Clustering of patients with end-stage chronic diseases by symptoms: a new approach to identify health needs

Finamore, Panaiotis; Spruit, Martijn A.; Schols, Jos M. G. A.; Incalzi, Raffaele Antonelli; Wouters, Emiel F.M.; Janssen, Daisy J.A.

doi:10.1007/s40520-020-01549-5

Cited by 13 publications

(13 citation statements)

References 48 publications

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“…Bacteria will migrate and colonize along the tissue around the catheter, and enter the body from the fibrin sheath, increasing the risk of catheter-related infections. [24][25][26] Therefore, in the nursing of patients with maintenance hemodialysis, we should master the method of sealing catheter, as well as the patients should actively learn the relevant nursing knowledge, avoid scratching the skin at the catheter site, and pay attention to personal hygiene habits. Hypoalbuminemia is associated with immunosuppression, malnutrition and long-term dialysis of patients, and can decrease the bactericidal ability and phagocytosis of macrophages and neutrophils, weaken the activity of NK cells, reduce the activity and quantity of T lymphocytes, and inhibit the differentiation, which will increase the risk of infections.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of catheter-related infection in patients with chronic renal failure End Stage Renal failure undergoing semi-permanent catheter placement during maintenance hemodialysis through tunnelled cuffed hemodialysis catheter

Dou¹,

Wu²,

Ao³

et al. 2022

Pak J Med Sci

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Objective: To analysis the relevant infections and risk factors of patients undergoing hemodialysis semi-permanent catheter (tunneled cuffed) placement during for maintenance hemodialysis. Methods: A total of 158 patients with chronic renal failure (CRF) End stage renal failure (ESRF) treated in our hospital from September 2018 to September 2021 were retrospectively analyzed. All the patients underwent semi-permanent catheter placement during maintenance hemodialysis. The occurrence of catheter-related infections in the patients were recorded. The patients with catheter-related infections were included in the infection group, and the others without infection in the non-infection group. The differences in hypertension, gender, diabetes, age, catheter indwelling time and dialysis time between the two groups were analyzed, and the distribution of pathogens in the patients with infections was analyzed. Results: The patients were followed up for 13 to 36 months, with an average of (22.18 ± 6.09) months. Among the 158 patients who underwent going semi-permanent catheter placement, 42 (26.58%) presented semi-permanent catheter-related infections, including four cases of catheter-related bacteremia, 16 cases of tunnel infection and 22 cases of catheter exit-site infection. Among total of 42 strains of pathogens were isolated from the 42 patients with catheter-related infections, including 243 strains of Gram-positive cocci were identified in 24/42(57.14%), and 163 strains of Gram-negative bacilli were identified 16/42(38.10%) and one starin of fungus was identified in 2/42 patients. Statistically significant differences were found in dialysis duration time, hypoalbuminemia, average mean age, diabetes and catheter indwelling time between patients with and without catheter-related infections (P < 0.05). Hypoalbuminemia, catheter indwelling time and diabetes were risk factors for catheter-related infections (P < 0.05). Conclusions: Patients with ESRF CRF are at risk and prone to catheter-related infections during hemodialysis using catheter, mainly tunnel infection and catheter exit-site infection. Gram-positive cocci are the main pathogens. Hypoalbuminemia, too long catheter indwelling time and diabetes are the risk factors for infections. doi: https://doi.org/10.12669/pjms.38.6.4834 How to cite this:Dou J, Wu X, Ao H, Zhang Q, Li M. Clinical characteristics of catheter-related infection in patients with chronic renal failure End Stage Renal failure undergoing semi-permanent catheter placement during maintenance hemodialysis through tunnelled cuffed hemodialysis catheter. Pak J Med Sci. 2022;38(6):---------. doi: https://doi.org/10.12669/pjms.38.6.4834 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionmentioning

confidence: 99%

Clinical characteristics of catheter-related infection in patients with chronic renal failure End Stage Renal failure undergoing semi-permanent catheter placement during maintenance hemodialysis through tunnelled cuffed hemodialysis catheter

Dou¹,

Wu²,

Ao³

et al. 2022

Pak J Med Sci

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“…Lo anterior por cuanto el ingreso temprano a estas unidades, incide signicativamente en la calidad de vida de las personas en el mediano y el largo plazo dependiendo del estadío de la enfermedad en el momento del diagnóstico (43)(44)(45)(46)50). El estudio elaborado por Allmagro et al sugiere que el hallazgo de criterios de pobre pronóstico vital sea considerado evidencia suciente para el requerimiento de cuidados paliativos (47). Las necesidades de cuidados paliativos aumentan durante el curso de la historia de la enfermedad, las hospitalizaciones por exacerbaciones están asociadas con un riesgo de mortalidad mayor y son estas hospitalizaciones las que se convierten en una oportunidad para la identicación de pacientes y su oportuno ingreso a programas de cuidados paliativos (31,(47)(48)(49).…”

Section: Discussionunclassified

Grupo de síntomas de enfermedad pulmonar obstructiva crónica y cuidados paliativos: una revisión sistemática

Cabal-Escandón

Monsalve

Sarmiento

et al. 2022

Investg. Enferm. Imagen Desarollo.

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La enfermedad pulmonar obstructiva crónica (EPOC) es una entidad patológica que se caracteriza por una serie de manifestaciones físicas persistentes como tos, fatiga, disnea y producción de esputo; síntomas que generan malestar en el paciente desde el momento del diagnóstico y que, al ser una enfermedad irreversible por el daño tisular que causa, progresivamente va incidiendo de manera negativa en la calidad de vida. De otra parte, se ha reportado presencia de síntomas psicológicos como depresión, inseguridad, ansiedad y alteraciones emocionales en los pacientes diagnosticados con EPOC. Así mismo, los pacientes con este diagnóstico tienden a desarrollar comportamientos que alteran sus relaciones sociales familiares y laborales, por cuanto tienden a aislarse debido a la sintomatología, especialmente física. La situación planteada genera la necesidad de desarrollar un trabajo de investigación con el objetivo de reconocer el clúster de síntomas físicos, psicológicos y sociales de los pacientes diagnosticados con EPOC, e identificar si se plantea un abordaje desde la atención paliativa. El estudio se desarrolló mediante una revisión sistemática de literatura en la que se identificaron 1776 artículos, de los que se evaluaron 41 para la identificación del clúster de síntomas. Se identificó el binomio disnea y tos, fatiga y expectoración como el clúster de síntomas físicos; la depresión y la ansiedad constituyen el clúster de síntomas psicológicos, y el impacto en la calidad de vida y la percepción de aislamiento o exclusión social.

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“…In a modern healthcare system, the provision of high-quality surgical services typically depends on symptoms of various patients. Classifying patients on the basis of their symptoms assist the decision-makers in identifying the target patient and making corresponding remedial decisions [13]. In recent years, several methods have been proposed by the authors for clustering of patients.…”

Section: Literature Reviewmentioning

confidence: 99%

“…In recent years, several methods have been proposed by the authors for clustering of patients. One of the studies used k-means clustering algorithm to partition the patients based on their health status [13]. Another study used a multilayer clustering approach for partitioning of Alzheimer disease patients into male and female groups [14].…”

Section: Literature Reviewmentioning

confidence: 99%

An Optimized Framework for Surgical Team Selection

Petwal¹,

Rani²

2021

Computers, Materials &Amp; Continua

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In the healthcare system, a surgical team is a unit of experienced personnel who provide medical care to surgical patients during surgery. Selecting a surgical team is challenging for a multispecialty hospital as the performance of its members affects the efficiency and reliability of the hospital's patient care. The effectiveness of a surgical team depends not only on its individual members but also on the coordination among them. In this paper, we addressed the challenges of surgical team selection faced by a multispecialty hospital and proposed a decision-making framework for selecting the optimal list of surgical teams for a given patient. The proposed framework focused on improving the existing surgical history management system by arranging surgery-bound patients into optimal subgroups based on similar characteristics and selecting an optimal list of surgical teams for a new surgical patient based on the patient's subgroups. For this end, two population-based meta-heuristic algorithms for clustering of mixed datasets and multi-objective optimization were proposed. The proposed algorithms were tested using different datasets and benchmark functions. Furthermore, the proposed framework was validated through a case study of a real postoperative surgical dataset obtained from the orthopedic surgery department of a multispecialty hospital in India. The results revealed that the proposed framework was efficient in arranging patients in optimal groups as well as selecting optimal surgical teams for a given patient.

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Clustering of patients with end-stage chronic diseases by symptoms: a new approach to identify health needs

Cited by 13 publications

References 48 publications

Clinical characteristics of catheter-related infection in patients with chronic renal failure End Stage Renal failure undergoing semi-permanent catheter placement during maintenance hemodialysis through tunnelled cuffed hemodialysis catheter

Clinical characteristics of catheter-related infection in patients with chronic renal failure End Stage Renal failure undergoing semi-permanent catheter placement during maintenance hemodialysis through tunnelled cuffed hemodialysis catheter

Grupo de síntomas de enfermedad pulmonar obstructiva crónica y cuidados paliativos: una revisión sistemática

An Optimized Framework for Surgical Team Selection

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