Mobility outcomes and associated factors of acute geriatric care in hospitalized older patients: results from the PAGER study

Werner, Christian; Bauknecht, Laura; Heldmann, Patrick; Hummel, Saskia; Günther-Lange, Michaela; Bauer, Jürgen M.; Hauer, Klaus

doi:10.1007/s41999-023-00869-9

Cited by 5 publications

(5 citation statements)

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“…Out of the 155 patients enrolled in the primary PAGER study, the predictor variables and 24-month follow-up data on mortality status were obtained for 115 patients (no assessment at hospital admission— n = 16, deceased during hospital stay— n = 2, lost to follow-up— n = 22). Details on the flow of patient screening, recruitment, and enrolment of the PAGER participants have been published previously [ 18 ]. Detailed characteristics of the 115 patients (age = 83.3 ± 6.3 years; females: n = 75, 65.2%) included in this secondary analysis are provided in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…This is a prospective secondary analysis of the PAGER study (“Physical Activity in Geriatric patients during Early Rehabilitation”) [ 18 ], which investigated mobility outcomes in hospitalized older patients receiving acute geriatric care (AGC). All patients admitted to the acute geriatrics wards of a German geriatric hospital from January to August 2019 were screened for eligibility.…”

Section: Methodsmentioning

confidence: 99%

“…[ 19 ], delirium, terminal illness, and severe neurologic, cardiovascular, metabolic or psychiatric disorders compromising the ability to complete study procedures, and isolation for infection control. Details on the “early rehabilitative geriatric complex treatment” has been described elsewhere [ 18 , 19 ].…”

Section: Methodsmentioning

confidence: 99%

“…The durations (min) of four activity categories (active, sedentary, walking, lying), step count, mean walking bout duration (s), and mean daily PA level (metabolic equivalent of tasks, METs (kcal/kg/h)) were extracted from the data processing software for the initial 24 h recordings to determine patients’ early in-hospital PA. Details on the data processing of the PA parameters have been described elsewhere [ 18 , 25 , 26 ].…”

Section: Methodsmentioning

confidence: 99%

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Predictors of 2-Year Post-Discharge Mortality in Hospitalized Older Patients

Werner,

Sturm,

Heldmann

et al. 2024

JCM

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Background: Understanding prognostic factors for adverse health outcomes is clinically relevant for improving treatment decision-making processes, potentially leading to enhanced patient prognosis. This secondary analysis of a prospective observational study aimed to identify independent factors associated with 2-year post-discharge mortality in acutely hospitalized older patients. Methods: All-cause mortality and date of death of 115 patients (83.3 ± 6.3 years, females: n = 75, 65.2%) admitted to acute geriatric wards were determined two years after hospital discharge through telephone interviews. Potential prognostic factors measured at hospital admission included demographic and clinical characteristics, nutritional, cognitive, and psychological status, Fried frailty phenotype, functioning in activities of daily living, locomotor capacity, and 24 h in-hospital mobility and objectively measured physical activity (PA) behaviors. Results: The 2-year mortality rate was 36.7% (n = 41). Univariate and multivariate Cox proportional hazards regression models revealed that mean daily PA level (hazards ratio (HR) = 0.59, 95% confidence interval (CI) 0.90–1.00; p = 0.042), frailty (HR = 3.39, 95% CI 1.20–9.51; p = 0.020), and underweight, in contrast to overweight (HR = 3.10, 95% CI 1.07–9.01; p = 0.038), at hospital admission were independently predictive of post-discharge mortality. Conclusion: PA, frailty, and underweight at hospital admission should be considered when evaluating long-term survival prognosis, establishing risk profiles, and developing personalized care pathways in acute hospital care of older adults.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Predictors of 2-Year Post-Discharge Mortality in Hospitalized Older Patients

Werner,

Sturm,

Heldmann

et al. 2024

JCM

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“…Also, intrinsic reaction coordinate analysis at the M06-2X − /6-311+G(2df,2pd) level was carried out to confirm that all transition states connect to the desired reactant and product. To improve the accuracy of energies, single-point energies were calculated at the levels of CCSD(T)-F12/cc-pVDZ-F12 by using ORCA program, while the energies of W2X and W3X-L − were performed by Molpro program.…”

Section: Theoretical Methodsmentioning

confidence: 99%

Atmospheric Chemistry of NH₂SO₃H in Polluted Areas: An Unexpected Isomerization of NH₂SO₃H in Acid-Polluted Regions

Zhang,

Wang,

Wang

et al. 2023

J. Phys. Chem. A

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NH2SO3H is an effective nucleation agent for the formation of atmospheric aerosols and cloud particles. So, the ammonolysis of SO3 to form NH2SO3H without and with neutral (H2O) and basic (NH3) trace gases has been extensively investigated. However, the acidic trace gas X (X = H2SO4 and CH3SO3H)-assisted ammonolysis of SO3 is still up for debate. In this work, a comprehensive theoretical investigation of X-assisted ammonolysis of SO3 and its reverse reaction (the isomerization of NH2SO3H to form SO3 –···NH3 +) was carried out in the gas phase and at the air–water interface. The gas-phase results show that X-assisted isomerization of NH2SO3H to form SO3 –···NH3 + is more energetically and kinetically favorable than its reverse reaction and the isomerization of NH2SO3H in the presence of H2O and NH3. Such unexpected findings revealed that gas-phase NH2SO3H is highly reactive in the presence of acidic trace gas in contrast to the high stability of NH2SO3H in neutral and basic conditions. At the air–water interface, the X-assisted isomerization reaction of NH2SO3H involves multiple water molecules. The loop structure of the reaction center (X···NH2SO3H···3H2O) promotes the transfer of protons in the water molecules to form the SO3 –···NH3 + ion pair, which can then interact with several interfacial water molecules to form ammonium bisulfate. These interfacial reaction channels follow a stepwise mechanism and proceed at the picosecond time-scale. The findings of this study will contribute to a better understanding of the atmospheric behavior of NH2SO3H in polluted acidic trace gases.

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Acute Sarcopenia: Systematic Review and Meta‐Analysis on Its Incidence and Muscle Parameter Shifts During Hospitalisation

Aldrich,

Ispoglou,

Prokopidis

et al. 2024

J cachexia sarcopenia muscle

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BackgroundAcute sarcopenia is sarcopenia lasting less than 6 months, typically following acute illness or injury. It may impact patient recovery and quality of life, advancing to chronic sarcopenia. However, its development and assessment remain poorly understood, particularly during hospitalisation. This systematic review aimed to elucidate the incidence of acute sarcopenia and examine changes in muscle parameters during hospitalisation.MethodsEighty‐eight papers were included in the narrative synthesis; 33 provided data for meta‐analyses on the effects of hospitalisation on handgrip strength (HGS), rectus femoris cross‐sectional area (RFCSA) and various muscle function tests. Meta‐regressions were performed for length of hospital stay (LoS) and age for all meta‐analyses; sex was also considered for HGS.ResultsAcute sarcopenia development was assessed in four studies with a pooled incidence of 18% during hospitalisation. Incidence was highest among trauma patients in intensive care (59%), whereas it was lower among medical and surgical patients (15%–20%). Time of development ranged from 4 to 44 days. HGS remained stable during hospitalisation (SMD = 0.05, 95% CI = −0.18:0.28, p = 0.67) as did knee extensor strength. LoS affected HGS performance (θ = 0.04, 95% CI = 0.001:0.09, p = 0.045) but age (p = 0.903) and sex (p = 0.434) did not. RFCSA, reduced by 16.5% over 3–21 days (SMD = −0.67, 95% CI = −0.92:−0.43, p < 0.001); LoS or time between scans did significantly predict the reduction (θ = −0.04, 95% CI = −0.077:−0.011, p = 0.012). Indices of muscle quality also reduced. Muscle function improved when assessed by the short physical performance battery (SMD = 0.86, 95% CI = 0.03:1.69, p = 0.046); there was no change in 6‐min walk (p = 0.22), timed up‐and‐go (p = 0.46) or gait speed tests (p = 0.98). The only significant predictor of timed up‐and‐go performance was age (θ = −0.11, 95% CI = −0.018:−0.005, p = 0.009).ConclusionsAssessment and understanding of acute sarcopenia in clinical settings are limited. Incidence varies between clinical conditions, and muscle parameters are affected differently. HGS and muscle function tests may not be sensitive enough to identify acute changes during hospitalisation. Currently, muscle health deterioration may be underdiagnosed impacting recovery, quality of life and overall health following hospitalisation. Further evaluation is necessary to determine the suitability of existing diagnostic criteria of acute sarcopenia. Muscle mass and quality indices might need to become the primary determinants for muscle health assessment in hospitalised populations.

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Mobility outcomes and associated factors of acute geriatric care in hospitalized older patients: results from the PAGER study

Cited by 5 publications

References 53 publications

Predictors of 2-Year Post-Discharge Mortality in Hospitalized Older Patients

Predictors of 2-Year Post-Discharge Mortality in Hospitalized Older Patients

Atmospheric Chemistry of NH₂SO₃H in Polluted Areas: An Unexpected Isomerization of NH₂SO₃H in Acid-Polluted Regions

Acute Sarcopenia: Systematic Review and Meta‐Analysis on Its Incidence and Muscle Parameter Shifts During Hospitalisation

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Mobility outcomes and associated factors of acute geriatric care in hospitalized older patients: results from the PAGER study

Cited by 5 publications

References 53 publications

Predictors of 2-Year Post-Discharge Mortality in Hospitalized Older Patients

Predictors of 2-Year Post-Discharge Mortality in Hospitalized Older Patients

Atmospheric Chemistry of NH2SO3H in Polluted Areas: An Unexpected Isomerization of NH2SO3H in Acid-Polluted Regions

Acute Sarcopenia: Systematic Review and Meta‐Analysis on Its Incidence and Muscle Parameter Shifts During Hospitalisation

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Atmospheric Chemistry of NH₂SO₃H in Polluted Areas: An Unexpected Isomerization of NH₂SO₃H in Acid-Polluted Regions