An 18-month prospective cohort study of delirium and subsyndromal delirium in Chinese elderly medical patients

2016 ◽  
Author(s):  
Ka-keung Yam
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Medical Patients ◽  
Chinese Elderly ◽  
Subsyndromal Delirium

Inter-observer reliability of a risk assessment model for venous thromboembolism in acutely-ill medical hospitalized patients: Results from a prospective cohort study

2021 ◽  
pp. 026835552110212
Author(s):  
Cassia RL Ferreira ◽  
Marcos de Bastos ◽  
Mirella L Diniz ◽  
Renan A Mancini ◽  
Yan S Raposo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Venous Thromboembolism ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Risk Classification ◽  
Assessment Model ◽  
Kappa Statistics ◽  
Medical Patients ◽  
Observer Reliability

Objectives To analyze the inter-observer reliability of risk for venous thromboembolism (VTE) in a population of adult acutely-ill medical patients. Methods In this prospective cohort study, we collected risk factors and risk classification for VTE using RAM IMPROVE7. Kappa statistics was used to evaluate inter-observer reliability between lead clinicians and trained researchers. We evaluated occurrence of VTE in patients with mismatched classification. Results We included 2,380 patients, median age 70 years (interquartile range [IQR], 58-79), 56.2% female. Adjusted Kappa for VTE risk factors ranged from substantial (0.64, 95% confidence interval [CI], 0.61-0.67) for “immobilization”, to almost perfect (0.98; 95% CI 0.97-0.99) for “thrombophilia”; risk classification was 0.64 (95% CI 0.60-0.67). Divergent risk classification occurred in 434 patients (18.2%) of whom seven (1.6%) developed VTE. Conclusion Despite substantial to almost perfect reliability between observers for risk factors and risk classification, lead clinicians tended to underestimate the risk for VTE.

Cooking with biomass fuels and mortality among Chinese elderly people: A prospective cohort study

Indoor Air ◽  
2021 ◽  
Author(s):  
Minzhi Xu ◽  
Pan Ke ◽  
Chao Wang ◽  
Hongkun Di ◽  
Xin Meng ◽  
...  
Keyword(s):  
Cohort Study ◽  
Elderly People ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Biomass Fuels ◽  
Chinese Elderly

scholarly journals Investigating the effect of sociodemographic factors on 30-day hospital readmission among medical patients in Toronto, Canada: a prospective cohort study

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e017956
Author(s):  
Robert W Smith ◽  
Kerry Kuluski ◽  
Andrew P Costa ◽  
Samir K Sinha ◽  
Richard H Glazier ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Hospital Readmission ◽  
Prospective Cohort ◽  
Final Analysis ◽  
Sociodemographic Factors ◽  
Emergency Department Visits ◽  
Charlson Comorbidity Index Score ◽  
Medical Patients ◽  
Patient Level

ObjectiveTo examine the influence of patient-level sociodemographic factors on the incidence of hospital readmission within 30 days among medical patients in a large Canadian metropolitan city.DesignProspective cohort study.Setting and participantsPatients admitted to the General Internal Medicine service of an urban teaching hospital in Toronto, Canada participated in a survey of sociodemographic information. Patients were not surveyed if deemed medically unstable, receiving care in medical/surgical step-down beds or were isolated for infection control. Included in the final analysis was a diverse cohort of 1427 adult, non-palliative, patients who were discharged home.MeasuresThirteen patient-level sociodemographic variables were examined in relation to time to unplanned all-cause readmission within 30 days. Illness level was accounted for by the following covariates: self-perceived health status, previous hospital utilisation, primary diagnosis case mix group, Charlson Comorbidity Index score and inpatient length of stay.ResultsApproximately, 14.4% (n=205) of patients experienced readmission within 30 days. Sociodemographic factors were not significantly associated with time to readmission in unadjusted and adjusted analyses. Indicators of illness level, namely, previous hospitalisations, were the strongest risk factors for readmission within this cohort. One previous admission (adjusted HR 1.78; 95% CI 1.22 to 2.59, P<0.01) and at least four previous emergency department visits (adjusted HR 2.33; 95% CI 1.46 to 4.43, P<0.01) were associated with increased hazard of readmission within 30 days.ConclusionsPatient-level sociodemographic factors did not influence the incidence of unplanned all-cause readmission within 30 days. Further research is needed to understand the generalisability of our findings and investigate whether contextual factors, such as access to universal health insurance coverage, attenuate the effects of sociodemographic factors.

scholarly journals Influences of Dysphagia on the Prognosis of Chinese Elderly Inpatients: a Prospective Cohort Study

2021 ◽  
Author(s):  
Zhangmin Meng ◽  
Yulan Zhou ◽  
Xiao Shu ◽  
Zijing Yang ◽  
Qian Chen
Keyword(s):  
Cohort Study ◽  
Aspiration Pneumonia ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Older Patients ◽  
Independent Predictor ◽  
Cross Sectional ◽  
Chinese Elderly ◽  
Older Inpatients ◽  
Elderly Inpatients

Abstract The increasing incidence of dysphagia may pose threats to the health of older patients. The aim of this study was to investigate the adverse influences of dysphagia on the prognosis of older Chinese inpatients. A total of 290 older inpatients with different swallowing functions were involved in this study through group sampling from the geriatric centre of a 3A-level hospital in China. Among them, 125 patients (43.1%) had dysphagia at admission. Based on a cross-sectional investigation, a prospective cohort study was conducted to investigate the incidence of complications, readmission, and death during 6 months of follow-up. A total of 34 patients (11.7%) died, and the remaining 256 patients (88.3%) were investigated concerning their complications. There was a higher prevalence of death among the older patients with dysphagia (15.6% vs 7.9%, RR = 2.361). In terms of complications, older patients with dysphagia were more likely to develop malnutrition (29.8% vs 5.9%, RR = 6.747) and aspiration pneumonia (34.6% vs 11.2%, RR = 4.204). Furthermore, multi-factor analysis demonstrated that dysphagia was an independent predictor of malnutrition and aspiration pneumonia but not an independent predictor of death. In conclusion, dysphagia was proven to be an independent predictor of a poor outcome of Chinese elderly inpatients. Specific clinical management and nursing interventions are recommended to prevent the potential adverse influences of dysphagia.

scholarly journals Impact of body mass index on survival of medical patients with sepsis: a prospective cohort study in a university hospital in China

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e021979 ◽  
Author(s):  
Qingtao Zhou ◽  
Meng Wang ◽  
Shuo Li ◽  
Jing Zhang ◽  
Qingbian Ma ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Cohort Study ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
University Hospital ◽  
Medical Patients ◽  
Chinese Cohort ◽  
Length Of Icu Stay

ObjectiveTo evaluate the impact of body mass index (BMI) on survival of a Chinese cohort of medical patients with sepsis.DesignA single-centre prospective cohort study conducted from May 2015 to April 2017.SettingA tertiary care university hospital in China.ParticipantsA total of 178 patients with sepsis admitted to the medical intensive care unit (ICU) were included.Main outcome measuresThe primary outcome was 90-day mortality while the secondary outcomes were in-hospital mortality, length of ICU stay and length of hospital stay.ResultsThe median age (IQR) was 78 (66–84) years old, and 77.0% patients were older than 65 years. The 90-day mortality was 47.2%. The in-hospital mortality was 41.6%, and the length of ICU stay and hospital stay were 12 (5–22) and 15 (9–28) days, respectively. Cox proportional hazard regression analysis identified that Sequential Organ Failure Assessment score (HR=1.229, p<0.001), Acute Physiology and Chronic Health Evaluation II score (HR=1.050, p<0.001) and BMI (HR=0.940, p=0.029) were all independently associated with the 90-day mortality. Patients were divided into four groups based on BMI (underweight 33 (18.5%), normal 98 (55.1%), overweight 36 (20.2%) and obese 11 (6.2%)). The 90-day mortality (66.7%, 48.0%, 36.1% and 18.2%, p=0.015) and in-hospital mortality (60.6%, 41.8%, 30.6% and 18.2%, p=0.027) were statistically different among the four groups. Differences in survival among the four groups were demonstrated by Kaplan-Meier survival analysis (p=0.008), with the underweight patients showing a lower survival rate.ConclusionsBMI was an independent factor associated with 90-day survival in a Chinese cohort of medical patients with sepsis, with patients having a lower BMI at a higher risk of death.

scholarly journals Number of natural teeth, denture use and mortality in Chinese elderly: a population-based prospective cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jin-Qiu Yuan ◽  
Yue-Bin Lv ◽  
Virginia Byers Kraus ◽  
Xiang Gao ◽  
Zhao-Xue Yin ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Population Based ◽  
Chinese Elderly ◽  
Natural Teeth

The incidence of heparin-induced thrombocytopenia in medical patients treated with low-molecular-weight heparin: a prospective cohort study

Blood ◽  
2005 ◽  
Vol 106 (9) ◽  
pp. 3049-3054 ◽  
Author(s):  
Paolo Prandoni ◽  
Sergio Siragusa ◽  
Bruno Girolami ◽  
Fabrizio Fabris ◽  
Keyword(s):  
Molecular Weight ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Low Molecular Weight Heparin ◽  
Low Molecular Weight ◽  
Medical Patients ◽  
Heparin Induced Thrombocytopenia ◽  
Medical Centers ◽  
Extensive Documentation

AbstractIn contrast with extensive documentation in patients treated with unfractionated heparin (UFH), the incidence of heparin-induced thrombocytopenia (HIT) in medical patients receiving low-molecular-weight heparin (LMWH) is less well defined. In a prospective cohort study, the platelet count was monitored in 1754 consecutive patients referred to 17 medical centers and treated with LMWH for prophylaxis or treatment of thromboembolic disorders. The diagnosis of HIT was accepted in case of a platelet drop of at least 50%, the absence of obvious explanations for thrombocytopenia, and the demonstration of heparin-dependent IgG antibodies. HIT developed in 14 patients (0.80%; 95% CI, 0.43%-1.34%), in all of them within the first 2 weeks, and was more frequent in patients who had (1.7%) than in those who had not (0.3%) been exposed to UFH or LMWH (OR = 4.9; 95% CI, 1.5-15.7). The prevalence of thromboembolic complications in HIT patients (4 of 14; 28.6%) was remarkably higher than that (41 of 1740; 2.4%) observed in the remaining patients (OR = 16.6; 95% CI, 5.0-55.0). Immune thrombocytopenia and related thromboembolism may complicate the clinical course of medical patients treated with LMWH with a frequency that is not different from that observed with the use of UFH. The previous administration of heparin increases the rate of HIT.

scholarly journals Factors associated with nutritional decline in hospitalised medical and surgical patients admitted for 7 d or more: a prospective cohort study

2015 ◽  
Vol 114 (10) ◽  
pp. 1612-1622 ◽  
Author(s):  
Johane P. Allard ◽  
Heather Keller ◽  
Anastasia Teterina ◽  
Khursheed N. Jeejeebhoy ◽  
Manon Laporte ◽  
...  
Keyword(s):  
Cohort Study ◽  
Food Intake ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Medical Information ◽  
Surgical Patients ◽  
Fluid Loss ◽  
Medical Patients ◽  
Discharge Data ◽  
Factors Associated

AbstractThis prospective cohort study was conducted in eighteen Canadian hospitals with the aim of examining factors associated with nutritional decline in medical and surgical patients. Nutritional decline was defined based on subjective global assessment (SGA) performed at admission and discharge. Data were collected on demographics, medical information, food intake and patients’ satisfaction with nutrition care and meals during hospitalisation; 424 long-stay (≥7 d) patients were included; 38 % of them had surgery; 51 % were malnourished at admission (SGA B or C); 37 % had in-hospital changes in SGA; 19·6 % deteriorated (14·6 % from SGA A to B/C and 5 % from SGA B to C); 17·4 % improved (10·6 % from SGA B to A, 6·8 % from SGA C to B/A); and 63·0 % patients were stable (34·4 % were SGA A, 21·3 % SGA B, 7·3 % SGA C). One SGA C patient had weight loss ≥5 %, likely due to fluid loss and was designated as stable. A subset of 364 patients with admission SGA A and B was included in the multiple logistic regression models to determine factors associated with nutritional decline. After controlling for SGA at admission and the presence of a surgical procedure, lower admission BMI, cancer, two or more diagnostic categories, new in-hospital infection, reduced food intake, dissatisfaction with food quality and illness affecting food intake were factors significantly associated with nutritional decline in medical patients. For surgical patients, only male sex was associated with nutritional decline. Factors associated with nutritional decline are different in medical and surgical patients. Identifying these factors may assist nutritional care.

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