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Frailty surgery

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https://www.readbyqxmd.com/read/28941581/use-of-frailty-to-predict-survival-in-elderly-patients-with-early-stage-non-small-cell-lung-cancer-treated-with-stereotactic-body-radiation-therapy
#1
Idalid Franco, Yu-Hui Chen, Fallon Chipidza, Vishesh Agrawal, John Romano, Elizabeth Baldini, Aileen Chen, Yolonda Colson, Ying Hou, David Kozono, Jon Wee, Raymond Mak
OBJECTIVES: Frailty has been shown to increase morbidity and mortality independent of age, but studies are lacking in radiation oncology. This study evaluates a modified frailty index (mFI) in predicting overall survival (OS) and non-cancer death for Stage I/II [N0M0] Non-Small-Cell Lung Cancer (NSCLC) patients treated with Stereotactic Body Radiation Therapy (SBRT). MATERIALS AND METHODS: Medical records for all patients with Stage I/II NSCLC treated at our institution with SBRT from 2009 to 2014 were reviewed...
September 20, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28936613/chronic-inflammatory-demyelinating-polyradiculoneuropathy-and-anesthesia-a-case-series
#2
Andrew R Mortenson, Juraj Sprung, James C Watson, P James B Dyck, Toby N Weingarten
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an acquired autoimmune demyelinating polyneuropathy characterized by symmetrical diffuse weakness that also can rarely affect bulbar and respiratory muscles. The study objective was to describe perioperative outcomes of patients with CIDP who received general anesthesia. This retrospective observational study evaluated patients with active (diagnosed or treated within the previous year) CIDP who underwent general anesthesia at our institution between January 1, 2010, and December 31, 2015...
September 21, 2017: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/28927173/the-relationship-between-preoperative-frailty-and-outcomes-following-transcatheter-aortic-valve-implantation-a-systematic-review-and-meta-analysis
#3
Atul Anand, Catherine Harley, Akila Visvanathan, Anoop S V Shah, Joanna Cowell, Alasdair MacLullich, Susan Shenkin, Nicholas L Mills
Aims: Transcatheter aortic valve implantation (TAVI) is an increasingly common intervention for patients with aortic stenosis deemed high risk for major cardiac surgery, but identifying those who will benefit can be challenging. Frailty reflects physiological reserve and may be a useful prognostic marker in this population. We performed a systematic review and meta-analysis of the association between frailty and outcomes after TAVI. Methods and Results: Five databases were searched between January 2000 and May 2015...
April 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28926087/self-reported-function-more-informative-than-frailty-phenotype-in-predicting-adverse-postoperative-course-in-older-adults
#4
Alok Kapoor, Theofilos Matheos, Matthias Walz, Christine McDonough, Abiramy Maheswaran, Evan Ruppell, Deeqo Mohamud, Nicholas Shaffer, Yanhua Zhou, Shubjeet Kaur, Stephen Heard, Sybil Crawford, Howard Cabral, Daniel K White, Heena Santry, Alan Jette, Roger Fielding, Rebecca A Silliman, Jerry Gurwitz
BACKGROUND/OBJECTIVE: Current preoperative assessment tools such as the American College of Surgeons Surgical Risk Calculator (ACS Calculator) are suboptimal for evaluating older adults. The objective was to evaluate and compare the performance of the ACS Calculator for predicting risk of serious postoperative complications with the addition of self-reported physical function versus a frailty score. DESIGN: Prospective cohort. SETTING: Two tertiary care academic medical centers in Massachusetts...
September 19, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28919566/predicting-short-term-outcome-after-surgery-for-primary-spinal-tumors-based-on-patient-frailty
#5
A Karim Ahmed, C Rory Goodwin, Rafael De la Garza-Ramos, Rachel C Kim, Nancy Abu-Bonsrah, Risheng Xu, Daniel M Sciubba
OBJECTIVE: The concept of 'Frailty,' i.e. decreased physiologic reserve and increased vulnerability to stressors beyond what is expected for normal aging is associated with increased risk of morbidity and mortality. The objective of this study was to develop a preoperative frailty index (STFI) for patients undergoing surgery for primary spinal column tumors that predicts morbidity, mortality, and length of stay. METHODS: The Nationwide Inpatient Sample database from 2002 to 2011 was used to identify patients who underwent surgery for a primary spinal tumor...
September 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28914661/percutaneous-aortic-leak-closure-in-a-small-and-frail-annulus-after-double-heart-valve-replacement
#6
Guglielmo Saitto, Paolo Nardi, Gian P Ussia, Domenico Sergi, Paolo Prati, Marco Russo, Francesco Romeo, Giovanni Ruvolo
: Paravalvular leak (PVL) is an uncommon but serious complication associated with the implantation of prosthetic valves. Following aortic valve replacement, up to 5% of patients affected by PVL develop clinical symptoms of heart failure, hemolysis or both. Percutaneous treatment of PVL has emerged instead of conventional surgery, as a well tolerated and less invasive procedure but remains a challenge. We present the case of a young woman with mechanical aortic and mitral prostheses, who presented surgical aortic PVL caused by a serious frailty of native annulus, became symptomatic after 5 months and was successfully percutaneously treated with an Amplatzer Duct Occluder device...
September 12, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28887259/morphometric-assessment-as-a-predictor-of-outcome-in-older-vascular-surgery-patients
#7
Mohammed M Chowdhury, Graeme K Ambler, Naail Al Zuhir, Alex Walker, Ellie R Atkins, Andrew Winterbottom, Patrick A Coughlin
INTRODUCTION: Frailty is a recognised predictor of poor outcome in patients undergoing surgical intervention. Frailty is intricately linked with body morphology, which can be evaluated using morphometric assessment via computerised tomographic (CT) imaging. We aimed to assess the predictive power of such objective assessments in a broad cohort of vascular surgical patients. PATIENTS AND METHODS: A consecutive series of patients aged over 65 years admitted to a vascular unit, who had undergone CT imaging of the abdomen, were analysed...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28887242/rapid-methods-for-routine-frailty-assessment-during-vascular-surgery-clinic-visits
#8
Luke G Mirabelli, Robert M Cosker, Larry W Kraiss, Claire L Griffin, Brigitte K Smith, Mark R Sarfati, Ragheed Al-Dulaimi, Benjamin S Brooke
BACKGROUND: Frailty assessment can help vascular surgeons predict perioperative risk and long term mortality for their patients. Unfortunately, comprehensive frailty assessments take too long to integrate into clinic workflow. This study was designed to evaluate 2 rapid methods for assessing frailty during vascular clinics-a short patient-reported survey and a provider-reported frailty scale. METHODS: We prospectively enrolled 159 patients presenting to an academic medical center vascular surgery clinic between May-November 2016...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28876376/pre-frailty-increases-the-risk-of-adverse-events-in-older-patients-undergoing-cardiovascular-surgery
#9
Miguel K Rodrigues, Artur Marques, Denise M L Lobo, Iracema I K Umeda, Mayron F Oliveira
BACKGROUND: Frailty is identified as a major predictor of adverse outcomes in older surgical patients. However, the outcomes in pre-frail patients after cardiovascular surgery remain unknown. OBJECTIVE: To investigate the main outcomes (length of stay, mechanical ventilation time, stroke and in-hospital death) in pre-frail patients in comparison with no-frail patients after cardiovascular surgery. METHODS: 221 patients over 65 years old, with established diagnosis of myocardial infarction or valve disease were enrolled...
September 4, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28869034/plasticity-and-function-of-human-skeletal-muscle-in-relation-to-disuse-and-rehabilitation-influence-of-ageing-and-surgery
#10
Charlotte Suetta
In order to study the influence of disuse and aging on skeletal muscle homeostasis, different human models were employed. Effects of chronic disuse were investigated in elderly patients suffering from uni-lateral hip-osteoarthritis, whereas the effect of short-term disuse (4 and 14 days of unilateral lower limb immobilisation) was assessed in healthy young and old individuals. In summary, chronic muscle disuse in the elderly was associated with marked quantitative as well as qualitative neuromuscular impairments...
August 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28866353/frail-questionnaire-screening-tool-and-short-term-outcomes-in-geriatric-fracture-patients
#11
Lauren Jan Gleason, Emily A Benton, M Loreto Alvarez-Nebreda, Michael J Weaver, Mitchel B Harris, Houman Javedan
OBJECTIVES: There are limited screening tools to predict adverse postoperative outcomes for the geriatric surgical fracture population. Frailty is increasingly recognized as a risk assessment to capture complexity. The goal of this study was to use a short screening tool, the FRAIL scale, to categorize the level of frailty of older adults admitted with a fracture to determine the association of each frailty category with postoperative and 30-day outcomes. DESIGN: Retrospective cohort study...
August 30, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28857797/a-comparison-of-3-frailty-indices-in-predicting-morbidity-and-mortality-after-on-pump-aortic-valve-replacement
#12
Gary Esses, Evie Andreopoulos, Hung-Mo Lin, Shipra Arya, Stacie Deiner
BACKGROUND: Aortic valve replacement is a high-risk surgery (3%-5%, 30-day mortality) performed on approximately 30,000 elderly patients a year in the United States. Currently, preoperative risk assessment is based on a composite of medical examination and a subjective evaluation for frailty ("eyeball test"). Objective frailty assessment using validated indices has the potential to improve risk stratification. The purpose of this study was to (1) establish whether frailty can predict 30-day mortality and composite morbidity in patients undergoing aortic valve replacement and (2) compare the predictive ability of 3 frailty indices in this population...
August 29, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28846014/a-new-approach-to-survival-analysis-of-head-and-neck-squamous-cell-carcinoma
#13
Sahar Masoudi, Seyed Ali Montazeri, Fereydoun Pourdanesh, Akbar Biglarian, Masoud Kazemi, Mehdi Rahgozar
BACKGROUND: Squamous cell carcinoma is the most common histological subtype of head and neck cancers. METHODS: In a retrospective longitudinal study, we assessed the risk of local or metastatic recurrence and death in 140 patients with head and neck squamous cell carcinoma (HNSCC). Multivariate and shared frailty models were used for survival analysis with sex, primary tumor site, grade and stage of the tumor, and treatment modalities as contributing factors. RESULTS: The most frequent site for HNSCC was the oral cavity (30%), followed by the tongue (26...
August 2017: Archives of Iranian Medicine
https://www.readbyqxmd.com/read/28843393/prospective-assessment-of-frailty-using-the-fried-criteria-in-patients-undergoing-left-ventricular-assist-device-therapy
#14
Susan M Joseph, Joshua L Manghelli, Justin M Vader, Tamra Keeney, Eric L Novak, Joost Felius, Sara C Martinez, Michael E Nassif, Brian Lima, Scott C Silvestry, Michael W Rich
Frail patients are more prone to adverse events after cardiac surgery, particularly after implantation of left ventricular assist devices. Thus, frailty assessment may help identify patients unlikely to benefit from left ventricular assist device therapy. The purpose was to establish a suitable measure of frailty in adults with end-stage heart failure. In a prospective cohort of 75 patients (age 58 ± 12 years) with end-stage heart failure, we assessed the association between frailty (5-component Fried criteria) and the composite primary outcome of inpatient mortality or prolonged length of stay, as well as extubation status, time on ventilator, discharge status, and long-term mortality...
August 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28835590/association-between-preoperative-frailty-and-mortality-in-patients-with-critical-limb-ischemia-following-infrainguinal-bypass-surgery%C3%A3-usefulness-of-the-barthel-index
#15
Akio Kodama, Akio Koyama, Masayuki Sugimoto, Kiyoaki Niimi, Hiroshi Banno, Kimihiro Komori
BACKGROUND: Most patients with critical limb ischemia (CLI) exhibit severe comorbidities accompanied by frailty. This study assessed and risk-stratified mortality after infrainguinal bypass (IB) in CLI and investigated the effects of frailty.Methods and Results:The study retrospectively reviewed 107 consecutive CLI patients who had undergone de novo IB due to atherosclerotic disease. Data regarding patient age, comorbidities, laboratory data, and functional status were collected; functional status was evaluated using the Barthel index (BI) and nutritional status was evaluated using albumin concentrations and body mass index (BMI)...
August 23, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28826892/incidence-of-postoperative-delirium-and-its-impact-on-outcomes-after-transcatheter-aortic-valve-implantation
#16
Maciej Bagienski, Pawel Kleczynski, Artur Dziewierz, Lukasz Rzeszutko, Danuta Sorysz, Jaroslaw Trebacz, Robert Sobczynski, Marek Tomala, Maciej Stapor, Dariusz Dudek
There are limited data on the occurrence of postoperative delirium after transcatheter aortic valve implantation (TAVI). We sought to investigate the incidence of delirium after TAVI and its impact on clinical outcomes. A total of 148 consecutive patients who underwent TAVI were enrolled. Of these patients, 141 patients survived hospital stay. The incidence of delirium was assessed in these patients for the first 4 days after the index procedure. The patients were divided into 2 groups based on the presence of delirium...
October 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28826805/cognitive-impairment-and-overall-survival-in-frail-surgical-patients
#17
Salima S Makhani, Frances Y Kim, Yuan Liu, Zixun Ye, Jessica L Li, Louis M Revenig, Camille P Vaughan, Theodore M Johnson, Paul S García, Kenneth Ogan, Viraj A Master
BACKGROUND: The definition of frailty, as modeled by the Fried criteria, has been limited primarily to the physical domain. The purpose of this study was to assess the additive value of cognitive function with existing frailty criteria to predict poor postoperative outcomes in a large multidisciplinary cohort of patients undergoing major surgery. STUDY DESIGN: A four-level composite frailty scoring system was created via the combination of the Fried Frailty score and the Emory clock draw test to assess preoperative frailty and cognitive impairment, respectively...
August 4, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28826406/the-impact-of-frailty-and-sarcopenia-on-postoperative-outcomes-in-older-patients-undergoing-gastrectomy-surgery-a-systematic-review-and-meta-analysis
#18
Yanjiao Shen, Qiukui Hao, Jianghua Zhou, Birong Dong
BACKGROUND: Gastric cancer is a major health problem, and frailty and sarcopenia will affect the postoperative outcomes in older people. However, there is still no systematic review to determine the role of frailty and sarcopenia in predicting postoperative outcomes among older patients with gastric cancer who undergo gastrectomy surgery. METHODS: We searched Embase, Medline through the Ovid interface and PubMed websites to identify potential studies. All the search strategies were run on August 24, 2016...
August 21, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28822392/optimal-modified-frailty-index-cutoff-in-older-gastrointestinal-cancer-patients
#19
Mary Garland, Fang-Chi Hsu, Perry Shen, Clancy J Clark
The newly characterized modified frailty index (mFI) is a robust predictor of postoperative outcomes for surgical patients. The present study investigates the optimal cutoff for mFI specifically in older gastrointestinal (GI) cancer patients undergoing surgery. All patients more than 60 years old who underwent surgery for a GI malignancy (esophagus, stomach, colon, rectum, pancreas, liver, and bile duct) were identified in the 2005 to 2012 National Surgical Quality Improvement Program, Participant Use Data File (NSQIP PUF)...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28819091/review-of-current-evidence-regarding-surgery-in-elderly-patients-with-meningioma
#20
Fusao Ikawa, Yasuyuki Kinoshita, Masaaki Takeda, Taiichi Saito, Satoshi Yamaguchi, Fumiyuki Yamasaki, Koji Iida, Kazuhiko Sugiyama, Kazunori Arita, Kaoru Kurisu
The Japanese population features the highest rate of elderly individuals worldwide. Moreover, Japan has the highest number of computed tomography/magnetic resonance imaging devices in the world, which has led to an increase in the incidental detection of meningioma in healthy elderly patients. Many previous papers have discussed the risks and indications for surgery in this patient population, but available information remains insufficient, and the definition of "elderly" has not been standardized. This review tried to clarify the published evidence and challenges associated with elderly meningioma based on a search of the PubMed database using the terms "meningioma," "elderly," and "surgery" for English-language clinical studies and collected related papers published from 2000 to 2016...
August 15, 2017: Neurologia Medico-chirurgica
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