Abstract:
OBJECTIVES:To develop and validate a prognostic case finding tool that classifies the risk of emergency department (ED) use in an older home care population. DESIGN:Population-based retrospective cohort study using routinely collected data from home care clinical assessments linked prospectively to ED records. SETTING:Ontario and the Winnipeg Regional Health Authority, Canada. PARTICIPANTS:Older adults living at home and expected to receive in-home services for at least 60 days (N = 361,942). MEASUREMENTS:One or more ED visits within 6 months after an in-home clinical assessment was used as the main dependent measure. Ninety-five person-level risk measures from a clinical assessment instrument were selected as potential independent variables. The Detection of Indicators and Vulnerabilities for Emergency Room Trips (DIVERT) Scale was derived using recursive partitioning analyses informed by a multinational clinical panel. RESULTS:Overall, 41.2% had one or more ED visits within 6 months of their in-home assessment. Previous ED use and cardiorespiratory symptoms, cardiac conditions, and specific geriatric syndromes were predictors within the six-level DIVERT Scale. The scale provided adequate risk differentiation for case finding, with an area under the receiver operating characteristic curve of 0.62 (95% confidence interval = 0.61-0.62) and distinct risk gradients between risk scores. The multilevel validation demonstrated consistent performance across geographic and participant clusters. CONCLUSION:The DIVERT Scale is a valid case-finding tool for ED use in older home care clients. It may be suitable for preemptively and systematically risk-stratifying individuals or groups for additional assessment, case management, and preventative interventions. It may also be suitable for the stratification and adjustment of performance metrics.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Costa AP,Hirdes JP,Bell CM,Bronskill SE,Heckman GA,Mitchell L,Poss JW,Sinha SK,Stolee Pdoi
10.1111/jgs.13336subject
Has Abstractpub_date
2015-04-01 00:00:00pages
763-9issue
4eissn
0002-8614issn
1532-5415journal_volume
63pub_type
杂志文章abstract:OBJECTIVES:Several studies have demonstrated that a large percentage of older people are inadequately immunized against tetanus. The aim of this study was to assess the immunity against tetanus in a group of individuals aged 69 and older and to examine the immune response to a single dose of tetanus toxoid. DESIGN:A c...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2000.tb06893.x
更新日期:2000-08-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:To optimize health and well-being for all older people, we must collectively develop leaders to pioneer models of care, educate the healthcare workforce, advance research, and engage the community. METHODS:The Emerging Leaders in Aging (ELIA) program was created to train a multiprofessional cadre...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15702
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVES:To evaluate the effect of nine disabling medical conditions upon recovery from functional limitations by elders. DESIGN:Retrospective analysis of prospective longitudinal cohort. SETTING:Community. PARTICIPANTS:Persons aged 65 and older in Framingham Heart Study. MEASUREMENTS:Change in function in elders...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.0002-8614.2004.52057.x
更新日期:2004-02-01 00:00:00
abstract:OBJECTIVES:To investigate the correlation between zopiclone use and risk of hip fracture in elderly adults. DESIGN:Case-control study. SETTING:Claim data from the Taiwan National Health Insurance Program. PARTICIPANTS:Individuals aged 65 and older who experienced their first episode of hip fracture between 1998 and ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13823
更新日期:2015-12-01 00:00:00
abstract:OBJECTIVES:To examine the association between serum albumin and cognitive impairment and decline in community-living older adults. DESIGNS:Population-based cohort study, followed up to 2 years; serum albumin, apolipoprotein E (APOE)-epsilon4, and cognitive impairment measured at baseline and cognitive decline (> or =2...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2008.02086.x
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVES:Lower than recommended doses of direct-acting oral anticoagulants are often prescribed to older adults with nonvalvular atrial fibrillation (NVAF). Our goal was to determine the consequences of lower than recommended dosing on plasma apixaban concentrations during the clinical care of older adults with NVAF....
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15982
更新日期:2019-09-01 00:00:00
abstract::(-)Deprenyl (Selegiline, Jumex, Eldepryl, Movergan), a close structural relative to phenylethylamine (PEA), is a drug with a unique pharmacological spectrum. (1) It is a highly potent and selective, irreversible inhibitor of B-type monoamine oxidase (MAO), a predominantly glial enzyme in the brain. The activity of thi...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1992.tb01860.x
更新日期:1992-08-01 00:00:00
abstract:OBJECTIVES:To determine the effects of cognitive training on cognitive abilities and everyday function over 10 years. DESIGN:Ten-year follow-up of a randomized, controlled single-blind trial (Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE)) with three intervention groups and a no-contact control...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/jgs.12607
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE:To compare the sensitivity to atrial natriuretic peptide (ANP) in young and elderly subjects. DESIGN:Double-blind, random-order, placebo-controlled study using two different rates of ANP infusion. SUBJECTS:Eight healthy young (23 +/- 3 years, mean +/- SD) and eight healthy elderly (76 +/- 4 years) subjects ...
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.1532-5415.1993.tb07309.x
更新日期:1993-11-01 00:00:00
abstract:OBJECTIVES:To examine the effect of mode of survey administration on response rates and response tendencies for the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Survey and develop appropriate adjustments. DESIGN:Survey response data were obtained after sampling and fielding of the CAHPS Hosp...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15265
更新日期:2018-03-01 00:00:00
abstract::Mortality in 159 patients who sustained 163 hip fractures in a single geriatric hospital and residential health facility in a ten-year period was studied. This study confirms the major problem of mortality associated with hip fractures in the very elderly. Factors that seemed associated with mortality were preoperativ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1983.tb05119.x
更新日期:1983-08-01 00:00:00
abstract:OBJECTIVES:To investigate whether health-related quality-of-life (HRQoL) scores in a primary care population can be used as a predictor of future hospital utilization and mortality. DESIGN:Prospective cohort study measuring Short Form 12 (SF-12) scores obtained using a mailed survey. SF-12 scores, age, and a comorbidi...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2006.00681.x
更新日期:2006-04-01 00:00:00
abstract::Urinary incontinence and other lower urinary tract symptoms exert a major influence on the health and independence of frail older people. Detrusor underactivity (DU) is defined as a contraction of reduced strength and/or duration, resulting in prolonged bladder emptying and/or a failure to achieve complete bladder emp...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.2006.00917.x
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Recently revised vaccination recommendations for US adults, aged 65 years and older, include both 23-valent pneumococcal polysaccharide vaccine (PPSV23) and 13-valent pneumococcal conjugate vaccine (PCV13), with PCV13 now recommended for immunocompetent older people based on shared decision making...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16373
更新日期:2020-06-01 00:00:00
abstract::The United States Senator from Maryland, as speaker at the Awards luncheon of the American Geriatrics Society (Washington meeting), presented his views on priorities in various health programs for the elderly, and asked for the Society's cooperation in making some of the difficult decisions that lie ahead. An importan...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1979.tb01672.x
更新日期:1979-09-01 00:00:00
abstract::The Integrated Memory Care Clinic (IMCC) is a patient-centered medical home as defined by the National Committee for Quality Assurance directed by advanced practice registered nurses (APRNs) caring for persons living with dementia (PLWD); physicians provide specialty consultation but do not direct care or care plannin...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15528
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVES:To estimate lifetime morbidity, mortality, and costs from hip fracture incorporating the effect of deficits in activities of daily living. DESIGN:Markov computer cohort simulation considering short- and long-term outcomes attributable to hip fractures. Data estimates were based on published literature, and ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1046/j.1532-5415.2003.51110.x
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVES:To test the effect of an adapted U.S. model of pharmaceutical care on prescribing of inappropriate psychoactive (anxiolytic, hypnotic, and antipsychotic) medications and falls in nursing homes for older people in Northern Ireland (NI). DESIGN:Cluster randomized controlled trial. SETTING:Nursing homes rando...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1532-5415.2009.02617.x
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVES:To examine whether the total burden of comorbidity and pattern of co-occurring conditions varies in individuals with heart failure (HF) with preserved left ventricular ejection fraction (LVEF) (HF-P) or HF with reduced LVEF (HF-R). DESIGN:Cross-sectional cohort study. SETTING:Four participating health plan...
journal_title:Journal of the American Geriatrics Society
pub_type: 历史文章,杂志文章,多中心研究
doi:10.1111/jgs.12062
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:Validation of a new instrument for screening dementia, the Cross Cultural Cognitive Examination (CCCE), is described. DESIGN:Criterion and concurrent validation and cross-cultural comparison of a new instrument. PARTICIPANTS:All individuals over the age of 40 in a village in southern Guam participated in a ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1993.tb06758.x
更新日期:1993-09-01 00:00:00
abstract::Primary carcinoma of the appendix, though rare, occurs often enough to warrant its inclusion in diagnostic possibilities when the symptoms of acute appendicitis, without leukocytosis, are present in geriatric patients. A case of mucinous adenocarcinoma of the appendix in an 88-year-old white woman is presented. The su...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1982.tb05665.x
更新日期:1982-09-01 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::Neurotoxic effects of habitual alcohol consumption were investigated by correlating the subjects' estimates of abstinence or frequency and amount of alcohol consumed with measurements of gray matter blood flow utilizing the 133Xe inhalation method. Two hundred and twenty-two subjects were studied, including 136 health...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1983.tb02198.x
更新日期:1983-09-01 00:00:00
abstract::Many physicians report that Internet health information can affect their clinical decisions. Much of Internet geriatric health information (IGHI) is not controlled for quality, and there is no available process to assess the quality of IGHI used in clinical practice or in medical education. The objective of this proje...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53272.x
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVES:To use an expert consensus process to identify indicators of delirium features to help enhance bedside recognition of delirium. DESIGN:Modified Delphi consensus process to assign existing cognitive and delirium assessment items to delirium features in the Confusion Assessment Method (CAM) diagnostic algorit...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2012.03996.x
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVES:To determine the efficacy of antidepressants in people with depression and dementia. DESIGN:A systematic review and meta-analysis based on a literature search of Medline and Cochrane Trials Registry for acute-phase, double-blind, placebo-controlled, parallel-design, random-assignment trials of antidepressan...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,meta分析,评审
doi:10.1111/j.1532-5415.2011.03355.x
更新日期:2011-04-01 00:00:00
abstract::We performed a prospective study of 250 men undergoing transurethral resection of the prostate to determine the incidence of perioperative myocardial infarction. The prevalence of coronary artery disease in the study group was 27%. Patients had measurement of total creatine kinase and its MB isoenzyme and electrocardi...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1989.tb01251.x
更新日期:1989-07-01 00:00:00
abstract::A trial by any means that can possibly prevent or retard the development of arteriosclerosis is to be recommended. Arteriosclerosis is the chief cause of strokes and heart attacks. The heavy evening meal now in vogue is characteristically rich in animal fats. Normal digestion is at its peak at about the seventh hour, ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1978.tb02404.x
更新日期:1978-06-01 00:00:00
abstract:OBJECTIVE:To determine whether low serum B12 levels are associated with an increased incidence of dementing illness. DESIGN:Longitudinal cohort study, 5-year follow-up. PARTICIPANTS:Volunteer cohort of 410 nondemented ambulatory subjects aged 75 to 85 years. MEASUREMENTS:Annual serum B12 determinations and neuropsyc...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1994.tb06583.x
更新日期:1994-09-01 00:00:00
abstract:OBJECTIVE:To assess the satisfaction of surrogate decision-makers with the decision to place feeding tubes in elderly patients with impaired decision-making capacity. DESIGN:Inception cohort followed for 5 weeks. SETTING:Four hospitals in the greater Los Angeles area. PARTICIPANTS:Fifty-eight surrogate decision-make...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1994.tb04946.x
更新日期:1994-02-01 00:00:00