1.Nation-Wide Observational Study of Cardiac Arrests Occurring in Nursing Homes and Nursing Facilities in Singapore.
Andrew Fw HO ; Kai Yi LEE ; Xinyi LIN ; Ying HAO ; Nur SHAHIDAH ; Yih Yng NG ; Benjamin Sh LEONG ; Ching Hui SIA ; Benjamin Yq TAN ; Ai Meng TAY ; Marie Xr NG ; Han Nee GAN ; Desmond R MAO ; Michael Yc CHIA ; Si Oon CHEAH ; Marcus Eh ONG
Annals of the Academy of Medicine, Singapore 2020;49(5):285-293
INTRODUCTION:
Nursing home (NH) residents with out-of-hospital cardiac arrests (OHCA) have unique resuscitation priorities. This study aimed to describe OHCA characteristics in NH residents and identify independent predictors of survival.
MATERIALS AND METHODS:
OHCA cases between 2010-16 in the Pan-Asian Resuscitation Outcomes Study were retrospectively analysed. Patients aged <18 years old and non-emergency cases were excluded. Primary outcome was survival at discharge or 30 days. Good neurological outcome was defined as a cerebral performance score between 1-2.
RESULTS:
A total of 12,112 cases were included. Of these, 449 (3.7%) were NH residents who were older (median age 79 years, range 69-87 years) and more likely to have a history of stroke, heart and respiratory diseases. Fewer NH OHCA had presumed cardiac aetiology (62% vs 70%, <0.01) and initial shockable rhythm (8.9% vs 18%, <0.01), but had higher incidence of bystander cardiopulmonary resuscitation (74% vs 43%, <0.01) and defibrillator use (8.5% vs 2.8%, <0.01). Non-NH (2.8%) residents had better neurological outcomes than NH (0.9%) residents ( <0.05). Factors associated with survival for cardiac aetiology included age <65 years old, witnessed arrest, bystander defibrillator use and initial shockable rhythm; for non-cardiac aetiology, these included witnessed arrest (adjusted odds ratio [AOR] 3.8, <0.001) and initial shockable rhythm (AOR 5.7, <0.001).
CONCLUSION
Neurological outcomes were poorer in NH survivors of OHCA. These findings should inform health policies on termination of resuscitation, advance care directives and do-not-resuscitate orders in this population.
2.Nutritional Status and Health-Related Quality of Life among Knee and Hip Osteoarthritis Patients under Rehabilitation Care in Kuala Nerus, Terengganu, Malaysia
Zamri NAA ; Harith S ; Mat-Hassan N ; Ong YQ
Malaysian Orthopaedic Journal 2021;15(No.2):77-88
Introduction: The World Health Organisation (WHO) has
estimated that 80% of people with osteoarthritis (OA) have
movement limitations while 25% of them cannot perform
their major daily activities, thus resulting in a decline of their
nutritional status and quality of life (QOL). Therefore, this
study aimed to compare the nutritional status and healthrelated quality of life (HRQOL) of OA patients between
gender and age group.
Material and methods: A cross-sectional study was
conducted on 131 OA patients in Rehabilitation Health
Organisation, Terengganu. Socio-demographic, clinical,
lifestyle histories, 24-hour dietary intake and HRQOL were
assessed using a structured questionnaire.
Results: Knee and/or hip OA patients recruited consisted of
19.1% of men and 80.9 % of women collectively with a
mean age of 61.81 (9.28) years ranging from 38 to 83 years.
The percentages of underweight, normal, overweight, and
obese patients were 1.5%, 12.2%, 36.7%, and 49.6%,
respectively. Further assessment of HRQOL showed that the
highest mean score was obtained by the social functioning
(SF) domain of 41.25 (27.16), while the mental domain
scored the least mean score of 21.15 (20.92). In terms of
gender breakdown, the males had significantly greater
weight and height but lower body fat (BF) compared to their
female counterparts, as well as a significantly higher energy,
carbohydrate and protein intake. According to the age group,
patients aged < 60 years had significantly greater weight,
height, and BF than those aged ≥ 60 years.
Conclusion: This study is an important baseline reference
for proper OA management and prevention by providing
crucial nutritional status and HRQOL information.