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Affiner la recherche Faire une suggestionHEALTH RELATED QUALITY OF LIFE TRAJECTORIES OF PATIENTS IN A MOROCCAN ACUTE MEDICAL UNIT : A LATENT CLASS GROWTH MODELING APPROACH / Adnane EL KHATTATE
Titre : HEALTH RELATED QUALITY OF LIFE TRAJECTORIES OF PATIENTS IN A MOROCCAN ACUTE MEDICAL UNIT : A LATENT CLASS GROWTH MODELING APPROACH Type de document : thèse Auteurs : Adnane EL KHATTATE, Auteur Année de publication : 2016 Langues : Français (fre) Mots-clés : Acute medical unit (AMU) EQ5D Health related quality of life (HRQoL) Trajectory. Résumé : Introduction:The objectives of this study were to identify and describe a set of longitudinal HRQoL trajectories of patients in an AMU,then determine factors associated with trajectory class membership of patients after acute illness.
Methods:This was a prospective cohort study conducted in an acute medical unit of Ibn-SinaUniversity-Hospital, Rabat, between June and September 2014. Patients aged≥17 years were included; those unable to complete the questionnaire were excluded. Demographic, medical-history, clinical and paraclinical characteristics were recorded at admission. EQ5D-index, EQ-VAS and survival status were collected at admission, 3, 6 and 18 months of follow-up. Latent-class-growth-analysis was applied to identify classes of HRQoL-trajectories. Association between baseline covariate and class membership were identified using polynomial-logistic-regression. Statistical analysis was carried out in STATA-14.
Results:We included 251 patients. The mean age: 55.6 ±18.9 years, women were 54.6%. In-hospital and 18 months follow-up mortality were 11.6% and 34.3%. Three trajectory classes were identified for EQ5D-Index; stably low(16.2%), stably moderate(30.6%), and high initially increasing(53.2%). The three trajectory classes of EQ-VAS were low increasing(29.7%), moderate initially increasing(48.5%) and high initially increasing(21.8%).
EQ5D-index: comparing to high initially increasing, factors associated to stably low trajectory membership were: age≥70years, ICU transit and low hemoglobinemia. EQ-VAS: comparing to high initially increasing, factors associated tolow increasing trajectory membership were: female gender, Km-hospital-residence and comorbidity.
Conclusions:We identified 3 stable HRQoL-trajectories, confirming that previous-HRQoL is more important in defining HRQoL evolution than acute illness. Elderly with low hemoglobinemia and who transited through ICU had the worst EQ5D-index. Females, with comorbidities, living far from hospital perceived an amelioration of their low EQ-VAS.
Keywords: Acute medical unit (AMU), EQ5D, Health related quality of life (HRQoL), Trajectory.
Numéro (Thèse ou Mémoire) : M3712016 Président : ABOUQAL.R Directeur : BELAYACHI.J Juge : MADANI.N Juge : AHID.S HEALTH RELATED QUALITY OF LIFE TRAJECTORIES OF PATIENTS IN A MOROCCAN ACUTE MEDICAL UNIT : A LATENT CLASS GROWTH MODELING APPROACH [thèse] / Adnane EL KHATTATE, Auteur . - 2016.
Langues : Français (fre)
Mots-clés : Acute medical unit (AMU) EQ5D Health related quality of life (HRQoL) Trajectory. Résumé : Introduction:The objectives of this study were to identify and describe a set of longitudinal HRQoL trajectories of patients in an AMU,then determine factors associated with trajectory class membership of patients after acute illness.
Methods:This was a prospective cohort study conducted in an acute medical unit of Ibn-SinaUniversity-Hospital, Rabat, between June and September 2014. Patients aged≥17 years were included; those unable to complete the questionnaire were excluded. Demographic, medical-history, clinical and paraclinical characteristics were recorded at admission. EQ5D-index, EQ-VAS and survival status were collected at admission, 3, 6 and 18 months of follow-up. Latent-class-growth-analysis was applied to identify classes of HRQoL-trajectories. Association between baseline covariate and class membership were identified using polynomial-logistic-regression. Statistical analysis was carried out in STATA-14.
Results:We included 251 patients. The mean age: 55.6 ±18.9 years, women were 54.6%. In-hospital and 18 months follow-up mortality were 11.6% and 34.3%. Three trajectory classes were identified for EQ5D-Index; stably low(16.2%), stably moderate(30.6%), and high initially increasing(53.2%). The three trajectory classes of EQ-VAS were low increasing(29.7%), moderate initially increasing(48.5%) and high initially increasing(21.8%).
EQ5D-index: comparing to high initially increasing, factors associated to stably low trajectory membership were: age≥70years, ICU transit and low hemoglobinemia. EQ-VAS: comparing to high initially increasing, factors associated tolow increasing trajectory membership were: female gender, Km-hospital-residence and comorbidity.
Conclusions:We identified 3 stable HRQoL-trajectories, confirming that previous-HRQoL is more important in defining HRQoL evolution than acute illness. Elderly with low hemoglobinemia and who transited through ICU had the worst EQ5D-index. Females, with comorbidities, living far from hospital perceived an amelioration of their low EQ-VAS.
Keywords: Acute medical unit (AMU), EQ5D, Health related quality of life (HRQoL), Trajectory.
Numéro (Thèse ou Mémoire) : M3712016 Président : ABOUQAL.R Directeur : BELAYACHI.J Juge : MADANI.N Juge : AHID.S Réservation
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Code barre Cote Support Localisation Section Disponibilité M3712016 WA Thèse imprimé Unité des Thèses et Mémoires ThèsesMéd2016 Disponible M3712016-1 WA Thèse imprimé Unité des Thèses et Mémoires ThèsesMéd2016 Disponible
Titre : Prevalence and Prognosis Impact of Malnutrition in Elderly of a Moroccan Acute Medical Unit Type de document : thèse Auteurs : Myriam BIZRANE, Auteur Année de publication : 2016 Langues : Français (fre) Mots-clés : Acute medical unit (AMU) Elderly Malnutrition Mini-nutritional assessment Mortality. Résumé : Introduction: Our study aimed to identify the prevalence of malnutrition in elderly admitted to an AMU and to compare patients according to their nutritional status; then analyze the prognosis impact of malnutrition at 540 days follow-up.
Method: This was a prospective cohort studyconducted in the AMU of IbnSina University Hospital, Rabat, from June to September 2014, including patients aged of ≥65 years. Demographic, anthropometric and clinical characteristics, comorbid diseases and in-hospital evolution data were included. Survival status was evaluated in the hospital and at 540 days follow-up. For malnutrition we used MNA, and for the health and functional status, EuroQol-5D and ADL. We identified the factors associated with long-term mortality. Then, multivariable model incorporating conventional risk variables (Model1 and Model2) was calculated and its predictive performance assessed. Statistical analyses were carried out in SPSS Statistics and STATA 14.
Results: We included 95 patients. Mean age was 75±5.9 years; 64.2% were women. In-hospital and 540 days mortality were 16.8% and 46.3%. Median of ADL and EQ5D-Index before acute illness were 5.5 [3.5;6] and 0.29 [-0.17;0.81]. Prevalences of well-nourished, at risk of malnutrition and malnourished patients were 46.3%, 27.4%, and 26.3%. Compared to well-nourished patients, others had significantly higher mortality. Multivariate analyses showed that malnutrition was a strong independent predictor of long-term mortality. Model2 included; unmarried patients, lower Mean arterial pressure, lower EQ5D index andmalnourished patients. For increasing probability thresholds, the model2 had higher net benefit, suggesting its potentially higher clinical utility.
Conclusion: Malnutrition has a negative prognosis impact on the long-term survival status of elderly in an AMU. Therefore, its high clinical utility should be considered to guide nutrition interventions.
Numéro (Thèse ou Mémoire) : M3722016 Président : ABOUQAL.R Directeur : BELAYACHI.J Juge : MADANI.N Juge : BARAKAT.A Prevalence and Prognosis Impact of Malnutrition in Elderly of a Moroccan Acute Medical Unit [thèse] / Myriam BIZRANE, Auteur . - 2016.
Langues : Français (fre)
Mots-clés : Acute medical unit (AMU) Elderly Malnutrition Mini-nutritional assessment Mortality. Résumé : Introduction: Our study aimed to identify the prevalence of malnutrition in elderly admitted to an AMU and to compare patients according to their nutritional status; then analyze the prognosis impact of malnutrition at 540 days follow-up.
Method: This was a prospective cohort studyconducted in the AMU of IbnSina University Hospital, Rabat, from June to September 2014, including patients aged of ≥65 years. Demographic, anthropometric and clinical characteristics, comorbid diseases and in-hospital evolution data were included. Survival status was evaluated in the hospital and at 540 days follow-up. For malnutrition we used MNA, and for the health and functional status, EuroQol-5D and ADL. We identified the factors associated with long-term mortality. Then, multivariable model incorporating conventional risk variables (Model1 and Model2) was calculated and its predictive performance assessed. Statistical analyses were carried out in SPSS Statistics and STATA 14.
Results: We included 95 patients. Mean age was 75±5.9 years; 64.2% were women. In-hospital and 540 days mortality were 16.8% and 46.3%. Median of ADL and EQ5D-Index before acute illness were 5.5 [3.5;6] and 0.29 [-0.17;0.81]. Prevalences of well-nourished, at risk of malnutrition and malnourished patients were 46.3%, 27.4%, and 26.3%. Compared to well-nourished patients, others had significantly higher mortality. Multivariate analyses showed that malnutrition was a strong independent predictor of long-term mortality. Model2 included; unmarried patients, lower Mean arterial pressure, lower EQ5D index andmalnourished patients. For increasing probability thresholds, the model2 had higher net benefit, suggesting its potentially higher clinical utility.
Conclusion: Malnutrition has a negative prognosis impact on the long-term survival status of elderly in an AMU. Therefore, its high clinical utility should be considered to guide nutrition interventions.
Numéro (Thèse ou Mémoire) : M3722016 Président : ABOUQAL.R Directeur : BELAYACHI.J Juge : MADANI.N Juge : BARAKAT.A Réservation
Réserver ce document
Exemplaires
Code barre Cote Support Localisation Section Disponibilité M3722016 WA Thèse imprimé Unité des Thèses et Mémoires ThèsesMéd2016 Disponible M3722016-1 WA Thèse imprimé Unité des Thèses et Mémoires ThèsesMéd2016 Disponible
