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frailty and comorbidity

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https://www.readbyqxmd.com/read/28190748/modified-frailty-index-associated-with-clavien-dindo-iv-complications-in-robot-assisted-radical-prostatectomies-a-retrospective-study
#1
Isaiah Levy, Mark Finkelstein, Khawaja Hassan Bilal, Michael Palese
OBJECTIVE: To determine the effect of frailty on patient outcomes including any complication, Clavien-Dindo IV (CDIV) (intensive care unit-level) complications, and 30-day mortality for robotic-assisted radical prostatectomies (RARP) patients in comparison to other predictive indices using the modified frailty index (mFI). MATERIAL AND METHODS: Patients undergoing RARP from 2008 to 2014 for a prostate cancer-related diagnosis were queried using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database...
February 9, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28190681/differential-effects-of-metformin-on-age-related-comorbidities-in-older-men-with-type-2-diabetes
#2
Chen-Pin Wang, Carlos Lorenzo, Samy L Habib, Booil Jo, Sara E Espinoza
AIMS: To identify distinct temporal likelihoods of age-related comorbidity (ARC) diagnoses: cardiovascular diseases (CVD), cancer, depression, dementia, and frailty-related diseases (FRD) in older men with type 2 diabetes (T2D) but ARC naïve initially, and assess the heterogeneous effects of metformin on ARCs and mortality. METHODS: We identified a clinical cohort of male veterans in the United States who were ≥65years old with T2D and free from ARCs during 2002-2003...
January 28, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28182802/the-association-of-geriatric-syndromes-with-hospital-outcomes
#3
Roman Romero-Ortuno, Duncan R Forsyth, Kathryn Jane Wilson, Ewen Cameron, Stephen Wallis, Richard Biram, Victoria Keevil
BACKGROUND: Frailty, history of dementia (HoD), and acute confusional states (ACS) are common in older patients admitted to hospital. OBJECTIVE: To study the association of frailty (≥6 points in the Clinical Frailty Scale [CFS]), HoD, and ACS with hospital outcomes, controlling for age, gender, acute illness severity (measured by a Modified Early Warning Score in the emergency department), comorbidity (Charlson Comorbidity Index), and discharging specialty (general medicine, geriatric medicine, surgery)...
February 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28157134/association-of-the-hospital-volume-of-frail-surgical-patients-cared-for-with-outcomes-after-elective-major-noncardiac-surgery-a-retrospective-population-based-cohort-study
#4
Daniel I McIsaac, Duminda N Wijeysundera, Allen Huang, Gregory L Bryson, Carl van Walraven
BACKGROUND: Frailty is a risk factor for adverse postoperative outcomes. Hospitals that perform higher volumes of surgery have better outcomes than low-volume providers. We hypothesized that frail patients undergoing elective surgery at hospitals that cared for a higher volume of similarly frail patients would have improved outcomes. METHODS: We conducted a retrospective, population-based cohort study using linked administrative data in Ontario, Canada. We identified all adult major, elective noncardiac surgery patients who were frail according to the validated Johns Hopkins Adjusted Clinical Groups (ACG) frailty-defining diagnoses indicator...
February 3, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28154088/a-concise-revised-myeloma-comorbidity-index-as-a-valid-prognostic-instrument-in-a-large-cohort-of-801-multiple-myeloma-patients
#5
Monika Engelhardt, Anne-Saskia Domm, Sandra Maria Dold, Gabriele Ihorst, Heike Reinhardt, Alexander Zober, Stefanie Hieke, Corine Baayen, Stefan Jürgen Müller, Hermann Einsele, Pieter Sonneveld, Ola Landgren, Martin Schumacher, Ralph Wäsch
With growing numbers of elderly multiple myeloma patients, reliable tools to assess their vulnerability are required. The objective of this analysis was to develop and validate an easy to use myeloma-risk-score (revised Myeloma Comorbidity Index) that allows risk prediction of OS and PFS differences in a large patient cohort. We conducted a geriatric assessment in 801 consecutive myeloma patients, including comorbidity risks obtained at diagnosis. The cohort was examined within a training and validation set...
February 2, 2017: Haematologica
https://www.readbyqxmd.com/read/28152784/breast-cancer-patient-functional-status-and-comorbidities-and-their-impact-on-treatment-aggressiveness-a-population-based-study
#6
Ramsankar Basak, Ronald C Chen
: 306 Background: The ASCO Choosing Wisely Campaign and other published guidelines recommend avoidance of aggressive treatments in early-stage cancer patients with limited life expectancy. However, patients with more advanced cancers are likely to benefit from aggressive treatment. The population-based SEER-MHOS (Medicare Health Outcomes Survey) provides unique data to allow assessment of aggressiveness of cancer treatment by cancer stage and patient frailty. METHODS: MHOS includes patient-reported functional deficits in a sample of Medicare beneficiaries, and has been linked with SEER data which provide diagnostic and treatment data...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28143863/perspectives-of-older-kidney-transplant-recipients-on-kidney-transplantation
#7
Jule Pinter, Camilla S Hanson, Jeremy R Chapman, Germaine Wong, Jonathan C Craig, Jane O Schell, Allison Tong
BACKGROUND AND OBJECTIVES: Older kidney transplant recipients are susceptible to cognitive impairment, frailty, comorbidities, immunosuppression-related complications, and chronic graft failure, however, there has been limited focus on their concerns and expectations related to transplantation. This study aims to describe the perspectives of older kidney transplant recipients about their experience of kidney transplantation, self-management, and treatment goals to inform strategies and interventions that address their specific needs...
January 31, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28139446/patient-frailty-and-discharge-disposition-following-radical-cystectomy
#8
Jeffrey A Pearl, Dattatraya Patil, Christopher P Filson, Shipra Arya, Mehrdad Alemozaffar, Viraj A Master, Kenneth Ogan
BACKGROUND: Patients with bladder cancer who are treated with cystectomy are at high risk for complications and prolonged length of stay. This population tends to be of advanced age with underlying comorbidities, and thus more likely to have decreased physiologic reserve (ie, frailty). Our objective was to evaluate the relationship between frailty and discharge disposition for patients with bladder cancer treated with cystectomy. MATERIALS AND METHODS: Using data from the National Surgical Quality Improvement Program, we identified patients with bladder cancer undergoing cystectomy (2011-2014)...
January 5, 2017: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28112778/use-of-health-resources-and-healthcare-costs-associated-with-frailty-the-fradea-study
#9
I García-Nogueras, I Aranda-Reneo, L M Peña-Longobardo, J Oliva-Moreno, P Abizanda
BACKGROUND: Frailty is associated with adverse health outcomes, but its association with hospital healthcare costs has not been analyzed. The main objective was to estimate the adjusted annual costs and use of hospital healthcare resources in frail older adults compared to non frail ones. DESIGN: FRADEA Study. Mean follow-up 1044 days (SD 314). SETTING: Albacete city, Spain. PARTICIPANTS: 830 adults ≥70 years. MEASUREMENTS: Age, sex, comorbidity measured with the Charlson index and Fried´s Frailty phenotype as independent variables, and use of hospital resources (hospital admissions, emergency visits, and specialist visits), and hospital healthcare costs as outcome variables...
2017: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/28098098/a-study-of-clinical-assessment-of-frailty-in-patients-on-maintenance-hemodialysis-supported-by-cashless-government-scheme
#10
Manjusha Yadla, Jyothi Priyadarshini John, Mahesh Mummadi
This is a prospective cohort study to assess the prevalence of frailty in patients undergoing maintenance hemodialysis (HD) under the government-funded scheme at our center and to assess the relationship between frailty and falls, hospitalizations, and mortality. This was done at our center which is completely supported by the government, which provides HD to all the patients under poverty line. Epidemiological data, anthropometric measurements, comorbidities assessment, frailty assessment using Fried criteria, subsequent hospitalizations, falls, and mortality were recorded in our prevalent dialysis population at our center between October 2014 and October 2015...
January 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28091402/geriatric-assessment-to-predict-survival-and-risk-of-serious-adverse-events-in-elderly-newly-diagnosed-multiple-myeloma-patients-a-multicenter-study-in-china
#11
Yu-Ping Zhong, Yi-Zhuo Zhang, Ai-Jun Liao, Su-Xia Li, Chen Tian, Jin Lu
BACKGROUND: Elderly multiple myeloma (MM) patients often tend to suffer a variety of diseases, so the treatment of choice is very difficult for the elderly myeloma patients. The overall survival (OS) time and side effects with elderly patients are unclear in China. The study tried to find out the role of geriatric assessment in the Chinese elderly MM. METHODS: We retrospectively analyzed the data of 628 newly diagnosed patients from six hospitals from June 2011 to June 2013...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28089304/management-of-prostate-cancer-in-elderly-patients-recommendations-of-a-task-force-of-the-international-society-of-geriatric-oncology
#12
REVIEW
Jean-Pierre Droz, Gilles Albrand, Silke Gillessen, Simon Hughes, Nicolas Mottet, Stéphane Oudard, Heather Payne, Martine Puts, Gilbert Zulian, Lodovico Balducci, Matti Aapro
CONTEXT: Prostate cancer is the most frequent male cancer. Since the median age of diagnosis is 66 yr, many patients require both geriatric and urologic evaluation if treatment is to be tailored to individual circumstances including comorbidities and frailty. OBJECTIVE: To update the 2014 International Society of Geriatric Oncology (SIOG) guidelines on prostate cancer in men aged >70 yr. The update includes new material on health status evaluation and the treatment of localised, advanced, and castrate-resistant disease...
January 11, 2017: European Urology
https://www.readbyqxmd.com/read/28073582/risk-of-inflammatory-bowel-disease-in-patients-with-rosacea-results-from-a-nationwide-cohort-study-in-taiwan
#13
Chun-Ying Wu, Yun-Ting Chang, Chao-Keui Juan, Jeng-Jer Shieh, Yu-Pu Lin, Han-Nan Liu, Jaw-Town Lin, Yi-Ju Chen
BACKGROUND: A link between rosacea and inflammatory bowel disease (IBD) has been proposed with unknown mechanisms. Epidemiologic evidence of this association needs to be examined. METHODS: In this nationwide cohort study, a total of 89,356 patients with rosacea and 178,712 matched patients without rosacea between 1997 and 2013 were identified in the Taiwanese National Health Insurance Research Database. Cumulative incidences of IBD were compared between these 2 cohorts...
January 7, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28065454/the-prevalence-association-and-clinical-outcomes-of-frailty-in-maintenance-dialysis-patients
#14
So-Young Lee, Dong Ho Yang, Eunah Hwang, Seock Hui Kang, Sun-Hee Park, Tae Woo Kim, Duk Hyun Lee, Kisoo Park, Jun Chul Kim
OBJECTIVE: To investigate the clinical implications of frailty in chronic kidney disease patients undergoing maintenance hemodialysis and chronic peritoneal dialysis. DESIGN: In this prospective study, all of the participants completed the Short Form of the Kidney Disease Quality of Life questionnaire, Korean version, to determine their frailty phenotype. We also obtained blood chemistry and demographic data at enrollment. Data regarding the history of hospitalization and death were collected during the follow-up period...
March 2017: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/28059648/validation-of-effectiveness-of-keyhole-clipping-in-nonfrail-elderly-patients-with-unruptured-intracranial-aneurysms
#15
Kentaro Mori, Kojiro Wada, Naoki Otani, Arata Tomiyama, Terushige Toyooka, Kazuya Fujii, Kosuke Kumagai, Satoru Takeuchi, Satoshi Tomura, Takuji Yamamoto, Yasuaki Nakao, Hajime Arai
OBJECTIVE Advanced age is known to be associated with a poor prognosis after surgical clipping of unruptured intracranial aneurysms (UIAs). Keyhole clipping techniques have been introduced for less invasive treatment of UIAs. In this study, the authors compared the complications and clinical and radiological outcomes after keyhole clipping between nonfrail elderly patients (≥ 70 years) and nonelderly patients. METHODS Keyhole clipping (either supraorbital or pterional) was performed to treat 260 cases of relatively small (≤ 10 mm) anterior circulation UIAs...
January 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28058214/older-candidates-for-kidney-transplantation-who-to-refer-and-what-to-expect
#16
REVIEW
Beatrice P Concepcion, Rachel C Forbes, Heidi M Schaefer
The number of older end-stage renal disease patients being referred for kidney transplantation continues to increase. This rise is occurring alongside the continually increasing prevalence of older end-stage renal disease patients. Although older kidney transplant recipients have decreased patient and graft survival compared to younger patients, transplantation in this patient population is pursued due to the survival advantage that it confers over remaining on the deceased donor waiting list. The upper limit of age and the extent of comorbidity and frailty at which transplantation ceases to be advantageous is not known...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28053514/clinical-outcome-and-predictors-of-adverse-events-of-an-enhanced-older-adult-psychiatric-liaison-service-rapid-assessment-interface-and-discharge-newport
#17
Inderpal Singh, Priya Fernando, Jane Griffin, Chris Edwards, Kathryn Williamson, Patrick Chance
BACKGROUND: Hospitals are currently admitting an increasing number of older people, and more than one-third could have an underlying mental health problem. The existing Older Adult Mental Health (OAMH) liaison service was increasingly unable to meet the escalating needs of older and frail patients. Therefore, the service was modernized and enhanced on an "invest-to-save" principle to provide a prompt holistic assessment for older adults with mental health problems. The objective of this study was a service evaluation to appraise clinical outcome, minimize the length of stay, and measure the predictors of adverse outcomes to streamline this enhanced service...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28049443/performance-of-edmonton-frail-scale-on-frailty-assessment-its-association-with-multi-dimensional-geriatric-conditions-assessed-with-specific-screening-tools
#18
Simone Perna, Matthew D'Arcy Francis, Chiara Bologna, Francesca Moncaglieri, Antonella Riva, Paolo Morazzoni, Pietro Allegrini, Antonio Isu, Beatrice Vigo, Fabio Guerriero, Mariangela Rondanelli
BACKGROUND: The aim of this study was to evaluate the performance of Edmonton Frail Scale (EFS) on frailty assessment in association with multi-dimensional conditions assessed with specific screening tools and to explore the prevalence of frailty by gender. METHODS: We enrolled 366 hospitalised patients (women\men: 251\115), mean age 81.5 years. The EFS was given to the patients to evaluate their frailty. Then we collected data concerning cognitive status through Mini-Mental State Examination (MMSE), health status (evaluated with the number of diseases), functional independence (Barthel Index and Activities Daily Living; BI, ADL, IADL), use of drugs (counting of drugs taken every day), Mini Nutritional Assessment (MNA), Geriatric Depression Scale (GDS), Skeletal Muscle Index of sarcopenia (SMI), osteoporosis and functionality (Handgrip strength)...
January 4, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28031949/the-effect-of-frailty-should-be-considered-in-the-management-plan-of-older-people-with-type-2-diabetes
#19
REVIEW
Ahmed H Abdelhafiz, Luan Koay, Alan J Sinclair
The prevalence of diabetes is increasing especially in older age due to increased life expectancy. In old age, diabetes is associated with high comorbidity burden and increased prevalence of geriatric syndromes including frailty in addition to micro- and macro-vascular complications. The emergence of frailty may change the natural history of Type 2 diabetes from a progressive to a regressive course with increased risk of hypoglycemia. This may result in normalization of blood glucose levels and lead to a state of burnt-out diabetes in frail older people with significant weight loss...
March 2016: Future Science OA
https://www.readbyqxmd.com/read/28024089/is-polypharmacy-associated-with-frailty-in-older-people-results-from-the-esther-cohort-study
#20
Kai-Uwe Saum, Ben Schöttker, Andreas D Meid, Bernd Holleczek, Walter E Haefeli, Klaus Hauer, Hermann Brenner
OBJECTIVES: To investigate the relationship between polypharmacy and frailty. DESIGN: Longitudinal, observational cohort study. SETTING: Saarland, Germany. PARTICIPANTS: 3,058 community-dwelling adults aged between 57 and 84 years. MEASUREMENTS: Frailty was assessed according to the frailty phenotype, described by Fried et al. Polypharmacy and hyperpolypharmacy were defined as the concomitant use of five or more and 10 or more drugs, respectively...
December 26, 2016: Journal of the American Geriatrics Society
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