As a proxy for the Zarowitz et al 15 immobility risk factor checklist (not derivable from the MDS), immobility was defined as having a score of 24 or higher (where 0 = total independence and 28 = total dependence) using a single global score from 7 items of activities of daily living in the index MDS Section G1A, applying the algorithm of Carpenter et al.
20 From the sampling universe, a total of 58,009 eligible residents were estimated to have 1 or more admissions (or readmissions) over the data collection period. The total number of years at risk for a postadmission VTE (from admission index date until end of follow-up) across all eligible residents was estimated at 20,586 PY. A total of 2901 eligible VTE cases were identified. SB203580 price Of these, 2144 (74%) had VTE identified BMS-354825 in vivo on the admission index date. These accounted for 3.7% of the 58,009 estimated admissions (Table 1). The remaining 757 (26%) of the 2901 VTE cases occurred during residence in study facilities. For these cases, mean time from admission until occurrence
of the VTE event was 116 days (SD = 162). This yielded a crude incidence rate of 3.68 VTE cases per 100 PY of postadmission follow-up (Table 1). Table 1 also shows VTE admission rates and incidence rates during residence separately by age and gender strata. Residents younger than 50 and 50 to 64 years of age had disproportionately higher rates of VTE-coded admissions (4.8% and 5.1%) compared with the remaining age cohorts (3.1%–3.6%). VTE admission rates and incidence rates for the remaining age and gender cohorts were similar. Table 2 shows admission rates (n = 1793 cases) and incidence rates (n = 615 cases) for residents with DVT only and admission rates (n = 270 cases) and incidence rates (n = 123 cases) for residents with PE only. The strata of DVT only and PE only, when combined, accounted for 97% of all VTE cases; 3% of cases were mixed DVT and PE. DVT only accounted for 6 admissions for every PE only–coded admission and for 5 incident cases for every PE only–coded incident case identified during residence. Patterns of findings were similar to those shown in Table 1 for VTE among age and gender
strata, with the exception of a more homogeneous rate of admissions coded for PE only Selleckchem 5-Fluoracil (shown by overlapping confidence intervals) across the age strata. Among the cohort of residents developing VTE on admission, Table 3 shows the distribution of comorbid conditions and VTE risk factors by age category. Residents younger than 75 accounted for 42% of those residents who presented with VTE on admission. Rates of the comorbid conditions atherosclerotic heart disease, hypertension, atrial fibrillation, Alzheimer disease, non-Alzheimer dementia, and osteoarthritis generally increased among older residents (P ≤ .041 for all distributions by age cohort), as did the VTE risk factors for lower limb fractures, congestive heart failure, and megestrol therapy (P ≤ .003 for all age distributions).