Mortality predictors in an acute care geriatric unit in Singapore

Goh, Kiat Sern; Low, Sui Pheng; Zhang, Di; Png, Gek Kheng; Lin, Hailun; Ang, Wendy Swee Tee; Lim, Jim Kim Hwa

doi:10.1177/2010105818762915

Cited by 3 publications

(3 citation statements)

References 19 publications

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“…A much lower death rate of 4.6% was reported by Goh et. al from an acute geriatric ward in Singapore [22] . Our future evaluations will focus on comparative analyses of deaths in older persons between the geriatrics unit and other medical wards in UBTH.…”

Section: Sanya Et Al Reported a Death Rate Of 317% In Elderly Patiementioning

confidence: 99%

A Quality Assessment of Clinical Service Utilization in a Geriatrics Unit in West Africa: 2014-2018

Obehi¹,

Osian²,

B³

et al. 2020

Preprint

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Background: Quality healthcare requires learning organizations who demonstrate commitment to evaluation and improvement. The Geriatrics Unit in the 850-bedded University of Benin Teaching Hospital (UBTH), Nigeria, was set up in 2014 to provide quality healthcare to older persons. The goal of this evaluation was to assess the extent to which that initiative met its objectives. Methods: Using the Donabedian's framework, we undertook a formative review of key service elements in the Geriatrics Unit of UBTH from April 1, 2014 to March 31, 2018, using data from routine ward documentation. Results: The unit had a multidisciplinary team of doctors, nurses, physiotherapists, occupational therapists, pharmacists, medical social workers and support staff throughout the period in focus. All records were manually kept. In-patient numbers more than doubled within the first year, from 62 to 133. Increasing utilization was also evident in bed occupancy rates that rose from 20.1% in 2014 to a peak that exceeded the maximum capacity of open beds (112%) in 2017, and required closed beds to be opened. Bed turnover rates increased from 3.7 in 2014 to 22.2 in 2017. The median average length of stay was 13.9 days. Gross mortality rate ranged between 23% and 31.8%; annual fall rates between 0.4 and 3.0 falls per thousand patient days, and discharges against medical advice (DAMA) between 0.8% and 6.1%.Conclusion: Multi-disciplinary care was maintained in the geriatrics unit, and available beds were oversubscribed within the 4 years reviewed. Opportunities for improvement include moving on to electronic patient records; increasing the number of functional beds; achieving lower mortality rates. Our findings also provide benchmarks against which future evaluations and quality improvement interventions will be measured.

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Section: Sanya Et Al Reported a Death Rate Of 317% In Elderly Patiementioning

confidence: 99%

A Quality Assessment of Clinical Service Utilization in a Geriatrics Unit in West Africa: 2014-2018

Obehi¹,

Osian²,

B³

et al. 2020

Preprint

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“…Due to its nature, hospitalization or prolonged bed rest can lead to impaired mobility or loss of autonomy, rehospitalization, and/or increased risk of mortality (Goh et al, 2018;Ponzetto et al, 2003). A growing body of evidence suggests that prolonged periods of physical inactivity or bed rest trigger signifi cant negative functional and metabolic changes in the human body (Pisot et al, 2016).…”

mentioning

confidence: 99%

Kognitivno spodbudno okolje lahko ublaži višje nevronske potrebe za procesiranje vidnih dražljajev po večdnevni hospitalizaciji

Marušič¹,

Pišot²,

Kavčič³

2021

psio

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Prolonged periods of complete physical inactivity or bed rest trigger various alterations in the functional and metabolic levels of the human body. However, bed rest-related adaptations of the central nervous system are less known and thoroughly studied. The aim of this study was to investigate brain electrophysiological changes using event-related potentials (ERPs) after 14 days of bed rest and 12 consecutive sessions of computerized cognitive training (CCT). Sixteen older (Mage= 60 years) healthy volunteers were randomly divided into a CCT treatment group and an active control group. All participants performed ERP measurements based on the foveal visual presentation of a circle on a black background before and after bed rest. After 14 days of bed rest, participants in the control group showed increased peak P1 amplitude (p = .012), decreased P1 latency (p = .024), and increased P2 amplitude (p = .036), while the CCT group also showed decreased P1 latency (p = .023) and decreased P2 latency (p = .049). Our results suggest that, even from a central adaptation perspective, prolonged periods of physical inactivity or bed rest trigger additional neural recruitment and should therefore be minimized, and that CCT may serve as a tool to mitigate this. Future research should focus on other aspects of central nervous system adaptation following periods of immobilization/hospitalization to improve our knowledge of influence of physical inactivity and its effects on cortical activity and to develop appropriate countermeasures to mitigate functional dysregulation.

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“…De hecho, la neumonía se ha descrito como la primera causa de muerte en estas unidades, con tasas elevadas que oscilan entre el 37,5 y el 40 % (17). A pesar de las opciones de tratamiento, la vacunación y la disponibilidad de pruebas diagnósticas, la letalidad por neumonía en los adultos mayores sigue siendo alta.…”

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Factores asociados con la letalidad por neumonía en una unidad de atención del paciente geriátrico agudo: una cohorte retrospectiva

Quintero‐González¹,

Ocampo²,

Ortíz³

2020

biomedica

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Introducción. La neumonía es la principal causa de muerte por infección en el mundo y afecta principalmente a la población de adultos mayores.Objetivo. Determinar los factores de riesgo asociados con la letalidad a 30 días en pacientes con neumonía en una unidad de atención del paciente geriátrico agudo.Materiales y métodos. Se hizo un estudio observacional y analítico de cohorte retrospectiva. Se incluyeron 114 pacientes de 60 años o más hospitalizados en una unidad de atención del paciente geriátrico agudo con diagnóstico de neumonía. El resultado primario fue la letalidad a 30 días. Se hicieron análisis de regresión log-binomial bivariado y multivariable para explorar la relación entre las variables independientes y el resultado primario.Resultados. La letalidad a 30 días fue de 26,3 % y la edad media de 84,45 ± 7,37 años. El 54,4 % de los participantes era de sexo masculino. En el análisis multivariable se encontró que una edad de 90 años o más (riesgo relativo, RR=1,62; IC95%: 1,05-2,68; p=0,04), el compromiso multilobar (RR=1,92; IC95%: 1,12-3,32; p=0,02), el nitrógeno ureico elevado (mediana≥22,5; RR=3,93; IC95%: 1,67-9,25; p<0,01), y un puntaje de cero en la escala de Lawton al ingreso (RR=3,20; IC95% 1,05-9,78; p=0,04) fueron factores predictores independientes de la letalidad a 30 días en adultos mayores con neumonía.Conclusión. En los pacientes adultos mayores hospitalizados por neumonía en una unidad de atención del paciente geriátrico agudo la edad muy avanzada, la presencia de compromiso multilobar, la dependencia en el estado funcional y los niveles de nitrógeno ureico elevados fueron los principales factores de riesgo de letalidad a corto plazo.

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Mortality predictors in an acute care geriatric unit in Singapore

Cited by 3 publications

References 19 publications

A Quality Assessment of Clinical Service Utilization in a Geriatrics Unit in West Africa: 2014-2018

A Quality Assessment of Clinical Service Utilization in a Geriatrics Unit in West Africa: 2014-2018

Kognitivno spodbudno okolje lahko ublaži višje nevronske potrebe za procesiranje vidnih dražljajev po večdnevni hospitalizaciji

Factores asociados con la letalidad por neumonía en una unidad de atención del paciente geriátrico agudo: una cohorte retrospectiva

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