A prospective cohort study of geriatric syndromes among older medical patients admitted to acute care hospitals.
ABSTRACT To identify the prevalence of geriatric syndromes in the premorbid for all syndromes except falls (preadmission), admission, and discharge assessment periods and the incidence of new and significant worsening of existing syndromes at admission and discharge.
Prospective cohort study.
Three acute care hospitals in Brisbane, Australia.
Five hundred seventy-seven general medical patients aged 70 and older admitted to the hospital.
Prevalence of syndromes in the premorbid (or preadmission for falls), admission, and discharge periods; incidence of new syndromes at admission and discharge; and significant worsening of existing syndromes at admission and discharge.
The most frequently reported premorbid syndromes were bladder incontinence (44%), impairment in any activity of daily living (ADL) (42%). A high proportion (42%) experienced at least one fall in the 90 days before admission. Two-thirds of the participants experienced between one and five syndromes (cognitive impairment, dependence in any ADL item, bladder and bowel incontinence, pressure ulcer) before, at admission, and at discharge. A majority experienced one or two syndromes during the premorbid (49.4%), admission (57.0%), or discharge (49.0%) assessment period. The syndromes with a higher incidence of significant worsening at discharge (out of the proportion with the syndrome present premorbidly) were ADL limitation (33%), cognitive impairment (9%), and bladder incontinence (8%). Of the syndromes examined at discharge, a higher proportion of patients experienced the following new syndromes at discharge (absent premorbidly): ADL limitation (22%); and bladder incontinence (13%).
Geriatric syndromes were highly prevalent. Many patients did not return to their premorbid function and acquired new syndromes.
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ABSTRACT: Urinary incontinence is a common problem experienced by patients in hospital. As part of a series of studies, a retrospective survey was carried out of 229 nursing and medical records of patients identified as incontinent of urine by the nurses-in-charge, in 14 acute medical wards and 26 health care of the elderly wards. The aims of the survey were to investigate the extent to which urinary incontinence had been identified as a problem, and to examine the nature of its assessment and management. The recording of the problem was found to be inconsistent and there was a paucity of information which might have contributed towards its assessment. The causes of incontinence were rarely recorded and in approximately half of the nursing and medical records examined there was a complete absence of any information related to a management plan. Where recorded, interventions reflected predominantly palliative measures such as routine toileting regimens and the use of continence aids. The implications of these findings are discussed.Journal of Advanced Nursing 12/1993; 18(11):1734-46. · 1.53 Impact Factor
Article: Geriatric syndromes.Journal of the American Geriatrics Society 03/2008; 56(2):363-4. · 3.98 Impact Factor
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ABSTRACT: The prevalence, time course, and factors associated with urinary incontinence were examined among 363 patients aged 65 years or older admitted to the acute medical and surgical services of a university hospital. Overall, 35% were incontinent of urine at some time during their hospital stay; incontinence was more common among women and among those older than 75 years. Indwelling catheters were used in 50% of the incontinent patients and 25% of the patients who were otherwise continent while in the hospital. Incontinence was associated with impaired cognitive and physical functioning and with treatment for urinary tract infections. In most of the patients who were incontinent while hospitalized, incontinence was a persistent phenomenon and had been present before hospitalization and was present afterward. Only 5% had "transient" or "nosocomial" incontinence. These data suggest that the acute-care hospital may provide a good opportunity for physicians to identify the often-ignored problem of incontinence, and to then initiate an appropriate diagnostic evaluation of this condition if it persists after hospital discharge.JAMA The Journal of the American Medical Association 05/1987; 257(13):1767-71. · 29.98 Impact Factor