Can we predict Acute Medical readmissions using the BOOST tool? A retrospective case note review

2016 ◽  
Vol 15 (3) ◽  
pp. 119-123
Author(s):  
Geraldine A Lee ◽  
◽  
D Freedman ◽  
Penelope Beddoes ◽  
Emily Lyness ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Risk Assessment ◽  
Risk Factor ◽  
Hospital Discharge ◽  
Assessment Tool ◽  
Case Note ◽  
Retrospective Case ◽  
The Uk ◽  
Case Note Review

Background: Readmissions within 30-days of hospital discharge are a problem. The aim was to determine if the Better Outcomes for Older Adults through Safe Transitions (BOOST) risk assessment tool was applicable within the UK. Methods: Patients over 65 readmitted were identified retrospectively via a casenote review. BOOST assessment was applied with 1 point for each risk factor. Results: 324 patients were readmitted (mean age 77 years) with a median of 7 days between discharge and readmission. The median BOOST score was 3 (IQR 2-4) with polypharmacy evident in 88% and prior hospitalisation in 70%. The tool correctly predicted 90% of readmissions using two or more risk factors and 99.1% if one risk factor was included. Conclusion: The BOOST assessment tool appears appropriate in predicting readmissions however further analysis is required to determine its precision.

Components of a risk assessment tool for prevention and control of bovine respiratory disease in preweaned dairy calves

2020 ◽  
pp. 1-7
Author(s):  
Sharif S. Aly ◽  
Betsy M. Karle ◽  
Deniece R. Williams ◽  
Gabriele U. Maier ◽  
Sasha Dubrovsky
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Risk Factor ◽  
Respiratory Disease ◽  
Scoring System ◽  
Prevention And Control ◽  
Assessment Tool ◽  
Bovine Respiratory Disease ◽  
And Control ◽  
Management Changes

Abstract Bovine respiratory disease (BRD) is the leading natural cause of death in US beef and dairy cattle, causing the annual loss of more than 1 million animals and financial losses in excess of $700 million. The multiple etiologies of BRD and its complex web of risk factors necessitate a herd-specific intervention plan for its prevention and control on dairies. Hence, a risk assessment is an important tool that producers and veterinarians can utilize for a comprehensive assessment of the management and host factors that predispose calves to BRD. The current study identifies the steps taken to develop the first BRD risk assessment tool and its components, namely the BRD risk factor questionnaire, the BRD scoring system, and a herd-specific BRD control and prevention plan. The risk factor questionnaire was designed to inquire on aspects of calf-rearing including management practices that affect calf health generally, and BRD specifically. The risk scores associated with each risk factor investigated in the questionnaire were estimated based on data from two observational studies. Producers can also estimate the prevalence of BRD in their calf herds using a smart phone or tablet application that facilitates selection of a true random sample of calves for scoring using the California BRD scoring system. Based on the risk factors identified, producers and herd veterinarians can then decide the management changes needed to mitigate the calf herd's risk for BRD. A follow-up risk assessment after a duration of time sufficient for exposure of a new cohort of calves to the management changes introduced in response to the risk assessment is recommended to monitor the prevalence of BRD.

scholarly journals A retrospective case note review of laparoscopic versus open reversal of Hartmann’s procedure

2014 ◽  
Vol 96 (7) ◽  
pp. 539-542 ◽  
Author(s):  
CL Walklett ◽  
NP Yeomans
Keyword(s):  
Case Note ◽  
Hartmann’S Procedure ◽  
Reversal Rate ◽  
Teaching Hospitals ◽  
Laparoscopic Technique ◽  
Complication Rates ◽  
Retrospective Case ◽  
Hartmann's Procedure ◽  
The Uk ◽  
Case Note Review

Introduction First described in 1921, Hartmann’s procedure is the gold standard treatment for complicated sigmoid diverticular disease. It is also used commonly for other causes of perforation of the large bowel. However, the reversal rate in the UK is much lower than in comparable countries, at only 18–22%. Furthermore, laparoscopic reversal (LRH) is used far less frequently than open reversal (ORH) despite evidence that a laparoscopic technique reduces patient morbidity and decreases patient recovery time. Methods This retrospective case note review undertook an analysis of all the patients who had undergone Hartmann’s procedure at two centres in Leeds Teaching Hospitals NHS Trust between February 2007 and February 2012. Out of 305 patients, 235 were identified and included in the analysis. Comparisons were then drawn between LRH and ORH groups. Results The reversal rate was 21%. Three-quarters (76%) were performed using an open technique, 20% were laparoscopic and 5% were converted to an open procedure. The mean hospital stay was longer for the ORH group (9.82 days, standard deviation [SD]: 5.85 days, 95% confidence interval [CI]: 2.99 days) than for the LRH group (7.29 days, SD: 4.65 days, 95% CI: 11.58 days) p=0.006). Seven ORH patients (21%) were reoperated but only one LRH patient (13%) had a reoperation at six months. Five factors were found to have a significant effect on the likelihood of reversal of Hartmann’s procedure. Conclusions The overall reversal rate for Hartmann’s procedure remains low. Shorter hospital stays, lower 6-month reoperation rates and reduced 30-day complication rates are associated with LRH when compared with ORH.

scholarly journals Utilizing diabetes mellitus risk assessment tool in screening of hemodialysis patients at risk of diabetes mellitus

2021 ◽  
Vol 2021 (2) ◽  
Author(s):  
Osama Azoubi ◽  
Tarek Abdullatif ◽  
Abdullah Hamad ◽  
Tarek Fouda ◽  
Sahar M Ismail ◽  
...  
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Risk Factors ◽  
Risk Assessment ◽  
Risk Factor ◽  
Assessment Tool ◽  
Risk Group ◽  
Dialysis Patients ◽  
Group Score ◽  
History Of

Background: Hamad General Hospital is the main provider of hemodialysis (HD) in Qatar, for approximately 650 patients per year. Over 60% of these patients have Diabetes Mellitus (DM) and 55% of them suffer from end stage renal disease (ESRD). 2% of ESRD patients develop DM after their first year of dialysis. The aims of this quality improvement study were early DM detection, risk factors modifications, and reduction of diabetes complications in our patients. Methods: A risk assessment tool was adapted to identify the risk level of HD patients to develop DM. They were screened to determine their risk score across 8 categories. Six categories (gender, history of gestational diabetes, family history of high blood pressure, diabetes, physical activity and smoking) were scored 0 to 1, age was scored 0 to 3, and relationship between weight and height scored 1 to 3. (Overall score range: 1-12). Patients were classified into two groups: a low-risk group (score < 5) and a high-risk group (score ≥ 5). Patients were referred to different medical specialties for further management according to the risk factor and a lifestyle modification management plan was set individually. Results: 189 non-diabetic dialysis patients were screened in the first quarter of 2020, their mean age was 51 years-old, and 69% were male. Forty-three percent of patients were found to be at high risk of developing DM. The most important risk factors were family history (55%), obesity (40%), age >60 years (32%), low physical activity (14%), and smoking (11%). Thirty-seven percent of patients were referred to the obesity clinic, 10% to the smoking cessation clinic, 5% to physiotherapy, and 100% of patients were referred to the multidisciplinary care. Conclusion: Screening for diabetes is pivotal for early detection and risk factor modification in dialysis patients. We recommend quarterly data assessment and evaluation so patients can be managed according to the findings.

Balloon sinuplasty: our first year

2010 ◽  
Vol 125 (1) ◽  
pp. 43-52 ◽  
Author(s):  
C Hopkins ◽  
E Noon ◽  
D Bray ◽  
D Roberts
Keyword(s):  
New Technology ◽  
Case Note ◽  
First Year ◽  
Subjective Improvement ◽  
Retrospective Case ◽  
Balloon Sinuplasty ◽  
Additional Costs ◽  
The Uk ◽  
Snot 22 ◽  
Case Note Review

AbstractIntroduction:Balloon sinuplasty is a new technology which has only recently been introduced in the UK. We review the current literature, and we present our first year's results for the technique together with a description of indications, outcomes and problems.Methods:Retrospective case note review of 27 consecutive patients undergoing sinuplasty alone in the first year in which this procedure was performed. The main outcome measures used were subjective improvement and Sino-Nasal Outcome Test (SNOT-22) score.Results:Dilatation was successful in 98 per cent of sinuses in which it was attempted; however, subjective improvement was noted in only 62 per cent of patients thus treated.Conclusion:We believe that balloon sinuplasty has a place in routine rhinology practice but that its applications are limited, and that its additional costs must be considered. We present advantages and possible limitations of the technique.

scholarly journals Polish Translation and Validation of the Mini Sarcopenia Risk Assessment (MSRA) Questionnaire to Assess Nutritional and Non-Nutritional Risk Factors of Sarcopenia in Older Adults

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1061
Author(s):  
Roma Krzymińska-Siemaszko ◽  
Ewa Deskur-Śmielecka ◽  
Arkadiusz Styszyński ◽  
Katarzyna Wieczorowska-Tobis
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Risk Assessment ◽  
Predictive Value ◽  
High Sensitivity ◽  
Community Dwelling ◽  
Nutritional Risk ◽  
Polish Language ◽  
Community Dwelling Older Adults ◽  
Translation And Validation

A simple, short, cheap, and reasonably sensitive and specific screening tool assessing both nutritional and non-nutritional risk factors for sarcopenia is needed. Potentially, such a tool may be the Mini Sarcopenia Risk Assessment (MSRA) Questionnaire, which is available in a seven-item (MSRA-7) and five-item (MSRA-5) version. The study’s aim was Polish translation and validation of both MSRA versions in 160 volunteers aged ≥60 years. MSRA was validated against the six sets of international diagnostic criteria for sarcopenia used as the reference standards. PL-MSRA-7 and PL-MSRA-5 both had high sensitivity (≥84.9%), regardless of the reference standard. The PL-MSRA-5 had better specificity (44.7–47.2%) than the PL-MSRA-7 (33.1–34.7%). Both questionnaires had similarly low positive predictive value (PL-MSRA-5: 17.9–29.5%; PL-MSRA-7: 14.4–25.2%). The negative predictive value was generally high for both questionnaires (PL-MSRA-7: 89.8–95.9%; PL-MSRA-5: 92.3–98.5%). PL-MSRA-5 had higher accuracy than the PL-MSRA-7 (50.0–55% vs. 39.4–45%, respectively). Based on the results, the Mini Sarcopenia Risk Assessment questionnaire was successfully adopted to the Polish language and validated in community-dwelling older adults from Poland. When compared with PL-MSRA-7, PL-MSRA-5 is a better tool for sarcopenia risk assessment.

scholarly journals Choice of a suitable diabetes risk assessment tool in Nepal – can we learn from Canada?

2016 ◽  
Vol 6 (2) ◽  
pp. 548-550
Author(s):  
Gina Agarwal ◽  
Brijesh Sathian ◽  
Sutapa Agrawal
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Health Outcomes ◽  
Assessment Tool ◽  
National Policy ◽  
Diabetes Risk ◽  
Risk Assessment Tool ◽  
Educational Tool ◽  
Diabetes Risk Factors ◽  
The Masses

If the population can be made more aware about diabetes by the use of a risk assessment tool as an educational tool as well, it could help to curb the diabetes epidemic in Nepal. Education of the masses about diabetes risk factors, prevention, and complications is urgently needed, using clear and simple messages. National policy efforts can be strengthened and health  outcomes improved when awareness is increased. Perhaps learning from Canada is a start, and Nepal will be able to make progress with something simple like ‘NEPAL-RISK’?

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