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Elderly patients with community-acquired pneumonia are not treated according to current guidelines.

https://arctichealth.org/en/permalink/ahliterature115819
Source
Dan Med J. 2013 Feb;60(2):A4572
Publication Type
Article
Date
Feb-2013
Author
Tove Lindhardt
Henrik Hedegaard Klausen
Christina Christiansen
Louise Lawson Smith
Janne Pedersen
Ove Andersen
Author Affiliation
Høje Lønholt 9, 3480 Fredensborg, Denmark. tove.lindhardt@gmail.com
Source
Dan Med J. 2013 Feb;60(2):A4572
Date
Feb-2013
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Anti-Bacterial Agents - therapeutic use
Community-Acquired Infections - diagnosis - rehabilitation - therapy
Denmark
Female
Guideline Adherence
Humans
Length of Stay
Male
Medical Audit
Nutrition Assessment
Nutritional Support
Patient Care Planning
Patient Readmission
Pneumonia - diagnosis - mortality - therapy
Practice Guidelines as Topic
Process Assessment (Health Care)
Retrospective Studies
Abstract
Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality in elderly patients, and the most important cause of death in the developed world. Optimised treatment and care will benefit patients as well as the health economy. This study investigated in-hospital compliance with guidelines for treatment and care of patients with CAP.
A retrospective nationwide study examining 100 patient records from 20 Danish hospitals regarding patients 65 years and older admitted for CAP.
A total of 74 patients with a mean age 81.6 years were included. The mean length of stay was 9.2 days, 30- and 90-day mortality rates were 12.2 and 17.6% and readmission rates 4% (seven days) and 9.5% (30 days). Severity assessment was made in two cases. Observations of vital parameters were unsystematic and the respiratory rate was measured only in six cases. Diagnostic tests and treatment initiation were mostly in accordance with guidelines. The mean number of days on intravenous antibiotics was 5.5. Nutrition and mobilisation were neglected or only sporadically addressed. No systematic plan for treatment and care was found.
While medical treatment mainly concurred with guidelines, a potential for reduced costs by early discharge planning and use of systematic assessment tools for site-of-care and treatment decisions was indicated. The lack of systematic interventions in the prevention and treatment of malnutrition and functional decline constitutes a threat to a successful final patient outcome.
The Danish Ministry of Health funded the study.
The Danish Data Register approved the project (J. No. 2010-41-5358).
PubMed ID
23461987 View in PubMed
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Twenty-four-hour mobility during acute hospitalization in older medical patients.

https://arctichealth.org/en/permalink/ahliterature120753
Source
J Gerontol A Biol Sci Med Sci. 2013 Mar;68(3):331-7
Publication Type
Article
Date
Mar-2013
Author
Mette Merete Pedersen
Ann Christine Bodilsen
Janne Petersen
Nina Beyer
Ove Andersen
Louise Lawson-Smith
Henrik Kehlet
Thomas Bandholm
Author Affiliation
Clinical Research Centre (136), Copenhagen University Hospital, Hvidovre, DK-2650 Hvidovre, Denmark. mette.merete.pedersen@hvh.regionh.dk
Source
J Gerontol A Biol Sci Med Sci. 2013 Mar;68(3):331-7
Date
Mar-2013
Language
English
Publication Type
Article
Keywords
Accelerometry
Aged
Aged, 80 and over
Algorithms
Bed Rest - statistics & numerical data
Denmark
Female
Hospitalization
Humans
Length of Stay - statistics & numerical data
Male
Mobility Limitation
Prospective Studies
Walking
Abstract
Inactivity during hospitalization in older medical patients may lead to functional decline. This study quantified 24-hour mobility, validated the accelerometers used, and assessed the daily level of basic mobility in acutely admitted older medical patients during their hospitalization.
This is a prospective cohort study in older medical patients able to walk independently (ambulatory patients) and those not able to walk independently (nonambulatory patients) on admission. The 24-hour mobility level during hospitalization was assessed by measuring the time in lying, sitting, and standing and/or walking, by two accelerometers. Basic mobility was quantified within 48 hours of admission and repeated daily throughout hospitalization.
Forty-three ambulatory patients and six nonambulatory patients were included. The ambulatory patients tended to be hospitalized for fewer days than the nonambulatory patients (7 vs 16, p = .13). The ambulatory patients were lying median 17 hours, (interquartile range [IQR]: 14.4-19.1), sitting 5.1 hours (IQR: 2.9-7.1), and standing and/or walking 1.1 hours (IQR: 0.6-1.7) per day. On days with independency in basic mobility, the ambulatory patients were lying 4.1 hours less compared with days with dependency in basic mobility (p
PubMed ID
22972940 View in PubMed
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