ABSTRACT
Introduction: In the wake of the SARS-CoV-2 (COVID-19) pandemic, our world has faced multiple challenges. Infection with this virus has commonly been associated with thrombotic events. However, little is known about bleeding risk and anticoagulation therapy. This study aims to determine factors that are associated with increased risk of bleeding in COVID-19 patients. Methods: A retrospective cohort study was conducted using the records of COVID-19 patients admitted during the COVID-19 pandemic from March 2020 through May 2020. Using patient charts, investigators manually collected data regarding patient characteristics and bleeding. Patients were included in the analysis if they had a confirmed COVID-19 PCR test, were older than 18 years of age and were admitted to the hospital. Patients who were pregnant or had incomplete charts were excluded from the study. ANOVA and logistic regression were used to determine the statistical significance of the data using SPSS version 27. Results: A total of 651 patients were included in the analysis out of 685 patients located in the database of COVID-19 infected patients during that time frame. The general characteristics of the patients were as follows: 54.2% were males; females 45.8% ages ranged from 28 to 83 years old (median age = 66 years old). There were 31 patients (4.9%) who required more than 1 unit of packed red blood cell (PRBC). A total of 16 (2.85%) patients had a documented gastrointestinal bleed (GIB), of which 8 received a total of 29 units of PRBC transfusions. The HAS-BLED score (without alcohol/drug due to inadequate charting) is calculated for patients who had a documented GI bleed and who received more than one unit of PRBC. It was noted that the higher the HAS-BLED score the greater the likelihood of having a GI bleed (p < 0.001). The HAS-BLED score (not including alcohol/drug) was also predictive for patients who received more than one unit of PRBC during their hospital stay (p < 0.001). Discussion: Using the HAS-BLED score without alcohol/drugs, patients with COVID-19 can be stratified in regard to their risk of GI bleeding and their risk of transfusion while in the hospital. When administering anticoagulation therapy, cautious monitoring should be carried out. Decisions regarding anticoagulant therapy should be based on individual patient characteristics.
ABSTRACT
Individuals with Parkinson's disease demonstrate a shorter step length compared to individuals without the disorder, which may place them at greater risk for falls. As a result, rehabilitation professionals often attempt to increase or maintain step length in this population. The ability to quantify step length may be useful for tracking changes or identifying individuals who may be at risk for a fall. However, there are few approaches to precisely/directly measure step length that are feasible for clinical use. The purposes of this study were to evaluate the reliability of step length measurements from two-dimensional (2D) video in individuals with Parkinson's disease and to compare the step lengths of individuals with/without a recent history of falls. A video camera recorded 24 individuals with Parkinson's disease as they walked at a comfortable pace. Step length measurements from the video demonstrated excellent intra- and inter-rater reliability (intraclass correlation coefficients greater than 0.90). In addition, individuals with Parkinson's disease who had experienced a fall within the previous year demonstrated shorter step lengths compared to individuals who had not experienced a recent fall. The ability to quantify step length from 2D video could be a useful tool when managing patients with Parkinson's disease.