Abstract:
OBJECTIVES:Increasing evidence has mounted in recent years on the potential prognostic role of biomarkers out of cardiac-specific medical settings. We aimed to test whether cardiac and inflammatory biomarkers are independently associated with in-hospital mortality in older unselected medical inpatients undergoing standardized multidimensional evaluation. DESIGN:Observational study conducted in a metropolitan university-teaching hospital. A standardized, multidimensional analysis was carried out on all patients by using medical and hospital discharge documentation and interview results integrated with information collected from family members or caregivers. PARTICIPANTS AND SETTING:Patients older than 65 years consecutively admitted to the acute geriatric ward and to 2 acute medical wards of the hospital. RESULTS:Male sex; low systolic blood pressure; APACHE score; functional impairment in activities of daily living (ADLs), instrumental ADLs, and Short Physical Performance Battery (SPPB); cognitive impairment; malnutrition; low albumin values; and elevated values of inflammatory and cardiac biomarkers were significantly associated with in-hospital mortality at univariate analysis. After multivariate analysis, male sex, low systolic blood pressure values at entry, severe cognitive impairment, and low functional performance measured by the SPPB resulted to be independently associated with in-hospital mortality. CONCLUSIONS:The main finding of the present study is that these biomarkers, although associated with in-hospital mortality, do not have independent predictive significance when a comprehensive and multidimensional evaluation is conducted. The main clinical implication is that our findings should discourage the indiscriminate recourse to measurement of cardiac and inflammatory biomarkers, at least in older medical inpatients, thereby reducing a patient's hospital cost and potentially minimizing further unnecessary diagnostic procedures.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Comba M,Fonte G,Isaia G,Pricop L,Sciarrillo I,Michelis G,Bo Mdoi
10.1016/j.jamda.2013.10.013subject
Has Abstractpub_date
2014-01-01 00:00:00pages
68-72issue
1eissn
1525-8610issn
1538-9375pii
S1525-8610(13)00596-3journal_volume
15pub_type
杂志文章abstract:OBJECTIVE:Older adults receiving Medicare home health services who experience undernutrition may be at increased risk of experiencing adverse outcomes. We sought to identify the association between baseline nutritional status and subsequent health service utilization and mortality over a 1-year period in older adults r...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2010.08.017
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abstract:OBJECTIVES:Paratonia, a form of hypertonia typically seen in dementia, is often associated with difficulties in positioning and daily care. No evidence-based therapy or clinical guideline for management is available. In this study, the short-term effect of harmonic techniques (HT) and supporting cushions (SC) on parato...
journal_title:Journal of the American Medical Directors Association
pub_type: 临床试验,杂志文章,多中心研究
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abstract::Internists and family physicians are trained in evidence-based medicine (EBM). The philosophy of incorporating clinical research "evidence" into medical practice is taught at the undergraduate and graduate levels of medical training. Practicing physicians incorporate EBM into their practices in variable degrees depend...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:
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abstract:OBJECTIVES:This study presents the design of an integrated, proactive palliative care pathway covering the full care cycle and evaluates its effects using 3 types of outcomes: (1) physician-reported outcomes, (2) outcomes reported by family, and (3) (utilization of) health care outcomes. DESIGN:A clustered, partially ...
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doi:10.1016/j.jamda.2020.10.025
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abstract:OBJECTIVES:The issue of subjects with mild cognitive impairment (MCI) reverting to normal cognition (NC) has to date been taken in limited consideration, and no conclusive data are available on the rate of reversion. We aimed at systematically reviewing available longitudinal studies on MCI and meta-analyzing data with...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jamda.2016.06.020
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abstract:OBJECTIVE:To assess whether medical orders within Physician Orders for Life-Sustaining Treatment (POLST) forms reflect patients' preferences for care at the end of life. DESIGN:This cross-sectional study assessed the agreement between medical orders in POLST forms and the free-form text documentation of an advance car...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.10.016
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abstract:OBJECTIVES:The aim of this systematic review was to summarize the validity of nutritional screening tools to detect the risk of malnutrition in community-dwelling older adults. DESIGN:A systematic review and meta-analysis. The protocol for this systematic review was registered in the PROSPERO database (CRD42017072703)...
journal_title:Journal of the American Medical Directors Association
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doi:10.1016/j.jamda.2019.06.024
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abstract:OBJECTIVE:To assess the prevalence of permanent atrial fibrillation (AF) in community-dwelling subjects aged 85 and to determine the anticoagulation therapy rate. DESIGN:Community-based survey of inhabitants aged 85 years. PARTICIPANTS:Participants were 328 people born in 1924 and assigned to 7 primary health care te...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2011.04.005
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abstract:OBJECTIVES:To describe current practices of incontinence care in nursing homes (NHs) provided by certified nurse assistants (CNAs), and to evaluate the feasibility and acceptability of an integrated incontinence care product, the One Step Incontinence System (OSIS) in the NH setting. While the ultimate purpose of OSIS ...
journal_title:Journal of the American Medical Directors Association
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更新日期:2007-05-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate the effect of sarcopenic obesity on activities of daily living and home discharge rates in adults undergoing convalescent rehabilitation. In addition, we evaluated diagnostic criteria for sarcopenic obesity to predict outcomes. DESIGN:A retrospective cohort study. SETTI...
journal_title:Journal of the American Medical Directors Association
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doi:10.1016/j.jamda.2020.03.029
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abstract:BACKGROUND:Although many older adults require skilled nursing facility (SNF) care after acute hospitalization, it is unclear whether internal medicine residents have sufficient knowledge of the care that can be provided at this site. METHODS:We developed a 10-item multiple choice pre-test that assessed knowledge of th...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.08.004
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to identify the clinical efficacy of acupuncture in combination with RehaCom cognitive training in poststroke patients with cognitive dysfunction. METHODS/DESIGN:This study was a 2 × 2 factorial design randomized controlled trial comparing acupuncture, computer-assisted cognitive re...
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.2016.07.021
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:More than one-half of nursing home residents experience a complex mix of pain. Despite this, assessment and treatment of pain remain inadequate. METHODS:Using techniques of the Cochrane Collaboration and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we assessed effi...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jamda.2016.09.016
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abstract::Currently, the Agency for Healthcare Research and Quality (AHRQ) Common Format for nursing homes (NHs) accommodates voluntary reporting for 4 adverse events: falls with injury, pressure ulcers, medication errors, and infections. In 2015, AHRQ funded a technical brief to describe the state of the science related to saf...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2016.03.005
更新日期:2016-06-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.jamda.2017.06.017
更新日期:2017-12-01 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.2005.05.010
更新日期:2005-11-01 00:00:00
abstract:OBJECTIVES:To establish the reliability and validity of a measure to assess pain in individuals with advanced dementia. DESIGN:Sixty-five residents of long-term care facilities were assessed using a new rating tool, the Pain Assessment for the Dementing Elderly (PADE), in two separate studies: (1) Residents were asses...
journal_title:Journal of the American Medical Directors Association
pub_type: 临床试验,杂志文章
doi:10.1097/01.JAM.0000043419.51772.A3
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abstract:OBJECTIVE:To evaluate the effects of the modified Hospital Elder Life Program (mHELP) comprising 3 nurse-administered protocols in older patients undergoing gastrointestinal (GI) surgery. DESIGN:Cluster randomized trial. SETTING:Two 36-bed GI wards at a university-affiliated medical center in Taiwan. PARTICIPANTS:Ol...
journal_title:Journal of the American Medical Directors Association
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更新日期:2019-05-01 00:00:00
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journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2013.09.015
更新日期:2013-12-01 00:00:00
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pub_type: 杂志文章
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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,随机对照试验
doi:10.1016/j.jamda.2015.12.008
更新日期:2016-03-01 00:00:00
abstract::A consensus among geriatricians, ethicists, and neurologists supports a palliative approach to the care of individuals with late-stage dementia. But ten years after the publication of the first large study demonstrating the lack of efficacy of percutaneous endoscopic gastrostomy (PEG) tubes in prolonging life for pati...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2008.03.011
更新日期:2008-06-01 00:00:00
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journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:
更新日期:2001-07-01 00:00:00
abstract:OBJECTIVES:To determine the prevalence, rate of underdiagnosis and undertreatment, and association with activities of daily living dependency of spasticity in a nursing home setting. DESIGN:Cross-sectional study. SETTING AND PARTICIPANTS:This study is an analysis of a deidentified data set generated by a prior qualit...
journal_title:Journal of the American Medical Directors Association
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更新日期:2020-08-01 00:00:00
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journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1097/01.JAM.0000110649.22467.B4
更新日期:2004-03-01 00:00:00
abstract::The prevalence of malnutrition ranges up to 50% among patients in hospitals worldwide, and disease-related malnutrition is all too common in long-term and other health care settings as well. Regrettably, the numbers have not improved over the past decade. The consequences of malnutrition are serious, including increas...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.05.011
更新日期:2014-08-01 00:00:00
abstract::Medication errors remain an important cause of patient morbidity and mortality. Although all medications have the potential to induce unwanted adverse effects, data on the actual incidence and overall severity of preventable adverse drug reactions remains unknown. An Institute of Medicine report (Institute of Medicine...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2007.07.004
更新日期:2007-10-01 00:00:00
abstract:OBJECTIVE:Motoric cognitive risk syndrome (MCR) is a predementia stage associated with increased risk for falls. There are conflicting results regarding its association with recurrent falls and no information about its association with postfall fractures. The aim of the study was to examine the association of MCR and i...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
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更新日期:2019-10-01 00:00:00
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journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jamda.2007.11.008
更新日期:2008-05-01 00:00:00