scholarly journals Weight Change during the Early Phase of Convalescent Rehabilitation after Stroke as a Predictor of Functional Recovery: A Retrospective Cohort Study

Nutrients ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 264
Author(s):  
Hiroshi Kishimoto ◽  
Yuka Nemoto ◽  
Takayuki Maezawa ◽  
Kazushi Takahashi ◽  
Kazunori Koseki ◽  
...  
Keyword(s):  
Weight Loss ◽  
Cohort Study ◽  
Functional Recovery ◽  
Retrospective Cohort Study ◽  
Early Phase ◽  
Retrospective Cohort ◽  
Statistical Significance ◽  
Weight Maintenance ◽  
Functional Independence ◽  
Wide Range

It has been reported that weight gain at discharge compared with admission is associated with improved activities of daily living in convalescent rehabilitation (CR) patients with low body mass index. Here, we investigated whether weight maintenance or gain during the early phase of CR after stroke correlates with a better functional recovery in patients with a wide range of BMI values. We conducted this retrospective cohort study in a CR ward of our hospital and included adult stroke patients admitted to the ward from January 2014 to December 2018. After ~1 month of hospitalization, the patients were classified into weight loss and weight maintenance or gain (WMG) groups based on the Global Leadership Initiative on Malnutrition criteria for weight. We adopted the motor functional independence measure (FIM) gain as the primary outcome. The motor FIM gain tended to be greater in the WMG group but without statistical significance. However, multiple regression analysis showed that WMG was significantly and positively associated with motor FIM gain. In conclusion, weight maintenance or gain in patients during the early phase of CR after stroke may be considered as a predictor of their functional recovery, and nutritional management to prevent weight loss immediately after the start of rehabilitation would contribute to this.

Abstract TP155: Weight Loss and Functional Outcomes After Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Nnana Amakiri ◽  
Michael Reding ◽  
Carolin I Dohle
Keyword(s):  
Weight Loss ◽  
Cohort Study ◽  
Weight Change ◽  
Retrospective Cohort Study ◽  
Stroke Rehabilitation ◽  
Retrospective Cohort ◽  
Pearson Correlation ◽  
Functional Independence ◽  
Stroke Severity ◽  
Hospital Inpatient

Introduction: It is a well described fact that elderly hospitalized patients lose weight, and this weight loss has been attributed to loss of muscle mass. On our acute Inpatient Stroke Rehabilitation Unit, patients with more severe deficits on admission appear to lose more weight than patients who are fairly functional. With this retrospective cohort study, we examined whether weight loss during stroke rehabilitation was associated with stroke severity as measured with the Functional Independence Measure (FIM) Score, and due to poor nutrition due to dysphagia or otherwise decreased food intake (estimated by Percent of Meal Consumed (PoMC)). Methods: 420 ischemic stroke patients, admitted to the Burke Rehabilitation Hospital Inpatient Stroke Unit between 12/14 and 12/15, were included in this retrospective cohort study. Weight change per admission day, as well as motor, cognitive and total FIM Scores was recorded. Patients who had mechanically altered diet orders or thickened liquid orders were judged to be dysphagic, and nutritional intake was estimated by PoMC. Results: Weight change per day during inpatient stroke rehabilitation was not correlated with gains in motor FIM (Pearson correlation 0.07, p=0.89) or cognitive FIM (Pearson Correlation -0.053, p=0.29) scores. Weight change per day was also not correlated with admission cognitive or motor FIM scores, indicating that stroke severity did not predict weight loss during admission. Of note, weight change per day was also not correlated with dysphagia, indicating that patient with swallowing difficulties were able to meet their nutritional needs through dietary modifications. Conclusion: Weight changes after stroke do not appear to be correlated to stroke severity and stroke outcomes, as measured by the FIM Score. In our cohort, dysphagia was not an independent risk factor for weight loss. Future prospective trials will be required in order to assess which patients are at risk for weight loss, and whether weight loss is correlated with other measures of impairment.

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

scholarly journals General versus regional anaesthesia for caesarean section indicated for acute foetal distress: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Junette Arlette Mbengono Metogo ◽  
Theophile Njamen Nana ◽  
Brian Ajong Ngongheh ◽  
Emelinda Berinyuy Nyuydzefon ◽  
Christoph Akazong Adjahoung ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Retrospective Cohort Study ◽  
Medical Records ◽  
Regional Anaesthesia ◽  
Retrospective Cohort ◽  
Statistical Significance ◽  
Neonatal Resuscitation ◽  
Maternal Outcomes ◽  
Foetal Distress

Abstract Background Acute foetal distress (AFD) is a life-threatening foetal condition complicating 2% of all pregnancies and accounting for 8.9% of caesarean sections (CS) especially in developing nations. Despite the severity of the problem, no evidence exists as to the safest anaesthetic technique for the mother and foetus couple undergoing CS for AFD. We aimed to compare general anaesthesia (GA) versus regional (spinal and epidural) anaesthesia in terms of their perioperative maternal and foetal outcomes. Methods We carried out a retrospective cohort study by reviewing the medical records of all women who underwent CS indicated for AFD between 2015 to 2018 at the Douala General Hospital, Cameroon. Medical records of neonates were also reviewed. We sought to investigate the association between GA, and regional anaesthesia administered during CS for AFD and foetal and maternal outcomes. The threshold of statistical significance was set at 0.05. Results We enrolled the medical records of 117 pregnant women who underwent CS indicated for AFD. Their mean age and mean gestational age were 30.5 ± 4.8 years and 40 weeks respectively. Eighty-three (70.9%), 29 (24.8%) and 05 (4.3%) pregnant women underwent CS under SA, GA and EA respectively. Neonates delivered by CS under GA were more likely to have a significantly low APGAR score at both the 1st (RR = 1.93, p = 0.014) and third-minute (RR = 2.52, p = 0.012) and to be resuscitated at birth (RR = 2.15, p = 0.015). Past CS, FHR pattern on CTG didn’t affect these results in multivariate analysis. Adverse maternal outcomes are shown to be higher following SA when compared to GA. Conclusion The study infers an association between CS performed for AFD under GA and foetal morbidity. This, however, failed to translate into a difference in perinatal mortality when comparing GA vs RA. This finding does not discount the role of GA, but we emphasize the need for specific precautions like adequate anticipation for neonatal resuscitation to reduce neonatal complications associated with CS performed for AFD under GA.

scholarly journals Changes of Body Weight and Body Composition in Obese Patients with Prader–Willi Syndrome at 3 and 6 Years of Follow-Up: A Retrospective Cohort Study

2020 ◽  
Vol 9 (11) ◽  
pp. 3596
Author(s):  
Giorgio Bedogni ◽  
Graziano Grugni ◽  
Sabrina Cicolini ◽  
Diana Caroli ◽  
Sofia Tamini ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Composition ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Density Lipoprotein ◽  
Rehabilitation Program ◽  
Long Term Results ◽  
Prader Willi Syndrome

Few short-term studies of weight loss have been performed in adult patients with Prader–Willi syndrome (PWS) undergoing metabolic rehabilitation. We performed a retrospective cohort study of 45 adult obese PWS patients undergoing a long-term multidisciplinary metabolic rehabilitation program based on diet and physical activity. Body composition was evaluated by dual-energy X-ray absorptiometry in 36 (80%) patients. The mean (95% CI) weight change was −3.6 (−7.6 to 0.4, p = 0.08) kg at 3 years and −4.6 (−8.5 to −0.8, p = 0.02) kg at 6 years, and that of BMI was −1.7 (−3.4 to 0.1, p = 0.06) kg/m2 at 3 years and −2.1 (−3.8 to −0.4, p = 0.02) kg/m2 at 6 years. A decrease of about 2% in fat mass per unit of body mass was observed, which is in line with the expectations for moderate weight loss. A possibly clinically relevant decrease in total and low-density lipoprotein cholesterol was also observed. These long-term results are important for patients with PWS, which is characterized by severe hyperphagia, behavioral disturbances, and cognitive impairment and is generally considered “resistant” to classical weight loss interventions.

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