Predicting mortality of residents at admission to nursing home: A longitudinal cohort study

<p>Abstract</p> <p>Background</p> <p>An increasing numbers of deaths occur in nursing homes. Knowledge of the course of development over the years in death rates and predictors of mortality is important for officials responsible for organizing care to be able to ensure that staff is knowledgeable in the areas of care needed. The aim of this study was to investigate the time from residents' admission to Icelandic nursing homes to death and the predictive power of demographic variables, health status (health stability, pain, depression and cognitive performance) and functional profile (ADL and social engagement) for 3-year mortality in yearly cohorts from 1996-2006.</p> <p>Methods</p> <p>The samples consisted of residents (N = 2206) admitted to nursing homes in Iceland in 1996-2006, who were assessed once at baseline with a Minimum Data Set (MDS) within 90 days of their admittance to the nursing home. The follow-up time for survival of each cohort was 36 months from admission. Based on Kaplan-Meier analysis (log rank test) and non-parametric correlation analyses (Spearman's rho), variables associated with survival time with a p-value < 0.05 were entered into a multivariate Cox regression model.</p> <p>Results</p> <p>The median survival time was 31 months, and no significant difference was detected in the mortality rate between cohorts. Age, gender (HR 1.52), place admitted from (HR 1.27), ADL functioning (HR 1.33-1.80), health stability (HR 1.61-16.12) and ability to engage in social activities (HR 1.51-1.65) were significant predictors of mortality. A total of 28.8% of residents died within a year, 43.4% within two years and 53.1% of the residents died within 3 years.</p> <p>Conclusion</p> <p>It is noteworthy that despite financial constraints, the mortality rate did not change over the study period. Health stability was a strong predictor of mortality, in addition to ADL performance. Considering these variables is thus valuable when deciding on the type of service an elderly person needs. The mortality rate showed that more than 50% died within 3 years, and almost a third of the residents may have needed palliative care within a year of admission. Considering the short survival time from admission, it seems relevant that staff is trained in providing palliative care as much as restorative care.</p

A Review of the Occurrence of Bats (Chiroptera) on Islands in the North East Atlantic and on North Sea Installations

The bats recorded from Iceland, the Faroe Islands, the Shetland Islands, the Orkney Islands, and North Sea installations are reviewed to the end of 2012. In total 12 species have been positively identified, while a considerable proportion of all records are sightings of unidentified bats. Eight of the species are European in origin and four originate from the New World. The largest number of species (8) has been recorded in Iceland, but the greatest number of individuals (180) has been found in Orkney. The bat invasion on the Faroe Islands in 2010 is without precedence, when 70 observations of a minimum of 45 individuals were noted. Most bat observations in the study area occurred in the autumn, with fewer in the spring. Most observations were of single animals, but there were also sightings of up to 12 individuals. There has been a marked increase in bat records in the past three decades. We discuss whether this is a real increase, or due to improved communications, increased public awareness, increased shipping, changes in weather patterns and/or the effects of climate change. All factors appear to be involved.© Museum and Institute of Zoology PAS. The attached document is the author(’s’) final accepted/submitted version of the journal article. You are advised to consult the publisher’s version if you wish to cite from it