Objectives: To develop and validate an instrument to predict probability of home discharge upon hospital admission.
Design: Prospective cohort study.
Setting: Geriatric convalescence unit (GCU) in Spain.
Participants: Seven hundred eighty-one patients aged 65 and older consecutively admitted to a GCU over a 4-year period. The total sample was randomized and divided into two subgroups; the first (n = 575) was used to construct the predictive instrument (development subgroup) and the second (n = 206) for the validation process (validation subgroup).
Measurements: All patients were evaluated within the first 72 hours after admission. Age, sex, functional status before admission, diagnostic categories, functional status on admission, comorbidity, cognitive function, and social support were assessed.
Results: Logistic regression analysis identified three patient characteristics as independent predictors of home discharge in the development subgroup: higher scores on functional status at admission (Barthel index), normal Mini-Mental State Examination scores, and lower scores on Social Familial Evaluation Scale. A scoring system ranging from 0 to 5 was constructed using these variables to predict probability of home discharge (PHD). Different PHD scores (0-1, 2, 3, 4, and 5) identified patients with different probabilities of returning home on discharge in the validation subgroup (36.5%, 53.6%, 60.8%, 83.3%, and 100%, respectively). PHD scores of 4 and 5 demonstrated substantially higher posttest than pretest probability, with moderate and high clinical effect value. Scores of 0 or 1 demonstrated substantially lower posttest than pretest probability.
Conclusion: A PHD instrument may be useful in identifying patients most likely to be discharged to home from the GCU. Patients with low probability of home discharge may also be identified early.
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http://dx.doi.org/10.1046/j.1532-5415.2003.51066.x | DOI Listing |
S Afr J Surg
December 2024
Department of Biostatistics, Faculty of Health Sciences, University of the Free State, South Africa.
Background: Postoperative patients' risk for developing venous thromboembolism (VTE) can be predicted using the adapted Caprini risk assessment model which informs administration of postoperative VTE prophylaxis. The study aimed to assess the appropriateness of postoperative VTE prophylaxis of patients according to the adapted Caprini scores and investigate whether a patient's HIV status influenced postoperative VTE prophylaxis administration.
Methods: This cohort study included patients who had elective or urgent surgery at a tertiary hospital, Bloemfontein.
Front Med (Lausanne)
January 2025
Department of Emergency Medicine, College of Medicine, Dong-A University Hospital, Dong-A University, Busan, Republic of Korea.
Background: Although the incidence of sudden cardiac death is higher in hemodialysis (HD) patients, whether out-of-hospital cardiac arrest (OHCA) survival outcomes are poorer in this group remains unclear. This study aimed to assess the impact of HD on survival outcomes among adult nontraumatic OHCA patients and to compare these outcomes between HD and non-HD groups.
Methods: This observational cohort study retrospectively analyzed data from adult nontraumatic OHCA patients in Ulsan, South Korea, from January 2017 through December 2022.
PeerJ
January 2025
Department of Endocrinology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
Background: The aim of this study was to investigate the impact of diabetes on mortality and adverse outcomes in COVID-19 patients and to analyse the associated risk factors.
Methods: This is a retrospective cohort study in 500 hospitalized patients with COVID-19 infection (214 with diabetes and 286 without diabetes) admitted to a tertiary hospital in China from December 2022 to February 2023. Demographic information, clinical characteristics and outcomes were collected.
Front Immunol
January 2025
Department of Emergency and Critical Care Medicine, Hitachi General Hospital, Ibaraki, Japan.
Background: Sepsis is a life-threatening condition caused by severe infection. The efficacy of intravenous immunoglobulin (IVIG) as adjunctive therapy on mortality remains controversial. Moreover, IVIG may favorably affect sepsis-induced immunosuppression like persistent inflammation, immunosuppression, and catabolism syndrome (PICS).
View Article and Find Full Text PDFJ Orthop Surg Res
January 2025
Department of Orthopedics, Pidu District People's Hospital, The Third Affiliated Hospital of Chengdu Medical College, Chengdu, 611730, China.
Background: The Clinical Frailty Scale (CFS) is a tool to assess the overall health of older adults. There are few reports of CFS and prognosis of ankle fracture. The objective of this study was to determine the predictive power of the CFS for adverse clinical and radiographic outcomes after surgery in elderly patients with trimalleolar fractures.
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