(Press-News.org) People who leave hospital against their doctors' orders are more likely to be readmitted to hospital or die, according to a new study in CMAJ (Canadian Medical Association Journal).
"Leaving the hospital against medical advice was associated with increased risks of readmission to hospital and death that persisted for at least 6 months," writes Dr. Allan Garland, Faculty of Medicine, University of Manitoba, Winnipeg, with coauthors. "Potential mechanisms for these associations directly related to the patients' acute illness include more severe illness or incomplete treatment of the illness."
Researchers looked at 1 916 104 adult admissions and live discharges over almost 20 years (1990) in Manitoba to determine rates of unplanned admission to hospital within 30 days and death within 90 days after discharge. There were 21 417 (1.1%) instances of patients leaving hospital against medical advice. People who left hospital against medical advice had 3 times the rate of readmission in the month following. Of readmissions within 30 days among patients who left hospital against medical advice, one-quarter occurred within 1 day and 75% within 2 weeks. People who were older, male, of lower socioeconomic status and who had multiple admissions to hospital in the preceding 5 years were more likely to be readmitted. The odds of death within 90 days were two and a half times higher for people who left hospital against medical advice.
"For both hospital readmission and death, the elevated rates among patients who left against medical advice started out high and then declined, but remained elevated to at least 180 days," write the authors.
They suggest that these elevated levels of risk may be linked to both the illness for which the patients were admitted to hospital or to their characteristics or health behaviors, such as not following medical advice or medication orders.
Other smaller studies exist, but his study was large, with more than 21 000 instances of patients leaving hospital against medical advice.
"Although strategies targeted at trying to convince patients not to leave prematurely might diminish the early effects of leaving against medical advice, reducing the persistently elevated risk will likely require longitudinal interventions extending beyond hospital admission," conclude the authors.
### END
Patients leaving hospital against medical advice more likely to be readmitted or die
2013-08-26
ELSE PRESS RELEASES FROM THIS DATE:
Changing river chemistry affects Eastern US water supplies
2013-08-26
COLLEGE PARK, Md – Human activities are changing the basic chemistry of many rivers in the Eastern U.S. in ways that have potentially major consequences for urban water supplies and aquatic ecosystems, a University of Maryland-led study has found.
In the first survey of its kind, a research team looked at long-term records of alkalinity trends in 97 rivers from Florida to New Hampshire. Over time spans of 25 to 60 years, two-thirds of the rivers had become significantly more alkaline.
Increased alkalinity complicates drinking water and wastewater treatment, encourages ...
Shopping in high heels could curb overspending
2013-08-26
When shopping for a big ticket item, such as a television, there is a checklist of things you should always do:
1. Read reviews
2. Compare prices
3. Wear high heels
If you're uncomfortable with No. 3, you have other options. You can ride up and down the escalator, play a few games using the Wii Fit, or just go shopping immediately following your yoga class.
A new BYU study finds that consumers experiencing a heightened sense of balance are more likely to weigh the options and go with a product that falls in the middle of the high-end, low-end scale.
"If you're ...
Study supports intracerebral stem cell injections to prevent/reduce post-stroke cognitive deficits
2013-08-26
Amsterdam, NL, August 23, 2013 – Cognitive deficits following ischemic stroke are common and debilitating, even in the relatively few patients who are treated expeditiously so that clots are removed or dissolved rapidly and cerebral blood flow restored. A new study in Restorative Neurology and Neuroscience demonstrates that intracerebral injection of bone-marrow-derived mesenchymal stem cells (BSCs) reduces cognitive deficits produced by temporary occlusion of cerebral blood vessels in a rat model of stroke, suggesting that BSCs may offer a new approach for reducing post-stroke ...
ASO corrects striatal transcriptional abnormalities & protects function in HD mice
2013-08-26
Amsterdam, NL, 26 August 2013 – Findings from postmortem studies of the brains of Huntington's Disease (HD) patients suggest that transcriptional dysregulation may be an early step in the pathogenesis of HD before symptoms appear. Other studies report transcriptional alterations in the brains of some mouse models of HD. A new study has found transcriptional changes in mouse striatum which correlate with progressive motor and psychiatric deficits and, most importantly, reports for the first time, that an antisense oligonucleotide (ASO) may be used therapeutically to both ...
First report of real-time manipulation and control of nuclear spin noise
2013-08-26
Basel Physicists in collaboration with Dutch researchers have demonstrated a new method for polarizing nuclear spins in extremely small samples. By Monitoring and controlling spin fluctuations, the method may provide a route for enhancing the resolution of magnetic resonance imaging (MRI) on the nanometer-scale, allowing researchers to make 3D images of smaller objects than ever before. The results have been published in the journal Nature Physics.
Many of the elements that make up the matter around us, such as hydrogen or phosphorus, contain a magnetic nucleus at the ...
Preschoolers who stutter do just fine emotionally and socially, study finds
2013-08-26
A study of over 1600 children, which followed the children from infancy to four years old, found the cumulative incidence of stuttering by four years old was 11 per cent, more than twice what has previously been reported.
However, the study refutes the long held view that suggests developmental stuttering is associated with a range of poorer outcomes in the preschool period. Interestingly, the study found the reverse was true, with stuttering associated with better language development, non-verbal skills with no identifiable effect on the child's mental health or temperament ...
Rim Fire Update Aug. 26, 2013
2013-08-26
The Rim Fire in northeastern California continues to burn on the Stanislaus National Forest, Yosemite National Park, and the Bureau of Land Management and State responsibility land. This fire began on August 17, 2013 and its cause is still currently under investigation. Over 224 square miles have been affected as of Sunday, August 25. It is still only 7 percent contained. Inaccessible terrain, strong winds, and dry conditions all present at this fire make for very difficult fire fighting. The ability for this fire to create havoc spreads far and wide, beyond even the ...
New function for a well-known immune messenger molecule
2013-08-26
The molecule interleukin-7 (IL-7) is an important immune messenger protein which ensures that a sufficient number of T cells are present in our body for immune defence. Researchers from ETH Zurich have now demonstrated that IL-7 has another important function: it enhances the drainage function of lymphatic vessels, which collect fluid that has leaked out of blood vessels into the body tissue and return it to the bloodstream. In the future, this finding could become useful for lymphedema patients, whose lymphatic drainage system does not work properly, resulting in fluid ...
Through 4 years' training, college football players gain strength and size
2013-08-26
Philadelphia, Pa. (August 26, 2013) - From freshman through senior year, college football players achieve significant increases in strength and size, reports a study in the September issue of The Journal of Strength and Conditioning Research, official research journal of the National Strength and Conditioning Association (NSCA).
The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.
But even with modern training regimens, these athletes show limited changes in speed and power, according to the study by Bert H. Jacobson, EdD, FACSM, ...
NASA sees Depression Pewa pass in Pacific
2013-08-26
Tropical Depression Pewa dissipated in the northwestern Pacific Ocean early on Aug. 26, 2013. NASA satellite data on the previous day showed that rainfall had greatly diminished in the depression.
On Aug. 25, Tropical Depression Pewa's circulation had expanded and the storm weakened. Forecasters at the Joint Typhoon Warning Center expected Pewa would dissipate over the next day. Earlier thoughts were that Pewa might hang together and become an extra-tropical storm, but it appears that the life is leaving the storm.
The Joint Typhoon Warning Center's official, final ...