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  1. Chan, Lai Fong, Tuti Iryani Mohd Daud, Hazli Zakaria, Phang, Cheng Kar, Loo, Tsui Huei, Ong, Lieh Yan, et al.
    ASEAN Journal of Psychiatry, 2010;11(1):25-35.
    MyJurnal
    Objective: According to Malaysian law, defendants found not guilty by reason of insanity may be admitted to a psychiatric hospital and discharge is subject to the state ruler’s assent. The objective of this study is to examine the clinical, socio-demographic and forensic factors that influence inpatient duration of insanity acquittees in a Malaysian mental institution. Methods:This is a cross-sectional study of one hundred and twelve insanity acquittee inpatients in Hospital Bahagia Ulu Kinta from January 2007 to February 2007. Patients with a clinical diagnosis of schizophrenia, major depressive disorder and bipolar disorder were assessed using the Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale (HAMD) and Young Mania Rating Scale (YMRS) respectively. Other relevant sociodemographic, clinical and forensic factors were also assessed. Results: The inpatient duration varied widely from three months to forty-seven years with a median of seven years. Seventy five percent of patients were in remission. According to the multiple linear regression model, the strongest predictor of a longer duration of hospital stay for insanity acquittees was older age (p
    Matched MeSH terms: Inpatients
  2. Marhani Midin, Salina Abdul Aziz, Phang, Cheng-Kar
    ASEAN Journal of Psychiatry, 2010;11(2):206-215.
    MyJurnal
    Objective: Mental health services in Malaysia often face competition from traditional healers especially among patients with psychosis. The objective of the study is to determine whether patients who sought help earlier from traditional healers had longer duration of untreated psychosis (DUP), and more adverse experiences in pathways to psychiatric care. Methods: This is a hospital-based cross-sectional study of 50 inpatients with first-episode
    psychosis in Hospital Kuala Lumpur. Structured Clinical Interview for DSM-IV (Diagnostic and statistical manual, 4th edition) Clinical Version for Axis I Disorders (SCID-CV) was used for establishing diagnosis. Onset of psychosis was defined as any one positive symptom with a score of >3 on the Positive and Negative Syndrome Scale (PANSS). Socio-demographic
    data, information on pathways and treatment delaying factors were determined through face-to-face interview and semi-structured questionnaire. Results: Fifty-four percent of the patients had at least one contact with traditional healers prior to consulting psychiatric service, and it was the most popular first point of non-psychiatric help-seeking contact
    (48%). Contact with traditional healers was not associated with age, gender, ethnic, education level, longer DUP or treatment delay, and admissions with violent behaviour or police assistance. Of those who had sought help from traditional healers, one third were recommended by at least one of their traditional healers to seek medical help. Conclusion:
    Consultation involving traditional healers was a popular choice, and not associated with treatment delay. Traditional healers in an urban setting may be potential collaborators in managing patients with first-episode psychosis. Future research should explore the frontiers of such collaborative work.
    Matched MeSH terms: Inpatients
  3. Zahiruddin Othman, Muhammad Najib Muhammad Alwi, Kamarul Imran Musa, Muhammad Najib Muhammad Alwi, Ruzita Jamaluddin
    ASEAN Journal of Psychiatry, 2009;10(1):54-74.
    MyJurnal
    Objective: Many studies have emphasized the significance of verbal memory for the functional outcome in schizophrenia. A preserved capability to encode and recall verbal information is essential for the long-term efficacy of psychoeducational programs and other
    psychological intervention to ensure the successful transfer of newly acquired skills or knowledge into everyday life. Aims of this study aimed to validate the MVALT among schizophrenia patients in HUSM. Methods: The subjects were 15 schizophrenia patients
    conveniently selected from the patients that attended follow up at the psychiatry clinic in HUSM or inpatients who have been admitted during the study period and 15 healthy control subjects as a comparison. Reliability and validity of the MVAVLT were analyzed. Results: The validation study showed that the Malay version Auditory Verbal Learning Test (MVAVLT) had a good validity (factor analysis 0.66 to 0.98) and test-retest reliability (pearson correlation ranged from 0.24 to 0.84) and has been shown to be sensitive in
    discriminating between normal and schizophrenia patients. In line with the previous research, the schizophrenia patients performed significantly worse than healthy control in all indexes measured in MVAVLT. Conclusion: The screening of deficits in verbal learning
    and memory among the schizophrenia patients is important, for early detection and treatment since it can be helpful for clinicians and psychologists in their counseling sessions. Subsequently, it helps patients to reduce such cognitive difficulties and their impact by using specific rehabilitation with the usage of newer antipsychotic agents.
    Matched MeSH terms: Inpatients
  4. Lee, Wen Jih, Ong, Lieh Yan, Koay, Siew Ni, Kwan, Zuan Er
    MyJurnal
    Objective: The main aim of this study is to assess the prevalence of early
    readmissions to inpatient care in Hospital Bahagia Ulu Kinta and the associated
    socio-demographic and clinical factors.

    Methods: This is an observational study
    for all patients with readmissions within 3 months from the last discharge, dated
    from 1 January 2013 to 31 December 2013. Related socio-demographic and
    clinical details are obtained from the medical records and compared between the
    patients who were readmitted within the first month after discharge to those who
    were readmitted later in the second and third month.

    Results: Total of 149
    records of patients who were readmitted within 3 months of last discharge were
    analyzed. Majority of them were from the same state of Perak (83.9%), male
    (74.5%), single (71.1%), unemployed (85.9%), taken care by family (75.2%),
    achieved secondary education level (59.7%) with mean age of 37.89 years (SD
    11.53). They were discharged for a mean of 32.52 days (SD 26.48) before
    readmission with a mean duration of 72.98 days in the previous admission, and
    mean previous admissions of 10.17 times. 69.8% of the patients were treated for
    psychotic disorders and the main reason for readmission was relapse (84.6%).
    Up to 34.2% of the patients reported to have substance abuse while 25.5% had
    medical co-morbidities. Most of the patients (63.8%) were not compliant to the
    treatment from the last discharge. Socioeconomic and clinical factors did not
    show statistical significance when the readmissions within the first month after
    discharge were compared to those who were admitted later at the second and
    third month.

    Conclusions: Due to limitations, further studies need to be done to
    identify risk factors associated with readmissions and adequate measures need to
    be taken to prevent these readmissions.
    Matched MeSH terms: Inpatients
  5. Hamdan M, Shuhaina S, Hong JGS, Vallikkannu N, Zaidi SN, Tan YP, et al.
    Acta Obstet Gynecol Scand, 2021 Nov;100(11):1977-1985.
    PMID: 34462906 DOI: 10.1111/aogs.14247
    INTRODUCTION: Multiparous labor inductions are typically successful, and the process can be rapid, starting from a ripened cervix with a predictable response to amniotomy and oxytocin infusion. Outpatient Foley catheter labor induction in multiparas with unripe cervixes is a feasible option as the mechanical process of ripening is usually without significant uterine contractions and well tolerated. Labor contractions can be initiated by amniotomy and titrated oxytocin infusion in the hospital for well-timed births during working hours as night birth are associated with adverse events. We sought to evaluate outpatient compared with inpatient Foley catheter induction of labor in multiparas for births during working hours and maternal satisfaction.

    MATERIAL AND METHODS: A randomized trial was conducted in the University of Malaya Medical Center. A total of 163 term multiparas (no dropouts) with unripe cervixes (Bishop score ≤5) scheduled for labor induction were randomized to outpatient or inpatient Foley catheter. Primary outcomes were delivery during "working hours" 08:00-18:00 h and maternal satisfaction on allocated care (assessed by 11-point visual numerical rating score 0-10, with higher score indicating more satisfied).

    CLINICAL TRIAL REGISTRATION: ISRCTN13534944.

    RESULTS: Comparing outpatient and inpatient arms, delivery during working hours were 54/82 (65.9%) vs. 48/81 (59.3%) (relative risk 1.1, 95% CI 0.9-1.4, p = 0.421) and median maternal satisfaction visual numerical rating score was 9 (interquartile range 9-9) vs. 9 (interquartile range 8-9, p = 0.134), repectively. Duration of hospital stay and membrane rupture to delivery interval were significantly shorter in the outpatient arm: 35.8 ± 20.2 vs. 45.2 ± 16.2 h (p = 0.001) and 4.1 ± 2.9 vs. 5.3 ± 3.6 h (p = 0.020), respectively. Other maternal and neonatal secondary outcomes were not significantly different.

    CONCLUSIONS: The trial failed to demonstrate the anticipated increase in births during working hours with outpatient compared with inpatient induction of labor with Foley catheter in parous women with an unripe cervix. Hospital stay and membrane rupture to delivery interval were significantly shortened in the outpatient group. The rate of maternal satisfaction was high in both groups and no significant differences were found.

    Matched MeSH terms: Inpatients
  6. Adnan S, Ratnam S, Kumar S, Paterson D, Lipman J, Roberts J, et al.
    Anaesth Intensive Care, 2014 Nov;42(6):715-22.
    PMID: 25342403
    Augmented renal clearance (ARC) refers to increased solute elimination by the kidneys. ARC has considerable implications for altered drug concentrations. The aims of this study were to describe the prevalence of ARC in a select cohort of patients admitted to a Malaysian intensive care unit (ICU) and to compare measured and calculated creatinine clearances in this group. Patients with an expected ICU stay of <24 hours plus an admission serum creatinine concentration <120 µmol/l, were enrolled from May to July 2013. Twenty-four hour urinary collections and serum creatinine concentrations were used to measure creatinine clearance. A total of 49 patients were included, with a median age of 34 years. Most study participants were male and admitted after trauma. Thirty-nine percent were found to have ARC. These patients were more commonly admitted in emergency (P=0.03), although no other covariants were identified as predicting ARC, likely due to the inclusion criteria and the study being under-powered. Significant imprecision was demonstrated when comparing calculated Cockcroft-Gault creatinine clearance (Crcl) and measured Crcl. Bias was larger in ARC patients, with Cockcroft-Gault Crcl being significantly lower than measured Crcl (P <0.01) and demonstrating poor correlation (rs=-0.04). In conclusion, critically ill patients with 'normal' serum creatinine concentrations have varied Crcl. Many are at risk of ARC, which may necessitate individualised drug dosing. Furthermore, significant bias and imprecision between calculated and measured Crcl exists, suggesting clinicians should carefully consider which method they employ in assessing renal function.
    Matched MeSH terms: Inpatients/statistics & numerical data
  7. Poh WY, Omar MS, Tan HP
    Ann Saudi Med, 2018 8 6;38(4):269-276.
    PMID: 30078025 DOI: 10.5144/0256-4947.2018.269
    BACKGROUND: Contrast-induced acute kidney injury (CI-AKI) is rec.ognized as a common complication of radiographic contrast-enhanced procedures. N-acetylcysteine (NAC) is commonly prescribed, but CI-AKI can still develop despite NAC administration as prophylaxis.

    OBJECTIVE: Identify the predictive factors for development of CI-AKI in patients prescribed NAC.

    DESIGN: Prospective, cross-sectional.

    SETTING: A tertiary hospital in Malaysia.

    PATIENTS AND METHODS: All adult patients who were prescribed NAC for prevention of CI-AKI were identified through an NAC drug us.age monitoring card maintained by the inpatient pharmacy. The study was conducted from March to July 2017.

    MAIN OUTCOME MEASURES: Statistically significant predictive fac.tors for development of CI-AKI despite NAC administration.

    SAMPLE SIZE: 152 RESULTS: The most commonly recognized risk factors for CI-AKI present in the study population were renal impairment (n=131, 86.2%), anemia (n=107, 70.4%), and diabetes mellitus (n=90, 59.2%). Hydration therapy was initiated in 128 patients (84.2%) prior to the contrast-enhanced procedure. Sixty-one (40.1%) were treated with nephrotoxic medications concomitantly with NAC. Fifteen (9.9%) patients developed AKI. Hypotension (OR: 6.02; 95% CI 1.25-28.97) and use of high contrast volume (OR: 6.56; 95% CI: 1.41-30.64) significantly increased the odds for AKI. Prior hydration therapy (OR: 0.13; 95% CI 0.03-0.59) showed protective effects.

    CONCLUSION: The risk predictors identified for CI-AKI were hypotension, high contrast volume and prior hydration therapy.

    LIMITATION: May not have identified other confounding factors for development of CI-AKI.

    CONFLICT OF INTEREST: None.

    Matched MeSH terms: Inpatients*
  8. Baskaran ND, Gan GG, Adeeba K
    Ann Hematol, 2008 Jul;87(7):563-9.
    PMID: 18437382 DOI: 10.1007/s00277-008-0487-7
    The purpose of this study was to determine if the Multinational Association for Supportive Care in Cancer (MASCC) risk-index score is able to predict the outcome of febrile neutropenia in patients with underlying hematological malignancy and to look at the other possible predictors of outcome. A retrospective study of 116 episodes of febrile neutropenia in patients who were admitted to the hematology ward of a local medical center in Malaysia between January 1st 2004 and January 31st 2005. Patient characteristics and the MASCC score were compared with outcome. The MASCC score predicted the outcome of febrile neutropenic episodes with a positive predictive value of 82.9%, a sensitivity of 93%, and specificity of 67%. Other predictors of a favorable outcome were those patients who had lymphomas versus leukemias, duration of neutropenia of less than 7 days, low burden of illness characterized by the absence of an infective focus and absence of lower respiratory tract infection, a serum albumin of >25 g/l, and the absence of gram-negative bacteremia on univariate analysis but only serum albumin level, low burden of illness, and presence of respiratory infection were significantly associated with unfavorable outcome after multivariate analysis. The MASCC score is a useful predictor of outcome in patients with febrile neutropenia with underlying hematological malignancies. This scoring system may be adapted for use in local settings to guide the clinical management of patients with this condition.
    Matched MeSH terms: Inpatients/classification; Inpatients/statistics & numerical data
  9. Loh LC, Rosdara Masayuni MS, Nor Izran Hanim AS, Raman S, Thayaparan T, Kumar S
    Ann Acad Med Singap, 2007 Aug;36(8):642-6.
    PMID: 17767334
    INTRODUCTION: In Malaysia, Klebsiella pneumoniae ranks high as a cause of adult pneumonia requiring hospitalisation.

    PATIENTS AND METHODS: With concern over its rising microbial resistance, we explored the association of empiric antibiotics choices with the hospital outcomes of patients treated for microbial proven K. pneumoniae pneumonia in an urban-based teaching hospital.

    RESULTS: In 313 eligible cases reviewed retrospectively, hospital mortality and requirement for ventilation were 14.3% and 10.8% respectively. Empiric regimes that had in vitro resistance to at least one empiric antibiotic (n = 90) were associated with higher hospital mortality (23.3% vs. 10.8%, P = 0.004) with risk increased by about two-fold [Odds ratio (OR), 2.5; 95% confidence interval (CI), 1.3 to 4.8]. Regimes (n = 84) other than the commonly recommended "standard" regimes (a beta-lactam stable antibiotic with or without a acrolide) were associated with higher ventilation rates (16.7% vs. 8.8%, P = 0.047) with similar increased risk [OR, 2.0; 95% CI, 1.0 to 4.3].

    CONCLUSIONS: Our findings reiterate the clinical relevance of in vitro microbial resistance in adult K. pneumoniae pneumonia and support empiric regimes that contain beta-lactam stable antibiotics.

    Matched MeSH terms: Inpatients*
  10. Keevil V, Mazzuin Razali R, Chin AV, Jameson K, Aihie Sayer A, Roberts H
    Arch Gerontol Geriatr, 2013 Jan-Feb;56(1):155-9.
    PMID: 23116975 DOI: 10.1016/j.archger.2012.10.005
    Grip strength is a marker of sarcopenia, the age-related decline in muscle mass and function, and has been little researched in Asian populations. We aimed to describe the feasibility and acceptability of measuring grip strength in hospitalized, older people in Malaysia and to explore its range, determinants and association with length of stay. Patients admitted acutely to the geriatrics ward of a teaching hospital were consecutively recruited. Inability to consent or use the dynamometer led to exclusion. Maximum grip strength, anthropometric data, length of hospital stay, discharge destination, 3-point Barthel score, mini-mental state examination, falls history and number of co-morbidities and medications on admission were recorded. 80/153 (52%) eligible patients were recruited (52 women; age range 64-100 years). 9/153 (6%) refused to participate and 64/153 (42%) were excluded (34 too unwell, 24 unable to consent, 4 unable to use the dynamometer, 2 other reasons). 76/80 patients (95%) reported that they would undergo grip strength measurement again. Determinants were similar to those of Caucasian populations but grip strength values were lower. After adjustment for sex, age and height, stronger grip strength was associated with shorter length of stay [hazard ratio 1.05 (95% CI 1.00, 1.09; P=0.03)]. This is the first report of grip strength measurement in hospitalized older people in Malaysia. It was feasible, acceptable to participants and associated with length of stay. Further research is warranted to elucidate the normative range in different ethnic groups and explore its potential use in clinical practice in Malaysia.
    Matched MeSH terms: Inpatients/statistics & numerical data
  11. Ng BK, Annamalai R, Lim PS, Aqmar Suraya S, Nur Azurah AG, Muhammad Abdul Jamil MY
    Arch Gynecol Obstet, 2015 Jan;291(1):105-13.
    PMID: 25078052 DOI: 10.1007/s00404-014-3388-0
    BACKGROUND: Study objective To assess the efficacy of outpatient misoprostol administration versus inpatient misoprostol administration for the treatment of first trimester incomplete miscarriage.
    MATERIALS AND METHODS: A prospective randomised controlled trial was conducted at a tertiary hospital from May 2012 to April 2013. A total of 154 patients with first trimester incomplete miscarriage were randomised to receive misoprostol either as outpatient or inpatient. Intra-vaginal misoprostol 800 mcg was administered eight hourly to a maximum of three doses. Complete evacuation is achieved when the cervical os was closed on vaginal examination or ultrasound showed no more retained products of conception evidenced by endometrial thickness of less than 15 mm. Treatment failure was defined as failure in achieving complete evacuation on day seven hence surgical evacuation is offered.
    RESULTS: Outpatient administration of misoprostol was as effective as inpatient treatment with success rate of 89.2 and 85.7 % (p = 0.520). The side effects were not significantly different between the two groups. Side effects that occurred were minor and only required symptomatic treatment. Duration of bleeding was 6.0 days in both groups (p = 0.317). Mean reduction in haemoglobin was lesser in the outpatient group (0.4 g/dl) as compared to in the inpatient group (0.6 g/dl) which was statistically significant (p = 0.048).
    CONCLUSION: Medical evacuation using intra-vaginal misoprostol 800 mcg eight hourly for a maximum of three doses in an outpatient setting is as effective as in inpatient setting with tolerable side effects.

    Study site: tertiary hospital
    Matched MeSH terms: Inpatients
  12. Looi JC, Allison S, Woon L
    Australas Psychiatry, 2023 Oct;31(5):659-661.
    PMID: 37424206 DOI: 10.1177/10398562231188264
    OBJECTIVE: Psychiatric cover for healthcare staffing shortfalls is increasingly common post-pandemic. We aim to provide comprehensive practical advice on providing temporary inpatient or outpatient cover as a psychiatrist, based on the authors' clinical experience and the existing research literature.

    CONCLUSIONS: There is limited peer-reviewed advice available on providing safe and effective temporary psychiatric consultant cover for patient care. We suggest a framework for reviewing the potential hazards and benefits of a temporary post, and planning for the role, guided by consideration of the following: caring for patients, supporting staff, working with peers, and understanding local healthcare systems and the local regulatory environment. Application of this reflective framework is informed by the psychiatrist's assessment of the temporary role, and consideration of the local service conditions.

    Matched MeSH terms: Inpatients
  13. Tan SB, Loh EC, Lam CL, Ng CG, Lim EJ, Boey CCM
    BMJ Support Palliat Care, 2019 Mar;9(1):e19.
    PMID: 27098972 DOI: 10.1136/bmjspcare-2015-001064
    Although suffering in palliative care has received increasing attention over the past decade, the psychological processes that underpin suffering remain relatively unexplored.

    OBJECTIVE: To understand the psychological processes involved in the experiencing of suffering at the end phase of life.

    METHODS: Semistructured interviews were conducted with 20 palliative care inpatients from an academic medical centre in Kuala Lumpur, Malaysia. The transcripts were thematically analysed with NVIVO9.

    RESULTS: 5 themes of psychological processes of suffering were generated: (1) perceptions, (2) cognitive appraisals, (3) hope and the struggles with acceptance, (4) emotions and (5) clinging. A model of suffering formation was constructed.

    CONCLUSION: The findings may inform the development of mechanism-based interventions in the palliation of suffering.

    Matched MeSH terms: Inpatients/psychology*
  14. Lee,Sze Chet, Ng,Chun Keat, Mohd Amiruddin Mohd Kassim, Pang,Nicholas Tze Ping
    Borneo Epidemiology Journal, 2020;1(1):79-87.
    MyJurnal
    COVID-19 has impacted the world in many ways due to fears of contracting the pandemic, social distancing, and large-scale movement control rules. These have especially grave consequences for inpatient psychiatry. This article reviews measures taken to adapt to the new norm in inpatient care, both for standalone psychiatry units and consultation-liaison units. For inpatient units, changes have been made for personal protective equipment usage, screening and triaging policies, and training and educational policies. Consultation liaison units together with inpatient units have been required to expand the scope of coverage and difficulties by providing certain teleconsultation services. As the new norm takes precedence, Sabah has to embrace and empower community-based psychiatry services for better outreach and coverage. This article discusses the issues underlying the new norm in the management of inpatient psychiatry patients in both units and presents some points and practical solutions on the ground to instil hope
    Matched MeSH terms: Inpatients
  15. Che Johan NAS, Rasani AAM, Keng SL
    Br J Nurs, 2023 Jan 26;32(2):74-80.
    PMID: 36715528 DOI: 10.12968/bjon.2023.32.2.74
    BACKGROUND: The use of mobile health (mHealth) applications, which provide opportunities to improve health and lessen health inequalities, is increasing. Studies assessing the readiness and ability of patients in Malaysia with chronic kidney disease (CKD) to use mobile phone apps to manage their health are limited.

    AIMS: This study aimed to assess the readiness and ability to use mHealth apps among patients with CKD in north-east Peninsular Malaysia.

    METHODS: A cross-sectional study was undertaken, using a convenience sample of 100 CKD medical inpatients in a tertiary teaching hospital. A structured, self-administered questionnaire on readiness and ability to use mHealth apps was adopted.

    FINDINGS: Nearly one in five patients (18%) actively used health applications. More than three-quarters (77%) were aged >40 years and a similar proportion were ready to use mHealth apps (78%), and nearly half (46%) were confident about connecting their device to wifi. There was a correlation between ability and readiness to use mHealth apps (r=0.4; P<0.05).

    CONCLUSIONS: Fewer than half of participants had a good command of mHealth applications. Therefore, support on the use of these apps is needed, and healthcare managers need to consider this.

    Matched MeSH terms: Inpatients
  16. Ong SB, Lam KL, Lam SK
    Bull World Health Organ, 1982;60(1):137-40.
    PMID: 6282479
    The results of this study indicate that the important viral agents associated with lower respiratory tract infections in young children are respiratory syncytial virus, rhinovirus, and parainfluenza virus, particularly in those under 2 years of age. This is in close agreement with studies done in temperate climates. Influenza A virus is seasonal and plays an important role in upper respiratory tract infections in older children.
    Study site: Inpatients and outpatients, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Inpatients
  17. Chan LF, Maniam T, Shamsul AS
    Crisis, 2011;32(5):283-7.
    PMID: 21940256 DOI: 10.1027/0227-5910/a000088
    Depressed inpatients constitute a high-risk population for suicide attempts.
    Matched MeSH terms: Inpatients/psychology; Inpatients/statistics & numerical data
  18. Tangiisuran B, Davies JG, Wright JE, Rajkumar C
    Drugs Aging, 2012 Aug 1;29(8):669-79.
    PMID: 22775477 DOI: 10.2165/11632630-000000000-00000
    The aims of the study were to determine the rates, types, severity and preventability of adverse drug reactions (ADRs) in a hospitalized population of very elderly patients (over 80 years of age) and to identify factors that predispose the very elderly to an ADR.
    Matched MeSH terms: Inpatients
  19. Petrovic M, Tangiisuran B, Rajkumar C, van der Cammen T, Onder G
    Drugs Aging, 2017 02;34(2):135-142.
    PMID: 28000156 DOI: 10.1007/s40266-016-0428-4
    BACKGROUND: Adverse drug reactions (ADRs) in older people are often preventable, indicating that screening and prevention programs aimed at reducing their rate are needed in this population.

    OBJECTIVE: The aim of this study was to externally validate the GerontoNet ADR risk score and to assess its validity in specific subpopulations of older inpatients.

    METHODS: Data from the prospective CRIteria to assess appropriate Medication use among Elderly complex patients (CRIME) cohort were used. Dose-dependent and predictable ADRs were classified as type A, probable or definite ADRs were defined according to the Naranjo algorithm, and diagnostic accuracy was tested using receiver operating characteristic (ROC) analyses. Sensitivity and specificity were calculated for a cut-off point of 4.

    RESULTS: The mean age of the 1075 patients was 81.4 years (standard deviation 7.4) and the median number of drugs was 10 (range 7-13). At least one ADR was observed in 70 patients (6.5%); ADRs were classified as type A in 50 patients (4.7%) and defined as probable or definite in 41 patients (3.8%). Fair diagnostic accuracy to predict both type A and probable or definite ADRs was found in subpopulations aged <70 or ≥80 years with heart failure, diabetes, or a previous ADR. Good accuracy to predict type A ADRs was found in patients with a low body mass index (BMI; >18.5 kg/m2) and a Mini-Mental State Examination (MMSE) score of >24/30 points, as well as in patients with osteoarthritis. The cut-off point of 4 points yielded very good sensitivity but poor specificity results in these subpopulations.

    CONCLUSION: This study suggests that the GerontoNet ADR risk score might represent a pragmatic approach to identifying specific subpopulations of older inpatients at increased risk of an ADR with a fair to good diagnostic accuracy.

    Matched MeSH terms: Inpatients/statistics & numerical data
  20. Othman J, Sahani M, Mahmud M, Ahmad MK
    Environ Pollut, 2014 Jun;189:194-201.
    PMID: 24682070 DOI: 10.1016/j.envpol.2014.03.010
    This study assessed the economic value of health impacts of transboundary smoke haze pollution in Kuala Lumpur and adjacent areas in the state of Selangor, Malaysia. Daily inpatient data from 2005, 2006, 2008, and 2009 for 14 haze-related illnesses were collected from four hospitals. On average, there were 19 hazy days each year during which the air pollution levels were within the Lower Moderate to Hazardous categories. No seasonal variation in inpatient cases was observed. A smoke haze occurrence was associated with an increase in inpatient cases by 2.4 per 10,000 populations each year, representing an increase of 31 percent from normal days. The average annual economic loss due to the inpatient health impact of haze was valued at MYR273,000 ($91,000 USD).
    Matched MeSH terms: Inpatients/statistics & numerical data
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