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Frailty surgery

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https://www.readbyqxmd.com/read/28090814/personalized-dynamic-prediction-of-death-according-to-tumour-progression-and-high-dimensional-genetic-factors-meta-analysis-with-a-joint-model
#1
Takeshi Emura, Masahiro Nakatochi, Shigeyuki Matsui, Hirofumi Michimae, Virginie Rondeau
Developing a personalized risk prediction model of death is fundamental for improving patient care and touches on the realm of personalized medicine. The increasing availability of genomic information and large-scale meta-analytic data sets for clinicians has motivated the extension of traditional survival prediction based on the Cox proportional hazards model. The aim of our paper is to develop a personalized risk prediction formula for death according to genetic factors and dynamic tumour progression status based on meta-analytic data...
January 1, 2017: Statistical Methods in Medical Research
https://www.readbyqxmd.com/read/28069729/systematic-review-on-the-predictive-ability-of-frailty-assessment-measures-in-cardiac-surgery
#2
REVIEW
Yusuf S Abdullahi, Leonidas V Athanasopoulos, Roberto P Casula, Marco Moscarelli, Mark Bagnall, Hutan Ashrafian, Thanos Athanasiou
OBJECTIVES: Patient frailty is increasingly recognised as contributing to adverse postoperative outcomes in cardiothoracic surgery. The goal of this review is to evaluate the predictive ability of frailty scoring systems and their limitations in risk assessment of patients undergoing cardiac surgery. METHODS: Frailty studies were identified by searching electronic databases. Studies in which the measuring instrument was defined as a multidimensional tool focusing on a population undergoing cardiac operations were included...
January 9, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28059648/validation-of-effectiveness-of-keyhole-clipping-in-nonfrail-elderly-patients-with-unruptured-intracranial-aneurysms
#3
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/28031245/robotic-enhanced-coronary-surgery-in-octogenarians
#4
Apostolos Roubelakis, Filip Casselman, Johan van der Merwe, Bernard Stockman, Ivan Degrieck, Frank Van Praet
OBJECTIVES: Robotic-enhanced minimally invasive direct coronary artery bypass grafting surgery (RE-MIDCAB) is based on the use of a robotic console and instrumentation for the dissection of the left internal thoracic artery (LITA). The LITA to left anterior descending (LAD) artery anastomosis is subsequently constructed through a mini thoracotomy. The purpose of this study is to present our experience of RE-MIDCAB outcomes in elderly patients. METHODS: From 2002 until 2015, 44 octogenarians (the mean age of 82...
December 27, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28000268/implants-for-elderly-patients
#5
REVIEW
Martin Schimmel, Frauke Müller, Valérie Suter, Daniel Buser
In the developed world, the large birth cohorts of the so-called baby boomer generation have arrived in medical and dental practices. Often, elderly patients are 'young-old' baby boomers in whom partial edentulism is the predominant indication for implant therapy. However, the generation 85+ years of age represents a new challenge for the dental profession, as their lives are frequently dominated by dependency, multimorbidity and frailty. In geriatric implant dentistry, treatment planning is highly individualized, as interindividual differences become more pronounced with age...
February 2017: Periodontology 2000
https://www.readbyqxmd.com/read/27999879/-perioperative-patient-management-in-orthogeriatrics
#6
P Moldzio, J Peters
The management of major orthopedic surgery in the elderly prototypically reflects the perioperative risks of geriatric, often very frail patients reflecting an aging population. To improve outcome, the risks of anesthesia and surgery as well as of patient comorbidities must be thoroughly assessed and balanced using a multidisciplinary approach. Particular risks include cardiopulmonary morbidity, anemia, risk of hemorrhage and the management by anticoagulation, cerebral impairments as well as frailty and limited physiological reserves in general...
December 20, 2016: Der Orthopäde
https://www.readbyqxmd.com/read/27989724/frailty-is-associated-with-morbidity-in-adults-undergoing-elective-anterior-lumbar-interbody-fusion-surgery-alif
#7
Kevin Phan, Jun S Kim, Nathan J Lee, Sulaiman Somani, John Di Capua, Parth Kothari, Dante Leven, Samuel K Cho
BACKGROUND CONTEXT: Prior studies have suggested no significant differences in functional status and postoperative complications of elderly versus non-elderly patients undergoing posterior lumbar interbody fusion; however, similar studies have not been comprehensively investigated in the setting of anterior lumbar interbody fusion (ALIF). PURPOSE: The objective was to quantify the ability of the modified Frailty Index (mFI) to predict postoperative events in patients undergoing ALIF...
October 27, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27986531/patient-function-and-the-value-of-surgical-care-for-kidney-cancer
#8
Hung-Jui Tan, Joseph D Shirk, Karim Chamie, Mark S Litwin, Jim C Hu
PURPOSE: Frailty and functional status have emerged as significant predictors of morbidity and mortality for patients undergoing cancer surgery. To articulate their impact on value (i.e., quality per cost), we compared perioperative outcomes and expenditures according to patient function for older adults undergoing kidney cancer surgery. MATERIALS AND METHODS: Using linked SEER-Medicare data, we identified 19,129 elderly patients with kidney cancer treated with non-ablative surgery from 2000-2009...
December 13, 2016: Journal of Urology
https://www.readbyqxmd.com/read/27979468/sarcopenia-in-emergency-abdominal-surgery
#9
Rebecca C Dirks, Brandy L Edwards, Elizabeth Tong, Basil Schaheen, Florence E Turrentine, Amber Shada, Philip W Smith
BACKGROUND: Sarcopenia, a loss of skeletal muscle mass associated with aging, is a practical measure of frailty and has been previously identified as a predictor of outcomes in surgical cohorts including cancer resection and elderly patients. We hypothesized that sarcopenia, as measured by preoperative computerized tomography (CT) scan, predicts mortality and morbidity in emergent laparotomy. METHODS: Institutional American College of Surgeons National Surgical Quality Improvement Program data were queried for adult patients who underwent open emergency abdominal surgery between 2008 and 2013...
January 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/27942414/lung-cancer-in-elderly-patients
#10
REVIEW
Federico Venuta, Daniele Diso, Ilaria Onorati, Marco Anile, Sara Mantovani, Erino A Rendina
There is a worldwide-accepted evidence of a population shift toward older ages. This shift favors an increased risk of developing lung cancer that is primarily a disease of older populations. Decision making is extremely difficult in elderly patients, since this group is under-represented in clinical trials with only 25% of them historically opening to patients older than 65 years. For all these reasons, a "customized" preoperative assessment to identify physiological or pathological frailty should be encouraged since standard tools may be less reliable...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27940954/frailty-and-cardiac-rehabilitation-a-call-to-action-from-the-eapc-cardiac-rehabilitation-section
#11
Carlo Vigorito, Ana Abreu, Marco Ambrosetti, Romualdo Belardinelli, Ugo Corrà, Margaret Cupples, Constantinos H Davos, Stefan Hoefer, Marie-Christine Iliou, Jean-Paul Schmid, Heinz Voeller, Patrick Doherty
Frailty is a geriatric syndrome characterised by a vulnerability status associated with declining function of multiple physiological systems and loss of physiological reserves. Two main models of frailty have been advanced: the phenotypic model (primary frailty) or deficits accumulation model (secondary frailty), and different instruments have been proposed and validated to measure frailty. However measured, frailty correlates to medical outcomes in the elderly, and has been shown to have prognostic value for patients in different clinical settings, such as in patients with coronary artery disease, after cardiac surgery or transvalvular aortic valve replacement, in patients with chronic heart failure or after left ventricular assist device implantation...
December 11, 2016: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/27939512/frailty-and-the-role-of-obliterative-versus-reconstructive-surgery-for-pelvic-organ-prolapse-a-national-study
#12
Anne M Suskind, Chengshi Jin, Louise C Walter, Emily Finlayson
PURPOSE: To determine whether frailty affects the type of pelvic organ prolapse (POP) surgery performed and the odds of postoperative complications. MATERIALS AND METHODS: This is a retrospective cohort study of women undergoing obliterative and reconstructive surgery for POP in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) from 2005 to 2013. We quantified frailty using the NSQIP Frailty Index (NSQIP-FI) and used logistic regression models predicting type of procedure (colpocleisis) and odds of post-operative complications...
December 6, 2016: Journal of Urology
https://www.readbyqxmd.com/read/27926626/frailty-assessed-by-the-forecast-is-a-valid-tool-to-predict-short-term-outcome-after-transcatheter-aortic-valve-replacement
#13
Adrian R Kobe, Alexander Meyer, Hassan Elmubarak, Jörg Kempfert, Jovana Pavicevic, Francesco Maisano, Thomas Walther, Volkmar Falk, Simon H Sündermann
OBJECTIVE: The term frailty is frequently used during decision-making in transcatheter heart valve procedures. Nevertheless, frailty is still measured by eyeballing rather than by using standardized frailty assessments. In a previous study, we developed a frailty score in a cardiac surgical patient population including patients, who underwent transcatheter aortic valve replacement (TAVR). Here, we present the results from the subsequent validation study focusing on the TAVR cohort. METHODS: One hundred thirty patients underwent TAVR...
November 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27926560/using-modified-frailty-index-to-predict-safe-discharge-within-48-hours-of-ileostomy-closure
#14
Yuxiang Wen, Murad A Jabir, Eslam M G Dosokey, Dongjin Choi, Clayton C Petro, Justin T Brady, Scott R Steele, Conor P Delaney
BACKGROUND: Enhanced recovery pathways allow for safe discharge and optimal outcomes within 48 hours after ileostomy closure. Unfortunately, some patients undergoing ileostomy closure have prolonged hospital stays. We have shown previously that the Modified Frailty Index can help predict patients who will fail early discharge after laparoscopic colorectal surgery. OBJECTIVE: The purpose of this study was to use the Modified Frailty Index to identify patients who were safe for early discharge after ileostomy closure...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27920475/impact-of-frailty-on-approach-to-colonic-resection-laparoscopy-vs-open-surgery
#15
Catalina Mosquera, Konstantinos Spaniolas, Timothy L Fitzgerald
AIM: To understand the influence of frailty on postoperative outcomes for laparoscopic and open colectomy. METHODS: Data were obtained from the National Surgical Quality Improvement Program (2005-2012) for patients undergoing colon resection [open colectomy (OC) and laparoscopic colectomy (LC)]. Patients were classified as non-frail (0 points), low frailty (1 point), moderate frailty (2 points), and severe frailty (≥ 3) using the Modified Frailty Index. 30-d mortality and complications were used as the primary end point and analyzed for the overall population...
November 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27914496/computed-tomography-derived-skeletal-muscle-index-a-novel-predictor-of-frailty-and-hospital-length-of-stay-after-transcatheter-aortic-valve-replacement
#16
Vishal Dahya, Jingjie Xiao, Carla M Prado, Penny Burroughs, Dan McGee, Aline C Silva, Julian E Hurt, Shafi G Mohamed, Thomas Noel, Wayne Batchelor
: To determine the prevalence of low skeletal muscle mass in patients undergoing transcatheter aortic valve replacement (TAVR) and whether skeletal muscle mass measured from preoperative computed tomography (CT) images provides value in predicting postoperative length of stay (LOS). BACKGROUND: There are limited data on the use of body composition as a frailty measure in TAVR patients and no studies have determined if this measure predicts LOS. METHODS: We studied 104 consecutive patients who underwent TAVR at Tallahassee Memorial Hospital from 2012 to 2016...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27909276/-closure-of-ascending-aortic-entry-by-debranching-endovascular-management-in-an-elderly-patient-with-acute-stanford-type-a-dissection
#17
Munehiro Saiki, Keiji Yunoki, Naoya Sakoda, Shigeru Hattori, Gaku Uchino, Takuya Kawabata, Yasufumi Fujita, Kunikazu Hisamochi, Hideo Yoshida
An 85-year-old woman was hospitalized by emergency for an acute Stanford type A aortic dissection. Computed tomography showed a primary entry on the ascending aorta and pericardial effusion. Although her hemodynamics was unstable due to cardiac shock, her family wished no open surgery considering her age and frailty. A couple of days later, her condition became stabilized with antihypertensive therapy. Since the dissection was limited within the ascending aorta, closure of the entry with the stentgraft was considered appropriate and much less invasive as compared with an open surgery...
December 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/27908316/-frail-patients-and-surgery
#18
Nadia A Henriksen, Frederik Helgstrand, Ismail Gögenur
It is estimated that 15% of patients above 65 years of age are frail. Frail patients have significantly higher risk of post-operative complications when undergoing both elective and emergency surgery than patients who are not frail. Therefore, it is recommended that all patients above 65 years are frailty scored prior to a surgical procedure. It seems advisable to include the following items in a multimodal frailty score: evaluation of the patient's cognitive ability, functional status, nutritional status and pulmonary and cardiac function...
November 21, 2016: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/27905087/robot-assisted-surgery-in-elderly-and-very-elderly-population-our-experience-in-oncologic-and-general-surgery-with-literature-review
#19
Graziano Ceccarelli, Enrico Andolfi, Alessia Biancafarina, Aldo Rocca, Maurizio Amato, Marco Milone, Marta Scricciolo, Barbara Frezza, Egidio Miranda, Marco De Prizio, Andrea Fontani
BACKGROUND: Although there is no agreement on a definition of elderly, commonly an age cutoff of ≥65 or 75 years is used. Nowadays most of malignancies requiring surgical treatment are diagnosed in old population. Comorbidities and frailty represent well-known problems during and after surgery in elderly patients. Minimally invasive surgery offers earlier postoperative mobilization, less blood loss, lower morbidity as well as reduction in hospital stay and as such represents an interesting and validated option for elderly population...
November 30, 2016: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/27902826/association-of-a-frailty-screening-initiative-with-postoperative-survival-at-30-180-and-365-days
#20
Daniel E Hall, Shipra Arya, Kendra K Schmid, Mark A Carlson, Pierre Lavedan, Travis L Bailey, Georgia Purviance, Tammy Bockman, Thomas G Lynch, Jason M Johanning
Importance: As the US population ages, the number of operations performed on elderly patients will likely increase. Frailty predicts postoperative mortality and morbidity more than age alone, thus presenting opportunities to identify the highest-risk surgical patients and improve their outcomes. Objective: To examine the effect of the Frailty Screening Initiative (FSI) on mortality and complications by comparing the surgical outcomes of a cohort of surgical patients treated before and after implementation of the FSI...
November 30, 2016: JAMA Surgery
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