Journal of the American Geriatrics Society
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Clinical Trial
Indices of dehydration among frail nursing home patients: highly variable but stable over time.
To determine changes in standard laboratory measures of dehydration among residents of a nursing home care unit (NHCU) over a 6-month period. ⋯ These data suggest that in the presence of clinical stability, long-term care residents may have a serum osm in the high normal/elevated range without overt clinical evidence of dehydration, an accompanying elevated Na, or BUN/Cr ratio. This may indicate a different central osm setting for these residents as the serum osm appeared to be stable for each resident over time. These data also suggest that measures of serum osm, Na, and BUN/Cr in the long-term care setting may accurately predict future laboratory values in an individual patient if baseline values are drawn when the patient is not acutely ill.
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Randomized Controlled Trial Comparative Study Clinical Trial
Reducing hospital costs for the geriatric patient admitted from the emergency department: a randomized trial.
To test the impact of a geriatric evaluation and management model on the costs of acute hospital management of emergently admitted older adults. ⋯ When controlled for important predictors of expected resource use, care provided by a geriatric management team resulted in a significant reduction in the cost of hospitalization. A reduction in the cost of laboratory, cardiographic, and pharmacy services is consistent with the team's philosophy of defining the services needed based on goals related to functional outcomes.