MARCOS DANIEL CABRAL SARAIVA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/66, Hospital das Clínicas, Faculdade de Medicina
LIM/66, Hospital das Clínicas, Faculdade de Medicina
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- Targeted Geriatric Assessment for Fast-Paced Healthcare Settings: Development, Validity, and Reliability(2018) ALIBERTI, Marlon J. R.; APOLINARIO, Daniel; SUEMOTO, Claudia K.; MELO, Juliana A.; FORTES-FILHO, Sileno Q.; SARAIVA, Marcos D.; TRINDADE, Carolina B.; COVINSKY, Kenneth E.; JACOB-FILHO, WilsonObjectivesTo develop and examine the validity and reliability of a targeted geriatric assessment (TaGA) for busy healthcare settings. DesignThe TaGA was developed through the consensus of experts (Delphi technique), and we investigated its construct validity and reliability in a cross-sectional study. SettingGeriatric day hospital specializing in acute care in Brazil. ParticipantsOlder adults (N = 534) aged 79.5 8.4, 63% female, consecutively admitted to the geriatric day hospital. MeasurementsThe Frailty Index (FI), Physical Frailty Phenotype, and Identification of Seniors at Risk (ISAR) were used to explore the TaGA's validity. External scales were used to investigate the validity of each matched TaGA domain. The interrater reliability and time to complete the instrument were tested in a 53-person subsample. ResultsIn 3 rounds of opinion, experts achieved consensus that the TaGA should include 10 domains (social support, recent hospital admissions, falls, number of medications, basic activities of daily living, cognitive performance, self-rated health, depressive symptoms, nutritional status, gait speed). They arrived at sufficient agreement on specific tools to assess each domain. A single numerical score from 0 to 1 expressed the cumulative deficits across the 10 domains. The TaGA score was highly correlated with the FI (Spearman coefficient = 0.79, 95% confidence interval (CI)=0.76-0.82) and discriminated between frail and nonfrail individuals better than the ISAR (area under the receiver operating characteristic curve 0.84 vs 0.72; P < .001). The TaGA score also had excellent interrater reliability (intraclass correlation coefficient = 0.92, 95% CI=0.87-0.95). Mean TaGA administration time was 9.5 +/- 2.2 minutes. ConclusionThe study presents evidence supporting the TaGA's validity and reliability. This instrument may be a practical and efficient approach to screening geriatric syndromes in fast-paced healthcare settings. Future research should investigate its predictive value and effect on care.
- COVID-19 is not over and age is not enough: Using frailty for prognostication in hospitalized patients(2021) ALIBERTI, Marlon Juliano Romero; SZLEJF, Claudia; AVELINO-SILVA, Vivian I.; SUEMOTO, Claudia Kimie; APOLINARIO, Daniel; DIAS, Murilo Bacchini; GARCEZ, Flavia Barreto; TRINDADE, Carolina B.; AMARAL, Jose Renato das Gracas; MELO, Leonardo Rabelo de; AGUIAR, Renata Cunha de; COELHO, Paulo Henrique Lazzaris; HOJAIJ, Naira Hossepian Salles de Lima; SARAIVA, Marcos Daniel; SILVA, Natalia Oliveira Trajano da; JACOB-FILHO, Wilson; AVELINO-SILVA, Thiago J.Background Frailty screening using the Clinical Frailty Scale (CFS) has been proposed to guide resource allocation in acute care settings during the pandemic. However, the association between frailty and coronavirus disease 2019 (COVID-19) prognosis remains unclear. Objectives To investigate the association between frailty and mortality over 6 months in middle-aged and older patients hospitalized with COVID-19 and the association between acute morbidity severity and mortality across frailty strata. Design Observational cohort study. Setting Large academic medical center in Brazil. Participants A total of 1830 patients aged >= 50 years hospitalized with COVID-19 (March-July 2020). Measurements We screened baseline frailty using the CFS (1-9) and classified patients as fit to managing well (1-3), vulnerable (4), mildly (5), moderately (6), or severely frail to terminally ill (7-9). We also computed a frailty index (0-1; frail >0.25), a well-known frailty measure. We used Cox proportional hazards models to estimate the association between frailty and time to death within 30 days and 6 months of admission. We also examined whether frailty identified different mortality risk levels within strata of similar age and acute morbidity as measured by the Sequential Organ Failure Assessment (SOFA) score. Results Median age was 66 years, 58% were male, and 27% were frail to some degree. Compared with fit-to-managing-well patients, the adjusted hazard ratios (95% confidence interval [CI]) for 30-day and 6-month mortality were, respectively, 1.4 (1.1-1.7) and 1.4 (1.1-1.7) for vulnerable patients; 1.5 (1.1-1.9) and 1.5 (1.1-1.8) for mild frailty; 1.8 (1.4-2.3) and 1.9 (1.5-2.4) for moderate frailty; and 2.1 (1.6-2.7) and 2.3 (1.8-2.9) for severe frailty to terminally ill. The CFS achieved outstanding accuracy to identify frailty compared with the Frailty Index (area under the curve = 0.94; 95% CI = 0.93-0.95) and predicted different mortality risks within age and acute morbidity groups. Conclusions Our results encourage the use of frailty, alongside measures of acute morbidity, to guide clinicians in prognostication and resource allocation in hospitalized patients with COVID-19.
conferenceObject Objective Structured Clinical Examination in geriatric training: 6-year results and participant opinions.(2015) AVELINO-SILVA, T. J.; KIKUCHI, E. L.; SARAIVA, M. D.; PAULO, M. I. Melo; GIL, L. A.; JACOB-FILHO, W.conferenceObject Nasopharyngeal carriage of Streptococcus pneumoniae, Haemophilus influenzae and Staphylococcus aureus in outpatient elderly in Brazil(2019) ZANELLA, R.; ALMEIDA, S.; BRANDILEONE, M.; LEMOS, A.; SACCHI, C.; GONCALVES, C.; GONCALVES, M.; FUKASAWA, L.; SARAIVA, M. D.; RANGEL, L.; CUNHA, J. Lassance; ROTTA, T.; DOURADINHO, C.; JACOB-FILHO, W.; MINAMISAVA, R.; ANDRADE, A.article 1 Citação(ões) na Scopus EVALUATING COMMUNICATION SKILLS OF GERIATRICS FELLOWS: INTERRATER AGREEMENT OF AN OBJECTIVE STRUCTURED CLINICAL EXAMINATION(2016) SARAIVA, Marcos Daniel; PAULO, Maria Luiza de Melo; AVELINO-SILVA, Thiago Junqueira; GIL-JUNIOR, Luiz Antonio; KIKUCHI, Elina Lika; FARIAS, Luciana Louzada; ALVES, Rafael Lyra Rodrigues; SUZUKI, Gisele Sayuri; OLIVIERI, Fabio Cesar; ARANHA, Valmari Cristina; LOPES, Leonardo da Costa; PASSARELLI, Maria Cristina Guerra; MORIGUTI, Julio Cesar; FERRIOLI, Eduardo; WEN, Chao Lung; APOLINARIO, Daniel; JACOB-FILHO, WilsonconferenceObject AMPI-AB accuracy: a multidimensional questionnaire for the management of the public healthcare for older people in the city of Sao Paulo, Brazil(2019) SARAIVA, M. D.; VENYS, A.; ABDALLA, F.; BIANCONI, B.; SOUSA, D.; HENRIQUE, E.; FERNANDES, M.; PISOLI, P.; CAVALHEIRO, M.; SUZUKI, G.; SERRANO, P.; MAZZA, M.; LIMA, L.; HIRATSUKA, M.; JACOB-FILHO, W.; PASCHOAL, S.