Predicting clinical instability of older patients in post‐acute care units: A nationwide cohort study

Lee, Wei Ju; Chou, Ming‐Yueh; Peng, Li‐Ning; Liang, Chih‐Kuang; Liu, Li-Kuo; Liu, Chien‐Liang; Chen, Liang Kung; Wu, Yung-Hung

doi:10.1111/ggi.12083

Cited by 11 publications

(10 citation statements)

References 40 publications

(62 reference statements)

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“…The high pooled prevalence of malnutrition and risk of malnutrition according to MNA confirm earlier findings from a meta-analysis with slightly higher pooled prevalence (95% CI) of 29% (22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37) for malnutrition and 49% (42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55) for risk of malnutrition [83]. However, heterogeneity was high, which limits the interpretation of these results.…”

Section: Discussionsupporting

confidence: 81%

“…The total Functional Independence Measure (FIM) score had a broad range between 56 (43.5) [36] and 88.5 (41.0) points [63] (median (IQR). The Katz ADL score and the Lawton Brody IADL score ranged from 2.6 ± 1.9 [78,80] to 3.9 ± 1.9 points [35] and from 1.7 ± 1.8 [55] to 4.8 ± 2.6 points [80] (mean ± SD), respectively, indicating reduced status of ADL and IADL.…”

Section: Functional Statusmentioning

confidence: 99%

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Nutritional status and functionality in geriatric rehabilitation patients: a systematic review and meta-analysis

et al. 2020

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Aim This systematic review and meta-analysis aims to characterize the nutritional status of geriatric rehabilitation patients and its association with functional parameters. Findings Malnutrition is prevalent in a relevant percentage of geriatric rehabilitation patients, whereas body mass index (BMI) is in the normal to overweight range. Furthermore, data suggest that protein and energy intake is reduced and vitamin D deficiency is prevalent in this population. Decreased physical function is associated with malnutrition according to Mini-Nutritional Assessment (MNA) and MNA short form, whereas BMI did not show any clear association. Message Nutritional status is reduced in a relevant percentage of geriatric rehabilitation patients and associated with decreased physical function which emphasizes the need for screening and targeted interventions.

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Section: Discussionsupporting

confidence: 81%

Section: Functional Statusmentioning

confidence: 99%

Nutritional status and functionality in geriatric rehabilitation patients: a systematic review and meta-analysis

et al. 2020

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“…46) We found that only approximately 12.9% of the patients are transferred to the acute ward, which is better than the figures for many European and American countries, and the reason for hospitalization is usually infectious disease. 46) Taiwan's National Health Insurance began implementing post-acute care services for stroke patients in 2014. In the community hospital post-acute care model for stroke patients, personnel provide high-intensity rehabilitation training based on the patient's Comprehensive Geriatric Assessment results, and patients are accepted based on the occurrence of stroke and a modified Rankin Scale Score of 2-4, indicating the patient's functional status as determined by the acute hospital diagnosis.…”

Section: Effectiveness and Quality Of Post-acute Care In Taiwanmentioning

confidence: 55%

Post-Acute Care as a Key Component in a Healthcare System for Older Adults

Wang

Chou

Liang

et al. 2019

Ann Geriatr Med Res

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Older adults often experience functional decline following acute medical care. This functional decline may lead to permanent disability, which will increase the burden on the medical and long-term care systems, families, and society as a whole. Post-acute care aims to promote the functional recovery of older adults, prevent unnecessary hospital readmission, and avoid premature admission to a long-term care facility. Research has shown that post-acute care is a cost-effective service model, with both the hospital-athome and community hospital post-acute care models being highly effective. This paper describes the post-acute care models of the United States and the United Kingdom and uses the example of Taiwan's highly effective post-acute care system to explain the benefits and importance of post-acute care. In the face of rapid demographic aging and smaller household size, a post-acute care system can lower medical costs and improve the health of older adults after hospitalization.

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“…No estudo realizado por Lee et al 12 foi utilizada a MAN como instrumento avaliador, atualmente considerada o melhor método de triagem e avaliação nutricional em idosos, por abranger as particularidades dessa população. O instrumento engloba antropometria, avaliação dietética, avaliação clínica global e autopercepção de saúde e do estado nutricional, podendo ser utilizada tanto para triagem como para avaliação nutricional.…”

Section: Discussionunclassified

Parâmetros de monitoramento do estado nutricional de idosos em estado crítico: uma revisão integrativa

Teixeira¹,

Morimoto²

2018

Geriatr., Gerontol. Aging

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Revisão integrativa realizada com a finalidade de identificar as ferramentas de triagem/avaliação nutricional do paciente idoso em estado crítico que constituem alternativas às limitações dos parâmetros tradicionais. Foram utilizadas quatro bases de dados e critérios de inclusão de artigos originais disponíveis na íntegra referentes à temática, em português e inglês, entre 2013 e 2017. As palavras-chave foram: "elderly AND critical ill AND nutritional assessment" e "elderly AND intensive care AND nutritional assessment". Nove artigos foram selecionados e divididos entre os que utilizaram parâmetros nutricionais convencionais e alternativos. Observou-se, no final do desenvolvimento, a ausência de estudos que utilizaram a análise da bioimpedância elétrica (BIA) e foram incluídos na discussão os artigos viáveis à temática do trabalho, segundo as palavras-chave "bioelectrical impedance analysis", "bioelectrical impedance vectorial analysis", "phase angle" e "intensive care". Os estudos que utilizaram o escore Nutrition Risk in Critically ill (NUTRIC), que inclui os escores Acute Physiology and Chronic Health disease Classification System II (APACHE II) e Sepsis-related Organ Failure Assessment (SOFA), e os que utilizaram esses escores isoladamente apresentaram bons resultados. Apesar do valor final do SOFA ter se mantido o mesmo nos estudos incluídos neste trabalho, nota-se que esse instrumento pode ser promissor. Sugere-se a exploração de estudos que avaliem a utilização da BIA, em pacientes idosos graves, da qual derivam o ângulo de fase, a análise vetorial da bioimpedância elétrica (BIVA) e outros que avaliem o NUTRIC associado ao ângulo de fase e/ou BIVA, nos pacientes críticos com baixo nível de consciência e/ou edema. PALAVRAS-CHAVE: envelhecimento; unidades de terapia intensiva; avaliação nutricional.

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Predicting clinical instability of older patients in post‐acute care units: A nationwide cohort study

Abstract: Approximately 13% of PAC patients might experience acute ward readmissions, and nearly 90% of them are caused by medical conditions. Poor cognitive function is a significant predictive factor for clinical instability in PAC, which deserves more clinical attention for all PAC patients.

Cited by 11 publications

References 40 publications

Nutritional status and functionality in geriatric rehabilitation patients: a systematic review and meta-analysis

Nutritional status and functionality in geriatric rehabilitation patients: a systematic review and meta-analysis

Post-Acute Care as a Key Component in a Healthcare System for Older Adults

Parâmetros de monitoramento do estado nutricional de idosos em estado crítico: uma revisão integrativa

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