Time to move on: The impending need for a new disease-specific comorbidity index for bladder cancer patients undergoing robot-assisted radical cystectomy

Lambert, Erica H.; D’Hondt, Frederiek; Mazzone, Elio; Vollemaere, Jonathan; Larcher, Alessandro; Jeugt, J. Van Der; Devos, Gaëtan; Uvin, Pieter; Goossens, M.; Poelaert, Filip; Naeyer, Geert De; Schatteman, Peter; Collins, Justin; Mottrie, Alexander; Dell’Oglio, Paolo

doi:10.1016/s1569-9056(19)32751-4

Cited by 1 publication

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients admitted to hospital had statistically significantly higher Charlson Index Scores than AC@H patients, which may suggest that these patients had more complex comorbidities. It is acknowledged though that the Charlson Index has not been recalculated to reflect the advances in medical treatments since its inception in 1993 (Lambert et al, 2019; Quan et al, 2011). Consequently, there is a possibility that the 1‐year mortality rate estimated by the Charlson Index may not be as high as predicted.…”

Section: Discussionmentioning

confidence: 99%

“…Not only is an increased Charlson Comorbidity Index associated with a high incidence of mortality, it is also a predictor of future healthcare costs, hospitalisation rates, hospital readmissions and healthcare burden (Austin et al, 2015). The key limitation of the Charlson Comorbidity Index is that it has not been appropriately weighted to reflect advances in medical treatments since its validation in 1993 (Lambert et al, 2019; Neuhaus et al, 2013; Quan et al, 2011). Consequently, Quan et al (2011) updated Charlson Index Score could provide a more reliable score; however, it has not been validated in the UK.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Service evaluation comparing Acute Care at Home for older people service and conventional service within an acute hospital care of elderly ward

Tierney

Melby

Todd

2021

Journal of Clinical Nursing

View full text Add to dashboard Cite

Aims and Objectives: This study evaluated the impact of a consultant-led Acute Care at Home service in comparison with conventional hospital admission to a care of elderly ward.Background: Globally, there has been an increased demand for healthcare services caused by population growth and a rise in chronic conditions and an ageing population. Acute Care at Home services offer acute, hospital-level care in a person's own home. Five services have been commissioned across Northern Ireland since 2014 with limited research investigating their feasibility and effectiveness.Design: Quantitative design, using service evaluation methodology.Methods: A 1-year retrospective chart review was undertaken exploring admission demographics and post-discharge clinical outcomes of patients admitted to a Northern Ireland, Care of the Elderly ward (n = 191) and a consultant-led Acute Care at Home Service (n = 314) between April 2018-March 2019. Data were analysed using descriptive and inferential data analysis methods including frequencies, independent t tests and chi-square analysis. Outcome measurements included length of stay, 30day, 3-and 6-month readmission and mortality rates, functional ability and residence on discharge. STROBE checklist was used in reporting this study.Results: Acute Care at Home services are associated with higher readmission and mortality rates at 30 days, 3 and 6 months. Fewer patients die while under Acute Care at Home care. Patients admitted to the Acute Care at Home services experience a reduced length of stay and decreased escalation in domiciliary care packages and are less likely to require subacute rehabilitation on discharge. There is no difference in gender, age and early warnings score between the two cohorts. Conclusion:The Acute Care at Home service is a viable alternative to hospital for older patients. It prevents functional decline and the need for domiciliary care or nursing home placement. It is likely that the Acute Care at Home service has higher mortality and readmissions rates due to treating a higher proportion of dependent, frail older adults. | 2979 TIERNEY ET al. 2 | INTRODUC TI ON The world's population continues to grow and is estimated to reach 8.5 billion by 2020 (United Nations, 2019). The United Kingdom (UK) population is projected to grow by 5.5% to 69.6 million by 2026 (Office for National Statistics, 2019). In Northern Ireland (NI), the population is expected to rise by 4.4% to 1.92 million by 2024 and to 2 million by 2041. In the last decade, NI has witnessed a 25% rise in the number of people aged >65 years and a 33% rise in those aged >85 years of age (Northern Ireland Statistics & Research Agency, 2018). This rise in the number of older people and those living with chronic conditions has been attributed to improvements in healthcare technology

show abstract

Section: Discussionmentioning

confidence: 99%