scholarly journals Demand and Predictors for Post-Discharge Medical Counseling in Home Care Patients: A Prospective Cohort Study

PLoS ONE ◽  
2013 ◽  
Vol 8 (5) ◽  
pp. e64274 ◽  
Author(s):  
Shih-Tan Ding ◽  
Chuan-Lan Wang ◽  
Yu-Han Huang ◽  
Chin-Chung Shu ◽  
Yu-Tzu Tseng ◽  
...  
Keyword(s):  
Cohort Study ◽  
Home Care ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Post Discharge ◽  
Medical Counseling

scholarly journals 168Supporting Older People with Complex Needs through the Intensive Home Care Package Initiative: Findings from a Prospective Cohort Study

2018 ◽  
Vol 47 (suppl_5) ◽  
pp. v13-v60
Author(s):  
Fiona Keogh ◽  
Maria Pierce ◽  
Karen Neylon ◽  
Padraic Fleming ◽  
Laura Carter ◽  
...  
Keyword(s):  
Cohort Study ◽  
Home Care ◽  
Older People ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Complex Needs ◽  
Care Package

scholarly journals Clinical features and outcomes of discharged coronavirus disease 2019 patients: a prospective cohort study

QJM ◽  
2020 ◽  
Vol 113 (9) ◽  
pp. 657-665 ◽  
Author(s):  
X Wang ◽  
H Xu ◽  
H Jiang ◽  
L Wang ◽  
C Lu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Clinical Outcomes ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Close Contact ◽  
Post Discharge ◽  
Global Pandemic ◽  
Discharged Patients ◽  
Suspected Recurrence

Summary Background Coronavirus disease 2019 (COVID-19) is a global pandemic but the follow-up data of discharged patients was barely described. Aim To investigate clinical outcomes, distribution of quarantine locations and the infection status of the contacts of COVID-19 patients after discharge. Design A prospective cohort study. Methods Demographics, baseline characteristics of 131 COVID-19 patients discharged from 3 February 2020 to 21 February 2020 in Wuhan, China were collected and analyzed by reviewing the medical records retrospectively. Post-hospitalization data related to clinical outcomes, quarantine locations and close contact history were obtained by following up the patients every week up to 4 weeks. Results Fifty-three (40.05%) patients on discharge had cough (29.01%), fatigue (7.63%), expectoration (6.11%), chest tightness (6.11%), dyspnea (3.82%), chest pain (3.05%) and palpitation (1.53%). These symptoms constantly declined in 4 weeks post-discharge. Transient fever recurred in 11 (8.4%) patients. Among the discharged patients, 78 (59.5%) underwent chest CT and 2 (1.53%) showed deterioration. A total of 94 (71.8%) patients received SARS-CoV-2 retest and 8 (6.10%) reported positive. Seven (2.29%) patients were readmitted because of fever or positive SARS-CoV-2 retest. After discharge, 121 (92.37%) and 4 (3.05%) patients were self-quarantined at home or community spots, respectively, after a close contact with 167 persons in total who were free of COVID-19 at the endpoint of study. Conclusion The majority of COVID-19 patients after discharge were in the course of recovery. Readmission was required in rare cases due to suspected recurrence of COVID-19. Although no contacted infection observed, appropriate self-quarantine and regular re-examination are necessary, particularly for those who have recurred symptoms.

scholarly journals Post-discharge opioid use and handling in surgical patients: A multicentre prospective cohort study

2020 ◽  
Vol 48 (1) ◽  
pp. 36-42 ◽  
Author(s):  
Megan L Allen ◽  
Charles C Kim ◽  
Sabine Braat ◽  
Karin Jones ◽  
Noam Winter ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Surgical Patients ◽  
Opioid Use ◽  
Post Discharge ◽  
Opioid Medication ◽  
Post Surgery ◽  
Opioid Medications

Our aim was to determine the frequency and characteristics of post-surgery prescription of opioid medication and to describe patients’ handling of discharge opioid medications. We performed a multicentre prospective cohort study of adult patients undergoing elective or emergency surgery with a postoperative stay of one or more nights, with phone follow-up at two weeks after hospital discharge. The main outcome measures included the proportion of patients prescribed discharge opioid medications, post-discharge opioid use, opioid storage and disposal. Of the 1450 eligible surgical patients, opioids were dispensed on discharge to 858 (59%, 95% confidence interval (CI) (57%–62%)), with immediate-release oxycodone the most common medication. Of the 581 patients who were discharged with opioid medication and completed follow-up, 27% were still requiring opioids two weeks after discharge. Post-discharge opioid consumption was highly variable in the study cohort. The majority (70%) of patients had leftover opioids and only a small proportion (5%) reported disposal of the surplus. In a multivariate model, patients with characteristics of age 45 years or less (odds ratio, OR = 1.78, 95% CI (1.36–2.33) versus older than 45 years), American Society of Anesthesiologists’ physical status (ASA) scores of 1 or 2 (OR = 1.96, 95% CI (1.52–2.53) versus ASA score 3 to 5), higher anticipated surgical pain (OR = 1.45, 95% CI (1.08–1.94) severe versus moderate, OR = 17.48, 95% CI (5.79–52.69) severe versus nil/mild) and public funding status (OR = 1.89, 95% CI (1.36–2.64) versus other) were more likely ( P < 0.001) to receive discharge opioids. Post-surgery prescription of opioids is common and supply is often excessive. Post-discharge opioid handling included suboptimal storage and disposal.

scholarly journals Association between clinical frailty, illness severity and post-discharge survival: a prospective cohort study of older medical inpatients in Norway

2021 ◽  
Author(s):  
Andreas Engvig ◽  
Torgeir Bruun Wyller ◽  
Eva Skovlund ◽  
Marc Vali Ahmed ◽  
Trygve Sundby Hall ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Frailty Index ◽  
Illness Severity ◽  
Cox Proportional Hazards Model ◽  
Early Warning Score ◽  
Post Discharge ◽  
Medical Wards ◽  
The Impact

Abstract Purpose Study associations between frailty, illness severity and post-discharge survival in older adults admitted to medical wards with acute clinical conditions. Methods Prospective cohort study of 195 individuals (mean age 86; 63% females) admitted to two medical wards with acute illness, followed up for all-cause mortality for 20 months after discharge. Ward physicians screened for frailty and quantified its degree from one to eight using Clinical Frailty Scale (CFS), while clinical illness severity was estimated by New Early Warning Score 2 (NEWS2) and laboratory illness severity was calculated by a frailty index (FI-lab) using routine blood tests. Results CFS, NEWS2 and FI-lab scores were independently associated with post-discharge survival in an adjusted Cox proportional hazards model with age, ward category (acute geriatric and general medical) and comorbidity as covariates. Adjusted hazard ratios and 95% confidence intervals were 1.54 (1.24–1.91) for CFS, 1.12 (1.03–1.23) for NEWS2, and 1.02 (1.00–1.05) for FI-lab. A frailty × illness severity category interaction effect (p = 0.003), suggested that the impact of frailty on survival was greater in those experiencing higher levels of illness severity. Among patients with at least moderate frailty (CFS six to eight) and high illness severity according to both NEWS2 and FI-lab, two (13%) were alive at follow-up. Conclusion Frailty screening aided prognostication of survival following discharge in older acutely ill persons admitted to medical wards. The prognostic value of frailty increased when combined with readily available illness severity markers acquired during admission.

Obesity, diabetes, and the risk of infections diagnosed in hospital and post-discharge infections after cesarean section: a prospective cohort study

2011 ◽  
Vol 90 (5) ◽  
pp. 501-509 ◽  
Author(s):  
RITA ANDERSEN LETH ◽  
NIELS ULDBJERG ◽  
METTE NØRGAARD ◽  
JENS KJØLSETH MØLLER ◽  
REIMAR WERNICH THOMSEN
Keyword(s):  
Cohort Study ◽  
Cesarean Section ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Post Discharge

scholarly journals P162: Patient-important outcomes in hyperglycemia after discharge from the emergency department: a prospective cohort study

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S114-S115
Author(s):  
J. W. Yan ◽  
L. Siddiqi ◽  
K. Van Aarsen ◽  
M. Columbus ◽  
K. M. Gushulak
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Healthcare Provider ◽  
Prospective Cohort Study ◽  
Burden Of Disease ◽  
Prospective Cohort ◽  
Tertiary Care ◽  
Adverse Outcomes ◽  
Post Discharge

Introduction: Hyperglycemic emergencies, including diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS), carry significant morbidity for individuals even after discharge. The objective of this study was to describe the patient-important outcomes and burden of disease for emergency department (ED) patients with hyperglycemia after discharge from hospital. Methods: This was a prospective cohort study of patients 18 years presenting to two tertiary care EDs (combined annual census 150,000 visits) with a discharge diagnosis of hyperglycemia, DKA or HHS over a 15-month period (Jul 2016-Oct 2017). During the ED visit, consent was obtained for a telephone follow-up call to determine patient-important outcomes. Trained research personnel collected data from medical records and completed a 14 day telephone follow-up using a standardized questionnaire to determine medication changes, missed days of school or work, and repeat admissions or visits to a healthcare provider. Descriptive statistics were used where appropriate to summarize the data. Results: Thus far, 172 patients have been enrolled in our study. Mean (SD) age is 53.9 (19.3) years and 97 (56.4%) are male. 65 (37.8%) patients were admitted from their initial ED visit. Of the 125 patients (72.7%) providing post-discharge outcomes, 75 (60.0%) required an adjustment to their diabetes medications or insulin. 21 (16.8%) patients missed days of school or work for a median (IQR) duration of 3.5 (1.3, 7.0) days. 85 (68.0%) saw another healthcare provider within a 14 day period, 45 (36.0%) saw their family physician, and 34 (27.2%) saw an internist or endocrinologist. 9 (7.2%) were seen again in the ED, 5 of these patients required admission to hospital. There was one death that occurred within the follow-up period. Conclusion: This prospective study builds on our previous retrospective work and demonstrates that visits for hyperglycemia carry a significant burden of disease beyond what may be seen in a single ED encounter. Further research will attempt to identify the factors that may be predictive of adverse outcomes in hyperglycemic patients presenting to the ED.

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