All Journals from Roman Romero-Ortuno
Abstract
Aim: to create and validate a Risk Index for Geriatric Acute Medical Admissions (RIGAMA) for those aged ≥ 65, based on accumulation of deficits.
Methods: we retrospectively validated a 30-item RIGAMA against inpatient mortality, length of stay (LOS), discharge to long-term care (LTC) and 30-day readmission, adjusted for age.
Results: ≥ 1 RIGAMA deficit was superior to age in predicting mortality and prolonged LOS, with a clear incremental effect. The latter was true for ≥3 deficits in predicting 30-day readmission. Three to 5 deficits predicted discharge to LTC better than age.
Conclusion: RIGAMA is easy to collect by the admitting junior doctor and may help trigger early senior support and inform the appropriate use of hospital resources by older patients.
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Abstract
Aim: to describe the characteristics and outcomes of homeless people admitted to our Internal Medicine service in St. James’s Hospital, Dublin (Ireland), between 2002 and 2011.
Methods: we interrogated an anonymized in-patient database.
Results: there were 1,460 homeless admissions (623 unique patients; 39% admitted more than once). Most patients were young, male, and had low comorbidity levels. Thirty-seven percent of the admissions were alcohol-related and 27% substance abuse-related. Thirteen percent had an active psychiatric illness. Their in-patient mortality rate was 5%. Seventy two percent were discharged without the residential arrangement being explicitly documented, 15% self-discharged or absconded, and 8% were discharged to a residential facility.
Conclusion: results are novel in our context and will be relevant for local policy and practice.
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