JOSE ANTONIO ESPER CURIATI
Índice h a partir de 2011
5
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
24 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 24
bookPart Cuidados pós-operatórios(2019) CURIATI, José Antonio Esper; PELAGGI, Elisabeth Rosa- Clinical and laboratory characteristics associated with referral of hospitalized elderly to palliative care(2018) ARCANJO, Suelen Pereira; SAPORETTI, Luis Alberto; CURIATI, Jose Antonio Esper; JACOB-FILHO, Wilson; AVELINO-SILVA, Thiago JunqueiraObjective: To investigate clinical and laboratory characteristics associated with referral of acutely ill older adults to exclusive palliative care. Methods: A retrospective cohort study based on 572 admissions of acutely ill patients aged 60 years or over to a university hospital located in Sao Paulo, Brazil, from 2009 to 2013. The primary outcome was the clinical indication for exclusive palliative care. Comprehensive geriatric assessments were used to measure target predictors, such as sociodemographic, clinical, cognitive, functional and laboratory data. Stepwise logistic regression was used to identify independent predictors of palliative care. Results: Exclusive palliative care was indicated in 152 (27%) cases. In the palliative care group, in-hospital mortality and 12 month cumulative mortality amounted to 50% and 66%, respectively. Major conditions prompting referral to palliative care were advanced dementia (45%), cancer (38%), congestive heart failure (25%), stage IV and V renal dysfunction (24%), chronic obstructive pulmonary disease (8%) and cirrhosis (4%). Major complications observed in the palliative care group included delirium (p<0.001), infections (p<0.001) and pressure ulcers (p<0.001). Following multivariate analysis, male sex (OR=2.12; 95% CI: 1.32-3.40), cancer (OR=7.36; 95% CI: 4.26-13.03), advanced dementia (OR=12.6; 95% CI: 7.5-21.2), and albumin levels (OR=0.25; 95% CI: 0.17-0.38) were identified as independent predictors of referral to exclusive palliative care. Conclusion: Advanced dementia and cancer were the major clinical conditions associated with referral of hospitalized older adults to exclusive palliative care. High short-term mortality suggests prognosis should be better assessed and discussed with patients and families in primary care settings.
- Comprehensive geriatric assessment predicts mortality and adverse outcomes in hospitalized older adults(2014) AVELINO-SILVA, Thiago J.; FARFEL, Jose M.; CURIATI, Jose A. E.; AMARAL, Jose R. G.; CAMPORA, Flavia; JACOB-FILHO, WilsonBackground: Comprehensive Geriatric Assessment (CGA) provides detailed information on clinical, functional and cognitive aspects of older patients and is especially useful for assessing frail individuals. Although a large proportion of hospitalized older adults demonstrate a high level of complexity, CGA was not developed specifically for this setting. Our aim was to evaluate the application of a CGA model for the clinical characterization and prognostic prediction of hospitalized older adults. Methods: This was a prospective observational study including 746 patients aged 60 years and over who were admitted to a geriatric ward of a university hospital between January 2009 and December 2011, in Sao Paulo, Brazil. The proposed CGA was applied to evaluate all patients at admission. The primary outcome was in-hospital death, and the secondary outcomes were delirium, nosocomial infections, functional decline and length of stay. Multivariate binary logistic regression was performed to assess independent factors associated with these outcomes, including socio-demographic, clinical, functional, cognitive, and laboratory variables. Impairment in ten CGA components was particularly investigated: polypharmacy, activities of daily living (ADL) dependency, instrumental activities of daily living (IADL) dependency, depression, dementia, delirium, urinary incontinence, falls, malnutrition, and poor social support. Results: The studied patients were mostly women (67.4%), and the mean age was 80.5 +/- 7.9 years. Multivariate logistic regression analysis revealed the following independent factors associated with in-hospital death: IADL dependency (OR= 4.02; CI= 1.52-10.58; p= .005); ADL dependency (OR= 2.39; CI= 1.25-4.56; p= .008); malnutrition (OR= 2.80; CI= 1.63-4.83; p< .001); poor social support (OR= 5.42; CI= 2.93-11.36; p< .001); acute kidney injury (OR= 3.05; CI= 1.78-5.27; p< .001); and the presence of pressure ulcers (OR= 2.29; CI= 1.04-5.07; p= .041). ADL dependency was independently associated with both delirium incidence and nosocomial infections (respectively: OR= 3.78; CI= 2.30-6.20; p< .001 and OR= 2.30; CI= 1.49-3.49; p< .001). The number of impaired CGA components was also found to be associated with in-hospital death (p< .001), delirium incidence (p< .001) and nosocomial infections (p= .005). Additionally, IADL dependency, malnutrition and history of falls predicted longer hospitalizations. There were no significant changes in overall functional status during the hospital stay. Conclusions: CGA identified patients at higher risk of in-hospital death and adverse outcomes, of which those with functional dependence, malnutrition and poor social support were foremost.
conferenceObject Prognostic effect of delirium superimposed on dementia in hospitalized older adults: a prospective cohort study(2016) AVELINO-SILVA, T. J.; CURIATI, J. A.; CAMPORA, F.; JACOB-FILHO, W.- Impact of hospitalization in the functionality and quality of life of adults and elderlies(2015) MEIRA, Debora; LAVOURA, Patricia; FERREIRA, Deise; CURIATI, Jose Antonio; LICHTENSTEIN, Arnaldo; CARVALHO, Celso; TANAKA, Clarice
conferenceObject Prognostic effects of delirium motor subtypes in hospitalized older adults: a prospective cohort study(2016) AVELINO-SILVA, T. J.; CURIATI, J. A.; CAMPORA, F.; JACOB-FILHO, W.conferenceObject Comprehensive Geriatric Assessment predicts mortality and adverse outcomes in hospitalized older adults(2015) AVELINO-SILVA, T. J.; FARTEL, J. M.; CURIATI, J. A. Esper; AMARAL, J. R. das Gracas; CAMPORA, F.; JACOB-FILHO, W.bookPart Medicina integrativa: possibilidades(2022) NAVAS, Anna Beatriz Moreira Marquesini Salles; CURIATI, José Antonio EsperconferenceObject Bullseye - targeted geriatric assessment improves prognostication in hospitalized older adults(2021) AVELINO-SILVA, T. J.; CAMPORA, F.; CURIATI, J. A.; JACOB-FILHO, W.; ALIBERTI, M.- Falls and re-hospitalization in COPD patients after hospital discharge: A 6 month follow up(2016) LAVOURA, Patricia; MEIRA, Debora; SILVA, Deise; CURIATI, Jose; LICHTENSTEIN, Arnaldo; CARVALHO, Celso; TANAKA, Clarice
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