Frequency and Risk Factors of Re-hospitalization in Geriatric Inpatient Wards: A Multicenter Retrospective Analysis

Purpose We aimed to evaluate frequency and risk factors of re-hospitalization which are not stated in comorbidity indexes in geriatric wards. Methods A total of 585 patients who were admitted to tertiary care geriatric inpatient clinics at least once between 1 September 2017 and 1 September 2018 and who survived to discharge during initial hospitalization were included in this cross-sectional retrospective multicenter study. Results Overall, 507(86.7%) patients were hospitalized once for treatment during the study period, while re-hospitalization occurred in 78(13.3%) patients. Rates of previous surgery (10.3 vs. 3.0%, p = .006), urinary incontinence (UI) (50.0 vs. 36.3%, p = .021), controlled hypertension (64.1 vs. 46.4%, p = .024), malnutrition (55.1 vs. 29.6%, p = .014) were significantly higher in re-hospitalized patients. Re-hospitalized patients were younger (mean +/- SD 76.4 +/- 8.3 vs. 79.6 +/- 7.9 years, p = .002) than once-hospitalized patients. Multivariate logistic regression analysis revealed the younger patient age (OR, 0.942, 95% CI 0.910 to 0.976, p = .001), higher Modified Charlson Comorbidity Index (MCCI) score (OR, 1.368, 95% CI 1.170 to 1.600, p < .001) to significantly predict the increased risk of re-hospitalization. Conclusions Our findings showed that previous history of surgery and geriatric syndromes such as UI, malnutrition were determined to significantly predict the increased risk of re-hospitalization. We suggest that these risk factors be added to prognostic tools designed for elderly patients

Frequency and Risk Factors of Re-hospitalization in Geriatric Inpatient Wards: A Multicenter Retrospective Analysis

Purpose We aimed to evaluate frequency and risk factors of re-hospitalization which are not stated in comorbidity indexes in geriatric wards. Methods A total of 585 patients who were admitted to tertiary care geriatric inpatient clinics at least once between 1 September 2017 and 1 September 2018 and who survived to discharge during initial hospitalization were included in this cross-sectional retrospective multicenter study. Results Overall, 507(86.7%) patients were hospitalized once for treatment during the study period, while re-hospitalization occurred in 78(13.3%) patients. Rates of previous surgery (10.3 vs. 3.0%, p = .006), urinary incontinence (UI) (50.0 vs. 36.3%, p = .021), controlled hypertension (64.1 vs. 46.4%, p = .024), malnutrition (55.1 vs. 29.6%, p = .014) were significantly higher in re-hospitalized patients. Re-hospitalized patients were younger (mean +/- SD 76.4 +/- 8.3 vs. 79.6 +/- 7.9 years, p = .002) than once-hospitalized patients. Multivariate logistic regression analysis revealed the younger patient age (OR, 0.942, 95% CI 0.910 to 0.976, p = .001), higher Modified Charlson Comorbidity Index (MCCI) score (OR, 1.368, 95% CI 1.170 to 1.600, p < .001) to significantly predict the increased risk of re-hospitalization. Conclusions Our findings showed that previous history of surgery and geriatric syndromes such as UI, malnutrition were determined to significantly predict the increased risk of re-hospitalization. We suggest that these risk factors be added to prognostic tools designed for elderly patients

The prevalence of childhood psychopathology in Turkey: a cross-sectional multicenter nationwide study (EPICPAT-T).

Aim: The aim of this study was to determine the prevalence of childhood psychopathologies in Turkey

The prevalence of childhood psychopathology in Turkey: a cross-sectional multicenter nationwide study (EPICPAT-T)

Conclusion: This is the largest and most comprehensive epidemiological study to determine the prevalence of psychopathologies in children and adolescents in Turkey. Our results partly higher than, and partly comparable to previous national and international studies. It also contributes to the literature by determining the independent predictors of psychopathologies in this age group

Prevalence of Childhood Affective disorders in Turkey: An epidemiological study

Aim: To determine the prevalence of affective disorders in Turkey among a representative sample of Turkish population. Methods: This study was conducted as a part of the "The Epidemiology of Childhood Psychopathology in Turkey" (EPICPAT-T) Study, which was designed by the Turkish Association of Child and Adolescent Mental Health. The inclusion criterion was being a student between the second and fourth grades in the schools assigned as study centers. The assessment tools used were the K-SADS-PL, and a sociodemographic form that was designed by the authors. Impairment was assessed via a 3 point-Likert type scale independently rated by a parent and a teacher. Results: A total of 5842 participants were included in the analyses. The prevalence of affective disorders was 2.5 % without considering impairment and 1.6 % when impairment was taken into account. In our sample, the diagnosis of bipolar disorder was lacking, thus depressive disorders constituted all the cases. Among depressive disorders with impairment, major depressive disorder (MDD) (prevalence of 1.06%) was the most common, followed by dysthymia (prevalence of 0.2%), adjustment disorder with depressive features (prevalence of 0.17%), and depressive disorder-NOS (prevalence of 0.14%). There were no statistically significant gender differences for depression. Maternal psychopathology and paternal physical illness were predictors of affective disorders with pervasive impairment. Conclusion: MDD was the most common depressive disorder among Turkish children in this nationwide epidemiological study. This highlights the severe nature of depression and the importance of early interventions. Populations with maternal psychopathology and paternal physical illness may be the most appropriate targets for interventions to prevent and treat depression in children and adolescents

A multidimensional approach to older patients during COVID-19 pandemic: a position paper of the Special Interest Group on Comprehensive Geriatric Assessment of the European Geriatric Medicine Society (EuGMS)

Purpose: The COVID-19 pandemic has been a dramatic trigger that has challenged the intrinsic capacity of older adults and of society. Due to the consequences for the older population worldwide, the Special Interest Group on Comprehensive Geriatric Assessment (CGA) of the European Geriatric Medicine Society (EuGMS) took the initiative of collecting evidence on the usefulness of the CGA-based multidimensional approach to older people during the COVID-19 pandemic. Methods: A narrative review of the most relevant articles published between January 2020 and November 2022 that focused on the multidimensional assessment of older adults during the COVID-19 pandemic. Results: Current evidence supports the critical role of the multidimensional approach to identify older adults hospitalized with COVID-19 at higher risk of longer hospitalization, functional decline, and short-term mortality. This approach appears to also be pivotal for the adequate stratification and management of the post-COVID condition as well as for the adoption of preventive measures (e.g., vaccinations, healthy lifestyle) among non-infected individuals. Conclusion: Collecting information on multiple health domains (e.g., functional, cognitive, nutritional, social status, mobility, comorbidities, and polypharmacy) provides a better understanding of the intrinsic capacities and resilience of older adults affected by SARS-CoV-2 infection. The EuGMS SIG on CGA endorses the adoption of the multidimensional approach to guide the clinical management of older adults during the COVID-19 pandemic

Comprehensive geriatric assessment in older people : an umbrella review of health outcomes

Background: Comprehensive geriatric assessment (CGA) has been in use for the last three decades. However, some doubts remain regarding its clinical use. Therefore, we aimed to capture the breadth of outcomes reported and assess the strength of evidence of the use of comprehensive geriatric assessment (CGA) for health outcomes in older Methods: Umbrella review of systematic reviews of the use of CGA in older adults searching in Pubmed, Embase, Scopus, Cochrane library and CINHAL until 05 November 2021. All possible health outcomes were eligible. Two independent reviewers extracted key data. The grading of evidence was carried out using the GRADE for intervention studies, whilst data regarding systematic reviews were reported as narrative findings. Results: Among 1,683 papers, 31 systematic reviews (19 with meta-analysis) were considered, including 279,744 subjects. Overall, 13/53 outcomes were statistically significant (P &amp;lt; 0.05). There was high certainty of evidence that CGA reduces nursing home admission (risk ratio [RR] = 0.86; 95% confidence interval [CI]: 0.75–0.89), risk of falls (RR = 0.51; 95%CI: 0.29–0.89), and pressure sores (RR = 0.46; 95%CI: 0.24–0.89) in hospital medical setting; decreases the risk of delirium (OR = 0.71; 95%CI: 0.54–0.92) in hip fracture; decreases the risk of physical frailty in community-dwelling older adults (RR = 0.77; 95%CI: 0.64–0.93). Systematic reviews without meta-analysis indicate that CGA improves clinical outcomes in oncology, haematology, and in emergency department. Conclusions: CGA seems to be beneficial in the hospital medical setting for multiple health outcomes, with a high certainty of evidence. The evidence of benefits is less strong for the use of CGA in other settings