CRONIGAL: Prognostic index for chronic patients after hospital admission

Suárez-Dono, Javier; E, Cervantes-Pérez; Pena-Seijo, M; Couceiro, F.J. Formigo; Ferrón-Vidan, Fernando; Novo-Veleiro, Ignacio; Corral-Beamonte, Esther Del; Díez-Manglano, Jesús; Gude‐Sampedro, Francisco; Pose‐Reino, Antonio

doi:10.1016/j.ejim.2016.08.002

Cited by 20 publications

(16 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The figure for 1-year mortality observed in our study (46%) is in accordance with results published in other similar Spanish cohorts, where they ranged between 40% and 50%. In these studies as well, no differences were found in mortality by gender [23,24,38,39,40]. Additionally, our study confirms the reliability of the PROFUND and Charlson indexes in the prediction of 1-year mortality.…”

Section: Discussionsupporting

confidence: 84%

“…However, the number of included patients was considerable, and their characteristics very similar to those observed in multicenter studies performed in the same geographical area. [17,23,24,38,39,40] Second, our study focuses on hospitalized elderly multimorbidity patients requiring complex health care, and their definition is not universally accepted. Currently, multimorbidity is defined as the presence of two or more chronic diseases in the same subject or the combination of one chronic illness with at least one other disease (acute or chronic) or bio-psychosocial factor [41].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Multimorbidity gender patterns in hospitalized elderly patients

et al. 2020

View full text Add to dashboard Cite

Patients with multimorbidity and complex health care needs are usually vulnerable elders with several concomitant advanced chronic diseases. Our research aim was to evaluate differences in patterns of multimorbidity by gender in this population and their possible prognostic implications, measured as in-hospital mortality, 1-month readmissions, and 1-year mortality. We focused on a cohort of elderly patients with well-established multimorbidity criteria admitted to a specific unit for chronic complex-care patients. Multimorbidity criteria, the Charlson, PROFUND and Barthel indexes, and the Pfeiffer test were collected prospectively during their stays. A total of 843 patients (49.2% men) were included, with a median age of 84 [interquartile range (IQR) 79-89] years. The women were older, with greater functional dependence [Barthel index: 40 (IQR:10-65) vs. 60 (IQR: 25-90)], showed more cognitive deterioration [Pfeiffer test: 5 (IQR:1-9) vs. 1 (0-6)], and had worse scores on the PROFUND index [15 (IQR:9-18) vs. 11.5 (IQR: 6-15)], all p <0.0001, while men had greater comorbidity measured with the Charlson index [5 (IQR: 3-7) vs. 4 (IQR: 3-6); p = 0.002]. In the multimorbidity criteria scale, heart failure, autoimmune diseases, dementia, and osteoarticular diseases were more frequent in women, while ischemic heart disease, chronic respiratory diseases, and neoplasms predominated in men. In the analysis of grouped patterns, neurological and osteoarticular diseases were more frequent in females, while respiratory and cancer predominated in males. We did not find gender differences for in-hospital mortality, 1-month readmissions, or 1-year mortality. In the multivariate analysis age, the Charlson, Barthel and PROFUND indexes, along with previous admissions, were independent predictors of 1-year mortality, while gender was non-significant. The Charlson and PROFUND indexes predicted mortality during follow-up more accurately in men than in women (AUC 0.70 vs. 0.57 and 0.74 vs. 0.62, respectively), with both p<0.001. In conclusion, our study shows differing patterns of multimorbidity by gender, with greater functional impairment in women and more comorbidity in men, although without differences in the prognosis. Moreover, some of these prognostic indicators had differing accuracy for the genders in predicting mortality.

show abstract

Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Multimorbidity gender patterns in hospitalized elderly patients

et al. 2020

View full text Add to dashboard Cite

show abstract

“…It is reported that BI score ≥60 is classified as basic self-care in life, score<60 indicates functional dependency. 20 In our study, the BI cut-off value of patients divided into two groups was 60, which was consistent with previous studies. [11][12][13][14]21 Statistical Analysis R 3.3.2 statistical software was used to perform all analyses.…”

Section: Data Collection and Outcomessupporting

confidence: 92%

<p>Main Risk Factors Related to Activities of Daily Living in Non-Dialysis Patients with Chronic Kidney Disease Stage 3–5: A Case–Control Study</p>

Chang¹,

Hou²,

Wang³

et al. 2020

CIA

View full text Add to dashboard Cite

Introduction: Elderly people are at increased risk of falls, disability and death due to reduced functional reserve, decline in multiple systems functions, which affects their activities of daily living (ADL) and eventually develop into frailty. The ADL assessment is conducive to early detection to avoid further serious situations. Previous studies on patients' activities of daily living with chronic kidney disease (CKD) are mainly focused on dialysis patients. Little information is available on non-dialysis patients. Patients and Methods: A total of 303 elderly patients with CKD stage 3-5 who were admitted to our hospital were selected. ADL evaluation was performed on patients at admission, with Barthel index (BI) as the evaluation tool. They were divided into two groups based on BI (≥60 and <60). Demographic information, lifestyle and clinical profile were collected. The risk factors related to ADL were analyzed by univariate and multivariate models. Results: The data of 303 patients enrolled in this study were analyzed. The average age of patients was 84.48± 7.14 years and 62.05% were male. There were 88 patients (29.04%) in BI <60 group and 215 patients (70.96%) in the BI ≥60 group. The average age of subjects in the two groups was 87.47 ± 5.85 years and 83.26± 7.28 years, respectively. On univariate analysis, ADL impairment was associated with many factors, such as age, body mass index, blood lipid, heart rate, smoking history, Charlson comorbidity index (CCI), hemoglobin, serum albumin, BNP, eGFR, etc. Multivariate logistic regression showed that age (OR 1.08, 95% CI 1.00-1.17, P=0.0390), Charlson comorbidity index (OR 4.75, 95% CI 1.17-19.30, P=0.0295), and serum albumin (OR 0.80, 95% CI 0.70-0.92, P=0.0012) were the independent risk factors of ADL impairment. Conclusion: Decline of ADL in CKD patients was independently correlated with age, Charlson comorbidity index and serum albumin. ADL and its influential factors in the elderly CKD patients deserve further attention.

show abstract

“…Hypernatremia is linked to a high mortality risk, not only in patients with NCSE, but in any older inpatient [42,43]. Atrial fibrillation is a risk factor linked to a higher mortality in older patients with any comorbidity, but its relevance in NCSE was not understood [44,45]. In light of our findings, ionic alterations and the presence of atrial fibrillation should warn physicians of a potential high risk of mortality in patients diagnosed with NCSE.…”

Section: Plos Onementioning

confidence: 86%

De-novo non-convulsive status epilepticus in adult medical inpatients without known epilepsy: Analysis of mortality related factors and literature review

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background Non-convulsive status epilepticus (NCSE) often goes unnoticed and is not easily detected in patients with a decreased level of consciousness, especially in older patients. In this sense, lack of data in this population is available. Aims The aim of the present study was to examine daily clinical practice and evaluate factors that may influence the prognosis of NCSE in non-epileptic medical inpatients. Methods We conducted a retrospective analysis including patients admitted by any cause in an Internal Medicine ward. All patients with compatible symptoms, exclusion of other causes, clinical suspicion or diagnosis of NCSE, and compatible EEG were included. Patients with a previous diagnosis of epilepsy were excluded. We also conducted a literature review by searching the PubMed/Medline database with the terms: Nonconvulsive Status OR Non-Convulsive Status. Results We included 54 patients, mortality rate reached 37% and the main factors linked to it were hypernatremia (OR = 16.2; 95% CI, 1.6–165.6; P = 0.019) and atrial fibrillation (OR = 6.7; 95% CI, 1.7–26; P = 0.006). There were no differences regarding mortality when comparing different diagnosis approach or treatment regimens. Our literature review showed that the main etiology of NCSE were neurovascular causes (17.8%), followed by antibiotic treatment (17.2%) and metabolic causes (17%). Global mortality in the literature review, excluding our series, reached 20%. Discussion We present the largest series of NCSE cases in medical patients, which showed that this entity is probably misdiagnosed in older patients and is linked to a high mortality. Conclusion The presence of atrial fibrillation and hypernatremia in patients diagnosed with NCSE should advise physicians of a high mortality risk.

show abstract

CRONIGAL: Prognostic index for chronic patients after hospital admission

Cited by 20 publications

References 37 publications

Multimorbidity gender patterns in hospitalized elderly patients

Multimorbidity gender patterns in hospitalized elderly patients

<p>Main Risk Factors Related to Activities of Daily Living in Non-Dialysis Patients with Chronic Kidney Disease Stage 3–5: A Case–Control Study</p>

De-novo non-convulsive status epilepticus in adult medical inpatients without known epilepsy: Analysis of mortality related factors and literature review

Contact Info

Product

Resources

About