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Abstracts From The 23rd Annual Health Care Systems Research Network Conference, March 21–23, 2017, San Diego, California, 2017 Aurora Health Care

Abstracts From The 23rd Annual Health Care Systems Research Network Conference, March 21–23, 2017, San Diego, California

Journal of Patient-Centered Research and Reviews

This proceedings supplement includes selected abstracts presented at the 23rd annual conference of the Health Care Systems Research Network (HCSRN), held March 21–23, 2017, in San Diego, California. Formerly called the HMO Research Network, HCSRN aims to improve individual and population health through research that connects the resources and capabilities of its member health care systems.


Purple Urine Bag Syndrome: An Educational Case Of A Colorful Condition In The Chronically Catheterized, Teshome Gebrmichael, Fikirte Feleke, Waseem Ahmed, Madhulika Urella, Samson Teka 2017 Marshall University School of Medicine

Purple Urine Bag Syndrome: An Educational Case Of A Colorful Condition In The Chronically Catheterized, Teshome Gebrmichael, Fikirte Feleke, Waseem Ahmed, Madhulika Urella, Samson Teka

Samson Teka

Purple Urine Bag Syndrome is a rare condition characterized by purple discoloration of the urinary drainage bag. It is typically seen in elderly patients with chronic indwelling urinary catheterization, and is associated with urinary tract infections with high bacterial load, female gender, severe disability, constipation, and alkaline urine. This phenomenon occurs when tryptophan metabolites in the urine are broken down by bacteria containing indoxyl sulphatase and phosphatase enzymes. This results in the production of indigo and indirubin, which combine to give a purple appearance. This article presents a 78-year-old male with chronic urinary retention requiring intermittent Foley catheterization for the ...


Trauma Team Activation For Geriatric Trauma At A Level Ii Trauma Center: Are The Elderly Under-Triaged?, Grant S. Buchanan, Daniel Scott Kahn, Harry Burke, Brian Czarkowski, Richard Boe, Milad Modarresi, Franklin D. Shuler 2017 Marshall University

Trauma Team Activation For Geriatric Trauma At A Level Ii Trauma Center: Are The Elderly Under-Triaged?, Grant S. Buchanan, Daniel Scott Kahn, Harry Burke, Brian Czarkowski, Richard Boe, Milad Modarresi, Franklin D. Shuler

Franklin D. Shuler

Abstract

Geriatric patients often sustain life-threatening injuries from minor trauma. A growing body of research suggests that these patients are often under-triaged in the emergency setting.The purpose of this research was to evaluate whether or not geriatric trauma patients are under-triaged at a community based level II trauma center.

1434 trauma patients over the age of 65 presenting from 2010-2015 were retrospectively reviewed from the Cabell Huntington Hospital trauma registry and analyzed for age, gender, arrival type, ED response, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), injury cause, ICD-9 diagnosis codes, and mortality. Under-triage and over-triage rates were ...


Trauma Team Activation For Geriatric Trauma At A Level Ii Trauma Center: Are The Elderly Under-Triaged?, Grant S. Buchanan, Daniel Scott Kahn, Harry Burke, Brian Czarkowski, Richard Boe, Milad Modarresi, Franklin D. Shuler 2017 Marshall University

Trauma Team Activation For Geriatric Trauma At A Level Ii Trauma Center: Are The Elderly Under-Triaged?, Grant S. Buchanan, Daniel Scott Kahn, Harry Burke, Brian Czarkowski, Richard Boe, Milad Modarresi, Franklin D. Shuler

Marshall Journal of Medicine

Abstract

Geriatric patients often sustain life-threatening injuries from minor trauma. A growing body of research suggests that these patients are often under-triaged in the emergency setting.The purpose of this research was to evaluate whether or not geriatric trauma patients are under-triaged at a community based level II trauma center.

1434 trauma patients over the age of 65 presenting from 2010-2015 were retrospectively reviewed from the Cabell Huntington Hospital trauma registry and analyzed for age, gender, arrival type, ED response, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), injury cause, ICD-9 diagnosis codes, and mortality. Under-triage and over-triage rates were ...


Purple Urine Bag Syndrome: An Educational Case Of A Colorful Condition In The Chronically Catheterized, Teshome Gebrmichael, Fikirte Feleke, Waseem Ahmed, Madhulika Urella, Samson Teka 2017 Marshall University School of Medicine

Purple Urine Bag Syndrome: An Educational Case Of A Colorful Condition In The Chronically Catheterized, Teshome Gebrmichael, Fikirte Feleke, Waseem Ahmed, Madhulika Urella, Samson Teka

Marshall Journal of Medicine

Purple Urine Bag Syndrome is a rare condition characterized by purple discoloration of the urinary drainage bag. It is typically seen in elderly patients with chronic indwelling urinary catheterization, and is associated with urinary tract infections with high bacterial load, female gender, severe disability, constipation, and alkaline urine. This phenomenon occurs when tryptophan metabolites in the urine are broken down by bacteria containing indoxyl sulphatase and phosphatase enzymes. This results in the production of indigo and indirubin, which combine to give a purple appearance. This article presents a 78-year-old male with chronic urinary retention requiring intermittent Foley catheterization for the ...


Recurrent Clostridium Difficile Infection Among Medicare Patients In Nursing Homes: A Population-Based Cohort Study, Marya D. Zilberberg, Andrew F. Shorr, William M. Jesdale, Jennifer Tjia, Kate L. Lapane 2017 University of Massachusetts Amherst

Recurrent Clostridium Difficile Infection Among Medicare Patients In Nursing Homes: A Population-Based Cohort Study, Marya D. Zilberberg, Andrew F. Shorr, William M. Jesdale, Jennifer Tjia, Kate L. Lapane

Jennifer Tjia

We explored the epidemiology and outcomes of Clostridium difficile infection (CDI) recurrence among Medicare patients in a nursing home (NH) whose CDI originated in acute care hospitals. We conducted a retrospective, population-based matched cohort combining Medicare claims with Minimum Data Set 3.0, including all hospitalized patients age > /=65 years transferred to an NH after hospitalization with CDI 1/2011-11/2012. Incident CDI was defined as ICD-9-CM code 008.45 with no others in prior 60 days. CDI recurrence was defined as (within 60 days of last day of CDI treatment): oral metronidazole, oral vancomycin, or fidaxomicin for > /=3 days ...


Sex Differences In Neighborhood Perceptions And Physical Activity Among Older Adults Living In Car-Dependent Neighborhoods, Wenjun Li, Linda C. Churchill, Scott Crouter, Kevin J. Kane, Jie Cheng, Fuding Rui, Jie Tian, Patricia D. Franklin, Judith K. Ockene, Jerry H. Gurwitz 2017 University of Massachusetts Medical School

Sex Differences In Neighborhood Perceptions And Physical Activity Among Older Adults Living In Car-Dependent Neighborhoods, Wenjun Li, Linda C. Churchill, Scott Crouter, Kevin J. Kane, Jie Cheng, Fuding Rui, Jie Tian, Patricia D. Franklin, Judith K. Ockene, Jerry H. Gurwitz

Jerry H. Gurwitz

INTRODUCTION: Older adults may have more physical limitations and no longer routinely travel outside their neighborhoods to work. Their daily living, health, and well-being may depend on neighborhood resources close to their homes. Therefore, access to resources critical for healthy aging may influence health in various aspects. In this study we investigated differences in neighborhood perceptions (NP) and their influences on physical activity (PA).

METHODS: Between 2012 and 2015, 111 men and 103 women aged 65 years and older living in car-dependent neighborhoods were queried on NP, use of neighborhood resources, and frequency and location of PA. Participants wore an ...


Sex Differences In Neighborhood Perceptions And Physical Activity Among Older Adults Living In Car-Dependent Neighborhoods, Wenjun Li, Linda C. Churchill, Scott Crouter, Kevin J. Kane, Jie Cheng, Fuding Rui, Jie Tian, Patricia D. Franklin, Judith K. Ockene, Jerry H. Gurwitz 2017 University of Massachusetts Medical School

Sex Differences In Neighborhood Perceptions And Physical Activity Among Older Adults Living In Car-Dependent Neighborhoods, Wenjun Li, Linda C. Churchill, Scott Crouter, Kevin J. Kane, Jie Cheng, Fuding Rui, Jie Tian, Patricia D. Franklin, Judith K. Ockene, Jerry H. Gurwitz

Patricia D. Franklin

INTRODUCTION: Older adults may have more physical limitations and no longer routinely travel outside their neighborhoods to work. Their daily living, health, and well-being may depend on neighborhood resources close to their homes. Therefore, access to resources critical for healthy aging may influence health in various aspects. In this study we investigated differences in neighborhood perceptions (NP) and their influences on physical activity (PA). METHODS: Between 2012 and 2015, 111 men and 103 women aged 65 years and older living in car-dependent neighborhoods were queried on NP, use of neighborhood resources, and frequency and location of PA. Participants wore an ...


Sex Differences In Neighborhood Perceptions And Physical Activity Among Older Adults Living In Car-Dependent Neighborhoods, Wenjun Li, Linda C. Churchill, Scott Crouter, Kevin J. Kane, Jie Cheng, Fuding Rui, Jie Tian, Patricia D. Franklin, Judith K. Ockene, Jerry H. Gurwitz 2017 University of Massachusetts Medical School

Sex Differences In Neighborhood Perceptions And Physical Activity Among Older Adults Living In Car-Dependent Neighborhoods, Wenjun Li, Linda C. Churchill, Scott Crouter, Kevin J. Kane, Jie Cheng, Fuding Rui, Jie Tian, Patricia D. Franklin, Judith K. Ockene, Jerry H. Gurwitz

Wenjun Li

INTRODUCTION: Older adults may have more physical limitations and no longer routinely travel outside their neighborhoods to work. Their daily living, health, and well-being may depend on neighborhood resources close to their homes. Therefore, access to resources critical for healthy aging may influence health in various aspects. In this study we investigated differences in neighborhood perceptions (NP) and their influences on physical activity (PA).

METHODS: Between 2012 and 2015, 111 men and 103 women aged 65 years and older living in car-dependent neighborhoods were queried on NP, use of neighborhood resources, and frequency and location of PA. Participants wore an ...


Ct Scanning Is Sufficient To Clear The Cervical Spine Of Elderly Falls Less Than 5 Feet., Douglas Lehman MD, Rovinder S. Sandhu MD, Leslie Baga BSN, Farheen Hussain MS, John J. Hong MD 2017 Lehigh Valley Health Network

Ct Scanning Is Sufficient To Clear The Cervical Spine Of Elderly Falls Less Than 5 Feet., Douglas Lehman Md, Rovinder S. Sandhu Md, Leslie Baga Bsn, Farheen Hussain Ms, John J. Hong Md

John J. Hong, M.D.

No abstract provided.


Predictors Of Hospitalization Among Newly Admitted Skilled Nursing Facility Residents: Rethinking The Role Of Functional Decline, Sun J. Kim, Joo H. Lee, Shunichi Nakagawa, Elizabeth Bukowy, Ankoor Biswas, Boram Han, Yeilim Cho, Hyun Phil Shin, Ji Won Yoo 2017 Department of Public Health, Institute of Health Services Research, Yonsei University College of Medicine

Predictors Of Hospitalization Among Newly Admitted Skilled Nursing Facility Residents: Rethinking The Role Of Functional Decline, Sun J. Kim, Joo H. Lee, Shunichi Nakagawa, Elizabeth Bukowy, Ankoor Biswas, Boram Han, Yeilim Cho, Hyun Phil Shin, Ji Won Yoo

Aurora Internal Medicine Residents

Purpose: Hospital transfer from a skilled nursing facility (SNF) is costly, and many are potentially preventable. This study examines: 1) whether functional decline is a predictor of hospital transfer, and 2) the magnitude of relationships between predictors (functional impairment and chronic medical illness) and hospital transfer from SNFs.

Methods: We used Minimum Data Set (MDS) Version 2.0 in the state of Michigan between 2007 and 2009. In total, 196,662 new SNF admissions were observed. Multilevel generalized estimating equations and regression models were performed for each functional and clinical domain while adjusting for demographic variables and change in activities ...


Nutrition Screening In The Adult Stroke Population Using The Canadian Nutrition Screening Tool In Comparison With The Subjective Global Assessment, Tess Coutu 2017 The University of Western Ontario

Nutrition Screening In The Adult Stroke Population Using The Canadian Nutrition Screening Tool In Comparison With The Subjective Global Assessment, Tess Coutu

Electronic Thesis and Dissertation Repository

Although the Canadian Best Practice Recommendations for Stroke Care recommend all acute stroke patients be screened for malnutrition within 48 hours of admission to hospital using a valid screening tool, none have been validated for use in adult acute stroke patients. The Canadian Nutrition Screening Tool (CNST) tool has been validated within medicine and surgery patients. The purpose of this study is to estimate the level of agreement between the CNST and the Subjective Global Assessment (SGA), a nutrition assessment tool, in a cohort of 58 acute adult stroke patients at the Southwestern Ontario Regional Stroke Centre in London. In ...


Prevalence, Predictors And Benefits Of Resistance Training For Improving Gait Speed In Aged Care, Justin Keogh, Timothy Henwood, Hugh Senior, Samantha Fien 2017 Bond University

Prevalence, Predictors And Benefits Of Resistance Training For Improving Gait Speed In Aged Care, Justin Keogh, Timothy Henwood, Hugh Senior, Samantha Fien

Justin Keogh

No abstract provided.


Prevalence, Consequences And Effects Of Exercise On Sarcopenia In Aged Care, Justin Keogh, Timothy Henwood, Hugh Senior, Jennifer Hewitt 2017 Bond University

Prevalence, Consequences And Effects Of Exercise On Sarcopenia In Aged Care, Justin Keogh, Timothy Henwood, Hugh Senior, Jennifer Hewitt

Justin Keogh

No abstract provided.


A Descriptive Study Of The Elderly In California Substance Abuse Treatment Programs, David Berenschot 2017 California State University - San Bernardino

A Descriptive Study Of The Elderly In California Substance Abuse Treatment Programs, David Berenschot

Electronic Theses, Projects, and Dissertations

As gerontologists may know, there are a great deal of studies and a variety of academic literature on the misuse of alcohol and prescription medication amongst the elderly population. While there is a plethora of information on alcohol and prescription misuse, there is little reported data about the prevalence of other substance misuse experienced by this population. This study aims to help to fill that gap in the data by using quantitative methods to describe the scope of substance abuse of individuals 55-years or older. This study utilizes data from the Treatment Data Set Admission (TEDS-A). The TEDS-A is a ...


Models For Predicting Incident Delirium In Hospitalized Older Adults: A Systematic Review, Sundeep Kalimisetty, Wajih Askar, Brenda Fay, Ariba Khan 2017 Aurora Health Care

Models For Predicting Incident Delirium In Hospitalized Older Adults: A Systematic Review, Sundeep Kalimisetty, Wajih Askar, Brenda Fay, Ariba Khan

Brenda Fay

Purpose The purpose of this systematic review is to summarize the reported risk prediction models and identify the most prevalent factors for incident delirium in older inpatient populations (age ≥ 65 years). In the future, these risk factors could be used to develop a delirium risk prediction model in the electronic health record that can be used by the Hospital Elder Life Program to reduce the incidence of delirium. Methods A medical librarian customized and conducted a search strategy for all published articles on delirium prediction models using an array of electronic databases and specific inclusion and exclusion criteria. Then, a ...


Optimizing Medication Appropriateness In Older Adults: A Randomized Clinical Interventional Trial To Decrease Anticholinergic Burden, Daniela C. Moga, Erin L. Abner, Dorinda N. Rigsby, Lynne Eckmann, Mark Huffmyer, Richard R. Murphy, Beth B. Coy, Gregory A. Jicha 2017 University of Kentucky

Optimizing Medication Appropriateness In Older Adults: A Randomized Clinical Interventional Trial To Decrease Anticholinergic Burden, Daniela C. Moga, Erin L. Abner, Dorinda N. Rigsby, Lynne Eckmann, Mark Huffmyer, Richard R. Murphy, Beth B. Coy, Gregory A. Jicha

Pharmacy Practice and Science Faculty Publications

Background

The complexity of medication therapy in older adults with multiple comorbidities often leads to inappropriate prescribing. Drugs with anticholinergic properties are of particular interest because many are not recognized for this property; their use may lead to increased anticholinergic burden resulting in significant health risks, as well as negatively impacting cognition. Medication therapy management (MTM) interventions showed promise in addressing inappropriate medication use, but the effectiveness of targeted multidisciplinary team interventions addressing anticholinergic medications in older populations is yet to be determined.

Methods

We conducted an 8-week, parallel-arm, randomized trial to evaluate whether a targeted patient-centered pharmacist–physician team ...


Pharmacotherapy Use In Older Patients With Heart Failure And Reduced Ejection Fraction Living In Skilled Nursing Facilities, Lin Li, William M. Jesdale, Anne Hume, Giovanni Gambassi, Robert J. Goldberg, Kate L. Lapane 2017 University of Massachusetts Medical School

Pharmacotherapy Use In Older Patients With Heart Failure And Reduced Ejection Fraction Living In Skilled Nursing Facilities, Lin Li, William M. Jesdale, Anne Hume, Giovanni Gambassi, Robert J. Goldberg, Kate L. Lapane

UMass Center for Clinical and Translational Science Research Retreat

Background: Little is known about the use of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) and β-blockers among older adults with heart failure and reduced ejection fraction (HFrEF) in skilled nursing facilities (SNFs).

Methods: Using national data Minimum Data Set 3.0 cross-linked with Medicare data (2011-2012), we studied 31,675 patients with HFrEF (ICD-9 codes: 428.2 or 428.4) aged ≥65 years admitted to 9,659 SNFs. We estimated the prevalence of a Part D claim for ACEIs/ARBs or β-blockers during 3 months before the SNF stay and used log-binomial models to evaluate correlates of ...


Home Interventions For Older Adults With Asthma, David Turcotte, Susan Woskie, Emily Chaves, Kelechi Adejumo, Rebecca Gore 2017 University of Massachusetts Lowell

Home Interventions For Older Adults With Asthma, David Turcotte, Susan Woskie, Emily Chaves, Kelechi Adejumo, Rebecca Gore

UMass Center for Clinical and Translational Science Research Retreat

Older asthmatic adults are more likely to experience respiratory failure than younger adults and children with asthma. Older adults spend up to 90% of their time in the home where many allergens are found. While there is sufficient evidence that home interventions improve the health of asthmatic children, there is insufficient evidence for the effectiveness of home interventions with adults. Our research evaluates the hypothesis that multi-trigger, multifaceted home interventions improve respiratory health and reduce home asthma triggers for older adults.

Methods: We evaluated the effectiveness of conducting interventions in the homes of 86 diverse, low-income older adults (age 62 ...


Resident And Facility-Level Correlations Of Long-Term Opioid Use In United States Nursing Homes, Jacob N. Hunnicutt, Christine M. Ulbricht, Anne Hume, Kate L. Lapane 2017 University of Massachusetts Medical School

Resident And Facility-Level Correlations Of Long-Term Opioid Use In United States Nursing Homes, Jacob N. Hunnicutt, Christine M. Ulbricht, Anne Hume, Kate L. Lapane

UMass Center for Clinical and Translational Science Research Retreat

Background: There is limited information on the prevalence and multilevel risk factors of long-term opioid use in older nursing home residents despite their high burden of pain and vulnerability to adverse drug events.

Objectives: To estimate the prevalence and correlates of long-term opioid use in United States (US) nursing homes.

Methods: We used comprehensive administrative/claims data (Minimum Data Set 3.0; Medicare Part D) from 2012 to conduct a cross-sectional study of 369,180 long-stay nursing home residents who were Medicare beneficiaries, ≥65 years old, and had no cancer. Resident factors of interest included demographics and physical/cognitive impairment ...


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