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de Miguel-Diez J, Lopez-de-Andres A, Jimenez-Garcia R, Hernández-Barrera V, Carabantes-Alarcon D, Zamorano-Leon JJ, Omaña-Palanco R, González-Barcala FJ, Cuadrado-Corrales N. Trends in prevalence and the effects on hospital outcomes of dementia in patients hospitalized with acute COPD exacerbation. Respir Med 2023; 212:107223. [PMID: 36965589 DOI: 10.1016/j.rmed.2023.107223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/20/2023] [Accepted: 03/23/2023] [Indexed: 03/27/2023]
Abstract
AIMS To assess changes in prevalence and the effects on hospital outcomes of dementia among patients hospitalized with an acute exacerbation of chronic obstructive pulmonary disease (AE-COPD); and to evaluate sex-differences, as well as the impact of COVID-19 pandemic in this relationship. METHODS We used a nationwide discharge database to select patients admitted with AE-COPD in Spain from 2011 to 2020. We identified those with any type of dementia, vascular dementia (VaD) or Alzheimer's disease (AD). RESULTS We identified 658,429 hospitalizations with AE-COPD (4.45% had any type of dementia, 0.79% VaD and 1.57% AD). The presence of any type of dementia remained stable from 2011 to 2015, and increased significantly between 2016 and 2020. For VaD, the time trend showed no change until 2020, when a significant increment was found. The probability of AD decreased significantly overtime. The in-hospital mortality (IHM) among patients with any type of dementia remained stable overtime until 2020, when it increased significantly. Older age, higher comorbidity, COVID-19, and use of mechanical ventilation were variables associated to IHM. Women had lower risk of dying in the hospital than men in all subgroups. CONCLUSIONS After a previous period of stability, the prevalence of any type of dementia increased over the last 5 years of the study, although we identified different trends depending on the specific cause of dementia. The IHM remained stable overtime until 2020, when it increased, probably related to the COVID-19 pandemic. It is remarkable the protective effect of female sex for IHM.
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Affiliation(s)
- Javier de Miguel-Diez
- Respiratory Care Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, 28007, Madrid, Spain
| | - Ana Lopez-de-Andres
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040, Madrid, Spain.
| | - Rodrigo Jimenez-Garcia
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040, Madrid, Spain
| | - Valentin Hernández-Barrera
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, 28922, Alcorcón, Spain
| | - David Carabantes-Alarcon
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040, Madrid, Spain
| | - Jose J Zamorano-Leon
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040, Madrid, Spain
| | - Ricardo Omaña-Palanco
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040, Madrid, Spain
| | - Francisco Javier González-Barcala
- Servicio de Neumología, Hospital Clínico Universitario de Santiago de Compostela. Universidad de Santiago de Compostela, 15706, Santiago de Compostela, Spain
| | - Natividad Cuadrado-Corrales
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040, Madrid, Spain
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Mai T, Flerchinger C. [Prevalence of cognitive impairments in acute nursing care-Analysis and comparison of routine data]. Z Gerontol Geriatr 2020; 54:264-271. [PMID: 32248304 PMCID: PMC8096734 DOI: 10.1007/s00391-020-01722-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 03/16/2020] [Indexed: 02/07/2023]
Abstract
Hintergrund Aufgrund des demografischen Wandels ist von einer zunehmenden Prävalenz stationärer Patienten mit kognitiven Beeinträchtigungen auszugehen. Für eine bestmögliche Versorgung gilt es, diese Patientengruppe mit einem routinemäßigen Verfahren frühzeitig zu erkennen. Methode Die aktuelle Studie untersuchte die Prävalenzrate von kognitiven Beeinträchtigungen bei stationären Patienten >65 Jahre, die mit dem Mini-Mental-Status-Test (MMST) während der pflegerischen Aufnahme untersucht wurden. Anhand der Screeningquote wurde die Bereitschaft von Pflegekräften, den MMST als Routineinstrument zu verwenden, überprüft. Die Quote wurde zudem mit der Anzahl der kodierten F‑Diagnosen der ICD-10-GM verglichen. Diese retrospektive Studie wurde vom Oktober 2018 bis März 2019 an einer Universitätsklinik durchgeführt. Ergebnisse Von 7311 stationären Patienten >65 Jahre wurden 11,7 % gescreent. Die Prävalenz kognitiver Beeinträchtigungen betrug 20,7 % und war höher als die Prävalenzrate von Demenz und Delir aufgrund medizinischer Diagnosen (p < 0,001). Mit 11,7 % ist die Bereitschaft des Pflegepersonals, den MMST zur Einschätzung kognitiver Beeinträchtigungen während der Patientenaufnahmen einzusetzen, gering. Diskussion Die höhere Prävalenz bestätigt die Notwendigkeit, Patienten mit kognitiven Störungen zu erkennen. Die geringe Bereitschaft, den MMST anzuwenden, legt jedoch nahe, dass zum einen ein kürzeres Instrument verwendet und zum anderen Pflegenden mehr Informationen zu kognitiv beeinträchtigten Patienten vermittelt werden sollten.
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Affiliation(s)
- Tobias Mai
- Stabsstelle Pflegeentwicklung, Pflegedirektion des Universitätsklinikums der Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.
| | - Christa Flerchinger
- Stabsstelle Pflegeentwicklung, Pflegedirektion des Universitätsklinikums der Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland
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Manietta C, Vogt B, Roes M. [Dementia-specific characteristics of patients with fall-related femur fractures : A case study based on routine hospital data of patients with unspecified dementia]. Z Gerontol Geriatr 2019; 53:437-445. [PMID: 31696362 DOI: 10.1007/s00391-019-01641-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 10/09/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND A fall-related femur fracture is one of the most frequent reasons for hospital admission of patients with dementia. The aim of the study was to identify dementia-specific characteristics of patients with fall-related femur fractures and additionally an unspecified dementia in order to gain further knowledge about this particular patient group. METHODS A descriptive explorative case study with a single case-embedded design based on routine hospital data from a university hospital was performed. A total number of 34 patient records from 2015 were analyzed. In the embedded unit of analysis I the data of selected items of the nursing assessment AcuteCare (ePA-AC©) were descriptively analyzed for the time of admission and discharge. In the embedded unit of analysis II a summarizing inductive content analysis was conducted. RESULTS The results of the embedded unit of analysis I showed that this patient group is characterized by a high need for care, changes of cognition and behavioral symptoms. The status of cognition, behavior and reciprocity as well as the self-care index stagnated or deteriorated in many patients from admission to discharge. The embedded unit of analysis II identified observable (social)behavior, (non)compliance and orientation as central dementia-specific characteristics. CONCLUSION The results reflect the complexity of the care situation of patients with unspecified dementia in acute care hospitals. The results showed that a higher awareness for this particular patient group is needed to improve outcomes.
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Affiliation(s)
- Christina Manietta
- Department für Pflegewissenschaft, Fakultät für Gesundheit, Private Universität Witten/Herdecke gGmbH, Witten/Herdecke, Deutschland. .,Deutsches Zentrum für Neurodegenerative Erkrankungen e. V. (DZNE), Witten, Deutschland.
| | - Birgit Vogt
- Department für Pflegewissenschaft, Fakultät für Gesundheit, Private Universität Witten/Herdecke gGmbH, Witten/Herdecke, Deutschland.,Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Martina Roes
- Department für Pflegewissenschaft, Fakultät für Gesundheit, Private Universität Witten/Herdecke gGmbH, Witten/Herdecke, Deutschland.,Deutsches Zentrum für Neurodegenerative Erkrankungen e. V. (DZNE), Witten, Deutschland
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