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Pappadis MR, Wood L, Haas A, Westra J, Kuo YF, Mouton CP. Risk Factors for Post-Discharge Adverse Outcomes Following Hospitalization Among Older Adults Diagnosed With Elder Mistreatment. J Appl Gerontol 2024; 43:194-204. [PMID: 37982679 PMCID: PMC10768323 DOI: 10.1177/07334648231203161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 08/25/2023] [Accepted: 08/31/2023] [Indexed: 11/21/2023] Open
Abstract
Using 100% Medicare data files, this study explored whether primary elder mistreatment (EM) diagnosis, EM type, and facility type were associated with 3-year mortality and 1-year unplanned hospital readmission among older patients diagnosed with EM with hospital discharge from 10/01/2015 through 12/31/2018 (n = 11,023). We also examined outcome differences between older patients diagnosed with EM and matched non-EM patient controls. Neglect by others was the most common EM diagnosis. Three-year mortality was 56.7% and one-year readmission rate was 53.8%. Compared to matched non-EM patient controls, older EM patients were at an increased risk of mortality and readmission. Among patients diagnosed with EM, patients with a secondary (vs. primary) diagnosis and those discharged from a skilled nursing facility (vs. acute hospital) were at an increased risk for both mortality and readmission. Compared to other EM types, patients diagnosed with neglect by others had a greater risk for mortality following discharge.
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Affiliation(s)
- Monique R. Pappadis
- Department of Population Health and Health Disparities, School of Public and Population Health, University of Texas Medical Branch (UTMB) at Galveston, Galveston, TX, USA
- Sealy Center on Aging, UTMB, Galveston, TX, USA
- Center for Violence Prevention, UTMB, Galveston, TX, USA
| | - Leila Wood
- Center for Violence Prevention, UTMB, Galveston, TX, USA
- SON Graduate Studies, School of Nursing, UTMB, Galveston, TX, USA
| | - Allen Haas
- Department of Biostatistics and Data Science, School of Public and Population Health, UTMB, Galveston, TX, USA
| | - Jordan Westra
- Department of Biostatistics and Data Science, School of Public and Population Health, UTMB, Galveston, TX, USA
| | - Yong-Fang Kuo
- Sealy Center on Aging, UTMB, Galveston, TX, USA
- Department of Biostatistics and Data Science, School of Public and Population Health, UTMB, Galveston, TX, USA
| | - Charles P. Mouton
- Sealy Center on Aging, UTMB, Galveston, TX, USA
- Provost Administration, Department of Family Medicine, School of Medicine, UTMB, Galveston, TX, USA
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Dawood FS, Couture A, Zhang X, Stockwell MS, Porucznik CA, Stanford JB, Hetrich M, Veguilla V, Thornburg N, Heaney CD, Wang J, Duque J, Jeddy Z, Deloria Knoll M, Karron R. Severe Acute Respiratory Syndrome Coronavirus 2 Neutralizing Antibody Responses After Community Infections in Children and Adults. Open Forum Infect Dis 2023; 10:ofad168. [PMID: 37213425 PMCID: PMC10199115 DOI: 10.1093/ofid/ofad168] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/24/2023] [Indexed: 04/01/2024] Open
Abstract
Background We compared postinfection severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) neutralizing antibody (nAb) responses among children and adults while the D614G-like strain and Alpha, Iota, and Delta variants circulated. Methods During August 2020-October 2021, households with adults and children were enrolled and followed in Utah, New York City, and Maryland. Participants collected weekly respiratory swabs that were tested for SARS-CoV-2 and had sera collected during enrollment and follow-up. Sera were tested for SARS-CoV-2 nAb by pseudovirus assay. Postinfection titers were characterized with biexponential decay models. Results Eighty participants had SARS-CoV-2 infection during the study (47 with D614G-like virus, 17 with B.1.1.7, and 8 each with B.1.617.2 and B.1.526 virus). Homologous nAb geometric mean titers (GMTs) trended higher in adults (GMT = 2320) versus children 0-4 (GMT = 425, P = .33) and 5-17 years (GMT = 396, P = .31) at 1-5 weeks postinfection but were similar from 6 weeks. Timing of peak titers was similar by age. Results were consistent when participants with self-reported infection before enrollment were included (n = 178). Conclusions The SARS-CoV-2 nAb titers differed in children compared to adults early after infection but were similar by 6 weeks postinfection. If postvaccination nAb kinetics have similar trends, vaccine immunobridging studies may need to compare nAb responses in adults and children 6 weeks or more after vaccination.
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Affiliation(s)
- Fatimah S Dawood
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Alexia Couture
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Xueyan Zhang
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Melissa S Stockwell
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
- Department of Population and Family Health, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York, USA
| | - Christina A Porucznik
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Joseph B Stanford
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Marissa Hetrich
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Vic Veguilla
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Natalie Thornburg
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Christopher D Heaney
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jing Wang
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Zuha Jeddy
- Abt Associates, Cambridge, Massachusetts, USA
| | - Maria Deloria Knoll
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ruth Karron
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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