CAN EPWORTH SLEEPINESS SCALE BE A PREDICTOR OF COGNITIVE DEFICT IN A COGNITIVE SCREENING TEST IN A COHORT OF ELDERLY FREE OF CLINICALLY MANIFEST VASCULAR BRAIN DISEASE

Background: The Obstructive Sleep Apnea Syndrome (OSAS) is highly prevalent among the elderly and relevant due to its cognitive impact. Objective: To evaluate an association between cognitive impairment (CI) and the presence of OSAS as assessed by the Mini Mental (MM) scale and the Ephorth Sleepiness Scale (ESS) in a population of octogens free from overt cerebral vascular disease (CVD). Methods: 137 individuals were selected. The study was approved by the ethics committee. Categorical variables were evaluated as percentages, continuous variables with normal distribution as mean ± SD and non-parametric variables as median. The subjects were not categorized into the presence or absence of CI according to the score on the MM scale according to education. In a multivariate binary logistic regression model with dependent variable CI, independent variables were incorporated according to the clinic and whether they were associated with CI in the bivariate models. All independent variables were defined in the model. Results: There was an association between high probability of OSAS by ESS and CI by MM. X2(1) = 5.34 p = 0.021. Conclusions: There was an association between high scores on the ESS and the presence of CI at the MM, even compatible for age, BMI, gender, coronary calcification, blood pressure.

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RISK FACTORS OF ADVERSE CLINICAL OUTCOMES IN THE ELDERLY AND SENILE PATIENTS WITH STROKE-ASSOCIATED PNEUMONIA

Успехи геронтологии ◽

10.34922/ae.2021.34.4.012 ◽

2021 ◽

pp. 586-591

Author(s):

В.А. Белобородов ◽

И.А. Степанов ◽

А.В. Щербатых ◽

И.И. Томашов ◽

З.С. Саакян ◽

...

Keyword(s):

Risk Factors ◽

Clinical Outcomes ◽

Nosocomial Pneumonia ◽

Binary Logistic Regression ◽

The Elderly ◽

Older Age ◽

Binary Logistic Regression Model ◽

Protein Levels ◽

Reactive Protein ◽

Degree Of Disability

В отечественной и зарубежной специализированной литературе отсутствуют исследования, посвященные изучению факторов риска развития неблагоприятного исхода у пациентов старшей возрастной группы с инсультассоциированной нозокомиальной пневмонией. Цель исследования - изучение факторов риска развития неблагоприятного клинического исхода у пациентов пожилого и старческого возраста с нозокомиальной пневмонией на фоне ОНМК. В исследование были включены 247 пациентов пожилого и старческого возраста (139 мужчин, 108 женщин, средний возраст - 74,1±6,3 года), госпитализированных с признаками ОНМК по ишемическому или геморрагическому типу. Согласно модели бинарной логистической регрессии, статистически значимо ассоциированы с развитием неблагоприятного исхода у изучаемой группы респондентов следующие параметры: возраст свыше 75 лет (p=0,011), степень инвалидизации по шкале mRS 3 (р=0,009), а также уровень С-РБ >100 мг/л (р=0,023) и мочевины >7 ммоль/л (р=0,044). Для снижения частоты встречаемости неблагоприятного клинического исхода у пациентов старшей возрастной группы с инсульт-ассоциированной нозокомиальной пневмонией необходимо верифицировать перечисленные выше клинико-лабораторные параметры на ранних этапах госпитализации. In the domestic and foreign specialized literature, there are no studies devoted to the study of risk factors of mortality in the older age patients with stroke-associated nosocomial pneumonia. The purpose of the study was to study the risk factors of adverse clinical outcomes in elderly and senile patients with stroke-associated nosocomial pneumonia. The study included 247 elderly and senile patients (139 men, 108 women, mean age - 74,1±6,3 years) who were hospitalized with signs of ischemic or hemorrhagic stroke. According to the binary logistic regression model, the following parameters are statistically significantly associated with adverse clinical outcomes in the studied group of respondents: age over 75 years (p=0.011), degree of disability according to mRS ≥3 (p=0,009), and C-reactive protein levels over 100 mg/l (p=0,023) and urea more than 7 mmol/l (p=0,044). In order to reduce the incidence of adverse clinical outcomes in patients of the older age group with stroke-associated nosocomial pneumonia, it is necessary to verify the above clinical and laboratory parameters at the early stages of hospitalization.

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Effect of wearing a helmet on the occurrence of head injuries in motorcycle riders in Benin: a case-control study nested in a cohort

10.21203/rs.3.rs-117833/v2 ◽

2021 ◽

Author(s):

Bella Adodo Hounkpe Dos Santos ◽

Yolaine Glele Ahanhanzo ◽

Alphonse Kpozehouen ◽

Donatien Daddah ◽

Emmanuel Lagarde ◽

...

Keyword(s):

Head Injury ◽

Case Control Study ◽

Head Injuries ◽

Binary Logistic Regression ◽

Case Control ◽

Binary Logistic Regression Model ◽

Independent Variables ◽

Road Users ◽

Trauma Victims ◽

Control Study

Abstract Background In Benin, motorcycles are the main means of transport for road users and are involved in more than half of crashes. This study aims to determine the effect of wearing a helmet on reducing head injuries in road crashes in Benin. Methods This case-control study nested in a cohort took place in 2020 and focused on road trauma victims. The sample, consisting of 242 cases (trauma victims with head injuries) for 484 controls (without head injuries), was drawn from a cohort of traffic crash victims recruited from five hospitals across the country from July 2019 to January 2020. Four groups of independent variables were studied: socio-demographic and economic variables, history, ²oural variables including helmet use and road-related and environmental variables. To assess the shape of the association between the independent variables and the dependent variable, a descending step-by-step binary logistic regression model was performed using an explanatory approach.. Results Fewer of the subjects with a head injury were wearing a helmet at the time of the crash 69.8% (95% CI = 63.6 - 75.6) compared to those without a head injury 90.3% (95% CI = 87.3 - 92.8). Adjusting for the other variables, subjects not wearing helmets were at greater risk of head injuries (OR = 3.8, 95% CI (2.5 - 5.7)); the head injury rating was 1.9 (95% CI = 1.2 - 3.3) times higher in subjects who were fatigued during the crash than among those who were not and 2.0 (95% CI = 1.2 - 3.3) times higher than in subjects with no medical history. Conclusion Failure to wear a helmet exposes motorcyclists to the risk of head injuries during crashes. It is important to increase awareness and better target such initiatives at the subjects most at risk.

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Polysomnography in Pediatric Otolaryngology: If Not Obstructive Sleep Apnea, What Is It?

Otolaryngology ◽

10.1177/0194599817726977 ◽

2017 ◽

Vol 157 (6) ◽

pp. 1053-1059 ◽

Cited By ~ 4

Author(s):

Christine H. Heubi ◽

Jareen Meinzen-Derr ◽

Sally R. Shott ◽

David F. Smith ◽

and Stacey L. Ishman

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Sleep Disturbances ◽

Case Series ◽

Central Sleep Apnea ◽

Categorical Variables ◽

Periodic Limb Movements ◽

Continuous Variables ◽

Retrospective Case ◽

Obstructive Sleep

Objective To determine common polysomnographic (PSG) diagnoses for children referred by otolaryngologists. Study Design Retrospective case series with chart review. Setting Single tertiary pediatric hospital (2010-2015). Subjects and Methods Review of the medical records of 1258 patients undergoing PSG by otolaryngology referral. Patients who underwent previous otolaryngologic surgery were excluded. Data distributions were evaluated using means with standard deviations for continuous variables and frequencies with percentages for categorical variables. Results A total of 1258 patients were included; 55.9% were male, 64.5% were Caucasian, 16.6% had Down syndrome, and 48% had public insurance. The median age at the time of PSG was 5.2 years (range = 0.2-18.94). Indications for PSG were sleep-disordered breathing (SDB; 69.4%), restless sleep (12.7%), airway anomalies (7.5%), and laryngomalacia (7.2%). SDB was seen in 73.4%, obstructive sleep apnea (OSA) in 53.2%, OSA + central sleep apnea (CSA) in 4.5%, CSA in 0.9%, and non-OSA snoring in 15%. Other diagnoses included periodic limb movements of sleep (PLMS; 7.4%), hypoventilation (6.8%), and nonapneic hypoxemia (2.6%). SDB was more common in younger children and seen in 91.4% of children <12 months and in 69.2% of children ≥24 months, while non-OSA snoring was more common with increasing age (3.7% in children <12 months, 17.7% of children ≥24 months). PLMS were seen in 8.9% of children ≥24 months and in no children <12 months. Conclusion While OSA and snoring were the most common diagnoses reported, PLMS, alveolar hypoventilation, and CSA occurred in 7.4%, 6.8%, and 5.4%, respectively. These findings indicate that additional diagnoses other than OSA should be considered for children seen in an otolaryngology clinic setting who undergo PSG for sleep disturbances.

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Determinan Keputusan Melakukan Migrasi Ulang-Alik

EFFICIENT Indonesian Journal of Development Economics ◽

10.15294/efficient.v1i3.27869 ◽

2018 ◽

Vol 1 (3) ◽

pp. 242-251

Author(s):

Rifqi Nur Fahmy

Keyword(s):

Logistic Regression ◽

Marital Status ◽

Logistic Regression Model ◽

Binary Logistic Regression ◽

Binary Logistic Regression Analysis ◽

Analysis Method ◽

Binary Logistic Regression Model ◽

Level Of Education ◽

Independent Variables ◽

Variable Level

The aim of this research is to analyze the influence of dependent variable of family dependent, education level, age, marital status, and distance partially to workforce’s decision to migrate from Surakarta to Karanganyar Regency. This research used binary logistic regression analysis method. The sample in this research is 100 respondents. The result of binary logistic regression model analysis in this research shows that from five independent variables, there are two variables that have significant effect on workforce’s decision to do the commuter migration that is dependent variable of family and marital status. While the variable level of education, age, and distance have no effect on workforce’s decisions to do the commuter migration. Tujuan dari penelitian ini adalah untuk menganalisis pengaruh variabel dependen dependen keluarga, tingkat pendidikan, usia, status perkawinan, dan jarak secara parsial terhadap keputusan tenaga kerja untuk bermigrasi dari Surakarta ke Kabupaten Karanganyar. Penelitian ini menggunakan metode analisis regresi logistik biner. Sampel dalam penelitian ini adalah 100 responden. Hasil analisis model regresi logistik biner dalam penelitian ini menunjukkan bahwa dari lima variabel independen, ada dua variabel yang berpengaruh signifikan terhadap keputusan angkatan kerja untuk melakukan migrasi komuter yang merupakan variabel dependen keluarga dan status perkawinan. Sedangkan tingkat variabel pendidikan, usia, dan jarak tidak berpengaruh pada keputusan tenaga kerja untuk melakukan migrasi komuter.

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Gender Differences in Healthcare-Seeking Behaviors in China’s Ageing Population: An Empirical Study of Shanghai

10.21203/rs.3.rs-122557/v1 ◽

2020 ◽

Author(s):

Luxue Liu ◽

Chunlan Wang ◽

Shangguang Yang ◽

Kevin Lo ◽

Xi Yang

Keyword(s):

Gender Differences ◽

Elderly Population ◽

Binary Logistic Regression ◽

The Elderly ◽

Influential Factors ◽

Ageing Population ◽

Binary Logistic Regression Model ◽

Healthcare Seeking ◽

Factors Influencing ◽

Tertiary Hospitals

Abstract Background: Given the growing healthcare demands of the elderly, an improved understanding of the factors influencing their healthcare-seeking behaviors is necessary to enhance the effectiveness of the current healthcare system. This study empirically investigates the factors influencing the elderly population’s healthcare-seeking behaviors in Shanghai, China, from a gender differences perspective.Methods: We combine both quantitative and qualitative analyses by constructing a binary logistic regression model and identifying the relevant influential factors based on the following types of dimensions: individual, family, and cultural.Results: The results indicate that gender differences exist in the elderly population with common diseases but not in those with severe diseases, and that the female elderly are more likely to choose non-tertiary hospitals than males. In addition, age, marital status, employment status, income, health conditions, medical insurance, family support, and social capital are found to be critical influencing factors.Conclusions: The findings provide a better understanding of the elderly population’s healthcare demands and can be used to promote healthcare equality.

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Transpalatal Advancement Pharyngoplasty Outcomes Compared With Uvulopalatopharygoplasty

Otolaryngology ◽

10.1016/j.otohns.2005.03.061 ◽

2005 ◽

Vol 133 (2) ◽

pp. 211-217 ◽

Cited By ~ 45

Author(s):

B. Tucker Woodson ◽

Sam Robinson ◽

Hyun J. Lim

Keyword(s):

Odds Ratio ◽

Retrospective Cohort ◽

Categorical Variables ◽

Apnea Hypopnea Index ◽

Continuous Variables ◽

Success Rates ◽

Obstructive Sleep ◽

Surgical Failure ◽

Clinical Records ◽

Overnight Polysomnography

Objective: Uvulopalatopharyngoplasty (UPPP) success rates in patients classified with Friedman stage 3 is reported as 8%. Surgical failure may result from persistent obstruction at the palate, which may be addressed by pharyngoplasty with palatal advancement (PA). The effectiveness of PA versus UPPP was evaluated by using polysomnographic outcomes in a retrospective cohort of patients classified with Friedman stage 3. Methods: Surgical records were reviewed for PA (n = 47) and UPPP (n = 124). Clinical records were reviewed and reclassified by Friedman stage. Respiratory data were collected from overnight polysomnography. Statistical analysis was conducted of continuous variables (ANOVA), categorical variables (χ 2 ), and adjusted odds ratios by using logistic regression. Results: PA (n = 30) and UPPP (n = 44) did not differ in baseline apnea hypopnea index (AHI), age, or BMI. Both PA (48.3 ± 24.6 to 19.8 ± 16.8 events per hour, P < 0.000) and UPPP (47.9 ± 30.0 to 30.9 ± 24.2 events per hour, P < 0.000) improved with surgery. In the PA group, final AHI was lower (17.1 ± 30.1 versus 28.5 ± 25.6, P < 0.04) and postoperative change was greater (30.9 ± 24.2 versus 19.8 ± 16.8, P < 0.02). For patients with Friedman stage 3, odds ratio of having an AHI of <20 events per hour and a greater than 50% reduction with PA compared with UPPP was 3.80 (95% CI, 1.41-10.29, P < 0.013). Adjusted for age, body mass index, preoperative apnea severity, and tongue-base surgery, OR was 5.77 (95% CI of 1.80-17.98). Conclusions: Polysomnographic outcomes using AHI support the use of palatopharyngoplasty using palatal advancement as an effective treatment of obstructive sleep apnea. PA may offer benefit over UPPP alone in patients classified with Friedman stage 3.

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1195. Where You Live Matters: United States Region as a Significant Predictor of Mortality for ESBL Infection Based on a Descriptive Study Using NIS Database

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.1028 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S361-S362 ◽

Cited By ~ 1

Author(s):

Elizabeth George ◽

Sarah Aurit ◽

Christopher Destache ◽

Renuga Vivekanandan

Keyword(s):

Case Fatality ◽

Binary Logistic Regression ◽

Multidrug Resistant ◽

Inpatient Setting ◽

Continuous Variables ◽

Binary Logistic Regression Model ◽

Chi Square ◽

The Us ◽

Resistant Infection ◽

Prolonged Hospital

Abstract Background Extended-spectrum β-lactamase (ESBL) enzymes are produced by multidrug-resistant (MDR) pathogens and confer resistance to β-lactam antibiotics. Infections due to MDR organisms, particularly those ESBL producing pathogens, are of major concern worldwide and are associated with prolonged hospital stay and increased case-fatality rate. Carbapenems are the treatment of choice for severe infections however overuse of this class of antibiotics is leading Carbapenemase-producing pathogens. Variations have been observed in the prevalence of ESBL strains from different US regions; however, it is unclear whether morbidity and mortality follow a similar pattern. This study was conducted to explore the incidence of ESBL infections in the inpatient setting and factors that affect morbidity/mortality. Methods The National Inpatient Sample (NIS) was used to identify all hospitalizations during 2002 to 2014; all primary and secondary diagnoses were searched to identify-resistant infection that utilized the ICD-9 code “V091.” All hospitalizations were stratified based on the indication of resistant infection, and comparisons were made with the chi-square test and linear regression for categorical and continuous variables, respectively. A multivariable binary logistic regression model was used to examine survival for those with ESBL infection. All analyses were conducted with SAS version 9.4; P < 0.005 was considered significant. Results The analysis identified 320,888,511 hospitalizations with 17,732 identified with ESBL infection. Significant differences for those with and without an ESBL infection were found based on the US region with the pertinent results as follows; Northeast: 19.95% vs. 23.30%, Midwest: 14.71% vs. 16.81%, South: 25.14% vs. 40.53%, and West: 40.20% vs. 19.35%; P < 0.001. Results indicated the US region as a significant predictor of mortality for those with ESBL infection. Regions identified in Figure 1. Conclusion Notable findings from this study include a statistically significant variation in mortality risk between US regions. Comparatively lower risk of mortality as related to ESBL infection was noted in the Midwest region when compared with the West region. A greater understanding of the regional epidemiology of β-lactamases is needed to clarify why this disparity exists. Figure 1 Disclosures All authors: No reported disclosures.

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Quality of life based on level of physical activity among elderly residents of urban and rural areas

Revista Brasileira de Geriatria e Gerontologia ◽

10.1590/1981-22562017020.160110 ◽

2017 ◽

Vol 20 (3) ◽

pp. 330-339 ◽

Cited By ~ 5

Author(s):

Cezar Grontowski Ribeiro ◽

Fátima Ferretti ◽

Clodoaldo Antônio de Sá

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Rural Areas ◽

The Elderly ◽

Categorical Variables ◽

Elderly Persons ◽

Continuous Variables ◽

Place Of Residence ◽

Cross Sectional

Abstract Objective: To analyze quality of life (QOL) according to level of physical activity among elderly persons living in rural (RA) and urban (UA) areas. Method: A descriptive cross-sectional study, analyzing 358 elderly residents of RA and 139 of UA, in the municipal region of Palmas, Paraná, Brazil was performed. Quality of life, level of physical activity and economic condition were evaluated. For the analysis of the continuous variables, the student’s t-test or the Mann-Whitney test were used, based on the normality or otherwise of the data. Pearson's chi-squared or Fischer’s exact test were used to analyze the categorical variables. Results: The general perception of QOL reported in RA was better than in UA (p<0.05). The analysis of the level of physical activity according to place of residence showed that the elderly are more physically active in RA (p<0.05), whereas insufficiently active or sedentary subjects prevail in UA. The variables age and gender were not associated with QOL (p>0.05), irrespective of place of residence, and active elderly persons had better QOL scores than insufficiently active or sedentary individuals, again irrespective of place of residence (p<0.05). Conclusion: The present study provides evidence that QOL is positively influenced by both maintaining satisfactory levels of physical activity and by residing in RA. It is important to establish public policies aimed at ensuring a more active and independent old age, thus generating greater health and quality of life.

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Burden of dementia in atrial fibrillation hospitalizations- analysis of national inpatient sample 2016-2018

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.002 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

H Thyagaturu ◽

K Shah ◽

S Li ◽

S Thangjui ◽

B Shrestha

Keyword(s):

Atrial Fibrillation ◽

Hospital Mortality ◽

Skilled Nursing Facility ◽

The Elderly ◽

Primary Diagnosis ◽

Categorical Variables ◽

Continuous Variables ◽

National Inpatient Sample ◽

Chi Square ◽

Student’S T

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Atrial fibrillation is a common disorder in the elderly population and a known risk factor for stroke and dementia. Purpose To study the burden of dementia in Afib hospitalizations and identify the predictors of in-hospital mortality in Afib with dementia hospitalizations. Methods We queried January 2016 to December 2018 National Inpatient Sample (NIS) to identify adult (≥18 yrs) hospitalizations with a primary diagnosis of Afib. Hospitalizations of Afib with dementia was compared with Afib without dementia. We used the Chi-square test for differences between categorical variables, and Student’s t-test for continuous variables. Multivariate logistic regression was used in outcomes analysis to adjust for potential hospital and patient-level confounders. Results We identified 1,236,540 weighted Afib hospitalizations across three years. Of which, 79,405 (6.4%) of them were associated with dementia. Afib with dementia hospitalizations were associated with older age (mean age 83.2 vs 70.0 yrs; P < 0.01), higher rate of chronic Afib (15.3% vs 7.5%; P < 0.01), higher rate of comorbidity (% of >3 Elixhauser comorbidity score 91.8% vs 83.6%; P < 0.01). After adjusting for patient and hospital-level characteristics, we observed that Afib with dementia hospitalizations was associated with higher odds of in-hospital mortality compared to Afib without dementia [Odds Ratio (OR): 1.6 (1.4 – 1.9); P < 0.01]. We also observed statistically significant association with increased LOS [4.7 vs 3.2 days; P < 0.01], repeated falls [OR: 2.8 (2.5 – 3.1); P < 0.01] and protein calorie malnutrition [OR: 1.9 (1.7 – 2.0); P < 0.01] in Afib with dementia group. Conclusion Afib with dementia hospitalizations are not only associated with higher mortality, but they are also associated with higher repeated fall rates, and skilled nursing facility discharge dispositions. Co-morbidities like hypertension, CKD, obesity, HFrEF, HFpEF, OSA are associated with higher in-hospital mortality. Our study findings emphasize the burden of dementia in Afib hospitalizations and the need for prevention of poor outcomes in this population.

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Clinical conditions and memory complaints in outpatient elderly

Dementia & Neuropsychologia ◽

10.1590/s1980-57642009dn20400015 ◽

2008 ◽

Vol 2 (4) ◽

pp. 315-320 ◽

Cited By ~ 2

Author(s):

Regina Miksian Magaldi ◽

Alexandre Leopold Busse ◽

Venceslau Antonio Coelho ◽

Daniel Apolinário ◽

Leonardo da Costa Lopes ◽

...

Keyword(s):

Comprehensive Evaluation ◽

Sleep Apnea Syndrome ◽

Vitamin B12 Deficiency ◽

Normal Pressure ◽

Screening Tests ◽

Cognitive Screening ◽

Memory Complaints ◽

Obstructive Sleep ◽

B12 Deficiency ◽

Clinical Conditions

Abstract Memory complaints are common in elderly, and may be associated with many clinical problems. Objective: To identify clinical conditions and possible factors related to memory complaints in elderly outpatients presenting at a tertiary unit. Methods: Patients with memory complaints and normal cognitive screening tests were submitted to clinical and laboratorial testing. Radiological evaluation was performed as needed for diagnosis. Results: One hundred and seventy-seven subjects were initially evaluated, 12 were excluded because of poor and inconsistent memory complaints. Of the remainder, seventeen had criteria for dementia diagnosis. Ninety-two (55.4%) had one or more comorbid conditions possibly related to their complaints. Major depression was present in 26.0%. Sixteen patients (9.6%) had vitamin B12 deficiency, 8 were in use of inappropriate medications, and 7 (4.2%) had hypothyroidism. Other conditions diagnosed were: generalized anxiety disorder, obstructive sleep apnea syndrome, hyperparathyroidism, normal pressure hydrocephalus. Three patients had severe hearing loss (in 22 with hearing complaints); one had severe visual impairment (in 22 with visual complaints). Conclusions: Comprehensive evaluation was able to identify treatable conditions possibly related to memory complaints.

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