Learn More
BACKGROUND Since in hospitalized older patients delirium is associated with poor outcomes, we evaluated the effectiveness of a multicomponent strategy for the prevention of delirium. METHODS We studied 852 patients 70 years of age or older who had been admitted to the general-medicine service at a teaching hospital. Patients from one intervention unit and(More)
To achieve more appropriate triage to the coronary care unit of patients presenting with acute chest pain, we used clinical data on 1379 patients at two hospitals to construct a simple computer protocol to predict the presence of myocardial infarction. When we tested this protocol prospectively in 4770 patients at two university hospitals and four community(More)
OBJECTIVE To prospectively develop and validate a predictive index to identify on admission elderly hospitalized medical patients at risk for functional decline. DESIGN Two prospective cohort studies, in tandem. The predictive model developed in the initial cohort was subsequently validated in a separate cohort. SETTING General medical wards of a(More)
OBJECTIVE To determine whether a home-based systematic multicomponent rehabilitation strategy leads to improved outcomes relative to usual care. DESIGN A randomized controlled trial with 12 months of follow-up. SETTING General community; 27 home care agencies. PARTICIPANTS Three hundred four nondemented persons at least 65 years of age who underwent(More)
In a prospective multicenter investigation of emergency room patients with acute chest pain, physicians admitted 96% of patients with acute myocardial infarction (AMI) and discharged 4%. Of 35 patients who were sent home with AMI, only 11 (31%) returned to the same hospital because of persistent symptoms. Compared with a control group of 105 randomly(More)
OBJECTIVES The economic impact of trauma in older persons is a matter of increasing concern to public health practitioners and planners, yet it is an issue that has not been widely studied. Available evidence does suggest, however, that falls are the costliest category of injury among older persons. METHODS This study used data from the Health Care(More)
INTRODUCTION Delirium, or acute confusional state, is a common and serious occurrence among hospitalized older persons. Current estimates suggest that delirium complicates hospital stays for more than 2.3 million older persons each year, involving more than 17.5 million hospital days and accounting for more than $4 billion (1994 dollars) of Medicare(More)
BACKGROUND National statistics indicate that African Americans are disproportionately affected by mortality and hospitalizations resulting from heart failure when compared with other racial/ethnic groups. This might, in part, reflect a poorer course of heart failure among African Americans. METHODS We conducted a prospective cohort study of 316 white and(More)
Myocardial infarction was diagnosed in 431 (30%) of 1460 patients with acute chest pain who had serial enzyme testing after admission to intensive or intermediate care units at three teaching and three community hospitals. The diagnosis was made within 12 hours of admission in 331 (77%) patients and within 24 hours in 415 (96%). Of the 16 patients with(More)
OBJECTIVE To test the effectiveness of a nursing-centered intervention to prevent functional decline among hospitalized elderly medical patients. DESIGN Prospective cohort study with stratified and matched cohort analyses. SETTING General medicine wards of a university teaching hospital. PATIENTS Two hundred sixteen patients aged > or = 70 years (85(More)