8 research outputs found
Validation of score in mna scale like nutritional risk factor in institutionalized geriatric patients with moderate and severe cognitive impairment
Introducción: La valoración geriátrica integral incluye
el examen del apartado nutricional debido a la alta prevalencia de desnutrición en este tipo de pacientes; especialmente en los pacientes con deterioro cognitivo asociado.
Las escalas de cribado del estado nutricional presentan
preguntas de autopercepción subjetiva de difícil respuesta en pacientes mayores con demencia.
Objetivo: Estudiar la especificidad, el valor predictivo
positivo y la sensibilidad de la escala MNA para la detección
de malnutrición en pacientes diagnosticados de enfermedad
de Alzheimer con deterioro cognitivo avanzado.
Material y métodos: Se diseñó un estudio descriptivo
poblacional con una muestra de 52 pacientes mayores de
70 años, institucionalizados, con enfermedad de Alzheimer grado moderado y severo. Se estudió la sensibilidad,
especificidad y valor predictivo positivo de la escala MNA
respecto a los parámetros de malnutrición del American
Institute of Nutrition (AIN).
Resultados: Los valores de sensibilidad, especificidad y
valor predictivo positivo son 60%, 94,7% y 93,8% respectivamente. Existe una correlación significativa (p < 0,001)
ente la puntuación obtenida en la escala MNA y la escala de
riesgo de caídas Tinneti (r = 0,577), de función Barthel (r =
0,742), de valoración cognitiva MEC (r = 0,651) y los niveles
de creatinina (r = 0,402). Más del 50% de la muestra presentó al menos un parámetro de malnutrición AIN alterado.
Conclusiones: La escala MNA presenta una menor
sensibilidad y especificidad en estos pacientes. El diseño
de una escala de valoración nutricional sin valoraciones
subjetivas y sólo con parámetros objetivos podría mejorar la eficacia de la misma en ancianos institucionalizados
con deterioro cognitivo moderado y severo.Introduction: comprehensive geriatric assessment
includes examination of the nutritional status given the
high prevalence of hyponutrition in this kind of patients,
particularly in patients with associated cognitive impairment. Scales for screening the nutritional status include
questions on self-perception difficult to answer by
demented elder patients.
Objective: To study the specificity, the positive predictive value, and the sensitivity of the MNA scale to detect
malnutrition in patients diagnosed with Alzheimer’s disease with advanced cognitive impairment.
Material and methods: a population-based descriptive
study with a sample of 52 patients older than 70 years,
institutionalized, and with moderate-severe Alzheimer’s
disease was designed. The sensitivity, specificity, and positive predictive value of MNA scale were studied regarding the parameters on malnutrition of the American
Institute of Nutrition (AIN).
Results: the sensitivity, specificity, and positive predictive values were 60%, 94.7%, and 93.8%, respectively.
There was a significant correlation (p < 0.001) between
the score obtained with the MNA Scale and the Tinneti’s
Risk of Fall Scale (r = 0.577), the Barthel’s function (r =
0.742), the MCT cognitive assessment (r = 0.651), and creatinine levels (r = 0.402). More than 50% of the sample
presented at least one malnutrition parameter altered.
Conclusions: the MNA Scale presents lower sensitivity
and specificity in these patients. Designing a nutritional
assessment scale without subjective evaluations and only
with objective parameters might improve its efficiency in
institutionalized elderly patients with moderate-severe
cognitive impairment.Nutrición humana y dietétic
Effectiveness of influenza vaccination programme in preventing hospital admissions, Valencia, 2014/15 early results
Preliminary results for the 2014/15 season indicate low to null effect of vaccination against influenza A(H3N2)-related disease. As of week 5 2015, there have been 1,136 hospital admissions, 210 were due to influenza and 98% of subtype A strains were H3. Adjusted influenza vaccine effectiveness was 33% (range: 6–53%) overall and 40% (range: 13% to 59%) in those 65 years and older. Vaccination reduced by 44% (28–68%) the probability of admission with influenza.The study was funded by a contract between FISABIO and Sanofi-Pasteur
The approach to patients with cognitive impairment and hip fracture: the role of orthogeriatric care
Effectiveness of influenza vaccination programme in preventing hospital admissions, Valencia, 2014/15 early results.
Preliminary results for the 2014/15 season indicate low to null effect of vaccination against influenza A(H3N2)-related disease. As of week 5 2015, there have been 1,136 hospital admissions, 210 were due to influenza and 98% of subtype A strains were H3. Adjusted influenza vaccine effectiveness was 33% (range: 6-53%) overall and 40% (range: 13% to 59%) in those 65 years and older. Vaccination reduced by 44% (28-68%) the probability of admission with influenza
Influenza epidemiology and influenza vaccine effectiveness during the 2014-2015 season: annual report from the Global Influenza Hospital Surveillance Network
Background: The Global Influenza Hospital Surveillance Network (GIHSN) aims to determine the burden of severe influenza disease and Influenza Vaccine Effectiveness (IVE). This is a prospective, active surveillance and hospital-based epidemiological study to collect epidemiological data in the GIHSN. In the 2016-2017 influenza season, 15 sites in 14 countries participated in the GIHSN, although the analyses could not be performed in 2 sites. A common core protocol was used in order to make results comparable. Here we present the results of the GIHSN 2016-2017 influenza season. Methods: A RT-PCR test was performed to all patients that accomplished the requirements detailed on a common core protocol. Patients admitted were included in the study after signing the informed consent, if they were residents, not institutionalised, not discharged in the previous 30 days from other hospitalisation with symptoms onset within the 7 days prior to admission. Patients 5 years old or more must also complied the Influenza-Like Illness definition. A test negative-design was implemented to perform IVE analysis. IVE was estimated using a logistic regression model, with the formula IVE = (1-aOR) × 100, where aOR is the adjusted Odds Ratio comparing cases and controls. Results: Among 21,967 screened patients, 10,140 (46.16%) were included, as they accomplished the inclusion criteria, and tested, and therefore 11,827 (53.84%) patients were excluded. Around 60% of all patients included with laboratory results were recruited at 3 sites. The predominant strain was A(H3N2), detected in 63.6% of the cases (1840 patients), followed by B/Victoria, in 21.3% of the cases (618 patients). There were 2895 influenza positive patients (28.6% of the included patients). A(H1N1)pdm09 strain was mainly found in Mexico. IVE could only be performed in 6 sites separately. Overall IVE was 27.24 (95% CI 15.62-37.27. Vaccination seemed to confer better protection against influenza B and in people 2-4 years, or 85 years old or older. The aOR for hospitalized and testing positive for influenza was 3.02 (95% CI 1.59-5.76) comparing pregnant with non-pregnant women. Conclusions: Vaccination prevented around 1 in 4 hospitalisations with influenza. Sparse numbers didn't allow estimating IVE in all sites separately. Pregnancy was found a risk factor for influenza, having 3 times more risk of being admitted with influenza for pregnant women