Abstract:
OBJECTIVE:We examined predictors of hospital and 6-month mortality in older Medical Intensive Care Unit (MICU) patients with particular attention to age and functional status. Age is generally thought to be strongly associated with intensive care outcomes, but this relationship may be confounded by age-related changes. These age-related changes may be approximated by changes in functional status (FS). DESIGN:We conducted a retrospective chart review and collected severity of illness data using the Acute Physiology Score (APS), pre-hospitalization FS dichotomized as limited or not limited, and hospital mortality. County death records were reviewed for 6-month mortality. SETTING:Three community hospital MICUs. PATIENTS:Four-hundred MICU patients aged 50 and older admitted during the study period. RESULTS:Limited FS was found in 42% of the 227 patients who had FS data in the chart. Mortality was significantly associated with APS, age, FS, immunocompromise state, comorbidity, and nursing home residence. In logistic regression analyses, while controlling for important variables, APS (P less than 0.001) and age greater than or equal to 75 with limited FS (P less than 0.05) were associated with hospital mortality. Six-month mortality predictors were APS (P less than 0.001), hospital (P less than 0.05), immunocompromised state (P less than 0.05) and age greater than or equal to 75 with limited FS (P less than 0.05). CONCLUSIONS:We found that among patients without functional limitations, the oldest group was no more likely to die than the youngest group. Age and functional status had a significant interaction: patients older than 75 years with functional limitations were almost six times more likely to die in hospital compared to the reference group of patients between 50-64 years old without functional limitations. We conclude that functional status is an important predictor of outcome in older MICU patients.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Mayer-Oakes SA,Oye RK,Leake Bdoi
10.1111/j.1532-5415.1991.tb04452.xsubject
Has Abstractpub_date
1991-09-01 00:00:00pages
862-8issue
9eissn
0002-8614issn
1532-5415journal_volume
39pub_type
杂志文章abstract:OBJECTIVES:To determine the association of dehydroepiandrosterone sulfate (DHEAS), body composition, and physical fitness in independent community-dwelling men and women aged 60 to 80 years. DESIGN:Cross sectional analysis. PARTICIPANTS:Independent men and women, 60 years of age and older, living in urban and suburba...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1998.tb01036.x
更新日期:1998-03-01 00:00:00
abstract:BACKGROUND:Weight loss among older patients is a severe problem, associated with an increased incidence of infections, decubiti, and death. Megestrol acetate (MA) causes weight gain in cachectic cancer and AIDS patients, but its effects in older cachectic patients are unknown. OBJECTIVE:To compare the effects of MA or...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1532-5415.2000.tb04993.x
更新日期:2000-05-01 00:00:00
abstract:OBJECTIVES:To investigate statin use and pain in people with cancer aged 70 to 79 and 80 and older. DESIGN:Cross-sectional. SETTING:Medical oncology outpatient clinic at the Royal Adelaide Hospital. PARTICIPANTS:Individuals aged 70 and older who presented consecutively between January 2009 and June 2010 (n = 385), o...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13051
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVE:Traditional mental status and psychometric assessments bottom out in the late stages of Alzheimer disease (AD). A method adapted from cognitive testing in infants, the Ordinal Scales of Psychological Development was modified (M-OSPD) and applied to a severely demented population. The concurrent validity of th...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章
doi:10.1111/j.1532-5415.1994.tb06509.x
更新日期:1994-12-01 00:00:00
abstract:OBJECTIVES:Impact assessment of drug benefits policies is a growing field of research that is increasingly relevant to health care planning for older people. Some cost-containment policies are thought to increase noncompliance. This paper examines mechanisms that can produce spurious reductions in drug utilization meas...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2002.50120.x
更新日期:2002-03-01 00:00:00
abstract::The benefits of prophylactic aspirin therapy to prevent cardiovascular and cerebrovascular disease in asymptomatic individuals remains unclear. The rationale for developing a multicentered, double-blind, placebo-controlled clinical trial to determine whether low-dose aspirin (100 mg daily) prevents cardiovascular and ...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1532-5415.1991.tb02494.x
更新日期:1991-05-01 00:00:00
abstract:OBJECTIVES:To examine whether chronic kidney disease (CKD) at any stage is associated with fracture risk after adjusting for competing mortality and to determine whether age or race modify the relationship between CKD and fracture risk. DESIGN:Prospective cohort study. SETTING:Department of Veterans Affairs (VA) nati...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15256
更新日期:2018-03-01 00:00:00
abstract::Ambulatory cardiac (Holter) monitoring is often recommended in the routine evaluation of patients who fall; however, the prevalence of arrhythmias in old people is high, and the usefulness of such monitoring is unproven. As part of a large study of institutionalized elderly fallers, we compared Holter findings of fall...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1989.tb02639.x
更新日期:1989-05-01 00:00:00
abstract:OBJECTIVES:To determine whether providing physical therapy (PT) services in the emergency department (ED) improves outcomes for older adults who fall. DESIGN:We used Medicare claims data to examine differences in recurrent fall-related ED revisit rates of older adults who presented to the ED for a ground-level fall an...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15469
更新日期:2018-11-01 00:00:00
abstract::The characteristic morphologic changes frequently observed in the brain of an old adult include a decrease in weight and volume, a change in the pattern of cerebral cortical convolutions, and an increase in ventricular size. Cell loss varies from region to region in the brain, and may be intensified in Alzheimer's dis...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1976.tb03246.x
更新日期:1976-01-01 00:00:00
abstract:OBJECTIVES:Older patients that have aged with their doctors will likely experience their physician retiring. It is unclear if this interruption in continuity of care leaves patients at risk for adverse events or whether a new physician improves care. We sought to identify and synthesize findings from all articles exami...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16216
更新日期:2020-03-01 00:00:00
abstract:PURPOSE:To determine whether the management of heart failure by specialized multidisciplinary heart failure disease-management programs was associated with improved outcomes. BACKGROUND:The advent of angiotensin-converting enzyme inhibitors, beta-blockers, and spironolactone has revolutionized the management of heart ...
journal_title:Journal of the American Geriatrics Society
pub_type: 评论,杂志文章
doi:10.1046/j.1532-5415.2002.50418.x
更新日期:2002-09-01 00:00:00
abstract:OBJECTIVES:To evaluate the effectiveness of exercise and amino acid supplementation in enhancing muscle mass and strength in community-dwelling elderly sarcopenic women. DESIGN:Randomized controlled trial. SETTING:Urban community in Tokyo, Japan. PARTICIPANTS:One hundred fifty-five women aged 75 and older were defin...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1532-5415.2011.03776.x
更新日期:2012-01-01 00:00:00
abstract::Oral temperature has long been used as a basis for clinical decisions. The ingestion of cold liquids such as iced water, which are frequently found at patients' bedsides or in clinic waiting areas, has been believed to potentially lower oral temperature readings. The degree and duration of this effect, however, has no...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1986.tb04245.x
更新日期:1986-07-01 00:00:00
abstract::Among 35 elderly patients with transtracheal aspirate (TTA)-documented nosocomial pneumonia, 7 (20 percent) had Streptococcus pneumoniae infection. Clinical and epidemiologic data are reported on these 7 patients and on 2 others with nosocomial pneumococcal pneumonia documented by bacteremia. Malignancy and chronic ob...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1981.tb01272.x
更新日期:1981-07-01 00:00:00
abstract:OBJECTIVES:To compare the value of dual tasking in predicting falling in the general population of oldest old with that of easy-to-administer single tasks. DESIGN:Prospective population-based follow-up study. SETTING:Municipality of Leiden, the Netherlands. PARTICIPANTS:Representative cohort of 380 individuals, all ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2003.51468.x
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVES:To explore changes in care goals and treatment orders around the occurrence of pneumonia and intake problems, and whether hospitalization is in line with earlier agreed-upon do-not-hospitalize orders. DESIGN:Data were collected as part of the Dutch End of Life in Dementia study (2007-2011), a longitudinal o...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14667
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:To describe the prevalence and content of long-term care facility policies regarding the use of life-sustaining treatments (cardiopulmonary resuscitation (CPR), artificial hydration and nutrition, dialysis, antibiotics for life-threatening infections, transfer to acute care hospital) and advance directives in...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1994.tb06980.x
更新日期:1994-11-01 00:00:00
abstract:OBJECTIVES:To examine the longitudinal associations between aging with preserved functionality, i.e. independent aging and survival, and lifestyle variables, dietary pattern and cardiovascular risk factors. DESIGN:Cohort study. SETTING:Uppsala Longitudinal Study of Adult Men, Sweden. PARTICIPANTS:Swedish men (n = 1,...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14971
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVES:To determine to what extent demographic, social support, socioeconomic, geographic, medical, and End-of-Life (EOL) planning factors explain racial and ethnic variation in Medicare spending during the last 6 months of life. DESIGN:Retrospective cohort study. SETTING:Health and Retirement Study (HRS). PARTI...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14263
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVES:To describe the types of continence aids that older adults hospitalized in acute medical units use and to test the association between use of continence aids and development of new urinary incontinence (UI) at discharge. DESIGN:Prospective cohort study. SETTING:A 900-bed teaching hospital in Israel. PARTI...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2011.03413.x
更新日期:2011-06-01 00:00:00
abstract:OBJECTIVE:To examine the relationship between gender and specific types of behavior problems that occur in patients with Alzheimer's disease. DESIGN:This was an observational study using the Dementia Behavior Disturbance Scale to quantify and define behavioral problems encountered by caregivers. Multiple regressions w...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1996.tb01447.x
更新日期:1996-05-01 00:00:00
abstract:OBJECTIVE:To determine if family members perceive that hospice improves the care of dying nursing home residents during the last 3 months of life. DESIGN:Mailed survey. PARTICIPANTS:Family members for all nursing home hospice enrollees in North Carolina during a 6-month period. MEASUREMENTS:After residents' deaths, ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2000.tb06883.x
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVES:To determine the association between multiple chronic conditions and risk of incident mild cognitive impairment (MCI) and dementia. DESIGN:Prospective cohort study. SETTING:Olmsted County, Minnesota. PARTICIPANTS:Cognitively normal individuals (N = 2,176) enrolled in the Mayo Clinic Study of Aging (MCSA)....
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13612
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVES:To describe the prevalence of and characteristics associated with major and minor depression in older medical inpatients and to compare associated characteristics by sex and history of depression. DESIGN:Cross-sectional study of two patient samples, with and without a screening diagnosis of major or minor d...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53404.x
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Nursing facility (NF) residents are commonly hospitalized, and many of these hospitalizations may be avoidable. A Centers for Medicare & Medicaid Services (CMS) initiative enables participating NFs to bill Medicare for providing on-site acute care to long-stay residents diagnosed with one of six a...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16901
更新日期:2020-11-12 00:00:00
abstract:OBJECTIVES:To identify valid tools to diagnose delirium superimposed on dementia. DESIGN:Systematic review of studies of delirium tools that explicitly included individuals with dementia. SETTING:Hospital. PARTICIPANTS:Studies were included if delirium assessment tools were validated against standard criteria, and t...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.2012.04199.x
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVES:To quantify incidence of tooth loss, prosthodontic dental restoration, and chewing difficulty onset and the effect of tooth loss and prosthodontic restoration on chewing difficulty onset. DESIGN:A prospective cohort study of oral health and related behaviors with in-person interviews and clinical examinatio...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2004.52253.x
更新日期:2004-06-01 00:00:00
abstract:OBJECTIVES:To examine the combined influence of alcohol use and comorbidity on 20-year mortality in older adults (average age 66 at the time of the baseline survey). DESIGN:Longitudinal analysis of a national probability sample-based cohort study. SETTING:Data sources were the National Health and Nutrition Examinatio...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2006.00728.x
更新日期:2006-05-01 00:00:00
abstract:OBJECTIVES:To compare the costs of mobile and stationary mammography and examine the incremental cost-effectiveness of using mobile mammography to increase screening rates. DESIGN:A cost-effectiveness analysis was performed using effectiveness data from a randomized clinical trial and modeling of costs associated with...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1532-5415.2008.02105.x
更新日期:2009-02-01 00:00:00