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Charlson's comorbidity-age index

M Gili-Miner, J López-Méndez, A Vilches-Arenas, G Ramírez-Ramírez, D Franco-Fernández, J Sala-Turrens, L Béjar-Prado
INTRODUCTION: The objective of this study was to analyse the impact of alcohol use disorders (AUD) in patients with multiple sclerosis (MS) in terms of in-hospital mortality, extended hospital stays, and overexpenditures. METHODS: We conducted a retrospective observational study in a sample of MS patients obtained from minimal basic data sets from 87 Spanish hospitals recorded between 2008 and 2010. Mortality, length of hospital stays, and overexpenditures attributable to AUD were calculated...
October 22, 2016: Neurología: Publicación Oficial de la Sociedad Española de Neurología
Giuseppina D'Onofrio, Mariadelina Simeoni, Paolo Rizza, Mariarita Caroleo, Maria Capria, Giovanni Mazzitello, Tiziana Sacco, Elena Mazzuca, Maria Teresa Panzino, Annamaria Cerantonio, Cristina Segura-Garcia, Michele Andreucci, Pasquale De Fazio, Giorgio Fuiano
RATIONAL: Our aim was to investigate the quality of life (QoL) in 103 patients undergoing chronic hemodialysis (HD) in an integrated assessment of clinical, personological, and adaptation parameters, also in a non-urban context. OBJECTIVES: We collected data from all chronic HD patients attending four HD units. Clinical status was assessed by Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines and by Age-adjusted Charlson Comorbidity Index (ACCI). Patients completed the following questionnaires: Kidney Disease Quality of Life Short Form (KDQOL-SF), Pittsburgh Sleep Quality Index (PSQI)...
October 25, 2016: Renal Failure
Giorgina B Piccoli, Federica Ventrella, Irene Capizzi, Federica N Vigotti, Elena Mongilardi, Giorgio Grassi, Valentina Loi, Gianfranca Cabiddu, Paolo Avagnina, Elisabetta Versino
Low-protein diets (LPDs) are often considered as contraindicated in diabetic patients, and are seldom studied. The aim of this observational study was to provide new data on this issue. It involved 149 diabetic and 300 non-diabetic patients who followed a LPD, with a personalized approach aimed at moderate protein restriction (0.6 g/day). Survival analysis was performed according to Kaplan-Meier, and multivariate analysis with Cox model. Diabetic versus non-diabetic patients were of similar age (median 70 years) and creatinine levels at the start of the diet (2...
October 21, 2016: Nutrients
C Toyas, C Aspiroz, R M Martínez-Álvarez, A I Ezpeleta, P Arazo, J C Ferrando
OBJECTIVE: To describe the characteristics of bacteraemias, according to age, in a community hospital. MATERIAL AND METHOD: A prospective study of bacteraemias was conducted in 2011. The patients were classified into 3 age groups: younger than 65 years, 65 to 79, and 80 or older. The study collected variables on the patients and episodes. RESULTS: The study analysed 233 bacteraemias in 227 patients (23.8% in those younger than 65 years; 38...
October 20, 2016: Revista Clínica Española
Nikolaos Charalampakis, Lianchun Xiao, Quan Lin, Elena Elimova, Yusuke Shimodaira, Kazuto Harada, Jane E Rogers, Jeannette Mares, Fatemeh G Amlashi, Bruce D Minsky, Prajnan Das, Wayne L Hofstetter, Aurelio Matamoros, Tara L Sagebiel, Mariela A Blum-Murphy, Jeffrey H Lee, Brian Weston, Manoop S Bhutani, Paul F Mansfield, Jeannelyn S Estrella, Brian D Badgwell, Jaffer A Ajani
BACKGROUND: Older patients with localized gastric adenocarcinoma (LGAC) have substantial postoperative morbidity and mortality; however, postoperative outcomes of the patients who receive preoperative chemotherapy and/or chemoradiation have not been reported. We examined the impact of age at baseline on potential predictors of postoperative outcomes. METHODS: Patients with LGAC who were treated with chemotherapy and/or chemoradiation followed by surgery (n = 203) formed two groups: (1) ≥65 years old (n = 70) and (2) <65 years old (n = 133)...
October 21, 2016: Annals of Surgical Oncology
J P Cata, K B Hagan, S D O Bhavsar, R Arunkumar, R Grasu, A Dang, R Carlson, B Arnold, Y Potylchansky, I Lipski, T McHugh, F Jimenez, A T Nguyen, L Feng, T F Rahlfs
BACKGROUND: Several studies have examined the impact of anesthetics on cancer recurrence. Isoflurane but not desflurane has protumoral effects. We hypothesize the use of isoflurane but not desflurane during surgery for primary GBM is an independent predictor of disease progression and mortality. METHODS: 378 adult patients were included in the study. The progression free survival (PFS) and overall survival (OS) rates at 1 and 5years were compared in patients who had either desflurane or isoflurane alone or in combination with propofol infusion...
October 17, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Weiwei Wang, Ting Jiang, Weihong Zhang, Chunyu Li, Jun Chen, Dandan Xiang, Kejiang Cao, Lian-Wen Qi, Ping Li, Wei Zhu, Wensen Chen, Yan Chen
The study was undertaken to describe the profile of patients and the characteristics of all multidrug-resistant gram-negative bacteria (MDR-GNB) and to assess mortality. We examined 138 patients with bloodstream infections (BSIs) caused by MDR-GNB. Clinical characteristics, antibiotic therapy, and in-hospital mortality were analyzed. Survivor and nonsurvivor subgroups were compared to identify predictors of mortality. The in-hospital mortality rate was 25.4%. Univariate analysis revealed that comorbidities and inadequate initial antimicrobial treatment could increase risk of death...
October 17, 2016: American Journal of Infection Control
M J Lin, F Baky, B C Housley, N Kelly, E Pletcher, J D Balshi, S P Stawicki, D C Evans
INTRODUCTION: Clinical information continues to be limited regarding changes in the temporal risk profile for readmissions during the initial postoperative year in vascular surgery patients. We set out to describe the associations between demographics, clinical outcomes, comorbidity indices, and hospital readmissions in a sample of patients undergoing common extremity revascularization or dialysis access (ERDA) procedures. We hypothesized that factors independently associated with readmission will evolve from "short-term" to "long-term" determinants at 30-, 180-, and 360-day postoperative cutoff points...
October 2016: Journal of Postgraduate Medicine
Kristi Reynolds, Daichi Shimbo, C Barrett Bowling, Luqin Deng, Adam Bress, John Sim, Paul Muntner
OBJECTIVE: To identify risk factors for serious fall injuries following initiation of antihypertensive medication among older adults. DESIGN AND METHOD: We conducted a retrospective cohort study using a 5% random sample of people with Medicare health insurance, a government program for older US adults. The analysis was restricted to patients with a diagnosis of hypertension who initiated antihypertensive medication between 2007 and 2011. Initiation was defined by the first antihypertensive medication fill in this time period preceded by 365 days with no antihypertensive medication fills...
September 2016: Journal of Hypertension
C Martínez, A S Jorge, A Pereira, M Moreno, J Núñez, J Gayoso, J Gonzalez-Medina, N Revilla, A Sampol, E Domingo-Domenech, F de la Cruz, A Morales, M J Rodriguez-Salazar, S Valiente, E Pérez-Ceballos, J Pérez de Oteyza, R García-Sanz
Autologous hematopoietic cell transplantation (AHCT) is the standard of care for young patients with relapsed/refractory (R/R) Hodgkin's lymphoma (HL). However, there is limited experience of its efficacy and feasibility in older patients. The characteristics and outcomes of 121 patients aged ≥50 years (42 of them are ≥60 years old) with R/R HL who underwent AHCT were reviewed. After a median follow-up of 3.1 years, overall survival (OS) and progression-free survival (PFS) at 5 years were 64 and 55 %, respectively, with no differences between 50-59-year-old and ≥60-year-old patients...
October 18, 2016: Annals of Hematology
Katarina Tomic, Marcus Westerberg, David Robinson, Hans Garmo, Pär Stattin
BACKGROUND: Knowledge on missing data in a clinical cancer register is important to assess the validity of research results. For analysis of prostate cancer (Pca), risk category, a composite variable based on serum levels of prostate specific antigen (PSA), stage, and Gleason score, is crucial for treatment decisions and a strong determinant of outcome. The aim of this study was to assess the proportion and characteristics of men in the National Prostate Cancer Register (NPCR) of Sweden with unknown risk category...
October 17, 2016: Acta Oncologica
Alex Herskovic, Elizabeth Mauer, Paul Christos, Himanshu Nagar
BACKGROUND: The role of postoperative radiotherapy (PORT) in the treatment of pathologic stage IIIA (N2) non-small cell lung cancer (NSCLC) remains controversial. We investigated practice patterns and outcomes for these patients in a prospectively maintained nationwide oncology outcomes database. METHODS: Patients with known histologies of pathologic stage IIIA (N2) NSCLC who underwent surgery with negative margins and received adjuvant multiagent chemotherapy from 2004-2013 were identified from the National Cancer DataBase (NCDB) and stratified by the use of PORT...
October 13, 2016: Journal of Thoracic Oncology
Olubode A Olufajo, Gally Reznor, Stuart R Lipsitz, Zara R Cooper, Adil H Haider, Ali Salim, Erika L Rangel
BACKGROUND: The risk of mortality after emergency general surgery (EGS) in elderly patients is prolonged beyond initial hospitalization. Our objective was to develop a preoperative scoring tool to quantify risk of 1-year mortality. METHODS: Three hundred ninety EGS patients aged 70 years or more were analyzed. Risk factors for 1-year mortality were identified using stepwise-forward logistic multivariate regression and weights assigned using natural logarithm of odds ratios...
September 3, 2016: American Journal of Surgery
Alexander Egeberg, Lone Skov, Yuki M F Andersen, Lotus Mallbris, Gunnar H Gislason, Jonathan I Silverberg, Jashin J Wu, Jacob P Thyssen
BACKGROUND: Psoriasis and atopic dermatitis (AD) are chronic inflammatory skin disorders. Mortality is increased in psoriasis, yet no studies on mortality in AD are currently available. OBJECTIVE: We investigated 10-year mortality after hospitalization for AD compared with psoriasis and the general population. METHODS: Between 1996 and 2002 all Danes aged 18 years or older with a first-time hospitalization as a result of AD or psoriasis and AD-matched healthy control subjects were examined in nationwide registers...
October 11, 2016: Journal of the American Academy of Dermatology
Jonas Schiffmann, Maxine Sun, Giorgio Gandaglia, Zhe Tian, Ioana Popa, Alessandro Larcher, Alberto Briganti, Michael McCormack, Shahrokh F Shariat, Francesco Montorsi, Markus Graefen, Fred Saad, Pierre I Karakiewicz
BACKGROUND: The role of adjuvant chemotherapy (AC) within urothelial carcinoma of the urinary bladder (UCUB) patients after radical cystectomy (RC) is under debate. We assessed contemporary AC utilization rates. We also examined the rates of AC according to patient disease and sociodemographic characteristics. METHODS: We relied on the SEER-Medicare database for non-organ-confined, muscle-invasive T2 N+ -T4a UCUB patients who underwent RC between 1991 and 2009 without neoadjuvant chemotherapy delivery...
October 12, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Ricardo Brandina, Katia Ramos Moreira Leite, Emerson Pereira Gregório, Karen Barros Parron Fernandes, Miguel Srougi
OBJECTIVES: To assess the association of histopathological parameters in non-neoplastic renal parenchyma with development of new onset chronic kidney disease (CKD) after radical nephrectomy. METHODS: Data were extracted from 222 patients who underwent radical nephrectomy. The Modification of Diet in Renal Disease (MDRD) formula was used. The study end point was development of CKD, defined as an estimated glomerular filtration rate (eGFR) of less than 60ml/minute/1,73m(2)...
October 7, 2016: Urology
Wilson Sui, Arindam RoyChoudry, Sven Wenske, Guarionex J Decastro, James M McKiernan, Christopher B Anderson
OBJECTIVE: To identify prognostic and treatment factors for primary urethral cancer using a nationwide database. MATERIALS AND METHODS: The National Cancer Database (NCDB) was queried for all cases of primary urethral cancer from 2004-2013. Patients with other cancer diagnoses, metastasis or diagnosis on autopsy we excluded. Proportional hazards regression was used to identify independent predictors of overall survival in patients with primary urethral cancer. Because we hypothesized that predictors may covary by sex, we also performed regression analysis stratified by sex...
October 5, 2016: Urology
Marie Laurent, Laurent Brureau, Mounira El Demery, Aude Fléchon, Aurélie Le Thuaut, Muriel Carvahlo-Verlinde, Sylvie Bastuji-Garin, Elena Paillaud, Florence Canoui-Poitrine, Stéphane Culine
PURPOSE: Median age for the diagnosis of metastatic bladder cancer (MBC) is 73 years. The feasibility of chemotherapy in older patients is controversial. Our objectives were to assess associations linking age to first line chemotherapy regimen selection, early chemotherapy discontinuation, and 1-year mortality in everyday practice. MATERIALS AND METHODS: Between 1999 and 2011, 197 consecutive patients aged≥70 years with MBC referred to 4 hospitals were included in the AGEVIM multicenter cohort...
October 6, 2016: Urologic Oncology
Maren E Hilton, Terence Gioe, Siamak Noorbaloochi, Jasvinder A Singh
BACKGROUND: Previous studies suggested that pre-operative comorbidity was a risk factor for worse outcomes after TKA. To our knowledge, studies have not examined whether postoperative changes in comorbidity impact pain and function outcomes longitudinally. Our objective was to examine if increasing comorbidity postoperatively is associated with worsening physical function and pain after primary total knee arthroplasty (TKA). METHODS: We performed a retrospective chart review of veterans who had completed Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Short Form-36 (SF36) surveys at regular intervals after primary TKA...
October 7, 2016: BMC Musculoskeletal Disorders
Jian Guan, Michael Karsy, William T Couldwell, Richard H Schmidt, Philipp Taussky, Joel D MacDonald, Min S Park
OBJECTIVE The choice between treating and observing unruptured intracranial aneurysms is often difficult, with little guidance on which variables should influence decision making on a patient-by-patient basis. Here, the authors compared demographic variables, aneurysm-related variables, and comorbidities in patients who received microsurgical or endovascular treatment and those who were conservatively managed to determine which factors push the surgeon toward recommending treatment. METHODS A retrospective chart review was conducted of all patients diagnosed with an unruptured intracranial aneurysm at their institution between January 1, 2013, and January 1, 2016...
October 7, 2016: Journal of Neurosurgery
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