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Papers by Pascal Couturier
Proceedings of the 1st International Workshop on Tele-Care and Collaborative Virtual Communities in Elderly Care, 2004
Background The discharge summary is the main vector of communication at the time of hospital disc... more Background The discharge summary is the main vector of communication at the time of hospital discharge, but it is known to be insufficient. Direct phone contact between hospitalist and primary care physician (PCP) at discharge could ensure rapid transmission of information, improve patient safety and promote interprofessional collaboration. The objective of this study was to evaluate the feasibility and benefit of a phone call from hospitalist to PCP to plan discharge. Methods This study was a prospective, single-center, cross-sectional observational study. It took place in an acute medicine unit of a French university hospital. The hospitalist had to contact the PCP by telephone within 72 hours prior discharge, making a maximum of 3 call attempts. The primary endpoint was the proportion of patients whose primary care physician could be reached by telephone at the time of discharge. The other criteria were the physicians' opinions on the benefits of this contact and its effect o...
Gérontologie et société, 2005
ACG Case Reports Journal, 2015
Journal of Nutrition, Health and Aging, 2011
Presse Medicale, Feb 1, 2011
Aging Clinical and Experimental Research, Aug 1, 2005
Journal of the American Medical Directors Association, 2019
Revue d'Épidémiologie et de Santé Publique, 2009
The Lancet Infectious Diseases, 2017
Revue de Chirurgie Orthopédique et Traumatologique, 2014
Orthopaedics & traumatology, surgery & research : OTSR, 2014
One percent of falls in over-75 years old cause hip fracture (HF). Protein-energy malnutrition (P... more One percent of falls in over-75 years old cause hip fracture (HF). Protein-energy malnutrition (PEM) is associated with falls and fracture. PEM screening and perioperative nutritional management are recommended by the European Society of Parenteral and Enteral Nutrition, yet data on nutritional status in elderly HF patients are sparse. The Mini Nutritional Assessment (MNA) score is presently the most effective screening tool for PEM in over-75 years old. The principal objective of the present study was to determine the prevalence on MNA of PEM in patients aged over 75 years admitted for HF. Secondary objectives were to identify factors associated with PEM and its role as a factor of evolution. A prospective observational epidemiological study included 50 patients aged over 75 years admitted for HF in an 8-bed orthopedic surgery department with a geriatric follow-up unit. PEM was defined by MNA<17/30. Assessment systematically comprised associated comorbidity (Cumulative Illness R...
Journal of Nutrition, Health and Aging, 2008
The aim of the study was, by early identification of deleterious prognostic factors that are open... more The aim of the study was, by early identification of deleterious prognostic factors that are open to remediation, to be in a position to assign elderly patients to different mortality risk groups to improve management. Prospective multicentre cohort. Nine French teaching hospitals. One thousand three hundred and six (1 306) patients aged 75 and over, hospitalised after having passed through Emergency Department (ED). Patients were assessed using Comprehensive Geriatric Assessment (CGA) tools. A Cox survival analysis was performed to identify prognostic variables for six-week mortality. Receiver Operating Characteristics analysis was used to study the discriminant power of the model. A mortality risk score is proposed to define three risk groups for six-week mortality. Crude mortality rate after a six week follow-up was 10.6% (n=135). Prognostic factors identified were: malnutrition risk (HR=2.1; 95% CI: 1.1-3.8; p=.02), delirium (HR=1.7; 95% CI: 1.2-2.5; p=.006), and dependency: moderate dependency (HR=4.9; 95% CI: 1.5-16.5; p=.01) or severe dependency (HR=10.3; 95% CI: 3.2-33.1; p &amp;lt; .001). The discriminant power of the model was good: the c-statistic representing the area under the curve was 0.71 (95% IC: 0.67 - 0.75; p &amp;lt; .001). The six-week mortality rate increased significantly (p &amp;lt; .001) across the three risk groups: 1.1% (n=269; 95% CI=0.5-1.7) in the lowest risk group, 11.1% (n=854; 95% CI=9.4-12.9) in the intermediate risk group, and 22.4% (n=125; 95% CI=20.1-24.7) in the highest risk group. A simple score has been calculated (using only three variables from the CGA) and a practical schedule proposed to characterise patients according to the degree of mortality risk. Each of these three variables (malnutrition risk, delirium, and dependency) identified as independent prognostic factors can lead to a targeted therapeutic option to prevent early mortality.
Revue d'Epidemiologie et de Sante Publique, 2012
![Research paper thumbnail of [Frailty: learnings from the SAFEs cohort study and future perspectives for the research]](https://attachments.academia-assets.com/120573211/thumbnails/1.jpg)
](Geriatrie et Psychologie Neuropsychiatrie du Vieillissement, 2011
Proceedings of the 1st International Workshop on Tele-Care and Collaborative Virtual Communities in Elderly Care, 2004
Background The discharge summary is the main vector of communication at the time of hospital disc... more Background The discharge summary is the main vector of communication at the time of hospital discharge, but it is known to be insufficient. Direct phone contact between hospitalist and primary care physician (PCP) at discharge could ensure rapid transmission of information, improve patient safety and promote interprofessional collaboration. The objective of this study was to evaluate the feasibility and benefit of a phone call from hospitalist to PCP to plan discharge. Methods This study was a prospective, single-center, cross-sectional observational study. It took place in an acute medicine unit of a French university hospital. The hospitalist had to contact the PCP by telephone within 72 hours prior discharge, making a maximum of 3 call attempts. The primary endpoint was the proportion of patients whose primary care physician could be reached by telephone at the time of discharge. The other criteria were the physicians' opinions on the benefits of this contact and its effect o...
Gérontologie et société, 2005
ACG Case Reports Journal, 2015
Journal of Nutrition, Health and Aging, 2011
Presse Medicale, Feb 1, 2011
Aging Clinical and Experimental Research, Aug 1, 2005
Journal of the American Medical Directors Association, 2019
Revue d'Épidémiologie et de Santé Publique, 2009
The Lancet Infectious Diseases, 2017
Revue de Chirurgie Orthopédique et Traumatologique, 2014
Orthopaedics & traumatology, surgery & research : OTSR, 2014
One percent of falls in over-75 years old cause hip fracture (HF). Protein-energy malnutrition (P... more One percent of falls in over-75 years old cause hip fracture (HF). Protein-energy malnutrition (PEM) is associated with falls and fracture. PEM screening and perioperative nutritional management are recommended by the European Society of Parenteral and Enteral Nutrition, yet data on nutritional status in elderly HF patients are sparse. The Mini Nutritional Assessment (MNA) score is presently the most effective screening tool for PEM in over-75 years old. The principal objective of the present study was to determine the prevalence on MNA of PEM in patients aged over 75 years admitted for HF. Secondary objectives were to identify factors associated with PEM and its role as a factor of evolution. A prospective observational epidemiological study included 50 patients aged over 75 years admitted for HF in an 8-bed orthopedic surgery department with a geriatric follow-up unit. PEM was defined by MNA<17/30. Assessment systematically comprised associated comorbidity (Cumulative Illness R...
Journal of Nutrition, Health and Aging, 2008
The aim of the study was, by early identification of deleterious prognostic factors that are open... more The aim of the study was, by early identification of deleterious prognostic factors that are open to remediation, to be in a position to assign elderly patients to different mortality risk groups to improve management. Prospective multicentre cohort. Nine French teaching hospitals. One thousand three hundred and six (1 306) patients aged 75 and over, hospitalised after having passed through Emergency Department (ED). Patients were assessed using Comprehensive Geriatric Assessment (CGA) tools. A Cox survival analysis was performed to identify prognostic variables for six-week mortality. Receiver Operating Characteristics analysis was used to study the discriminant power of the model. A mortality risk score is proposed to define three risk groups for six-week mortality. Crude mortality rate after a six week follow-up was 10.6% (n=135). Prognostic factors identified were: malnutrition risk (HR=2.1; 95% CI: 1.1-3.8; p=.02), delirium (HR=1.7; 95% CI: 1.2-2.5; p=.006), and dependency: moderate dependency (HR=4.9; 95% CI: 1.5-16.5; p=.01) or severe dependency (HR=10.3; 95% CI: 3.2-33.1; p &amp;lt; .001). The discriminant power of the model was good: the c-statistic representing the area under the curve was 0.71 (95% IC: 0.67 - 0.75; p &amp;lt; .001). The six-week mortality rate increased significantly (p &amp;lt; .001) across the three risk groups: 1.1% (n=269; 95% CI=0.5-1.7) in the lowest risk group, 11.1% (n=854; 95% CI=9.4-12.9) in the intermediate risk group, and 22.4% (n=125; 95% CI=20.1-24.7) in the highest risk group. A simple score has been calculated (using only three variables from the CGA) and a practical schedule proposed to characterise patients according to the degree of mortality risk. Each of these three variables (malnutrition risk, delirium, and dependency) identified as independent prognostic factors can lead to a targeted therapeutic option to prevent early mortality.
Revue d'Epidemiologie et de Sante Publique, 2012
Geriatrie et Psychologie Neuropsychiatrie du Vieillissement, 2011