The Barthel index as an indicator of hospital outcomes: A retrospective cross‐sectional study with healthcare data from older people

Ocagli, Honoria; Cella, Nicoletta; Stivanello, Lucia; Degan, Mario; Canova, Cristina

doi:10.1111/jan.14708

Cited by 40 publications

(24 citation statements)

References 36 publications

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“…Barthel and Charlson indexes and medical history were also recorded. The Barthel index (BI) is a measure of previous functional status and predicts healthcare outcomes, such as length of stay or in-hospital mortality ( Ocagli et al, 2021 ). The Charlson comorbidity index (CCI) is a method of estimating the risk of death from comorbid disease and it is related with poor outcomes in COVID-19 patients ( Kuswardhani et al, 2020 ).…”

Section: Methodsmentioning

confidence: 99%

Neuropsychological functioning in post-ICU patients after severe COVID-19 infection: The role of cognitive reserve

Costas-Carrera¹,

Sánchez-Rodríguez²,

Cañizares³

et al. 2022

Brain, Behavior, & Immunity - Health

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Background Cognitive manifestations associated with Severe Acute Respiratory Syndrome by Coronavirus 2 (SARS-CoV-2) are yet to be described in the existing literature. The aim of this exploratory study is to analyze the impact of severe SARS-CoV-2 infection on neuropsychological performance 6 months following hospital discharge, and to identify which medical variables predict worse outcome. In this context, we study if cognitive reserve (CR) may play a protective role on cognitive impairment. Methods We enrolled a cohort of 102 severe SARS-CoV-2 survivors who had been admitted to the Intensive Care Unit (ICU) and were contacted 6-months post discharge. A total of 58 agreed to participate in this 6-month follow-up study. Patients with previously known cognitive impairment were excluded. Demographic, clinical and laboratory data were collected. Firstly, to test the magnitude of neurocognitive sequalae two standard deviations below normative group were considered. Secondly, to analyze the main effects of medical variables on cognition and the interaction with cognitive reserve, ANCOVA analyses were performed. Results 53.4% obtained a score below the cutoff point (<26) in the screening test MOCA. ICU variables including mechanical ventilation, days of sedation or high CRP days were related with cognition. Cognitive Reserve (CR) interacted with delirium (F = 6.8, p = 0.01) and sedation days (F = 9.40, p = 0.003) to predict verbal memory and interacted with high CRP to predict phonemic fluency (F = 6.47, p = 0.01). Finally, no differences in neuropsychological performance were found depending on subjective cognitive impairment (SCI). However, patients with SCI had a higher score in the HAD anxiety subscale (t = −2.2; p < 0.05). Conclusions In our cohort, cognitive dysfunction was related with ICU variables such as delirium, mechanical ventilation, and inflammation. CR modulated the impact of these variables on cognition. Cognitive complaints were related with anxiety but not with cognitive performance. Despite some limitations, including the need of replication of the findings with larger samples and control groups, our study suggests that high CR may be protective for severe COVID-19-related cognitive impairment.

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Section: Methodsmentioning

confidence: 99%

Neuropsychological functioning in post-ICU patients after severe COVID-19 infection: The role of cognitive reserve

Costas-Carrera¹,

Sánchez-Rodríguez²,

Cañizares³

et al. 2022

Brain, Behavior, & Immunity - Health

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“…The questionnaire included detailed questions about patients' physical condition, current clinical symptoms and signs, postoperative complications if they have had VPS placement, and activity of daily living (ADL). The Barthel Index (BI) was used to assess the ADL by 10 items (grooming, bathing, toilet use, bowel movement, urinary incontinence, dressing, feeding, stair climbing, transferring, and walking) ( 13 ).…”

Section: Methodsmentioning

confidence: 99%

Short-term and long-term outcomes in patients with cryptococcal meningitis after ventriculoperitoneal shunt placement

et al. 2022

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ObjectiveThe purpose of this study was to assess the short-term and long-term outcomes of ventriculoperitoneal shunt (VPS) placement in patients with cryptococcal meningitis (CM).MethodsWe performed a retrospective analysis of all patients with CM admitted to the Peking Union Medical College Hospital from September 1990 to January 2021. We collected related clinical features to analyze the short- and long-term outcomes of VPS at 1 month and 1 year at least the following therapy, respectively. Overall survival (OS) was compared with all patients and a subgroup of critically ill cases by the Kaplan–Meier method with the log-rank test. Univariable and multivariable analyses were also performed using the Cox proportional hazard model to identify statistically significant prognostic factors.ResultsWe enrolled 98 patients, fifteen of whom underwent VPS. Those who received VPS had a lower cerebrospinal fluid (CSF) Cryptococcus burden (1:1 vs. 1:16; p = 0.046), lower opening pressures (173.3 mmH2 O vs. 224 mmH2O; p = 0.009) at lumbar punctures, and a lower incidence of critical cases (6.7 vs. 31.3%; p = 0.049). According to our long-term follow-up, no significant difference was shown in the Barthel Index (BI) between the two groups. Two patients in the VPS group suffered postoperative complications and had to go through another revision surgery. According to survival analysis, overall survival (OS) between the VPS and non-VPS groups was not significantly different. However, the Kaplan–Meier plots showed that critical patients with VPS had better survival in OS (p < 0.009). Multivariable analyses for critical patients showed VPS was an independent prognostic factor.ConclusionA VPS could reduce the intracranial pressure (ICP), decrease the counts of Cryptococcus neoformans by a faster rate and reduce the number of critical cases. The VPS used in critical patients with CM has a significant impact on survival, but it showed no improvement in the long-term Barthel Index (BI) vs. the conservative treatment and could lead to postoperative complications.

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“…Other items were more essential for discharged patients without caregivers, including grooming, dressing, mobility, and stairs climbing. The Barthel index has been used as an important indicator of hospital outcome [ 25 ] and could be used as a predictor of mortality [ 26 ]. On the other hand, there have been studies on patients with COVID-19 that aimed to identify predictive factors of functional prognosis [ 18 , 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Predictors of Basic Activity in Daily Living and Length of Hospitalization in Patients with COVID-19

2022

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Background: Patients recovered from COVID-19 often suffer from the sequelae of the disease, which can hinder the patients’ activity in daily living. Early recognition of the patients at risk of prolonged hospitalization and impaired physical functioning is crucial for early intervention. We aim to identify the predictors of prolonged hospitalization and impaired activity in daily living in this study. Methods: COVID-19 patients hospitalized in a medical center were divided into two groups according to the Barthel index three months after discharge and the median length of hospital stay, respectively. Chi-square test and Mann–Whitney U test were performed to check the differences between the two groups in patient characteristics as well as hematology tests at the emergency department, the intensive care unit mobility scale (ICUMS), and the medical research council sum score (MRCSS). Logistic regression and the receiver operating characteristic curve analysis were further performed for the factors with significant differences between the two groups. Results: Both ICUMS and MRCSS showed significant differences between the groups. The ICUMS had an odds ratio of 0.61 and the MRCSS of 0.93 in predicting a Barthel index score less than 100 three months after discharge. The MRCSS had an odds ratio of 0.82 in predicting a prolonged length of hospital stay. Conclusion: Both ICUMS and MRCSS upon admission are predictive of a Barthel index score of less than 100 three months after discharge. On the other hand, only MRCSS has predictive value of a prolonged hospitalization.

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The Barthel index as an indicator of hospital outcomes: A retrospective cross‐sectional study with healthcare data from older people

Cited by 40 publications

References 36 publications

Neuropsychological functioning in post-ICU patients after severe COVID-19 infection: The role of cognitive reserve

Neuropsychological functioning in post-ICU patients after severe COVID-19 infection: The role of cognitive reserve

Short-term and long-term outcomes in patients with cryptococcal meningitis after ventriculoperitoneal shunt placement

Predictors of Basic Activity in Daily Living and Length of Hospitalization in Patients with COVID-19

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