scholarly journals Elaboration and Validation of Two Predictive Models of Postpartum Traumatic Stress Disorder Risk Formed by Variables Related to the Birth Process: A Retrospective Cohort Study

2020 ◽  
Vol 18 (1) ◽  
pp. 92
Author(s):  
Antonio Hernández-Martínez ◽  
Sergio Martínez-Vazquez ◽  
Julián Rodríguez-Almagro ◽  
Miguel Delgado-Rodríguez ◽  
Juan Martínez-Galiano
Keyword(s):  
Traumatic Stress ◽  
Predictive Models ◽  
Health Professionals ◽  
Hospital Readmission ◽  
Retrospective Cohort ◽  
Stress Disorder ◽  
Validation Cohort ◽  
Partner Support ◽  
Predictive Capacity ◽  
Delivery Type

This study aimed to develop and validate two predictive models of postpartum post-traumatic stress disorder (PTSD) risk using a retrospective cohort study of women who gave birth between 2018 and 2019 in Spain. The predictive models were developed using a referral cohort of 1752 women (2/3) and were validated on a cohort of 875 women (1/3). The predictive factors in model A were delivery type, skin-to-skin contact, admission of newborn to care unit, presence of a severe tear, type of infant feeding at discharge, postpartum hospital readmission. The area under curve (AUC) of the receiver operating characteristic (ROC) in the referral cohort was 0.70 (95% CI: 0.67–0.74), while in the validation cohort, it was 0.69 (95% CI: 0.63–0.75). The predictive factors in model B were delivery type, admission of newborn to care unit, type of infant feeding at discharge, postpartum hospital readmission, partner support, and the perception of adequate respect from health professionals. The predictive capacity of model B in both the referral cohort and the validation cohort was superior to model A with an AUC-ROC of 0.82 (95% CI: 0.79–0.85) and 0.83 (95% CI: 0.78–0.87), respectively. A predictive model (model B) formed by clinical variables and the perception of partner support and appropriate treatment by health professionals had a good predictive capacity in both the referral and validation cohorts. This model is preferred over the model (model A) that was formed exclusively by clinical variables.

Original and refitted HOSPITAL scores as predictors of 30-day potentially avoidable hospital readmissions: retrospective cohort study (Preprint)

2020 ◽  
Author(s):  
Nayara Cristina Da Silva ◽  
Marcelo Keese Albertini ◽  
André Ricardo Backes ◽  
Geórgia Das Graças Pena
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Hospital Readmission ◽  
Retrospective Cohort ◽  
Hospital Readmissions ◽  
Hospital Costs ◽  
Area Under The Curve ◽  
University Hospital ◽  
Predictive Capacity ◽  
Avoidable Readmission

BACKGROUND Hospital readmissions are associated with several negative health outcomes and higher hospital costs. The HOSPITAL score is one of the tools developed to identify patients at high risk of hospital readmission, but its predictive capacity in more heterogeneous populations involving different diagnoses and clinical contexts is poorly understood. OBJECTIVE The aim of this study was to propose a refitted HOSPITAL score to predict the risk of potentially avoidable readmission in 30 days and compare the predictive capacity of the original and refitted HOSPITAL score. METHODS Retrospective cohort study was carried out in a tertiary university hospital with patients over the age of 18 years. We developed a refitted HOSPITAL score with the same definitions and predictive variables included in the original HOSPITAL score and compared the predictive capacity of both. The receiver operating characteristic was constructed by comparing the performance risk forecasting tools measuring the area under the curve (AUC). RESULTS Of the 47,464 patients 50.9% were over 60 years and 58.4% were male. The frequency of 30-day potentially avoidable readmission is 7.70% (3638). The accuracy of HOSPITAL score in readmission was AUC: 0.733 (CI 95%: 0.718, 0.748) and the accuracy of HOSPITAL score refitted was AUC: 0.7401 (CI 95%: 0.7256, 0.7547). The frequency of 60, 90, 180, and 365-days readmissions ranged from 10.60% (5,033) to 18.30% (8693). Discussion: Readmission prediction tools have been developed in recent years, but its predictive capacity in more population with different diagnoses is poorly understood. CONCLUSIONS The refitted HOSPITAL score have similar discrimination to predict 30-day potentially avoidable readmission, in patients with different diagnoses. In this sense, our study expands and reinforces the usefulness of the HOSPITAL score as a tool that can be used as part of intervention strategies to reduce the rate of hospital readmission.

scholarly journals Mental health and human trafficking: responding to survivors' needs

2017 ◽  
Vol 14 (1) ◽  
pp. 21-23 ◽  
Author(s):  
Sukran Altun ◽  
Melanie Abas ◽  
Cathy Zimmerman ◽  
Louise M. Howard ◽  
Sian Oram
Keyword(s):  
Mental Health ◽  
Human Trafficking ◽  
Mental Health Professionals ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Health Professionals ◽  
Stress Disorder ◽  
Mental Health Problems ◽  
Post Traumatic Stress ◽  
Post Traumatic

Mental health professionals have opportunities to intervene and provide care for trafficked people. Research shows that mental health problems – including depression, anxiety and post-traumatic stress disorder – are prevalent among trafficked people, and that at least some trafficked people come into contact with secondary mental health services in England.

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