, ankle dorsiflexion angle, and ambulation Functional Independence Measure score.Conclusions: We identified a requirement for hemodialysis, ankle dorsiflexion angle, and functional independence measure (FIM) ambulation as the factors associated with reamputation in patients with diabetes who had undergone minor amputation. In the future, developing a physical therapy program that focuses on these factors could help reduce reamputations.

scholarly journals Characteristics, outcomes and risk factors for mortality of 522 167 patients hospitalised with COVID-19 in Brazil: a retrospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e049089
Author(s):  
Marcia C Castro ◽  
Susie Gurzenda ◽  
Eduardo Marques Macário ◽  
Giovanny Vinícius A França
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cox Proportional Hazards ◽  
Secondary Outcome ◽  
Hospital Death ◽  
Factors Associated ◽  
Icu Admission ◽  
Hospitalised Patients

ObjectiveTo provide a comprehensive description of demographic, clinical and radiographic characteristics; treatment and case outcomes; and risk factors associated with in-hospital death of patients hospitalised with COVID-19 in Brazil.DesignRetrospective cohort study of hospitalised patients diagnosed with COVID-19.SettingData from all hospitals across Brazil.Participants522 167 hospitalised patients in Brazil by 14 December 2020 with severe acute respiratory illness, and a confirmed diagnosis for COVID-19.Primary and secondary outcome measuresPrevalence of symptoms and comorbidities was compared by clinical outcomes and intensive care unit (ICU) admission status. Survival was assessed using Kaplan Meier survival estimates. Risk factors associated with in-hospital death were evaluated with multivariable Cox proportional hazards regression.ResultsOf the 522 167 patients included in this study, 56.7% were discharged, 0.002% died of other causes, 30.7% died of causes associated with COVID-19 and 10.2% remained hospitalised. The median age of patients was 61 years (IQR, 47–73), and of non-survivors 71 years (IQR, 60–80); 292 570 patients (56.0%) were men. At least one comorbidity was present in 64.5% of patients and in 76.8% of non-survivors. From illness onset, the median times to hospital and ICU admission were 6 days (IQR, 3–9) and 7 days (IQR, 3–10), respectively; 15 days (IQR, 9–24) to death and 15 days (IQR, 11–20) to hospital discharge. Risk factors for in-hospital death included old age, Black/Brown ethnoracial self-classification, ICU admission, being male, living in the North and Northeast regions and various comorbidities. Age had the highest HRs of 5.51 (95% CI: 4.91 to 6.18) for patients≥80, compared with those ≤20.ConclusionsCharacteristics of patients and risk factors for in-hospital mortality highlight inequities of COVID-19 outcomes in Brazil. As the pandemic continues to unfold, targeted policies that address those inequities are needed to mitigate the unequal burden of COVID-19.

scholarly journals Characteristics and Outcomes of Hip Fracture Patients Hospitalized in an Orthogeriatric Unit Versus an Orthopedic Department: A Retrospective Cohort Study

2021 ◽  
Vol 12 ◽  
pp. 215145932098629 ◽  
Author(s):  
Yulia Bugaevsky ◽  
Yochai Levy ◽  
Avital Hershkovitz ◽  
Irena Ocheretny ◽  
Adaya Nissenholtz ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Hip Fracture ◽  
Hip Fractures ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Functional Independence ◽  
Functional Improvement ◽  
Orthopedic Department ◽  
Successful Recovery

Introduction: Hip fractures are a significant health risk in older adults and a major cause of morbidity, functional decline and mortality. Our aim was to compare clinical outcomes of older patients hospitalized in an ortho-geriatric (OG) unit to those hospitalized in an orthopedic department (OD) for surgical treatment of a hip fracture. Methods: A retrospective cohort study of hip fractured patients hospitalized between 2015-2016 in a single tertiary university-affiliated medical center. Included were patients aged 65 and older who had undergone hip fracture surgery and were admitted to either a geriatric or orthopedic ward. Results: 441 patients met the inclusion criteria (195 in the OG unit, 246 in the OD); 257 were transferred to an affiliated geriatric center hospital (107 from the OG unit and 127 from the OD) for rehabilitation. Patients in the OG unit were older, more cognitively and functionally impaired and with more comorbidities. The 1-year mortality rate was significantly lower in the OD group (OR 0.32, CI 95% 0.19-0.53, p < 0.001), however, after propensity matching, the 30-day and 1 year mortality rates were similar in both groups. No difference was found in the rehabilitation length of stay between the groups. The functional independence measure improvement was similar in both groups, with a non-significant trend toward better functional improvement among OG unit patients. Conclusions: Despite the higher complexity of patients, worse baseline functional capacity in the OG unit, improvement after rehabilitation was similar in both groups. These results demonstrate the advantages of the OG unit in treating and stabilizing frail older adults, thus maximizing their chances for a successful recovery after hip fractures. Level of Evidence: Level IV

Risk factors associated with pseudoaldosteronism in patients with chronic hepatitis: A retrospective cohort study

2018 ◽  
Vol 124 (5) ◽  
pp. 607-614 ◽  
Author(s):  
Akihiro Komatsu ◽  
Tetsuhiro Yoshino ◽  
Takeshi Suzuki ◽  
Tomonori Nakamura ◽  
Takanori Kanai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Hepatitis ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Hepatitis A ◽  
Factors Associated
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