Comorbidity–Polypharmacy Score as Predictor of Outcomes in Older Trauma Patients: A Retrospective Validation Study

Mubang, Ronnie; Stoltzfus, Jill; Cohen, M.; Hoey, Brian A.; Stehly, Christy D.; Evans, David C.; Jones, Christian; Papadimos, Thomas J.; Grell, Jennifer; Hoff, William S.; Thomas, Pete; Cipolla, James; Stawicki, Stanislaw P

doi:10.1007/s00268-015-3041-5

Cited by 41 publications

(34 citation statements)

References 63 publications

(100 reference statements)

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“…Study variables included patient age, gender, ethnicity, admission diagnosis, comorbidities, measured by the Comorbidity‐Polypharmacy Score (CPS), falls risk assessment score on day of fall, unit length of stay (LOS), hospital LOS and daily census of unit. The CPS is calculated by merely adding the total patient medications with the patient's total comorbidities based on past medical/medication history abstracted from the electronic medical record (Mubang, et al, ; Stawicki, et al, ; Tolentino, et al, ). Additional structural and nurse‐specific variables at the time of the fall were also gathered.…”

Section: Methodsmentioning

confidence: 99%

“…An analysis of pooled data from the National Database of Nursing Quality Indicators (NDNQI) suggests an increased number of nurses on units is accompanied by a corresponding decrease in patient falls (Aydin et al, 2015;Dunton et al, 2007;Everhart, et al, 2014 (Mubang, et al, 2015;Stawicki, et al, 2015;Tolentino, et al, 2017). Additional structural and nurse-specific variables at the time of the fall were also gathered.…”

Section: Backg Rou N Dmentioning

confidence: 99%

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Impact of level of nurse experience on falls in medical surgical units

2019

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Aim To describe nurse‐specific and patient risk factors present at the time of a patient fall on medical surgical units within an academic public health care system. Background The incidence of falls can be devastating for hospitalized patients and their families. Few studies have investigated how patient and nurse‐specific factors can decrease the occurrence of falls in hospitals. Method In this retrospective cohort study, data were gathered on all patients who experienced a fall during January 2012 to December 2013. Results Falls were reduced dramatically when the number of nurses on the unit increased to five or six. Patient falls occurred most often when either the least experienced or most experienced nursing staff were providing care. Conclusion Patient falls in hospitals can be influenced not only by patient‐specific factors, but also by nurse staffing and experience level. Implications for nursing management Findings from this study highlight factors which may contribute to hospital‐based falls prevention initiatives and are amenable to nursing management decisions.

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Section: Methodsmentioning

confidence: 99%

Section: Backg Rou N Dmentioning

confidence: 99%

Impact of level of nurse experience on falls in medical surgical units

2019

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“…CPS weighs the "severity" of comorbidities based on the number of medications necessary to treat each respective chronic condition [33,57]. In clinical studies, CPS correlated with morbidity, mortality, readmissions, post-emergency department (ED) triage, and the need for discharge to skilled nursing/extended care facility [33,[56][57][58][59][60]. CPS may thus constitute the "missing link" that uses the "intensity" of polypharmacy to connect the concepts of frailty and comorbidity.…”

Section: Frailty Versus Comorbidities: Similar But Differentmentioning

confidence: 99%

Patient Frailty: Key Considerations, Definitions and Practical Implications

Cohen¹,

Paul²,

Nuschke³

et al. 2016

Challenges in Elder Care

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By 2020, the elderly (≥65-year-old) world population is projected to exceed one billion individuals. This demographic megatrend has brought topics such as physiological age and frailty to the forefront of medical research efforts around the globe. The concept of frailty has evolved significantly since the mid-twentieth century. The outdated stereotype of a "thin, stooped, slow octogenarian" has transitioned to a more scientific and objective understanding of the problem. Still, a comprehensive and concise definition of "frailty" remains elusive. Until such a definition is firmly established and universally agreed upon, clinicians continue to rely on the somewhat subjective conceptual framework of today. In this chapter, the authors review key issues pertaining to clinical management of frail patients, including diagnosis/identification, preventive strategies, therapeutic approaches, and common pitfalls. The relationship between frailty, various domains of life, and functional status is also discussed. Finally, we will touch upon the concepts of end-of-life and goals of care, focusing on their relationship to frailty.

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“…In medicine, a number of comorbidity indices are used to predict which patients are likely to experience poor outcomes. The comorbidity–polypharmacy score (CPS) was developed in a population of trauma patients in 2011 (Evans et al, ) and has been validated in a number of other settings (Housley, Stawicki, Evans, & Jones, ; Justiniano et al, ; Mubang et al, ; Nossaman et al, ; Tolentino et al, ). The CPS is the sum of the number of pre‐MRONJ medications plus all known comorbidities, with the total score indicating the patient's cumulative severity.…”

Section: Introductionmentioning

confidence: 99%

Systemic comorbidities are associated with medication‐related osteonecrosis of the jaws: Case–control study

et al. 2019

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Objectives Medication‐related osteonecrosis of the jaws (MRONJ) is a serious condition developed in up to 15% of patients who take antiresorptive medications. Its underlying pathogenesis remains unclear. The association between systemic comorbidities and MRONJ was investigated. Subjects and Methods A case–control study was conducted in Brisbane, Australia. Hospital records were used to identify 68 cases of MRONJ between January 2003 and March 2017. Each case was individually matched to three controls (204 in total) according to sex, age, primary disease, and type and duration of antiresorptive therapy. Data on patient demographic, social and clinical characteristics were collected. Systemic comorbidities and medications were quantified as a comorbidity–polypharmacy score (CPS). Associations were investigated using conditional logistic regression. Results The CPS calculated for patients who developed MRONJ (mean ± SD = 20.2 ± 5.1) was significantly higher than for controls (12.9 ± 4.6). Multivariable analysis determined a significant relationship between CPS and the presence of MRONJ (OR = 1.5; 95% CI = 1.3, 1.8, p < 0.001). Conclusions Patients with multiple systemic comorbidities and high levels of polypharmacy were more likely to develop MRONJ. The CPS is a simple and effective tool to quantify the risk of MRONJ attributed to a patient's systemic condition and should be considered in conjunction with the patient's oral health to assess the overall risk of MRONJ.

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Comorbidity–Polypharmacy Score as Predictor of Outcomes in Older Trauma Patients: A Retrospective Validation Study

Cited by 41 publications

References 63 publications

Impact of level of nurse experience on falls in medical surgical units

Impact of level of nurse experience on falls in medical surgical units

Patient Frailty: Key Considerations, Definitions and Practical Implications

Systemic comorbidities are associated with medication‐related osteonecrosis of the jaws: Case–control study

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