4 results on '"Feindt, B"'
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2. GeriNOT in the Surgical Inpatient Setting.
- Author
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Feindt B, Roth A, Heyde CE, Behrens J, Feist B, Kasprick L, Sultzer R, and Baerwald C
- Abstract
The guideline of the Federal Joint Committee (G-BA) on quality assessment measures for the care of patients with hip fracture makes it mandatory for hospitals to use an appropriate geriatric screening instrument in the context of acute inpatient care. After systematic application of GeriNOT and data collection in the admission process with integration into the Hospital Information System (HIS), it is possible to identify potential risks in geriatric patients with other diagnoses as well.With the integration of GeriNOT into the acute inpatient admission process, it was examined whether vulnerable geriatric patients with other diagnoses could benefit from the early initiation of risk identification.The data base for the present study was a retrospective bicentric collection of electronic case records (May 2014 to April 2015, n = 3,443). From this primary data set, the subgroup of inpatient acute admissions (n = 821) in the orthopaedic/trauma surgery of a study centre was analysed and evaluated with respect to the endpoints "utilisation of needs-based post-inpatient care services" and "new admission to inpatient permanent/short-term care". The predictive power and classification accuracy of GeriNOT of these patients who were 70 years and older to the endpoints were assessed for several groups: total acute admissions, total fractures, hip fracture, and spinal disorders including spinal fractures.A total of 821 patients were admitted as acute inpatients during the study period. The mean age of the patients was 81.4 ± 6.8 years (n = 821; 68.1% women, 31.9% men). The following subgroups were formed and analysed: total fractures (n = 490), spinal disorders (n = 265) including spinal fractures (n = 174), and hip fracture (n = 108). Both in the overall group (n = 821; M = 4.279; SD = 2.180) and in the subgroups, the mean GeriNOT score was above the threshold ≥ 4. The highest score was found in the hip fracture group (M = 4.852; SD = 2.022), and the lowest in the spine fracture group (M = 4.177; SD = 2.171). At admission, if the terms of variables for requiring treatment were "polypharmacy" and "nursing services already used as needed", there were only slight differences in the diagnostic groups. Admissions from short-term and long-term care occurred in the total group in 16.44% of cases, most frequently with 31.48% in the group of hip fractures, compared to spinal diseases with 6.79%. For this group, GeriNOT detected an elevated risk with respect to the defined endpoints. However, only 4.26% of all patients with identified geriatric risk potential received further geriatric care.The results showed increased geriatric risk in all analysed groups, but most pronouncedly within the group of spinal diseases. The HIS-supported use of GeriNOT offers the possibility of systematic risk identification in acute inpatient admission management. The continuous visualisation of results at HIS workstations throughout the workflow could be used as a starting point for the subsequent application of standardized assessment tools and risk-adjusted treatment pathways. These findings could potentially improve outcomes., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)
- Published
- 2024
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3. Symptoms of older orthopedic and rheumatic patients : A telephone survey about symptoms, symptom communication, treatment and further support after hospital discharge.
- Author
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Schiek S, Hintzer K, Dahley C, Wernecke K, Feindt B, Baerwald C, Spiegl UJA, and Bertsche T
- Subjects
- Male, Humans, Female, Aged, Aged, 80 and over, Communication, Telephone, Hospitals, Patient Discharge, Hospitalization
- Abstract
Background: In older multimorbid orthopedic and rheumatic patients, data on symptoms besides pain or reduced mobility are rarely published., Objective: We investigated patients' perspectives on their symptoms after hospital discharge., Material and Methods: Orthopedic and rheumatic patients aged over 70 years were asked via telephone interviews about (i) their symptoms, (ii) communication, (iii) treatment, and (iv) support., Results: (i) The 60 participants (35 women and 25 men) reported a median of 6 (min-max: 1-14) different symptoms, of which 86% (356 of 415) had existed before hospitalization, (ii) patients did not communicate 28% (117) of symptoms to either healthcare professionals, family or friends and (iii) 52 (87%) patients desired improvement. Of the 280 most impairing symptoms, 19% (52) were not treated at all. (iv) Almost all patients (59; 98%) considered it easy to obtain support., Conclusion: Remarkably, many symptoms were not communicated or treated despite the patients having been hospitalized., (© 2023. The Author(s).)
- Published
- 2024
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4. [Trial of the GeriNOT screening tool : Identification of geriatric risk potentials on admission to hospital care from the age of 70 years].
- Author
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Feist B, Feindt B, Kasprick L, Baerwald C, Simm A, Müller-Werdan U, Sultzer R, and Behrens J
- Subjects
- Humans, Aged, Aged, 80 and over, Retrospective Studies, ROC Curve, Geriatric Assessment, Hospitals, Hospitalization, Patient Discharge
- Abstract
Background: Geriatric-specific characteristics influence patient-relevant outcomes of inpatient hospital care in patients aged 70 years and older: prolonged length of stay, complications, increase in utilization of required services as well as mortality rates., Objective: The screening tool GeriNOT, identification of geriatric risk potential with 7 items, of which mobility and cognition are double-weighted, score 9 points, was tested for its predictive content and diagnostic quality., Material and Methods: Diagnostic study from a retrospective, bicentric complete survey in all types of admission from 70 years with 2541 patient cases. Regression analyses in linked samples of the 7 items in GeriNOT and as noncombined end points: prolonged length of stay, complications, increase in need-based service at discharge and death., Results: Mean age ± SD: 77.0 ± 6.4 years. ROC analyses report at a cut-off value calculated using the Youden index of ≥ 4 points in 2541 cases: increase in need-based service at discharge (AUC = 0.693, 95% CI = 0.663-0.723, sensitivity 75.2%, specificity 59.7%), complications (AUC = 0.662, 95% CI = 0.636-0.688, sensitivity 64.2%, specificity 61.6%) and death (AUC = 0.734, 95% CI = 0.682-0.786, sensitivity 76.4%, specificity 57.5%). Possibly suitable for use as screening to identify geriatric risk potentials at a cut-off of ≥ 4 points., Discussion: Provide an initial filter screening with regard to mobility. Such identification could provide the involved persons with the opportunity for an improved treatment outcome by adapting the inpatient process. Prospective validation of GeriNOT needed., (© 2022. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)
- Published
- 2023
- Full Text
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