{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T11:05:23Z","timestamp":1756811123642,"version":"3.41.2"},"reference-count":68,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003524","name":"Ministry of Business, Innovation and Employment","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003524","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The timely identification of acute deterioration in people living in residential aged care is critical to reducing rates of resident morbidity and mortality. However, residents often present with atypical or nonspecific presentations that make this difficult. This study aimed to quantify the strength of the relationship between the indicators acute deterioration reported in the literature and morbidity and mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A retrospective cohort study using routinely collected health data. A single dependant acute deterioration variable (emergency department presentation or hospital admission or death within 7 days of the last completed international resident assessment instrument long\u2010term care facility (interRAI\u2010LTCF) assessment) was correlated with indicators of acute deterioration reported in the literature and available in interRAI\u2010LTCF. Univariate and multivariate logistic regression analysis evaluated this association.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nine variables were independently associated with acute deterioration. These were being \u2018largely asleep or unresponsive\u2019 odds ratio (OR): 7.95, 95% CI: 4.72\u201313.39, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, \u2018easily distracted\u2019 (OR: 1.78, 95% CI: 1.28\u20132.49, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), eating \u2018one or fewer meals a day\u2019 (OR: 2.13, 95% CI: 1.67\u20132.73, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), reduced activities of daily living (OR: 2.06, 95% CI: 1.11\u20133.82, <jats:italic>p<\/jats:italic> = 0.02) inability to complete toilet transfer (OR: 1.95, 95% CI: 1.24\u20133.03, <jats:italic>p<\/jats:italic> = 0.004), \u2018dyspnoea; at rest\u2019 (OR: 1.81, 95% CI: 1.32\u20132.49, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), \u2018two or more falls in 30 days\u2019 (OR: 1.53, 95% CI: 1.15\u20132.03, <jats:italic>p<\/jats:italic> = 0.003), peripheral oedema (OR: 1.37, 95 CI: 1.07\u20131.77, <jats:italic>p<\/jats:italic> = 0.014) and daily pain (OR: 1.37, 95% CI: 1.05\u20131.77, <jats:italic>p<\/jats:italic> = 0.019).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Presenting with one of nine variables made residents between 1.4 and 8 times more likely to be experiencing acute deterioration than others living in the facility. The monitoring the resident for these variables by healthcare assistants could support the timely identification of acute deterioration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Registration<\/jats:title><jats:p>Not applicable.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jep.70068","type":"journal-article","created":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T03:56:14Z","timestamp":1743566174000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association of Clinical Indicators of Acute Deterioration and Morbidity and Mortality in the Residential Aged Care Population: A Retrospective Cohort Study of Routinely Collected Health Data"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5063-9705","authenticated-orcid":false,"given":"Julie Frances","family":"Daltrey","sequence":"first","affiliation":[{"name":"Faculty of Medical and Health Sciences, School of Nursing University of Auckland Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8895-1251","authenticated-orcid":false,"given":"Michal Kathleen","family":"Boyd","sequence":"additional","affiliation":[{"name":"Faculty of Medical and Health Sciences, School of Nursing University of Auckland Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6789-127X","authenticated-orcid":false,"given":"Vanessa","family":"Burholt","sequence":"additional","affiliation":[{"name":"Faculty of Medical and Health Sciences, School of Nursing University of Auckland Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6833-0079","authenticated-orcid":false,"given":"Heather","family":"McLeod","sequence":"additional","affiliation":[{"name":"Faculty of Commerce, Actuarial Science University of Cape Town  South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6712-8602","authenticated-orcid":false,"given":"W. 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