Predictors of XXXX in nursing home residents.

@entity1 @entity353 @entity55 @entity1174 @entity10281 @entity1282 @entity933 @entity734 @entity1173
@entity1174 is a serious problem for the elderly institutionalized @entity1 , often requiring transfer to a hospital and a lengthy stay there. It is associated with a high mortality rate and is very costly to the health care system. The current study sought to determine the key predictors of @entity1174 in a nursing home population with the hope that health care providers could identify those residents at highest risk and focus more efforts on prevention of this serious disease. A cross-sectional, retrospective analysis was done, using the @entity10281 ( @entity10281 ) nursing home assessment data for three states (New York, Mississippi, Maine) from 1993 to 1994 (N = 102842). Nursing home residents were aged 65+. Standardized @entity10281 summary scales and their component items were used, including: the Activities of Daily Living (ADL) scale, the cognitive performance scale (CPS), and the Resource Utilization Groups (RUGs). Results of these analyses showed the prevalence of @entity55 among this population was 3% (n = 3118). Results from the logistic regression models indicated 18 significant predictors of @entity1174 . The strongest to weakest predictors of @entity55 were, respectively, suctioning use, COPD, CHF, presence of feeding tube, bedfast, high case mix index, @entity933 , @entity353 , swallowing problems, urinary tract infections, mechanically altered diet, @entity734 for eating, bed mobility, locomotion, number of medications, and age, while both CVA and tracheotomy care were inversely predictive of @entity55 . The emergence of these significant predictors suggested a different pathogenesis of @entity55 in the elderly nursing home resident from the acute care @entity1 or the outpatient. Nursing home residents have chronic medical conditions that gradually lead to "decompensation" in functional status, nutritional status, and pulmonary clearance. @entity1282 and @entity1173 are common complications of their medical conditions and may slowly worsen as their status deteriorates. Alternatively, a sudden adverse event may dramatically increase the amount aspirated or the ability to resist infection and lead to sudden decompensation. Clinical staff must identify residents with @entity1282 and @entity1173 and work to prevent decline in functional status in all residents. They must be aware of the dangers of adverse events that lead to sudden inactivity or illness and increase the risk of @entity1174 . Prevention of this disease whenever possible will reduce costs, improve health outcomes, and improve our quality of care.
