Aims And Background: The study analyzed the value of physical and psychosocial frailty assessment in predicting the need for supportive care and the risk of short-term failures after discharge in hospitalized cancer patients.
Methods And Study Design: Frailty was assessed in 350 consecutive patients using a multidimensional tool. Patients were followed for 4 months after discharge to record the occurrence of chemotherapy interruption, urgent hospital readmission or death. The association between patient characteristics and the outcomes were analyzed with either logistic or Cox multivariable models.
Results: About 40% of patients were classified as frail, with a higher prevalence of clinical frailty (alone or together with psychosocial frailty). Psychosocial frailty was positively associated with the need for supportive care at discharge (adjusted OR, 3.46; 95% CI, 1.55-7.76) but did not predict a worse prognosis when other important clinical factors were considered. However, the need for supportive care at discharge, in addition to advanced disease and reduced performance status, was a strong predictor of short-term hospital readmission or death (HR 7.50; 95% CI, 3.12-18.02).
Conclusions: A more comprehensive assessment of frailty in cancer patients can aid in the timely identification of the need for supportive care after hospital discharge and improves the prediction of the short-term risk of hospital readmission or death.
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http://dx.doi.org/10.1700/1430.15822 | DOI Listing |
Presse Med
January 2025
Department of Hematology and Cellular Therapy, National Reference Center "AL Amyloidosis and Other Monoclonal Immunoglobulin Deposit Diseases, University Hospital of Limoges, Limoges, France.
POEMS syndrome (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal Protein, Skin changes) is a syndrome that involves a monoclonal B-cell proliferation, most often plasmacytic, and a variable number of manifestations listed or not in the acronym. These manifestations include sclerotic bone lesions, plasmacytic Castleman disease, papillary edema, peripheral edema, ascites, thrombocytosis and/or polycythemia, venous and/or arterial thrombosis, and renal, pulmonary, and cardiac impairments . Diagnosis is often delayed due to the rarity of this entity and its clinical polymorphism, which can mimic other neurological disorders.
View Article and Find Full Text PDFChest
January 2025
Division of General Internal Medicine, Section of Palliative Care and Medical Ethics, University of Pittsburgh, Pittsburgh, Pennsylvania; Palliative Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania.
Background: Quoting patients in electronic medical record (EMR) notes is controversial. Quotations may be used to promote accuracy in documentation. However they also may be used to cast skepticism on patient speech.
View Article and Find Full Text PDFJ Nutr
January 2025
Department of Human Physiology of the Chair of Preclinical Sciences, Medical University in Lublin, Lublin, Poland.
Background: Systemic inflammation plays a crucial role in the development and progression of chronic heart failure (CHF) across all phenotypes. The continuous release of pro-inflammatory cytokines causes muscle atrophy and adipocyte breakdown, ultimately resulting in cachexia. Long non-coding RNAs (lncRNAs) are emerging as potential biomarkers associated with cachexia, as they indirectly regulate muscle and fat tissue metabolism.
View Article and Find Full Text PDFNurse Educ Pract
January 2025
Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK.
Aim: To explore different types of interprofessional education (IPE) teaching strategies used in pre-licensure interprofessional learning programmes and the effective components of these strategies in promoting student learning, IPE skills, behavioural change, organisational practice, or patient health outcomes.
Background: IPE is rapidly becoming a core element of health professions preparation programmes worldwide, but the differential effects of different ways of delivering IPE are not well documented.
Design: Systematic narrative review.
Am J Emerg Med
January 2025
Departments of Emergency Medicine and Critical Care Medicine, Stanford Health Care, 900 Welch Road, Palo Alto, CA 94304, USA.
Background: Critically ill ED patients on life support may undergo transition to comfort care as decided by the surrogate decision maker. When several hours are needed for loved ones to arrive and say farewell before initiating comfort care ("delayed comfort care"), these patients require prolonged ED stays or costly intensive care unit (ICU) admissions.
Methods: A novel ED observation unit (EDOU)-based delayed comfort care pathway for ED patients on invasive mechanical ventilation and/or vasopressors was created in 2013 at Stanford Hospital.
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