Abstract：
OBJECTIVE:To identify predictors of adverse outcomes (nursing home placement and hospital length of stay) in a cohort of older hospitalized patients. DESIGN:Prospective cohort study. SETTING:A suburban medical center in the New York City metropolitan area. PARTICIPANTS:Patients aged 65 years and older admitted from the emergency department to medical services who could be seen within 24 hours. Patients with terminal illness, planned stays < 2 days, and admission to other than medicine were excluded. MEASUREMENTS:Sociodemographic data, mobility, Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), mental status, length of stay (LOS), discharge diagnosis, and disposition (nursing home vs. other). RESULTS:Of 681 patients screened, 322 were eligible and assessed at admission,206 were reassessed at discharge. Using multiple regression, greater dependency in IADL, more household help, and impaired mental status at admission predicted hospital LOS significantly (P = 0.0001). Compared with those discharged home, the nursing home (NH) group had lower scores on mean mobility and mean ADLs and IADLs and was more likely to exhibit a decline in at least one ADL. Stepwise discriminant analysis was performed using admission, discharge, and combined variables. In our final model of the predictors of discharge disposition, the use of admission functional variables, age, and sex correctly classified 100% of the NH group and 91% of the other group, with IADL, ADL, and mobility defining the function that discriminated the groups. CONCLUSIONS:Our data indicate the value of cognitive and physical function at admission as predictors of adverse outcomes and support early assessment of the elderly for discharge planning for long-term care.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Fogel JF,Hyman RB,Rock B,Wolf-Klein Gkeywords:
subject
Has Abstractpub_date
2000-09-01 00:00:00pages
202-10issue
5eissn
1525-8610issn
1538-9375journal_volume
1pub_type
杂志文章abstract：OBJECTIVES:The aim of this study was to evaluate the potential association between anemia associated with chronic kidney disease (CKD) and the ability for older nursing home (NH) residents with these conditions to perform basic activities of daily living (ADL). DESIGN:This is a multicenter, retrospective, observationa...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jamda.2008.08.012
更新日期：2009-02-01 00:00:00
abstract：OBJECTIVES:This study examined the extent to which program site-based and Veteran characteristics were associated with potentially avoidable hospitalizations or other hospitalization of Veterans enrolled in the Veterans Affairs (VA) Home Based Primary Care (HBPC). DESIGN:Retrospective claims-based study. SETTING AND ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.12.033
更新日期：2021-01-29 00:00:00
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jamda.2014.12.005
更新日期：2015-03-01 00:00:00
abstract：OBJECTIVES:Psychotropic drugs are usually prescribed to deal with behavioral and psychological symptoms of dementia, especially when nonpharmacologic approaches are not available or have limited efficacy. Poor outcomes and serious adverse events of the drugs used must be addressed, and risk-benefit ratios need to be co...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
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更新日期：2014-07-01 00:00:00
abstract：OBJECTIVES:To provide an estimate and level of uncertainty for Medicaid cost savings due to Minnesota's Return to Community Initiative (RTCI). DESIGN:Medicaid cost savings are estimated using a semi-Markov model and simulation approach. SETTING AND PARTICIPANTS:RTCI is a statewide program that assists private paying ...
journal_title：Journal of the American Medical Directors Association
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abstract：OBJECTIVES:To evaluate the impact of a multicenter intervention to reduce potentially inappropriate antipsychotic use in Canadian nursing homes at the individual and facility levels. DESIGN:Longitudinal, population-based cohort study to evaluate the Canadian Foundation for Healthcare Improvement's Spreading Healthcare...
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.01.007
更新日期：2020-06-01 00:00:00
abstract：OBJECTIVES:To establish the mortality risk and adverse events associated with the use of atypical antipsychotic medications in people with Parkinson disease psychosis (PDP) in a clinically defined trial cohort. DESIGN:Post hoc analysis of data from a multicenter, open-label extension study of pimavanserin comparing pe...
journal_title：Journal of the American Medical Directors Association
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
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journal_title：Journal of the American Medical Directors Association
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abstract：:The phenomenon of elderly sexual offenders is poorly catalogued, and is especially complex. In institutions, elderly people are often unrecognized victims of sexual abuse but are also at great risk for doing abuse toward vulnerable victims like children. The lack of attention to an elder's basic needs can endanger or ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2012.05.012
更新日期：2012-09-01 00:00:00
abstract：BACKGROUND:The subject of estrogen in regard to short-term memory is controversial. There is support in the medical literature for estrogen improving short-term memory in women, but there are few data on this subject pertaining to genetic men. OBJECTIVE:To examine the effects of supplemental estrogen on short-term mem...
journal_title：Journal of the American Medical Directors Association
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doi：
更新日期：2000-01-01 00:00:00
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.09.016
更新日期：2020-10-26 00:00:00
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2005.06.011
更新日期：2006-01-01 00:00:00
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.11.037
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2014.12.003
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
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journal_title：Journal of the American Medical Directors Association
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doi：
更新日期：2000-05-01 00:00:00
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,meta分析,评审
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doi：
更新日期：2002-03-01 00:00:00
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2013.10.013
更新日期：2014-01-01 00:00:00
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journal_title：Journal of the American Medical Directors Association
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doi：10.1016/j.jamda.2017.02.009
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journal_title：Journal of the American Medical Directors Association
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更新日期：2020-11-19 00:00:00
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.12.022
更新日期：2021-01-15 00:00:00
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journal_title：Journal of the American Medical Directors Association
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doi：10.1016/j.jamda.2010.02.010
更新日期：2011-01-01 00:00:00
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2016.06.019
更新日期：2016-11-01 00:00:00
abstract：:Urinary tract infection (UTI) is arguably the most common infection in the long term care (LTC) setting. Making the diagnosis of UTI and deciding when to initiate treatment with antimicrobial therapy is a challenge to all LTC providers. Widespread prevalence of asymptomatic bacteriuria, lack of an accepted clinical or...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2013.11.009
更新日期：2014-02-01 00:00:00
