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Functional recovery in elderly patients with cerebral vascular accident (CVA)
9th Congress of the EUGMS / European Geriatric Medicine 4 (2013) S81–S141 b Zorggroep Solis, Postbus 5014, Diepenveenseweg 169, 7400 GC Deventer, The Netherlands c Deventer Hospital, Pulmonary Department, Nico Bolkesteinlaan 75, 7416 SE Deventer, The Netherlands
Introduction and objectives.– Storetveit nursing home has organized a 19-bed intermediate care unit staffed with a geriatrician and increased multidisciplinary staff. A heterogeneous group of elderly (70+ years) community-living patients with acute illness and/or trauma are transferred after acute hospitalization for further treatment and rehabilitation. The aim was to explore factors associated with 6 months survival. Methods.– A prospective observational study was initiated in July 2011. Pre-hospital informations, comprehensive geriatric assessment and patient outcome were registered on all consecutive patients. The data were analyzed with univariate and multivariate regression analyses. Results– Four hundred and seventy-eight patients with median age 85 years have been followed for at least 6 months. Fifty-five of the patients (11%) died, with median 72 days (range 9–168) alive before death. Barthel ADL index at discharge (P = 0.048), proBNP (P = 0.001) and readmission to hospital from the intermediate care unit (P < 0.001) were significantly associated with 6-month survival in the multivariate regression analysis. Cognition, depression, nutrition, drug prescription, living condition or other blood tests did not demonstrate significant association. Key conclusions.– A high proBNP and a low Barthel ADL index at discharge were significantly associated with mortality at 6 months. Readmission to hospital during stay in the intermediate care unit was the strongest predictor for death. http://dx.doi.org/10.1016/j.eurger.2013.07.342 P279
Predictors for 6 months survival after acute hospitalization followed by intermediate care in a nursing home E. Engtrø , C. Haugland , R.M. Nilsen , A.H. Ranhoff , J.F. Abrahamsen Storetveit nursing home, Community of Bergen, Bergen, Norway Introduction and objectives.– Storetveit nursing home has organized a 19-bed intermediate care unit staffed with a geriatrician and increased multidisciplinary staff. A heterogeneous group of elderly (70+ years) community-living patients with acute illness and/or trauma are transferred after acute hospitalization for further treatment and rehabilitation. The aim was to explore factors associated with 6 months survival. Methods.– A prospective observational study was initiated in July 2011. Prehospital information, comprehensive geriatric assessment and patient outcome were registered on all consecutive patients. The data were analyzed with univariate and multivariate regression analyses. Results.– Four hundred and seventy-eight patients with median age 85 years have been followed for at least 6 months. Fifty-five of the patients (11%) died, with median 72 days (range 9–168) alive before death. Barthel ADL index at discharge (P = 0.048), proBNP (P = 0.001) and readmission to hospital from the intermediate care unit (P < 0,001) were significantly associated with 6-month survival in the multivariate regression analysis. Cognition, depression, nutrition, drug prescription, living condition or other blood tests did not demonstrate significant association. Key conclusions.– A high proBNP and a low Barthel ADL index at discharge were significantly associated with mortality at 6 months. Readmission to hospital during stay in the intermediate care unit was the strongest predictor for death. http://dx.doi.org/10.1016/j.eurger.2013.07.343
S105
P280
Functional recovery in elderly patients with cerebral vascular accident (CVA) ˜ F.A. Quinónez Bareiro , C.O. Minea , M.S. Chiriboga Lozada , E. Valente Rodriguez , R.E. Solis Hospital Virgen del Valle, Toledo, Spain Introduction.– The pathology stroke are high incidence in elderly people with greater impact in terms of dependency and institutionalization. Objective.– Determine functional recovery in patients older than 70 years old with CVA, and the association with depression and previous functional impairment. Method.– An observational, retrospective study of 72 patients older than 70 years old admitted for a period of 12 months in MediumStay Unit, in Toledo–HVV, included in the rehabilitation program after suffering an CVA. Variables were collected including age, gender, cognitive impairment, type of CVA, depression, discharge destination, Barthel Index (BI) at admission (BA), at discharge (BD), the Functional Improvement was calculated (FI = BD-BA), a FI > 20 points has been considered positive. Results.– From 72 patients, 54.2% were women, with the mean age was 82.45 years, of them 77.8% were diagnosed with ischemic CVA, 51.7% had poor functional improvement (FI < 20) at discharge, were institutionalized in nursing homes 19.64%. For hemorrhagic CVA found similar results in functional recovery according to FI, were institutionalized in 31.25% of cases. The 66.6% of patients diagnosed with depression and 15.2% with Barthel index less than 60 points, had poor functional gain. Conclusion.– The functional recovery was associated negatively in patients with Barthel Index less than 60 points before the CVA and with development of post CVA depression, these patients had a greater tendency to institutionalization at discharge. http://dx.doi.org/10.1016/j.eurger.2013.07.344 P281
Physical and daily activities for residents in Nordic nursing home settings – A randomized, controlled trial – Results: After 3 months of intervention K. Frändin a , H. Grönstedt a , A. Bergland b , J.L. Helbostad c , L. Puggaard d , M. Andresen e , R. Granbo f , K. Hellström g a Karolinska Institutet, NVS, Stockholm, Sweden b Oslos University College, Norway c Norwegian University of Science and Technology, Trondheim, Norway d University of Southern Denmark, Odense, Denmark e University College, Sjaelland, Naestved, Denmark f SørTrøndelag University College, Trondheim, Norway g Uppsala University, Sweden Objective.– To describe the impact of an individually tailored intervention program, for residents in a nursing home setting, on physical functions and daily life activities. Methods.– Nursing homes in Sweden, Norway and Denmark were involved, and 322 residents were randomised to either Intervention or Control group. The intervention lasted for three months and consisted of physical and daily activities, led by physiotherapists and occupational therapists, and was built on their evaluation and on goals expressed by each resident. Testing of muscle strength, mobility, balance function and confidence, ADL, level of physical activity, well-being and cognitive function was performed at baseline, directly after the intervention period and after another three months.
Introduction and objectives.– Storetveit nursing home has organized a 19-bed intermediate care unit staffed with a geriatrician and increased multidisciplinary staff. A heterogeneous group of elderly (70+ years) community-living patients with acute illness and/or trauma are transferred after acute hospitalization for further treatment and rehabilitation. The aim was to explore factors associated with 6 months survival. Methods.– A prospective observational study was initiated in July 2011. Pre-hospital informations, comprehensive geriatric assessment and patient outcome were registered on all consecutive patients. The data were analyzed with univariate and multivariate regression analyses. Results– Four hundred and seventy-eight patients with median age 85 years have been followed for at least 6 months. Fifty-five of the patients (11%) died, with median 72 days (range 9–168) alive before death. Barthel ADL index at discharge (P = 0.048), proBNP (P = 0.001) and readmission to hospital from the intermediate care unit (P < 0.001) were significantly associated with 6-month survival in the multivariate regression analysis. Cognition, depression, nutrition, drug prescription, living condition or other blood tests did not demonstrate significant association. Key conclusions.– A high proBNP and a low Barthel ADL index at discharge were significantly associated with mortality at 6 months. Readmission to hospital during stay in the intermediate care unit was the strongest predictor for death. http://dx.doi.org/10.1016/j.eurger.2013.07.342 P279
Predictors for 6 months survival after acute hospitalization followed by intermediate care in a nursing home E. Engtrø , C. Haugland , R.M. Nilsen , A.H. Ranhoff , J.F. Abrahamsen Storetveit nursing home, Community of Bergen, Bergen, Norway Introduction and objectives.– Storetveit nursing home has organized a 19-bed intermediate care unit staffed with a geriatrician and increased multidisciplinary staff. A heterogeneous group of elderly (70+ years) community-living patients with acute illness and/or trauma are transferred after acute hospitalization for further treatment and rehabilitation. The aim was to explore factors associated with 6 months survival. Methods.– A prospective observational study was initiated in July 2011. Prehospital information, comprehensive geriatric assessment and patient outcome were registered on all consecutive patients. The data were analyzed with univariate and multivariate regression analyses. Results.– Four hundred and seventy-eight patients with median age 85 years have been followed for at least 6 months. Fifty-five of the patients (11%) died, with median 72 days (range 9–168) alive before death. Barthel ADL index at discharge (P = 0.048), proBNP (P = 0.001) and readmission to hospital from the intermediate care unit (P < 0,001) were significantly associated with 6-month survival in the multivariate regression analysis. Cognition, depression, nutrition, drug prescription, living condition or other blood tests did not demonstrate significant association. Key conclusions.– A high proBNP and a low Barthel ADL index at discharge were significantly associated with mortality at 6 months. Readmission to hospital during stay in the intermediate care unit was the strongest predictor for death. http://dx.doi.org/10.1016/j.eurger.2013.07.343
S105
P280
Functional recovery in elderly patients with cerebral vascular accident (CVA) ˜ F.A. Quinónez Bareiro , C.O. Minea , M.S. Chiriboga Lozada , E. Valente Rodriguez , R.E. Solis Hospital Virgen del Valle, Toledo, Spain Introduction.– The pathology stroke are high incidence in elderly people with greater impact in terms of dependency and institutionalization. Objective.– Determine functional recovery in patients older than 70 years old with CVA, and the association with depression and previous functional impairment. Method.– An observational, retrospective study of 72 patients older than 70 years old admitted for a period of 12 months in MediumStay Unit, in Toledo–HVV, included in the rehabilitation program after suffering an CVA. Variables were collected including age, gender, cognitive impairment, type of CVA, depression, discharge destination, Barthel Index (BI) at admission (BA), at discharge (BD), the Functional Improvement was calculated (FI = BD-BA), a FI > 20 points has been considered positive. Results.– From 72 patients, 54.2% were women, with the mean age was 82.45 years, of them 77.8% were diagnosed with ischemic CVA, 51.7% had poor functional improvement (FI < 20) at discharge, were institutionalized in nursing homes 19.64%. For hemorrhagic CVA found similar results in functional recovery according to FI, were institutionalized in 31.25% of cases. The 66.6% of patients diagnosed with depression and 15.2% with Barthel index less than 60 points, had poor functional gain. Conclusion.– The functional recovery was associated negatively in patients with Barthel Index less than 60 points before the CVA and with development of post CVA depression, these patients had a greater tendency to institutionalization at discharge. http://dx.doi.org/10.1016/j.eurger.2013.07.344 P281
Physical and daily activities for residents in Nordic nursing home settings – A randomized, controlled trial – Results: After 3 months of intervention K. Frändin a , H. Grönstedt a , A. Bergland b , J.L. Helbostad c , L. Puggaard d , M. Andresen e , R. Granbo f , K. Hellström g a Karolinska Institutet, NVS, Stockholm, Sweden b Oslos University College, Norway c Norwegian University of Science and Technology, Trondheim, Norway d University of Southern Denmark, Odense, Denmark e University College, Sjaelland, Naestved, Denmark f SørTrøndelag University College, Trondheim, Norway g Uppsala University, Sweden Objective.– To describe the impact of an individually tailored intervention program, for residents in a nursing home setting, on physical functions and daily life activities. Methods.– Nursing homes in Sweden, Norway and Denmark were involved, and 322 residents were randomised to either Intervention or Control group. The intervention lasted for three months and consisted of physical and daily activities, led by physiotherapists and occupational therapists, and was built on their evaluation and on goals expressed by each resident. Testing of muscle strength, mobility, balance function and confidence, ADL, level of physical activity, well-being and cognitive function was performed at baseline, directly after the intervention period and after another three months.