Predictors of hospital readmission in a cohort of 236 elderly discharged after surgical repair of hip fracture: one-year follow-up

2008 ◽  
Vol 20 (3) ◽  
pp. 253-259 ◽  
Author(s):  
Andrea Giusti ◽  
Antonella Barone ◽  
Monica Razzano ◽  
Monica Pizzonia ◽  
Mauro Oliveri ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Hospital Readmission ◽  
Surgical Repair ◽  
One Year

scholarly journals Four or Twelve Months' Follow-Up in the Evaluation of Functional Outcome after Hip Fracture Surgery?

2005 ◽  
Vol 94 (1) ◽  
pp. 59-66 ◽  
Author(s):  
T. Heikkinen ◽  
P. Jalovaara
Keyword(s):  
Hip Fracture ◽  
Repeated Measures ◽  
The Elderly ◽  
Important Variable ◽  
Walking Ability ◽  
Hip Fracture Surgery ◽  
Age Related ◽  
Walking Aids ◽  
One Year

Background and Aims: As a rule, follow-up for at least one year is recommended for fracture studies. This is considered the shortest reliable interval. Still, in the case of hip fractures of the elderly, shorter follow-up might be more practical, since the life expectancy of these patients is often short. The aim of this study was to see if a short four months follow-up period would be acceptable in hip fracture surveys. Material and Methods: Information on 196 consecutive non-pathological hip fracture patients aged 50 years or over (mean 79 years) was collected using a standardised hip fracture audit concentrating on functional measurements at admission and at four and twelve months' follow-ups. Results: 167 patients were alive at four months and 152 and at one year. The patients who died between four and twelve months had poorer functional capacity in the four-month evaluation than those who survived one year. The analysis of repeated measures, including only the patients alive at the last follow-up, showed that residential status, use of walking aids and 6 out of 10 and ADL variables (bathing, toileting, shopping, household activities, doing laundry, banking) did not change significantly. Walking ability and the rest 4 ADL variables (dressing, eating, food preparation, use of transportation) improved and pain decreased. Conclusions: Due to high mortality and age-related deterioration of functioning, no steady state i.e. “final result” is ever reached after hip fracture in the elderly. Four-month follow-up is justified as the shortest possible period, because the socioeconomically most important variable, i.e. place of living, and most of the ADL functions do not change significantly after that.

scholarly journals 099 Do clinical nurse specialist led stroke follow-up clinics reduce post-stroke hospital readmissions and recurrent vascular events?

2019 ◽  
Vol 90 (e7) ◽  
pp. A32.2-A32
Author(s):  
Alex Kao ◽  
Jeremy Lanford ◽  
Lai-Kin Wong ◽  
Anna Ranta
Keyword(s):  
Hospital Readmission ◽  
Readmission Rate ◽  
Clinical Nurse Specialist ◽  
Vascular Event ◽  
Nurse Specialist ◽  
Vascular Events ◽  
Clinical Nurse ◽  
One Year ◽  
The One

IntroductionPost-discharge stroke follow-up clinics have been associated with improved outpatient care and reduced readmission. Pre-2014 there was no consistent follow-up care offered at Wellington Hospital. Our aim was to determine whether the establishment of a clinical nurse specialist (CNS) follow-up clinic reduced the readmission 12-monthrate.MethodsThis is a sequential comparison of patient admitted with stroke one year prior and one year after the clinic was established in 2013. The primary outcome was hospital 12-month hospital readmission rate; main secondary outcome was recurrent vascular event. Patients were identified from the hospital discharge records and underwent detailed electronic chart review. Results were adjusted for differences in baseline characteristics.ResultsWe identified 874 patients; 439 pre- and 435 post-nurse clinic implementation. There was no significant difference between the one-year readmission rate after the establishment of the stroke follow up clinic (adjusted OR=1.06; 95% CI, 0.85–1.64; p=0.804) and no difference in recurrent composite vascular events at one-year (adjusted OR=1.20; 95% CI, 0.68–2.11; p=0.528). The median (IQR) time to follow-up to clinic after discharge was 85 (63–98.5) days. There was a trend towards a reduction in vascular events when limiting the analysis to patients who actually attended clinic, but this trend disappeared when adjusting for baseline inter-group differences.ConclusionsThere was no reduction in the one-year hospital readmission or vascular event recurrence rate for patients with stroke following the establishment of a nurse specialist led stroke follow up clinic. Earlier timed follow-up and the psychosocial value offered by these clinics requires further evaluation.

Mortality after proximal hip fracture in the Singapore population

2005 ◽  
Vol 15 (3) ◽  
pp. 166-170 ◽  
Author(s):  
K.H. Lin ◽  
Y.W. Lim ◽  
Y.J. Wu ◽  
K.S. Lam
Keyword(s):  
Hip Fracture ◽  
Mortality Risk ◽  
Cox Regression ◽  
Regional Hospital ◽  
Age Group ◽  
Risk Of Death ◽  
The Past ◽  
The Mean ◽  
One Year

The aims were to prospectively assess the mortality risk following proximal hip fractures, identify factors predictive of increased mortality and to investigate the time trends in mortality with comparison to previous studies. Prospectively collected data from 68 consecutive patients who had been admitted to a regional hospital from May 2001 to September 2001 were reviewed. The mean age of the patients was 79.3 years old (range, 55–98) and 72.1% females. Patients were followed prospectively to determine the mortality risk associated with hip fracture over a two-year follow-up period. The acute in-hospital mortality rate at six months, one year and two years was 5.9% (4/68), 14.7% (10/68), 20.6% (14/68) and 25% (17/68) respectively. One-year and two-year mortality for those patients who were 80 or older was significantly higher than for other patients and the number of co-morbid illnesses also had significant effect. Cox regression was performed to determine the significant predictors for survival time. It was noted that patients 80 years or older were at higher risk of death compared with those less than 80 years as well as those with higher number of co-morbid illnesses. Our mortality rates have not declined in the past 10 years when compared with previous local studies. We conclude that for this group of patients studied, their mortality at one year and two years could be predicted by their age group and their number of co-morbid illnesses.

A European multicentric experience using the CardioSEAL® and Starflex double umbrella devices to close interatrial communications holes within the oval fossa

2000 ◽  
Vol 10 (5) ◽  
pp. 519-526 ◽  
Author(s):  
M. Carminati ◽  
S. Giusti ◽  
G. Hausdorf ◽  
S. Qureshi ◽  
M. Tynan ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Surgical Repair ◽  
Clinical Success ◽  
The Other ◽  
Thromboembolic Events ◽  
Clinical Complications ◽  
The Mean ◽  
One Year ◽  
Flap Valve

AbstractIn this review, we describe the experience from 13 European centres using the CardioSEAL and Starflex double umbrella devices to close interatrial communications within the oval fossa (so-called ‘stcundum’ defects). Between October 1996 and April 1999, the procedure was attempted in 334 patients with a mean age of 12 years and a mean weight of 44kg. The mean measured stretched diameter of the defect was 15 mm. In the overall group, the defect was solitary in 245 patients (73%), multiple in 21 (6%), associated with an aneurysm of the flap valve in 15 (5%), was represented by patency of the oval foramen in 44 (13%), and was a fenestration in a Fontan repair in 9 (3%). In all patients, the devices were inserted under general anesthesia, using fluoroscopic and transesophageal echocardiographic control. Implantation was achieved in 325 (97,3%). The device embolized within either a few minutes or a few hours in 13 patients (4%). Of these, uncomplicated surgical repair was undertaken in 10, while the device was retrieved in 3 using catheters and a second device was successfully implanted. Residual shunting was detected immediately after the procedure in 41% of the patients, with the incidence decreasing to 31% at discharge, 24% at 1 month, 21% at 6 months, and 20.5% at one year. During the period of follow-up, elective surgical repair became necessary in two patients, due to malposition of the device in one, and late embolization in the other. Fractures of arms were seen in 6.1%, most commonly with the largest devices. All those with fractured arms of the device were asymptomatic, and no clinical complications related to the fractures were observed. There were no arrythmias, endocarditis, valvar distortion, thromboembolic events, or other complications. After one year of follow-up, clinical success, defined as complete closure of the defect or presence of only a trivial leak, had been obtained in 92.5% of the patients. We conclude, therefore, that these devices produce excellent results when used to close defects of small to moderate size. Results are less than optimal, or else complications ensure, when attempts are made to close very large defects.

scholarly journals 66 Short Term Outcomes Following Fragility HIP Fracture in Malaysia

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv13-iv17
Author(s):  
Hui Min Khor ◽  
Hui Xin Teh ◽  
Fang Chin Tan ◽  
Tharshne Shanmugam ◽  
Sankara C Kumar ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Kuala Lumpur ◽  
Short Term ◽  
Fragility Hip Fracture ◽  
Tertiary Center ◽  
Mortality Outcome ◽  
One Year ◽  
A Prospective Study ◽  
Mobility Status

Abstract Introduction Hip fracture carries huge burden to the older person with 40% of patients unable to walk independently after a year and mortality risk of 30% at one year. The study aims to report short-term outcomes following hip fracture from the experience of a tertiary center in Kuala Lumpur. Methods A prospective study was performed in University of Malaya where consecutive patients admitted to the orthopaedic wards with fragility hip fracture from March 2016 to August 2018 were recruited. Information on basic socio-demographics, comorbidities, functional status, pre and post-operative assessments, and discharge details were recorded. Outcome measures include the ability to return to pre-fracture mobility status and mortality in 6 months post fracture. Results A total of 302 patients with mean age of 79.8 (SD 7.28) years old were included in the study. 276 (91.4%) underwent surgery with mortality rate of 7% in 30days and 14.4% in 6 months. 16.4% of patients underwent surgery within 48hours of admission. Time to surgery was not associated with morbidity or mortality outcome in our study. In 6 months follow up, 23.6% of patients were freely mobile, 27.1% were mobile with one aid, 35.5% required walking frame and 13.8% were immobile. 41.6% of patients managed to regain prefracture mobility status. Multivariate analysis showed that age, length of hospitalization and prefracture mobility statuses were predictors of mobility recovery after hip fracture. Conclusion Fragility hip fracture has devastating consequences from our study. There is an urgent call to improve acute hip fracture care and post-acute care rehabilitation in Malaysia.

Abstract WP323: Bridging The Gap Between Acute Care and Public Health

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Kari D Moore ◽  
Bonita Bobo ◽  
Peter Rock ◽  
Elizabeth Wise
Keyword(s):  
Public Health ◽  
Blood Pressure ◽  
Medication Adherence ◽  
Hospital Readmission ◽  
Community Resources ◽  
Post Discharge ◽  
Readmission Rates ◽  
National Quality ◽  
One Year

Background: The WHO estimates that only 50% of patients with chronic illness adhere to treatment recommendations. The Affordable Care Act targets hospital readmission rates as cost savings opportunities. Readmission rates reported in the literature range from 6-33%. Transitional care programs have been shown to improve patient outcomes. Purpose: To reduce readmission and recurrent stroke, the Stroke Patient Education and Navigation (SPEN) Project sought to enhance the continuum of care post discharge by forming collaboration between the University of Louisville Stroke Center (UL), Taylor Regional Hospital (TRH) and the Department for Public Health. Primary outcomes of this three-year project were hospital readmission, medication adherence, utilization of community resources, and National Quality Forum (NQF) 18: blood pressure less than 140/90. Methods: Stroke patients transferred from TRH to UL discharged home from October 2013 to January 2015 were invited to participate. After discharge nurses made 3 home visits at 2 weeks, 3 months, and 6 months to assess outcomes, biometrics, and blood pressure self-management. A follow up phone call was made at one year. Results: 44 patients participated (mean age 70, 28 male, 16 female). 32/44 (73%) completed all 3 visits. 36/44 (82%) with medication adherence. 2/44 (5%) readmitted within 30 days (1 with TIA and 1 with pneumonia). 2/24 (8%) participated in a community resource (smoking cessation program and diabetes classes). Reasons for not using community resources were lack of transportation and “not needed”. Results of NQF 18 goals achieved: 29/44 (66%) at visit 1 and 12/28 (43%) for all 3 visits. At one-year post discharge 10 patients had been readmitted, 3 for vascular events (1 TIA, 1 MI, 1 HTN). Cost of project per patient was $306.62. Conclusions: the SPEN project achieved low 30-day readmission rate and positive medication compliance, but did not achieve utilization of community resources or satisfactory NQF 18 results. Future projects should consider methods to improve resource utilization and cost effective methods of follow-up, such as multiple telephone or telehealth interactions.

Farmacological treatment of osteoporosis after hip fracture: Results of a one-year follow up study (PERFEM)

Bone ◽  
2010 ◽  
Vol 47 ◽  
pp. S206-S207
Author(s):  
S. Carda ◽  
M. Bevilacqua ◽  
C. Cisari ◽  
M. Invernizzi ◽  
G. Sguazzini Viscontini
Keyword(s):  
Hip Fracture ◽  
Treatment Of Osteoporosis ◽  
Follow Up Study ◽  
One Year

scholarly journals O42 SURGICAL REPAIR OF DIASTASIS RECTI ABDOMINIS (DRA) PROVIDES LONG-TERM IMPROVEMENT OF ABDOMINAL CORE FUNCTION AND QUALITY OF LIFE: A THREE-YEAR FOLLOW-UP

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Anders Olsson ◽  
Olivia Kiwanuka ◽  
Sofia Wilhelmsson ◽  
Gabriel Sandblom ◽  
Otto Stackelberg
Keyword(s):  
Quality Of Life ◽  
Surgical Repair ◽  
Post Partum ◽  
Diastasis Recti ◽  
Sf 36 ◽  
Core Function ◽  
One Year ◽  
The One

Abstract Aim Diastasis Recti Abdominis (DRA) is a condition affecting many post-partum women. The aim of this study was to evaluate long-term results of surgical repair of DRA in a cohort of post-partum women. Material and Methods Sixty post-partum women with DRA and training-resistant core dysfunctions were included. Surgical repair was performed with suture plication of the linea alba. Abdominal core function was evaluated with the Abdominal Trunk Function Protocol (ATFP) including a self-report questionnaire and seven functional tests. Urinary incontinence and Quality of Life was evaluated with the Urogenital Distress Inventory (UDI-6), the Incontinence Impact Questionnaire (IIQ-7) and the SF-36 questionnaire. Follow-up was performed at one year and three years’ post-operatively. Results Response rate at the three-year follow-up was 86.7 % for the DRI questionnaire; and 71.7% for ATFP, the UDI-6, IIQ-7, and SF-36 questionnaires. All DRI-parameters were improved (p < 0,05) after three-years of follow-up compared to preoperative values. The functional tests in the ATFP showed an improvement (p < 0.05) in core muscle strength and stability, persisting back and abdominal muscle strength compared to preoperative values as well as an improvement compared to the one-year follow-up values (p < 0.05). UDI-6 and IIQ-7 results were improved (p < 0.05) compared to preoperative values and showed consistent values compared to the one-year follow-up. Quality of life measured with SF-36 were improved compared to preoperative values and showed consistent values compared to the one-year follow-up (p < 0.05). Conclusions The functional improvement of surgical reconstruction of the DRA persisted for three years in this series of post-partum women with DRA.

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