Factors predictive of outcome on admission to an acute geriatric ward

Alarcón, T.; Barcena, A Escriba; González-Montalvo, Juan Ignacio; Penalosa, C.; Salgado, A.

doi:10.1093/ageing/28.5.429

Cited by 156 publications

(97 citation statements)

References 12 publications

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“…In the study of Laniece et al functional disability was relevant to explain the risk of early readmissions in a cohort of patients aged 75 and older [23]. However, in this study, functional disability as assessed by the Barthel index was not associated with readmission, in agreement with the findings of Alarcon et al, who showed that limited activities of daily living were only predictive of hospital mortality and prolonged stay [24].…”

Section: Discussionsupporting

confidence: 89%

Risk factors for hospital readmission of elderly patients

Franchi

Nobili

Mari

et al. 2013

European Journal of Internal Medicine

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Background: The aim of this study was to identify which factors were associated with a risk of hospital readmission within 3 months after discharge of a sample of elderly patients admitted to internal medicine and geriatric wards. Methods: Of the 1178 patients aged 65 years or more and discharged from one of the 66 wards of the 'Registry Politerapie SIMI (REPOSI)' during 2010, 766 were followed up by phone interview 3 months after discharge and were included in this analysis. Univariate and multivariate logistic regression models were used to evaluate the association of several variables with rehospitalization within 3 months from discharge. Results: Nineteen percent of patients were readmitted at least once within 3 months after discharge. By univariate analysis in-hospital clinical adverse events (AEs), a previous hospital admission, number of diagnoses and drugs, comorbidity and severity index (according to Cumulative Illness Rating Scale-CIRS), vascular and liver diseases with a level of impairment at discharge of 3 or more at CIRS were significantly associated with risk of readmission. Multivariate logistic regression analysis showed that only AEs during hospitalization, previous hospital admission, and vascular and liver diseases were significantly associated with the likelihood of readmission.Conclusions: The results demonstrate the need for increased medical attention towards elderly patients discharged from hospital with characteristics such as AEs during the hospitalization, previous admission, vascular and liver diseases.

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Section: Discussionsupporting

confidence: 89%

Risk factors for hospital readmission of elderly patients

Franchi

Nobili

Mari

et al. 2013

European Journal of Internal Medicine

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“…Studies exploring polypharmacy have been conducted in different clinical settings, in out-patients/ambulatory patients (14,25,(30)(31)(32)(33), hospitalised patients (26,(34)(35)(36), patients in nursing homes (37,38), and elderly patients (25)(26)(27)32,33,39). Studies have also been performed based on data from prescription or population databases (13,28,(40)(41)(42).…”

Section: Frequency Of Polypharmacymentioning

confidence: 99%

“…Studies have shown that the use of many drugs is connected to negative health outcomes such as adverse drug reactions, interactions, poor patient adherence and hospitalisations (10,17,19,26,32,(45)(46)(47)(48)(49). We have previously shown that the number of drugs on admission to hospital is an independent risk factor for the occurrence of drug-related problems, like for example wrong drug choice, non-optimal dosage, adverse drug reactions, drug interactions and non-adherence (50).…”

Section: Consequences Of Polypharmacymentioning

confidence: 99%

The Janus face of polypharmacy – overuse versus underuse of medication

Viktil¹,

Blix²,

Reikvam³

2009

Nor J Epidemiol

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As modern guidelines may recommend several drugs for a single medical condition, it follows that many patients, especially if co-morbidity is present, use a number of medications. Also, an aging population implies more morbidity and consequently will have the result that many patients use many drugs -a situation often referred to as polypharmacy. Polypharmacy has been linked to negative health outcomes such as adverse drug reactions, interaction problems, poor patient adherence, and hospitalisations. Such experiences have led to the attitude that efforts should be made to reduce polypharmacy. However, this approach might prevent patients from obtaining optimal treatment. There is no universal definition of polypharmacy and measuring of a reduction in polypharmacy becomes problematic. Because polypharmacy is an imprecise term it should be used with caution in research as well as in patient management. Moreover, studies have shown that undertreatment occurs frequently also among patients using many drugs. This is the Janus face of polypharmacy: too many drugs should be avoided, but the individual patient should receive the appropriate drugs that have the potential to reduce morbidity and improve quality of life. It is the individual drugs themselves, along with patient specific factors, and not a fixed number of drugs, that we should pay attention to.

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“…Alguns autores consideram que a desnutrição pode ser difícil de distinguir das alterações resultantes do processo natural do envelhecimento (62,63), porém se não for detectada, pode resultar em agravamento de condições clínicas e aumento da mortalidade (62). A população idosa é particularmente propensa a problemas nutricionais devido a fatores relacionados com as alterações fisiológicas e sociais, ocorrência de doença crônica, uso de várias medicações, problemas na alimentação (comprometendo a mastigação e deglutição), depressão e alterações da mobilidade com dependência funcional (62,64,65).…”

Section: Aspectos Peculiares Do Idosounclassified

Avaliação do estado nutricional de adultos e idosos e situação nutricional da população brasileira

Acuña

Cruz

2004

Arq Bras Endocrinol Metab

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RESUMOAs alterações do estado nutricional (desnutrição e obesidade) são relacionadas com sérios agravos para a saúde. O presente trabalho de revisão da literatura tem por objetivo descrever os principais métodos de avaliação do estado nutricional, com finalidade de facilitar o diagnóstico dos problemas nutricionais e acompanhar intervenções dietoterápicas. Descreve o método clínico, detalha aspectos da antropometria e os exames laboratoriais utilizados em avaliação do estado nutricional. Relaciona alguns dos principais índices múltiplos, utilizados tanto com fins diagnósticos e prognósticos. Informa a respeito da impedância bioelétrica, completando abordagem sobre os méto-dos convencionais, além de descrever as principais vantagens e desvantagens dos métodos não-convencionais. Finaliza com revisão sobre a situação nutricional da população brasileira, através da análise de dados obtidos em três inquéritos populacionais (1974, 1989, 1997). Nutritional disorders (undernutrition and obesity) are associated to increases in morbidity and mortality. This paper consists on a review of literature with the purpose of describing the main methods of nutritional assessment, in order to facilitate the diagnosis of nutritional disorders and the follow-up of dietetics interventions. It describes the clinical method, details procedures of anthropometry and laboratory evaluation and enrolls some of the multiple indices used for diagnosis and prognosis. Information about bioelectric impedance is given. Some aspects of non-conventional methods are reminded. Nutritional status of the Brazilian population is discussed, using the analysis of data collected from three populational surveys (1974, 1989, and 1997). (1), para manter a composição e funções adequadas do organismo (2), resultando do equilíbrio entre ingestão e necessidade de nutrientes (1). As alterações do estado nutricional contribuem para aumento da morbi-mortalidade. Assim sendo, a desnutrição predispõe a uma série de complicações graves, incluindo tendência à infecção, deficiência de cicatrização de feridas, falência respi- ratória (3), insuficiência cardíaca, diminuição da sín-tese de proteínas a nível hepático com produção de metabólitos anormais, diminuição da filtração glomerular e da produção de suco gástrico (4). Por outro lado, o sobrepeso e a obesidade são fatores de risco para variado número de agravos à saúde, dos quais os mais freqüentes são doença isquêmica do coração, hipertensão arterial, acidente vascular cerebral, diabetes mellitus tipo 2, colelitíase, osteoartrite (especialmente de joelhos), neoplasia maligna de mama pós-menopausa e de endométrio, esofagite de refluxo, hér-nia de hiato e problemas psicológicos (5,6). AVALIAÇÃO DO ESTADO NUTRICIONALOs objetivos da avaliação do estado nutricional são: a) identificar os pacientes com risco aumentado de apresentar complicações associadas ao estado nutricional (CAN), para que possam receber terapia nutricional adequada (1,7-9); b) monitorizar a eficácia da intervenção dietoterápica (1,9).Esta avaliação pode...

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Factors predictive of outcome on admission to an acute geriatric ward

Abstract: Limited activities of daily living and geriatric problems on admission are the strongest predictive factors of outcome, independent of diagnoses.

Cited by 156 publications

References 12 publications

Risk factors for hospital readmission of elderly patients

Risk factors for hospital readmission of elderly patients

The Janus face of polypharmacy – overuse versus underuse of medication

Avaliação do estado nutricional de adultos e idosos e situação nutricional da população brasileira

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