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frailty and comorbidity

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https://www.readbyqxmd.com/read/29776643/review-of-risk-assessment-tools-to-predict-morbidity-and-mortality-in-elderly-surgical-patients
#1
REVIEW
Gilgamesh Eamer, Mohamed J H Al-Amoodi, Jayna Holroyd-Leduc, Darryl B Rolfson, Lindsey M Warkentin, Rachel G Khadaroo
BACKGROUND: Informed surgical consent requires accurate estimation of risks and benefits. Multiple risk assessment tools are available; however, most are not widely used or are specific to certain interventions. Assessing surgical risk is especially challenging in elderly patients because of their range of comorbidities, level of frailty, or severity of illness and a number of available surgical interventions. DATA SOURCES: We searched MEDLINE from January 2014 to July 2017 for studies that used risk assessment tools in studies on elderly surgical patients...
April 18, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29775746/anthropometric-measurements-and-mortality-in-frail-older-adults
#2
Jonathan F Easton, Christopher R Stephens, Heriberto Román-Sicilia, Matteo Cesari, Mario Ulises Pérez-Zepeda
BACKGROUND: As the number of older adults increases, so does the number of frail older adults. Although anthropometry has been widely used as a way to stratify the overall mortality risk of a person, the significance of these measurements becomes blurred in the case of frail older adults who have changes in body composition. Therefore, the aim of this study is to determine the association of anthropometric measurements (body mass index, knee-adjusted height body mass index, waist-to-hip ratio and calf circumference) with mortality risk in a group of older Mexican adults...
May 15, 2018: Experimental Gerontology
https://www.readbyqxmd.com/read/29770315/a-high-burden-of-comorbid-conditions-leads-to-decreased-survival-in-breast-cancer
#3
Ingrid A Woelfel, Leopoldo J Fernandez, Michael O Idowu, Kazuaki Takabe
Background: Despite our most advanced medical and surgical treatment 40,000 women die from breast cancer each year. The aging population and their increasing burden of comorbidities may not be able to realize the full benefit of treatments due to a combination of the side effects and patient frailty. The aim of this study was to characterize the comorbidities of breast cancer patients and to determine if the number of comorbidities is a significant contributor to survival. Methods: A database including patients from the year 2002 to 2012 was created to include health comorbidities from the electronic medical record...
April 2018: Gland Surgery
https://www.readbyqxmd.com/read/29746546/transcatheter-aortic-valve-implantation-for-aortic-stenosis-in-high-surgical-risk-patients-a-systematic-review-and-meta-analysis
#4
Zulian Liu, Elaine Kidney, Danai Bem, George Bramley, Susan Bayliss, Mark A de Belder, Carole Cummins, Rui Duarte
BACKGROUND: Symptomatic aortic stenosis has a poor prognosis. Many patients are considered inoperable or at high surgical risk for surgical aortic valve replacement (SAVR), reflecting their age, comorbidities and frailty. The clinical effectiveness and safety of TAVI have not been reviewed systematically for these high levels of surgical risk. This systematic review compares mortality and other important clinical outcomes up to 5 years post treatment following TAVI or other treatment in these risk groups...
2018: PloS One
https://www.readbyqxmd.com/read/29746318/hiv-1-status-is-independently-associated-with-decreased-erectile-function-among-middle-aged-msm-in-the-era-of-combination-antiretroviral-therapy
#5
Maartje Dijkstra, Rik H W van Lunsen, Katherine W Kooij, Udi Davidovich, Rosan A van Zoest, Ferdinand W M N Wit, Maria Prins, Peter Reiss, Maarten F Schim van der Loeff
INTRODUCTION: HIV-1-infected MSM more often experience sexual dysfunctions than the general population. We assessed associations between HIV-1 status and decreased sexual functioning among MSM. METHODS: We used cross-sectional data from 399 HIV-1-infected MSM mostly on combination antiretroviral therapy (cART) and 366 HIV-1-uninfected MSM aged at least 45 years participating in the AGEhIV Cohort Study. The study questionnaire included questions on erectile function, sexual satisfaction, and sexual desire...
June 1, 2018: AIDS
https://www.readbyqxmd.com/read/29734155/role-of-frailty-on-outcomes-of-dialysis-patients
#6
Kosaku Nitta, Norio Hanafusa, Ken Tsuchiya
Frailty is a clinical state in which there is an increase in the individual's vulnerability to developing increased dependency and/or mortality when exposed to a stressor. Since the mean age of dialysis patients is increasing worldwide, frailty has recently come to be considered one of the risk factors for mortality in the older dialysis population. The prevalence of frailty among dialysis patients has ranged from 3.0- to 10-fold higher than in community-dwelling elderly, depending on the method of assessing frailty and patient characteristics...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29730983/the-challenge-of-aging-and-pharmacoterapeutic-complexity-in-the-hiv-patient
#7
Ramón Morillo-Verdugo, José Ramón Blanco Ramos, Laila Abdel-Kader Martín, María Álvarez de Sotomayor
OBJECTIVE: To describe the current knowledge and management of aging and  pharmacotherapeutic complexity in HIV + patients. METHOD: A review of literature was carried out, including articles, originals or  reviews, published in English or Spanish, from 2007 to 2017, which analysed the aging and pharmacotherapeutic complexity in HIV + patients. The terms  «Polypharmacy»/»Polypharmacy», «Aging»/»Aging», «Frailty»/»Fragility»,  «Pharmacotherapeutic Complexity»/»Medication Regimen Complexity» and  «HIV»/"HIV» were combined...
May 1, 2018: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/29729455/the-5-item-modified-frailty-index-is-predictive-of-30-day-postoperative-complications-in-patients-undergoing-kyphoplasty-vertebral-augmentation
#8
Dale Segal, Jacob M Wilson, Christopher Staley, Keith W Michael
BACKGROUND: Vertebral compression fractures are the most common spine injury seen in elderly patients. Vertebral augmentation is considered a safe and effective treatment. The ability to predict outcomes based on comorbidities is lacking. The modified frailty index has been used to predict complications after orthopedic and surgical procedures. We hypothesized that despite a low rate of adverse outcomes, postoperative complications following kyphoplasty would be higher in frail patients...
May 2, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29724357/arrhythmias-in-patients-%C3%A2-80-years-of-age-pathophysiology-management-and-outcomes
#9
REVIEW
Anne B Curtis, Roshan Karki, Alexander Hattoum, Umesh C Sharma
Advances in medical care have led to an increase in the number of octogenarians and even older patients, forming an important and unique patient subgroup. It is clear that advancing age is an independent risk factor for the development of most arrhythmias, causing substantial morbidity and mortality. Patients ≥80 years of age have significant structural and electrical remodeling of cardiac tissue; accrue competing comorbidities; react differently to drug therapy; and may experience falls, frailty, and cognitive impairment, presenting significant therapeutic challenges...
May 8, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29714028/the-prevalence-and-health-burden-of-malnutrition-in-belgian-older-people-in-the-community-or-residing-in-nursing-homes-results-of-the-nutriaction-ii-study
#10
Maurits F J Vandewoude, Janneke P van Wijngaarden, Lieven De Maesschalck, Yvette C Luiking, André Van Gossum
INTRODUCTION: In 2008, the NutriAction study showed that (risk of) malnutrition was highly prevalent (57%) among Belgian older people living in the community or in a nursing home. In 2013, this study was repeated to re-evaluate the occurrence of malnutrition, as well as mobility problems and dependence in activities of daily living (ADL). METHODS: Health care professionals (HCPs) associated with homecare organizations and nursing homes across Belgium were invited to screen their patients and complete an online questionnaire...
April 30, 2018: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29707921/obesity-weight-loss-and-progression-of-disability-in-rheumatoid-arthritis
#11
Joshua F Baker, Bryant R England, Ted R Mikuls, Harlan Sayles, Grant W Cannon, Brian C Sauer, Michael D George, Liron Caplan, Kaleb Michaud
BACKGROUND: Obese patients with rheumatoid arthritis (RA) report greater disability in cross-sectional studies. The longitudinal effects of obesity, however, are not well-characterized. We evaluated associations between obesity, weight loss, and worsening of disability in two large registry studies with long-term follow-up. METHODS: This study included patients with RA from the National Data Bank of Rheumatic Diseases (Forward) (N=23,323) and the Veterans Affairs RA (VARA) registry study (N=1,697)...
April 29, 2018: Arthritis Care & Research
https://www.readbyqxmd.com/read/29699709/endocrine-surgery-in-the-geriatric-population
#12
REVIEW
John Benjamin McIntire, Susan McCammon, Eric R Mong
Age must be a factor when considering endocrine surgery. Age itself is a risk factor for complications after thyroidectomy, specifically pulmonary, infectious, and cardiac complications. For this reason, in patients with nodular thyroid disease or thyroid microcarcinoma, length of observation must be measured against age and surgical risk. Outcomes of thyroid surgery in geriatric patients can be improved with several measures, including careful preoperative risk stratification based on comorbidities and frailty...
April 23, 2018: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/29685382/managing-older-patients-with-head-and-neck-cancer-the-non-surgical-curative-approach
#13
Muhammad Shahid Iqbal, Divyanshu Dua, Charles Kelly, Paolo Bossi
Managing older patients with head and neck cancers poses a challenge due to the often reduced levels of physiological reserve, the frequent comorbidities and treatment related toxicity. These factors have implications on speech, breathing and swallowing functions. Treatment management plans in these patients may result in de-intensification strategies and as a result of this, use of non-standard treatments is increasing. There have been published reports that indicate the addition of concurrent systemic therapy to radiation in selected older patients is feasible, and produces outcomes comparable with younger patients...
April 20, 2018: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/29668839/prognostic-factors-of-functional-outcome-after-hip-fracture-surgery-a-systematic-review
#14
K J Sheehan, L Williamson, J Alexander, C Filliter, B Sobolev, P Guy, L M Bearne, C Sackley
Objective: this systematic review aimed to identify immutable and modifiable prognostic factors of functional outcomes and their proposed mechanism after hip fracture surgery. Design: systematic search of MEDLINE, Embase, CINAHL, PEDRO, OpenGrey and ClinicalTrials.gov for observational studies of prognostic factors of functional outcome after hip fracture among surgically treated adults with mean age of 65 years and older. Study selection, quality assessment, and data extraction were completed independently by two reviewers...
April 12, 2018: Age and Ageing
https://www.readbyqxmd.com/read/29659593/the-complexity-of-patients-hospitalized-in-internal-medicine-wards-evaluated-by-fadoi-complimed-score-s-a-hypothetical-approach
#15
Erminio Bonizzoni, Gualberto Gussoni, Giancarlo Agnelli, Raffaele Antonelli Incalzi, Moira Bonfanti, Franco Mastroianni, Marco Candela, Carlotta Franchi, Stefania Frasson, Antonio Greco, Micaela La Regina, Roberta Re, Giorgio Vescovo, Mauro Campanini
OBJECTIVES: The aim of this study is to develop a new predictive model to measure complexity of patients in medical wards. SETTING: 29 Internal Medicine departments in Italy. MATERIALS AND METHODS: The study cohort was made of 541 consecutive patients hospitalized for any cause, aged more than 40 years and with at least two chronic diseases. First, we applied a hierarchical cluster analysis and the principal component analysis (PCA) to a panel of questionnaires [comorbidity (Charlson, CIRS), clinical stability (MEWS), social frailty (Flugelman), cognitive dysfunction (SPSMQ), depression (5-item GDS), functional dependence (ADL, IADL, Barthel), risk of sore threats (Exton-Smith scale), nutrition (MNA), pain (NRPS), adherence to therapy (Morisky scale)], in order to select domains informative for the definition of complexity...
2018: PloS One
https://www.readbyqxmd.com/read/29651743/polypharmacy-in-palliative-care-copd-and-multimorbidity-a-case-report
#16
Marcel Rowhani, Bernhard Iglseder
This is the case report of an 80-year-old woman with advanced chronic obstructive pulmonary disease (COPD), multimorbidity and frailty. Despite regular critical re-evaluation of on-going medication, a significant reduction of prescribed medication was not achieved up until the patient's terminal phase, and this may have contributed to several episodes of delirium. It was particularly difficult to reduce the number of prescribed drugs due to cardiovascular, endocrinologic, orthopaedic, neurologic, psychiatric and pulmonary comorbidities...
April 12, 2018: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29649609/surgical-treatment-improves-survival-of-elderly-with-axis-fracture-a-national-population-based-multi-registry-cohort-study
#17
Anna-Lena Robinson, Claes Olerud, Yohan Robinson
Background Context Fractures of the axis (C2) are the most common cervical spinal injuries in the elderly population. Several authors have reported improved survival among elderly patients with C2 fractures when treated surgically. Purpose To analyze whether surgery improves survival of elderly with C2 fractures. Study Design/ Setting Observational population-based longitudinal multi-registry study Patient Sample Swedish Patient Registry 1997 to 2014, and Swedish Cause of Death Registry 1997 to 2014 Outcome measures Survival after C2 fracture according to non-surgical and surgical treatment...
April 9, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29642691/high-risk-pci-how-to-define-it-today
#18
Vincenzo DE Marzo, Domenico D'Amario, Mattia Galli, Rocco Vergallo, Italo Porto
Before the percutaneous spread, the mortality rate of patients with coronary heart disease not suitable for cardiac surgery was markedly high. This limit has been progressively exceeded with the advent of minimally invasive approaches, which, although was initially intended exclusively for low risk patients, was then employed in complex patients often too compromised to undergo cardiac surgery. Given to the rising of high-risk population, due to an increase of patients with multiple chronic conditions linked to the best care offered, we are witnessing an expansion of the high-risk percutaneous coronary interventions (PCI) population...
April 11, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29627964/evaluating-concurrent-validity-of-criminal-justice-and-clinical-assessments-among-women-on-probation
#19
Camila D Odio, Megan Carroll, Susan Glass, Ashley Bauman, Faye S Taxman, Jaimie P Meyer
BACKGROUND: Women in the criminal justice (CJ) system experience complex and comorbid medical, psychiatric, and substance use disorders, which often contribute to CJ involvement. To identify intersections between CJ and health needs, we calculated Spearman r correlations between concurrent CJ and clinical assessments from women on probation in Connecticut who were enrolled in a clinical trial. We examined longitudinal trends in CJ risk scores over 9 years of observation (2005-2014), modeling time to probation recidivism with shared gamma frailty models and comparing contiguous time points by Wilcoxon matched-pairs signed rank tests...
April 7, 2018: Health & Justice
https://www.readbyqxmd.com/read/29625717/prospective-observational-study-in-elderly-patients-with-non-valvular-atrial-fibrillation-rationale-and-design-of-the-all-nippon-af-in-the-elderly-anafie-registry
#20
Hiroshi Inoue, Takeshi Yamashita, Masaharu Akao, Hirotsugu Atarashi, Takanori Ikeda, Ken Okumura, Yukihiro Koretsune, Wataru Shimizu, Hiroyuki Tsutsui, Kazunori Toyoda, Atsushi Hirayama, Masahiro Yasaka, Takenori Yamaguchi, Masahiro Akishita, Naoyuki Hasebe, Kazuomi Kario, Yuji Mizokami, Ken Nagata, Masato Nakamura, Yasuo Terauchi, Takatsugu Yamamoto, Satoshi Teramukai, Tetsuya Kimura, Jumpei Kaburagi, Atsushi Takita
BACKGROUND: Although anticoagulation effectively prevents stroke in patients with atrial fibrillation (AF), it has been underused in elderly AF patients for many reasons, mainly because of knowledge gaps regarding cardiovascular treatment of these populations with multiple comorbidities and poor prognosis. The objectives of the All Nippon AF In the Elderly (ANAFIE) Registry are to collect real-world information about the clinical status of patients with non-valvular AF (NVAF) aged ≥75 years, current status of anticoagulant therapy, and prognosis with/without anticoagulation to establish a database for this specific patient population that is increasing remarkably worldwide...
April 3, 2018: Journal of Cardiology
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