The rate of esophageal adenocarcinoma in Denmark has increased eightfold over a 20-yr period, and this increase is not explained by changes in classification or diagnostic routines. More than 98% of esophageal adenocarcinomas were found in patients who could not have entered endoscopic surveillance, as Barrett's esophagus had not been diagnosed before the cancer diagnosis. Endoscopic surveillance to detect dysplasia may be an option for the individual patient with Barrett's esophagus, but these screening programs are not likely to reduce the death rate from esophageal adenocarcinomas in the general population.

The rate of esophageal adenocarcinoma in Denmark has increased eightfold over a 20-yr period, and this increase is not explained by changes in classification or diagnostic routines. More than 98% of esophageal adenocarcinomas were found in patients who could not have entered endoscopic surveillance, as Barrett's esophagus had not been diagnosed before the cancer diagnosis. Endoscopic surveillance to detect dysplasia may be an option for the individual patient with Barrett's esophagus, but these screening programs are not likely to reduce the death rate from esophageal adenocarcinomas in the general population.

PurposeThe Barthel Index (BI)-100 is used to measure geriatric patients’ activities of daily living (ADL). The aim of this study was to explore whether BI at hospital admission is associated with mortality.Patients and methodsIn a nationwide population-based cohort study, patients aged ≥65 years admitted during 2005–2014 to Danish geriatric departments were assessed with BI at admission. Data were entered into the Danish National Database of Geriatrics and linked at the individual level to the Danish health registers (Civil Registration System, National Patient Register, and National Database of Reimbursed Prescriptions). The BI was categorized into four predefined standard subcategories according to the national Danish version of the statistical classification of diseases (BI =80–100 [independent ADL], BI =50–79 [moderate reduced ADL], BI =25–49 [low ADL], and BI =0–24 [very low ADL]). Patients were followed until death, emigration, or end of the study (December 31, 2015). Associations with mortality adjusted for age, admission year, marital status, body mass index, Charlson comorbidity index, polypharmacy, and hospitalizations during the preceding year were analyzed by multivariable Cox regression analysis.ResultsTotally, 74,603 patients were included. Women (63%) were older than men (mean [SD] age; 83 [7] vs 81 [7] years) and had higher BI (median [IQR]; 55 [30–77] vs 52 [26–77]). Median survival (years [95% CI]) was lowest in the subcategory “BI =0–24” in both women (1.3 [1.2–1.4]) and men (0.9 [0.8–0.9]). Adjusted mortalities (HR [95% CI]; reference BI =80–100) in women were 2.41 (2.31–2.51) for BI =0–24, 1.66 (1.60–1.73) for BI =25–49, and 1.34 (1.29–1.39) for BI =50–79 and in men were 2.07 (1.97–2.18) for BI =0–24, 1.58 (1.51–1.66) for BI =25–49, and 1.29 (1.23–1.35) for BI =50–79.ConclusionBI at admission is strongly and independently associated with mortality in geriatric patients. BI has the potential to provide useful supplementary information for the planning of treatment and future care of older patients.

To determine outcomes of nontyphoid Salmonella infections, we reviewed all 3328 cases of infection registered in a large Danish county from 1991 to 1999. The hospitalization rate was 27% among patients <5 years old, 22% among patients 5-59 years old, and 54% among patients > or =60 years old; complications were present in 7% and extraintestinal disease in 4% of patients. We conclude that nontyphoid Salmonella infections may frequently cause severe disease even among patients without predisposing conditions.

Aim of databaseThe aim of the National Database of Geriatrics is to monitor the quality of interdisciplinary diagnostics and treatment of patients admitted to a geriatric hospital unit.Study populationThe database population consists of patients who were admitted to a geriatric hospital unit. Geriatric patients cannot be defined by specific diagnoses. A geriatric patient is typically a frail multimorbid elderly patient with decreasing functional ability and social challenges. The database includes 14–15,000 admissions per year, and the database completeness has been stable at 90% during the past 5 years.Main variablesAn important part of the geriatric approach is the interdisciplinary collaboration. Indicators, therefore, reflect the combined efforts directed toward the geriatric patient. The indicators include Barthel index, body mass index, de Morton Mobility Index, Chair Stand, percentage of discharges with a rehabilitation plan, and the part of cases where an interdisciplinary conference has taken place. Data are recorded by doctors, nurses, and therapists in a database and linked to the Danish National Patient Register.Descriptive dataDescriptive patient-related data include information about home, mobility aid, need of fall and/or cognitive diagnosing, and categorization of cause (general geriatric, orthogeriatric, or neurogeriatric).ConclusionThe National Database of Geriatrics covers ∼90% of geriatric admissions in Danish hospitals and provides valuable information about a large and increasing patient population in the health care system.