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Epidemiology
- adults >= 65 years of age comprise 13% of the population, account for 36% of hospitalizations, & 50% of hospital costs
- hospitalized elderly with lower risk of mortality (11.1% vs 11.5%) when treated by female internist rather than male internist[20]
- older patients triaged in the emergency department as less urgent or not urgent, are much more likely than younger patients to be admitted at the initial presentation (5% vs 0.6%) or over the next 14 days (4% vs. 0.7%)
- the oldest patients (>85 years) were most likely to be admitted (9% vs 2% of those aged 65-74 years)[27]
- older patients spending the night in the emergency department waiting for admission to a hospital ward are increased risk of morbidity & mortality[41]
Complications
- hospital-acquired infection
- loss of ability to perform basic activities of daily living (bADLs) during hospitalization portends substantial 1-year morbidity & mortality in older patients (see functional status in hospitalized elderly)
- risk factors for in hospital functional decline & nursing home placement
- advanced age
- dependence in iADLs
- delirium
- cognitive impairment
- risk factors for rehospitalization (inpatients):
- advanced age
- multiple comorbid conditions
- cognitive impairment
- depression[11][12]
- living alone
- recent hospitalization
- impaired physical function
- "never events" such as falls & pressure ulcers
- more common after weekend hospital admissions[15]
- weekend & public holiday hospitalization associated with higher 30 day mortality than hospitalization on weekdays (5.1 & 5.8% vs 4.7%)[22]
- 4.3% vs 3.6% 30 mortality for weekend admissions vs weekday admissions[24]
- adverse events associated with longer length of hospital stay (2-fold)[42]
- depression is common among hospitalized elderly (30%)[11][12]
- depression persisting after hospital discharge increases risk of functional dependence & death[11][12]
- nursing (RN) staffing below target levels & high patient burden associated with increased in-hospital mortality[2]
- hospitalization of community-dwelling elderly is associated with accelerated cognitive impairment[13]
- executive dysfunction & diminished ventricular size after hospitalization of older adults[14]
- slightly higher risk (RR=1.18) for cardiac arrest or intensive care unit transfer in the 6 hours after an index patient's critical event[21]
- sleep disturbance: patients awakened on average once an hour[32]
- cognitive decline
- hospitalization (> 2 nights) for surgery, medical conditions, or stroke associated with excess cognitive decline, equivalent to 5 months, 1.4 years, & 13 years of aging, respectively[36]
Management
- assess functional status in hospitalized elderly
- admission of hospitalized elderly to an acute geriatric unit is associated with lower risk of functional decline & greater chance of discharge to home from the hospital (GRS9)[1]
- see functional status in hospitalized elderly
- guidelines for improving outcomes in hospitalized elderly[1]
- recommended noise levels[25]
- optimize the environment to promote mobility & orientation
- interdisciplinary team-based care with protocols for
- independent self-care
- nutrition[8]
- individualized diet plans improve outcomes vs hospital food[34]
- unclear whether thickened liquid diet benefits patients with Alzheimer's disease & related dementias & dysphagia[44]
- sleep hygiene
- skin care (prevention of pressure ulcers)
- mood assessment
- cognitive assessment
- early discharge planning with social work intervention
- medication reconciliation[1]
- assessing mobility on admission assists in discharge planning[37]
- mobilize within 48 hours for prevent ICU admission[16]
- walk 2-3 times/day to prevent functional decline[1][10]
- an individualized, multicomponent in hospital exercise program may mitigate functional decline associated with acute hospitalization in very elderly patients[31]
- supervised walking programs improve mobility of hospitalized elderly & may prevent discharge to skilled nursing facility[38]
- structured mobility program that includes early mobilization & walking to facilitate maintainence of prehospital walking ability[1][47]
- no evidence of improvement in functional benefit or reduction in length of hospital stay with supplements of protein or energy[19]
- triage to appropriate hospital ward (level of care)
- patients placed on off-service units (non-internal medicine wards) at higher risk of in-hospital mortality (RR=3.3)[26]
- reducing unnecessary hospitalization
- preventing unnecessary hospitalizations & ED visits in nursing home patients involves more than just staff education & care planning[23]
- prophylaxis for venous thromboembolism with LMW heparin if patient immobilized for >= 4 days
hypertension in hospitalized patients
- hospitalized patients with asymptomatic elevations in blood pressure do not require treatment with IV antihypertensive medications[33][46]
- intensive antihypertensive treatment of hospitalized older adults with elevated blood pressures is associated with a greater risk of adverse events[39]
- treatment associated with higher risks of acute kidney injury & myocardial injury[40]
- malignant hypertension (BP > 180/120 with end-organ damage) is treated with intravenous antihypertensive agents in intensive care settings[43][46]
- no consensus on treatment (or not) of hypertensive urgency[43][46]
- maintain prehospitalization blood pressure regimen at hospital discharge unless hypotension contributed to hospital admission[45]
- avoid intensification of blood pressure medications at hospital discharge[45][46]
communication with outpatient physician(s)
- preferred mode of communication varies with primary care practice type
- most primary care providers prefer communication at admission & prior to discharge
- discharge summary alone is insufficient
Notes
- in hospital strategies that reduce mortality (example = MI)
- monthly meetings to review myocardial infarction cases with hospital clinicians & staff who transport patients to the hospital
- having an on-site cardiologist at all times
- cultivating an environment in which clinicians are encouraged to solve problems creatively
- avoiding cross-training of intensive care unit nurses for cardiac catheterization laboratories
- having at least one quality-improvement champion who is a physician rather than a nurse
- in hospital coordinated discharge planning with follow-up at home reduces subsequent hospitalization
- the KELS evaluates needs of patient in the community after hospital discharge
- multicomponent interventions at the healthcare systems level are required to influence care outcomes associated with hospital discharge[4]
- higher quality of care for hospitalized elderly by ACOVE measures results in lower one year post-hospitalization mortality[6]
- specialized care units for cognitively-impaired patients does not improve patient outcomes, but slightly improves family caregiver satisfaction[5]
- single room accomodations do not improve safety outcomes[18]
- quality sleep should be treated as fundamental to recovery from illness, rather than a casualty of other priorities[29]
- sleep disruption is common in hospitalized patients & is a risk factor for delirium[30] (see in-hospital sleep disruption)
- early involvement of an endocrinologist & diabetes nurse improves glycemic control but not most clinical outcomes[35]
More general terms
More specific terms
Additional terms
- 3-day hospital stay rule
- functional status in hospitalized elderly
- hospital
- hospital discharge
- justification for hospitalization
- Kohlman Evaluation of Living Skills (KELS)
- length of stay (LOS)
- preventing hospitalization; reducing hospitalization
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010
Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016
Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022 - ↑ 2.0 2.1 Needleman J et al. Nurse staffing and inpatient hospital mortality. N Engl J Med 2011 Mar 17; 364:1037 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21410372
- ↑ Bradley EH et al. Hospital strategies for reducing risk-standardized mortality rates in acute myocardial infarction. Ann Intern Med 2012 May 1; 156:618. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22547471
- ↑ 4.0 4.1 Hesselink G et al Improving patient handovers from hospital to primary care: A systematic review. Ann Intern Med 2012 Sep 18; 157:417. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22986379
Prvu Bettger J et al. Transitional care after hospitalization for acute stroke or myocardial infarction. Ann Intern Med 2012 Sep 18; 157:407. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22986378
Bray-Hall ST. Transitional care: Focusing on patient-centered outcomes and simplicity. Ann Intern Med 2012 Sep 18; 157:448. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22986380 - ↑ 5.0 5.1 Goldberg SE et al. Care in specialist medical and mental health unit compared with standard care for older people with cognitive impairment admitted to general hospital: Randomised controlled trial (NIHR TEAM trial). BMJ 2013 Jul 2; 347:f4132 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23819964 <Internet> http://www.bmj.com/content/347/bmj.f4132?ijkey=80c8cd420c4fa9629f6ab82ffdef06043f7c6a76&keytype2=tf_ipsecsha
- ↑ 6.0 6.1 Arora VM, Fish M, Basu A et al Relationship between quality of care of hospitalized vulnerable elders and postdischarge mortality. J Am Geriatr Soc. 2010 Sep;58(9):1642-8. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20863323
- ↑ Dykes PC et al, Fall Prevention in Acute Care Hospitals JAMA. 2010;304(17):1912-1918 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/21045097 <Internet> http://jama.ama-assn.org/cgi/content/abstract/304/17/1912
- ↑ 8.0 8.1 Feldblum I, German L, Castel H, Harman-Boehm I, Shahar DR. Individualized nutritional intervention during and after hospitalization: the nutrition intervention study clinical trial. J Am Geriatr Soc. 2011 Jan;59(1):10-7 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21087222
- ↑ Mehta KM, Pierluissi E, Boscardin WJ et al A clinical index to stratify hospitalized older adults according to risk for new-onset disability. J Am Geriatr Soc. 2011 Jul;59(7):1206-16. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21649616
- ↑ 10.0 10.1 Zisberg A, Shadmi E, Sinoff G et al Low mobility during hospitalization and functional decline in older adults. J Am Geriatr Soc. 2011 Feb;59(2):266-73. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21314647
- ↑ 11.0 11.1 11.2 11.3 Barry LC, Murphy TE, Gill TM. Depression and functional recovery after a disabling hospitalization in older persons. J Am Geriatr Soc. 2011 Jul;59(7):1320-5. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21668916
- ↑ 12.0 12.1 12.2 12.3 Pierluissi E, Mehta KM, Kirby KA, et al. Depressive symptoms after hospitalization in older adults: function and mortality outcomes. J Am Geriatr Soc. 2012;60:2254-2262 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23176725
- ↑ 13.0 13.1 Wilson RS et al Cognitive decline after hospitalization in a community population of older persons Neurology March 21, 2012 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22442434 <Internet> http://www.neurology.org/content/early/2012/03/21/WNL.0b013e31824d5894.abstract
- ↑ 14.0 14.1 Brown CH IV et al. Association of hospitalization with long-term cognitive and brain MRI changes in the ARIC cohort. Neurology 2015 Mar 11 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25762715 <Internet> http://www.neurology.org/content/early/2015/03/11/WNL.0000000000001439
- ↑ 15.0 15.1 Attenello FJ et al. Incidence of "never events" among weekend admissions versus weekday admissions to US hospitals: National analysis. BMJ 2015 Apr 15; 350:h1460. PMID: https://www.ncbi.nlm.nih.gov/pubmed/25876878
- ↑ 16.0 16.1 Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015
- ↑ Churpek MM, Yuen TC, Edelson DP. Risk stratification of hospitalized patients on the wards. Chest. 2013 Jun;143(6):1758-65. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23732586 Free PMC Article
- ↑ 18.0 18.1 Simon M, Maben J, Murrells T, Griffiths P Is single room hospital accommodation associated with differences in healthcare-associated infection, falls, pressure ulcers or medication errors? A natural experiment with non-equivalent controls. J Health Serv Res Policy. 2016 Jan 24 PMID: https://www.ncbi.nlm.nih.gov/pubmed/26811373
- ↑ 19.0 19.1 Milne AC, Potter J, Vivanti A, Avenell A. Protein and energy supplementation in elderly people at risk from malnutrition. Cochrane Database Syst Rev. 2009 Apr 15;(2):CD003288. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19370584
- ↑ 20.0 20.1 Lou N Older Hospital Patients Get Better Care from Female Docs. MedPage Today. December 19, 2016 http://www.medpagetoday.com/HospitalBasedMedicine/GeneralHospitalPractice/62156
Tsugawa Y, Jena AB, Figueroa JF et al Comparison of Hospital Mortality and Readmission Rates for Medicare Patients Treated by Male vs Female Physicians. JAMA Intern Med. 2017;177(2):206-213 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27992617 <Internet> http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2593255
Parks AL, Redberg RF Outcomes: Equal Rights for Better Work? JAMA Intern Med. Published online December 19, 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27992623 <Internet> http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2593252 - ↑ 21.0 21.1 Volchenboum SL et al. Association between in-hospital critical illness events and outcomes in patients on the same ward. JAMA 2016 Dec 27; 316:2674 PMID: https://www.ncbi.nlm.nih.gov/pubmed/28027358
- ↑ 22.0 22.1 Walker AS, Mason A, Quan TP et al. Mortality risks associated with emergency admissions during weekends and public holidays: An analysis of electronic health records. Lancet 2017 May 9; <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28499548 Free Article <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30782-1/fulltext
- ↑ 23.0 23.1 Kane RL, Huckfeldt P, Tappen R et al Effects of an Intervention to Reduce Hospitalizations From Nursing Homes: A Randomized Implementation Trial of the INTERACT Program. JAMA Intern Med. 2017 Jul 3. PMID: https://www.ncbi.nlm.nih.gov/pubmed/28672291
- ↑ 24.0 24.1 Pauls LA, Johnson-Paben R, McGready J et al. The weekend effect in hospitalized patients: A meta-analysis. J Hosp Med 2017 Sep; 12:760. PMID: https://www.ncbi.nlm.nih.gov/pubmed/28914284
Quinn KL, Bell CM. Does the week-end justify the means? J Hosp Med 2017 Sep; 12:779 PMID: https://www.ncbi.nlm.nih.gov/pubmed/28914289 - ↑ 25.0 25.1 25.2 Jaiswal SJ, Garcia S, Owens RL. Sound and light levels are similarly disruptive in ICU and non-ICU wards. J Hosp Med 2017 Oct; 12:798. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28991944 <Internet> http://www.journalofhospitalmedicine.com/jhospmed/article/147918/hospital-medicine/sound-and-light-levels-are-similarly-disruptive-icu-and
Kamdar BB, Martin JL, Needham DM Noise and light pollution in the hospital: A call for action. J Hosp Med 2017 Oct; 12:861. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28991956 <Internet> http://www.journalofhospitalmedicine.com/jhospmed/article/147929/hospital-medicine/noise-and-light-pollution-hospital-call-action - ↑ 26.0 26.1 Bai AD, Srivastava S, Tomlinson GA et al. Mortality of hospitalised internal medicine patients bedspaced to non-internal medicine inpatient units: Retrospective cohort study. BMJ Qual Saf 2018 Jan; 27:11 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29101293 <Internet> http://qualitysafety.bmj.com/content/27/1/11
- ↑ 27.0 27.1 Hendin A, Eagles D, Myers V, Stiell IG. Characteristics and outcomes of older emergency department patients assigned a low acuity triage score. CJEM. 2018 Mar 5:1-8 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29502553 https://www.cambridge.org/core/journals/canadian-journal-of-emergency-medicine/article/characteristics-and-outcomes-of-older-emergency-department-patients-assigned-a-low-acuity-triage-score/0237D91AAFABFB10685A51D082E086D7
- ↑ Lawrence D, Shah AK, Lee EK et al. Primary care provider preferences for communication with inpatient teams: One size does not fit all. J Hosp Med 2018 Mar; 13:177. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29154380 https://www.journalofhospitalmedicine.com/jhospmed/article/150917/hospital-medicine/primary-care-provider-preferences-communication-inpatient
- ↑ 29.0 29.1 Bevan R, Grantham-Hill S, Bowen R et al. Sleep quality and noise: Comparisons between hospital and home settings. Arch Dis Child 2018 Jul 17; PMID: https://www.ncbi.nlm.nih.gov/pubmed/30018067
- ↑ 30.0 30.1 Wesselius HM, van den Ende ES, Alsma J et al. Quality and quantity of sleep and factors associated with sleep disturbance in hospitalized patients. JAMA Intern Med 2018 Jul 16; PMID: https://www.ncbi.nlm.nih.gov/pubmed/30014139 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2687528
Growdon ME, Inouye SK. Minimizing sleep disruption for hospitalized patients: A wake-up call. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30014149 JAMA Intern Med 2018 Jul 16; https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2687522 - ↑ 31.0 31.1 Martinez-Velilla N, Casas-Herrero A, Zambom-Ferraresi F et al Effect of Exercise Intervention on Functional Decline in Very Elderly Patients During Acute HospitalizationA Randomized Clinical Trial. JAMA Intern Med. Published online November 12, 2018. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30419096 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2714300
Hall WJ. A Novel Exercise Intervention and Functional Status in Very Elderly Patients During Acute Hospitalization. JAMA Intern Med. Published online November 12, 2018. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30419130 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2714298 - ↑ 32.0 32.1 Arora VM, Machado N, Anderson SL et al. Effectiveness of SIESTA on objective and subjective metrics of nighttime hospital sleep disruptors. J Hosp Med 2019 Jan; 14:38 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30667409
- ↑ 33.0 33.1 Jacobs ZG, Najafi N, Fang MC et al. Reducing unnecessary treatment of asymptomatic elevated blood pressure with intravenous medications on the general internal medicine wards: A quality improvement initiative. J Hosp Med 2019 Mar; 14:144. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30811319 https://www.journalofhospitalmedicine.com/jhospmed/article/195045/hospital-medicine/reducing-unnecessary-treatment-asymptomatic-elevated-blood
Pasik SD, Chiu S, Yang J et al. Assess before Rx: Reducing the overtreatment of asymptomatic blood pressure elevation in the inpatient setting. J Hosp Med 2019 Mar; 14:151. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30811320 https://www.journalofhospitalmedicine.com/jhospmed/article/195046/hospital-medicine/assess-rx-reducing-overtreatment-asymptomatic-blood
Anstey J, Lucas BP. Treatment of inpatient asymptomatic hypertension: Not a call to act but to think. J Hosp Med 2019 Mar; 14:190 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30811330 https://www.journalofhospitalmedicine.com/jhospmed/article/195057/hospital-medicine/treatment-inpatient-asymptomatic-hypertension-not-call-act - ↑ 34.0 34.1 Schuetz P, Fehr R, Baechli V et al. Individualised nutritional support in medical inpatients at nutritional risk: A randomised clinical trial. Lancet 2019 Jun 8; 393:2312 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31030981
- ↑ 35.0 35.1 Kyi M, Colman PG, Wraight PR et al. Early intervention for diabetes in medical and surgical inpatients decreases hyperglycemia and hospital-acquired infections: A cluster randomized trial. Diabetes Care 2019 May; 42:832. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30923164 https://care.diabetesjournals.org/content/42/5/832
- ↑ 36.0 36.1 Krause BM, Sabia S, Manning HJ, Singh-Manoux A, Sanders RD. Association between major surgical admissions and the cognitive trajectory: 19 year follow-up of Whitehall II cohort study. BMJ 2019 Aug 7; 366:l4466 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31391161 Free PMC Article https://www.bmj.com/content/366/bmj.l4466
- ↑ 37.0 37.1 Young DL, Colantuoni E, Friedman LA et al, Prediction of disposition within 48-hours of hospital admission using patient mobility scores. J Hosp Med 2019 Dec 23; 14:E1-E4. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31869298 https://www.journalofhospitalmedicine.com/jhospmed/article/212336/hospital-medicine/prediction-disposition-within-48-hours-hospital-admission
- ↑ 38.0 38.1 Hastings SN et al. Effects of implementation of a supervised walking program in Veterans Affairs hospitals: A stepped-wedge, cluster randomized trial. Ann Intern Med 2023 Jun; 176:743. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37276590 https://www.acpjournals.org/doi/10.7326/M22-3679
- ↑ 39.0 39.1 Anderson TS et al. Clinical outcomes of intensive inpatient blood pressure management in hospitalized older adults. JAMA Intern Med 2023 Jul; 183:715. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37252732 PMCID: PMC10230372 (available on 2024-05-30) https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2805021
- ↑ 40.0 40.1 Rastogi R, Sheehan MM, Hu B, Shaker V, Kojima L, Rothberg MB. Treatment and outcomes of inpatient hypertension among adults with noncardiac admissions. JAMA Intern Med 2020 Dec 28; PMID: https://www.ncbi.nlm.nih.gov/pubmed/33369614 https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2774562
- ↑ 41.0 41.1 Roussel M, Teissandier D, Yordanov Y et al Overnight Stay in the Emergency Department and Mortality in Older Patients. JAMA Intern Med. Published online November 6, 2023. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37930696 PMCID: PMC10628833 Free PMC article. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2811179
- ↑ 42.0 42.1 Bates DW, Levine DM, Salmasian H et al The Safety of Inpatient Health Care. N Engl J Med. 2023 Jan 12;388(2):142-153. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36630622 https://www.nejm.org/doi/10.1056/NEJMsa2206117
- ↑ 43.0 43.1 43.2 Wilson LM, Herzig SJ, Steinman MA et al. Management of inpatient elevated blood pressures: A systematic review of clinical practice guidelines. Ann Intern Med 2024 Apr 2 PMID: https://www.ncbi.nlm.nih.gov/pubmed/38560900 Review. https://www.acpjournals.org/doi/10.7326/M23-3251
- ↑ 44.0 44.1 Makhnevich A et al. Thick liquids and clinical outcomes in hospitalized patients with Alzheimer disease and related dementias and dysphagia. JAMA Intern Med 2024 May 6; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/38709510 PMCID: PMC11074929 (available on 2025-05-06) https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2818195
- ↑ 45.0 45.1 45.2 Rastogi R et al. Treatment and outcomes of inpatient hypertension among adults with noncardiac admissions. JAMA Intern Med 2020 Dec 28; [e-pub] PMID: https://www.ncbi.nlm.nih.gov/pubmed/33369614 PMCID: PMC7770615 Free PMC article. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2774562
- ↑ 46.0 46.1 46.2 46.3 46.4 Bress AP et al. The management of elevated blood pressure in the acute care setting: A scientific statement from the American Heart Association. Hypertension 2024 Aug; 81:e94. PMID: https://www.ncbi.nlm.nih.gov/pubmed/38804130 Free article. Review. https://www.ahajournals.org/doi/10.1161/HYP.0000000000000238
- ↑ 47.0 47.1 Smart DA, Dermody G, Coronado ME, Wilson M. Mobility Programs for the Hospitalized Older Adult: A Scoping Review. Gerontol Geriatr Med. 2018 Nov 1;4:2333721418808146. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30450367 PMCID: PMC6236485 Free PMC article. Review.