Mortality and readmission risk can be predicted by the record-based Multidimensional Prognostic Index: a cohort study of medical inpatients older than 75 years

2021 ◽  
Vol 12 (2) ◽  
pp. 253-261 ◽  
Author(s):  
Troels Kjærskov Hansen ◽  
Seham Shahla ◽  
Else Marie Damsgaard ◽  
Sofie Ran Lindhardt Bossen ◽  
Jens Meldgaard Bruun ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prognostic Index ◽  
Medical Inpatients ◽  
Readmission Risk

Estimating life expectancy among older multimorbid adults to personalize preventive care

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
V Gastens ◽  
C Del Giovane ◽  
D Anker ◽  
L Syrogiannouli ◽  
N Schwab ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cancer Screening ◽  
Life Expectancy ◽  
Preventive Care ◽  
Hospital Admissions ◽  
Prognostic Index ◽  
Preventive Treatment ◽  
Prognostic Indices ◽  
Multimorbid Patients

Abstract Background Providing high value care and avoiding care overuse is a challenge among older multimorbid adults. There is evidence on benefits and harms of cancer screening and cardiovascular diseases (CVD) preventive treatment up to the age of 75. However, this evidence is not directly applicable to older multimorbid patients. Because each cancer and CVD preventive care has a specific lagtime to benefit, many guidelines recommend tailoring preventive care according to the estimated life expectancy (LE). However, there is no tool to estimate LE among multimorbid patients. Our objectives are therefore to develop new mortality risk prognostic indices and to derive a new LE estimator, what will help clinicians tailoring preventive care in older multimorbid adults. Methods and Results We conduct a prospective cohort study by extending the follow-up of 822 patients in Bern, Switzerland, included in the OPtimising thERapy to prevent Avoidable hospital admissions in Mulitmorbid older people (OPERAM) study over 3 years. Detailed information about cancer screening and CVD preventive treatment will be collected. We will identify variables independently associated with mortality and weight the variables to create 1 year and 3 year mortality prognostic indices. We will transform the 3 year prognostic index into a LE estimator. Preliminary results will be presented at the congress. Conclusions We will develop the first life expectancy estimator specifically for older multimorbid adults. This tool will help clinicians to tailor cardiovascular and cancer preventive care in older multimorbid adults. Key messages Because of the lagtime to benefit, personalizing preventive care by estimated life expectancy is recommended. We will provide the first life expectancy estimator for older multimorbid adults.

Seasonality of Hypoosmolar Hyponatremia in Medical Inpatients – Data from a Nationwide Cohort Study

2020 ◽  
Vol 105 (4) ◽  
pp. e947-e954
Author(s):  
Alexander Kutz ◽  
Fahim Ebrahimi ◽  
Clara O Sailer ◽  
Ulrich Wagner ◽  
Philipp Schuetz ◽  
...  
Keyword(s):  
Cohort Study ◽  
Odds Ratio ◽  
Primary Outcome ◽  
Age Groups ◽  
Outdoor Temperature ◽  
Specific Difference ◽  
Electrolyte Disturbance ◽  
Elderly Female ◽  
Medical Inpatients ◽  
Secondary Outcomes

Abstract Context Hyponatremia is the most prevalent electrolyte disturbance in hospitalized patients. Previous studies have shown a seasonal variation of profound hyponatremia with higher prevalence during warmer months. Objective This study aimed at analyzing the seasonal prevalence and sex- and age-specific differences of hyponatremia in medical inpatients. Design Nationwide cohort study from January 2009 and December 2015 using prospective administrative data. Setting Medical inpatients. Patients Diagnosis of hypoosmolar hyponatremia. Main outcome measures The primary outcome was the monthly alteration in hyponatremia prevalence. Secondary outcomes were the association of outdoor temperature with hyponatremia prevalence and differences among sex and age groups. Results Of 2 426 722 medical inpatients, 84 210 were diagnosed with hypoosmolar hyponatremia, of whom 61% (n = 51 262) were female. The highest overall prevalence of hyponatremia was observed in July (4.5%, n = 8976); the lowest in December (2.7%, n = 6530). The overall prevalence of hyponatremia in women compared with men was higher by 58% (odds ratio [OR], 1.58; 95% confidence interval [CI], 1.56-1.60). The sex-specific difference was most pronounced in the warmest month of July (mean temperature 20.1°C (OR, 1.76; 95% CI, 1.68-1.84). We observed the strongest association between seasonality and hyponatremia in elderly (>80 years) female inpatients admitted during the month of July (OR, 2.40; 95% CI, 2.20-2.62]). Conclusion The prevalence of diagnosed hypoosmolar hyponatremia in medical inpatients increases during summer months with higher outdoor temperature. Elderly female inpatients were most susceptible to the seasonal rise in hyponatremia prevalence.

scholarly journals Prognostic value of lymphocyte-to-monocyte ratio and neutrophil-to-lymphocyte ratio in follicular lymphoma: a retrospective cohort study

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e017904 ◽  
Author(s):  
Shing Fung Lee ◽  
Miguel Angel Luque-Fernandez
Keyword(s):  
Cohort Study ◽  
Prognostic Factors ◽  
Follicular Lymphoma ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
International Prognostic Index ◽  
Prognostic Index ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Lymphocyte To Monocyte Ratio

ObjectivesThe clinical course and prognosis of follicular lymphoma (FL) are diverse and associated with the patient’s immune response. We investigated the lymphocyte-to-monocyte ratio (LMR) and neutrophil-to-lymphocyte ratio (NLR) as prognostic factors in patients with FL, including those receiving radiotherapy.DesignA retrospective cohort study.SettingRegional cancer centre in Hong Kong.Participants88 patients with histologically proven FL diagnosed between 2000 and 2014.Materials and methodsThe best LMR and NLR cut-off values were determined using cross-validated areas under the receiver operating characteristic curves. The extent to which progression-free survival (PFS) and overall survival differed by NLR and LMR cut-off values was assessed using Kaplan-Meier analysis and log-rank tests. A Cox proportional hazards model was fitted to adjust for confounders.ResultsThe best cut-off values for LMR and NLR were 3.20 and 2.18, respectively. The 5-year PFS was 73.6%. After multivariate adjustment, high LMR (>3.20) at diagnosis was associated with superior PFS, with a HR of 0.31 (95% CI 0.13 to 0.71), whereas high NLR at relapse was associated with poorer postprogression survival (HR 1.24, 95% CI 1.04 to 1.49).ConclusionsBaseline LMR and NLR at relapse were shown to be independent prognostic factors in FL. LMR and NLR are cheap and widely available biomarkers that could be used in combination with the Follicular Lymphoma International Prognostic Index by clinicians to better predict prognosis.

scholarly journals What Are They Worth? Six 30-Day Readmission Risk Scores for Medical Inpatients Externally Validated in a Swiss Cohort

2020 ◽  
Vol 35 (7) ◽  
pp. 2017-2024
Author(s):  
Tristan Struja ◽  
Ciril Baechli ◽  
Daniel Koch ◽  
Sebastian Haubitz ◽  
Andreas Eckart ◽  
...  
Keyword(s):  
Risk Scores ◽  
Medical Inpatients ◽  
Readmission Risk

Patterns of multimorbidity in medical inpatients: a multinational retrospective cohort study

2020 ◽  
Vol 15 (7) ◽  
pp. 1207-1217 ◽  
Author(s):  
Carole Elodie Aubert ◽  
Jeffrey Lawrence Schnipper ◽  
Niklaus Fankhauser ◽  
Pedro Marques-Vidal ◽  
Jérôme Stirnemann ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Medical Inpatients

scholarly journals Validation of risk assessment models predicting venous thromboembolism in acutely ill medical inpatients: A cohort study

2020 ◽  
Vol 18 (6) ◽  
pp. 1398-1407 ◽  
Author(s):  
Thomas Moumneh ◽  
Jérémie Riou ◽  
Delphine Douillet ◽  
Samir Henni ◽  
Dominique Mottier ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Cohort Study ◽  
Venous Thromboembolism ◽  
Risk Assessment Models ◽  
Medical Inpatients
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