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Frailty

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https://www.readbyqxmd.com/read/28748872/assessment-of-frailty-in-elderly-pre-dialysis-population-using-simple-tools
#1
REVIEW
Hatem Ali, Fatima Abdelaal, Jyoti Baharani
Prevalence of chronic kidney disease (CKD) is increasing worldwide principally among the elderly population many of whom will eventually need renal replacement therapy. The relationship between frailty and CKD in the elderly population has been recognized. However, studies concentrating on frailty in pre-dialysis patients are limited. CKD predisposes to frailty through many potential mechanisms; anemia, bone mineral disease, oxidative stress, and malnutrition which in turn lead to progression of CKD culminating in a vicious cycle...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28747535/palliative-care-in-end-stage-valvular-heart-disease
#2
REVIEW
Jill M Steiner, Stephanie Cooper, James N Kirkpatrick
Valvular heart disease (VHD), particularly aortic valve disease, is prevalent with increasing incidence. When surgery is not possible, or when risks outweigh benefits, percutaneous treatment options may offer effective alternatives. However, procedures may not always go as planned, and frail patients or those whose symptoms are caused by other comorbidities may not benefit from valve intervention at all. Significant effort should be made to assess frailty, comorbidities and patient goals prior to intervention...
August 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28743320/mobility-assessments-of-geriatric-emergency-department-patients-a-systematic-review
#3
Debra Eagles, Krishan Yadav, Jeffrey J Perry, Marie Josée Sirois, Marcel Emond
OBJECTIVES: We wished to determine the impact of emergency department (ED) mobility assessments for older patients on hospitalization, return visits, future falls, and frailty. METHODS: We searched MEDLINE, Embase, CINAHL, Cochrane Library, PEDro, and OTseeker (September 2016). Two independent reviewers identified studies of patients ≥65 years with ED physical mobility assessments and outcomes of hospitalization, return to ED, falls, and frailty. Language was not restricted...
July 26, 2017: CJEM
https://www.readbyqxmd.com/read/28742855/decreases-in-heart-rate-variability-are-associated-with-postoperative-complications-in-hip-fracture-patients
#4
Gernot Ernst, Leiv Otto Watne, Frede Frihagen, Torgeir Bruun Wyller, Andreas Dominik, Morten Rostrup
BACKGROUND: To explore relevant associations between deviations in linear and nonlinear heart rate variability (HRV) scores, and short-term morbidity and mortality in patients undergoing hip-surgery after a fracture. METHODS: 165 patients with hip fractures being admitted for surgery at two hospitals were included in a prospective cohort study. A short-term ECG was recorded within 24 hours of arrival. 15 patients had to be excluded due to insufficient quality of the ECG recordings...
2017: PloS One
https://www.readbyqxmd.com/read/28741676/the-association-of-abdominal-muscle-with-outcomes-after-scheduled-abdominal-aortic-aneurysm-repair
#5
N Shah, L Abeysundara, P Dutta, M Christodoulidou, S Wylie, T Richards, N Schofield
Sarcopenia is the degenerative loss of core muscle mass. It is an aspect of frailty, which is associated with increased rates of peri-operative harm. We assessed the association of the cross-sectional areas of abdominal muscles, including psoas, with survival during a median (IQR [range]) follow-up of 3.8 (3.2-4.4 [0.0-5.1]) years after scheduled endovascular (132) or open (5) abdominal aortic aneurysm repair in 137 patients. In multivariate analysis, mortality hazard (95%CI) was independently associated with: age, 1...
July 25, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28741145/thigh-muscle-and-subcutaneous-tissue-thickness-measured-using-ultrasound-imaging-in-older-females-living-in-extended-care-a-preliminary-study
#6
Daniella Welch, Laetitia Sungu Ndanyo, Simon Brown, Sandra Agyapong-Badu, Martin Warner, Maria Stokes, Dinesh Samuel
BACKGROUND: Thigh tissue thickness has not been examined in older females living in extended care in UK as an indicator of musculoskeletal health. This study examined the feasibility of using ultrasound imaging to measure the thickness of superficial (fat) and deep layers (muscle) of the thigh in older females living in extended care. METHODS: In ten older females in extended care (aged 80-98 years, mean 88 ± 6.8; body mass: 56.5 ± 12.6 kg) images of the anterior thigh (dominant) were taken in supine using B-mode ultrasound imaging...
July 24, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28739453/modified-frailty-index-can-be-used-to-predict-adverse-outcomes-and-mortality-after-lower-extremity-bypass-surgery
#7
Tarik Ali, Erik Lehman, Faisal Aziz
OBJECTIVES: Frailty has been increasingly used as a prognostic indicator for various surgical operations. Patients with peripheral arterial disease represent a cohort of population with advanced medical comorbidities. The aim of this study is to correlate the postoperative outcomes after lower extremity bypass surgery with pre operative modified frailty index. METHODS: Using 2010 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database, patients undergoing infrainguinal arterial bypass surgery were identified...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28739158/assessment-and-management-of-radiotherapy-induced-toxicity-in-older-patients
#8
Anita O'Donovan, Michelle Leech, Charles Gillham
Radiotherapy is an attractive treatment option for older adults, especially where surgery and chemotherapy pose too great a risk. Radiotherapy toxicity may be divided into acute/early and late effects of treatment. The latter may have limited relevance to an older patient with competing causes of mortality due to significant comorbidity. Altered fractionation regimes have been employed in numerous sites, with no significant toxicity impact. These offer greater convenience in the elderly, especially those with limited social support or in active caregiving roles...
July 21, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28738809/surgical-frailty-assessment-a-missed-opportunity
#9
Gilgamesh Eamer, Jennifer A Gibson, Chelsia Gillis, Amy T Hsu, Marian Krawczyk, Emily MacDonald, Reid Whitlock, Rachel G Khadaroo
BACKGROUND: Preoperative frailty predicts adverse postoperative outcomes. Despite the advantages of incorporating frailty assessment into surgical settings, there is limited research on surgical healthcare professionals' use of frailty assessment for perioperative care. METHODS: Healthcare professionals caring for patients enrolled at a Canadian teaching hospital were surveyed to assess their perceptions of frailty, as well as attitudes towards and practices for frail patients...
July 24, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28737297/correlates-of-frailty-phenotype-and-frailty-index-and-their-associations-with-clinical-outcomes
#10
G Guaraldi, A Malagoli, O Theou, T D Brothers, Lmk Wallace, R Torelli, C Mussini, S Sartini, S A Kirkland, K Rockwood
OBJECTIVES: Frailty is a predictor of adverse health outcomes and can be measured across the life course, including among people living with HIV. The purpose of this study was to examine two commonly used measures of frailty - the frailty index (FI) and frailty phenotype - to assess common characteristics and to describe associations with multimorbidity, falls, and disability in people aging with HIV. METHODS: This was a cross-sectional observational study including 482 consecutive HIV-infected patients (mean age 53...
July 24, 2017: HIV Medicine
https://www.readbyqxmd.com/read/28736345/preoperative-frailty-score-predicts-30-day-morbidity-and-mortality-following-cranial-neurosurgery
#11
Samuel B Tomlinson, Keaton Piper, Kristopher T Kimmell, Edward Vates
BACKGROUND: Evaluating preoperative frailty is critical for guiding shared surgical decision-making. The purpose of this study was to develop a novel preoperative frailty index for prediction of adverse outcomes following cranial neurosurgery procedures. METHODS: The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database was queried for all cranial neurosurgery cases from 2006-2014. Sequential univariate and multivariate testing was used to identify significant independent predictors of 30-day mortality...
July 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28736037/-frequency-of-successful-aging-and-frailty-associated-risk-factors
#12
Karla Berenice Carrazco-Peña, Katia Farías-Moreno, Benjamín Trujillo-Hernández
OBJECTIVE: To determine the frequency of successful aging (SA) and its relationship with frailty in an elderly population. MATERIAL AND METHODS: An analytical cross-sectional study of subjects ≥60 years of age seen as outpatients in a general hospital. Successful aging was defined as scores of ≥ 90 in the Barthel index and ≤ 2 in the Pfeiffer test. Frailty was determined using the Fried criteria. RESULTS: The study included 400 subjects (272 women and 128 men), with a mean age of 71...
July 20, 2017: Revista Española de Geriatría y Gerontología
https://www.readbyqxmd.com/read/28735715/thirty-day-morbidity-of-abdominal-sacrocolpopexy-is-influenced-by-additional-surgical-treatment-for-stress-urinary-incontinence
#13
William R Boysen, Melanie A Adamsky, Andrew J Cohen, Joseph Rodriguez, Sarah F Faris, Gregory T Bales
OBJECTIVE: To assess the impact of concurrent anti-incontinence procedure (AIP) at time of abdominal sacrocolpopexy (ASC) on 30-day complications, readmission, and reoperation. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2006-2013 was queried to identify patients undergoing ASC with or without AIP. We assessed baseline characteristics and 30-day perioperative outcomes including complications, readmission, and reoperation...
July 20, 2017: Urology
https://www.readbyqxmd.com/read/28734627/the-impact-of-frailty-on-functional-survival-in-patients-1%C3%A2-year-after-cardiac-surgery
#14
James Lytwyn, Andrew N Stammers, D Scott Kehler, Patrick Jung, Bryce Alexander, Brett M Hiebert, Chris Dubiel, Dustin Kimber, Naomi Hamm, Mekayla Clarke, Carly Fraser, Brittany Pedreira, Todd A Duhamel, Navdeep Tangri, Rakesh C Arora
OBJECTIVE: This study determined whether frailty provides incremental value to the European System for Cardiac Operative Risk Evaluation II in identifying patients at risk of poor 1-year functional survival. METHODS: This prospective study in patients undergoing cardiac surgery defined frailty using 3 common definitions: (1) the Modified Fried Criteria; (2) the Short Physical Performance Battery; and (3) the Clinical Frailty Scale. The primary outcome was functional survival, defined as being alive at 1 year postsurgery with a health-related quality of life score greater than 60 on the EuroQol-Visual Analogue Scale...
June 24, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28734497/functional-not-chronologic-age-frailty-index-predicts-outcomes-in-advanced-ovarian-cancer
#15
Amanika Kumar, Carrie L Langstraat, Stephanie R DeJong, Michaela E McGree, Jamie N Bakkum-Gamez, Amy L Weaver, Nathan K LeBrasseur, William A Cliby
OBJECTIVES: To assess the impact of frailty as measured by a frailty deficit index (FI) on outcomes in advanced epithelial ovarian cancer (EOC) after primary debulking surgery (PDS). METHODS: Women with Stage IIIC/IV EOC who underwent PDS between 1/1/2003-12/31/2011 were included. Medical records were reviewed for patient characteristics and outcomes. The FI includes 30 items scored at 0, 0.5 or 1 and is calculated by summing across all the item scores and dividing by the total...
July 19, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28734173/reliability-and-validity-of-the-tilburg-frailty-indicator-tfi-among-chinese-community-dwelling-older-people
#16
Lijuan Dong, Na Liu, Xiaoyu Tian, Xiaoxia Qiao, Robbert J J Gobbens, Robert L Kane, Cuili Wang
OBJECTIVE: To translate the Tilburg Frailty Indicator (TFI) into Chinese and assess its reliability and validity. METHODS: A sample of 917 community-dwelling older people, aged ≥60 years, in a Chinese city was included between August 2015 and March 2016. Construct validity was assessed using alternative measures corresponding to the TFI items, including self-rated health status (SRH), unintentional weight loss, walking speed, timed-up-and-go tests (TUGT), making telephone calls, grip strength, exhaustion, Short Portable Mental Status Questionnaire (SPMSQ), Geriatric Depression scale (GDS-15), emotional role, Adaptability Partnership Growth Affection and Resolve scale (APGAR) and Social Support Rating Scale (SSRS)...
July 15, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28734043/enabling-reduction-of-low-grade-inflammation-in-seniors-pilot-study-concept-rationale-and-design
#17
Todd M Manini, Stephen D Anton, Daniel P Beavers, Jane A Cauley, Mark A Espeland, Roger A Fielding, Stephen B Kritchevsky, Christiaan Leeuwenburgh, Kristina H Lewis, Christine Liu, Mary M McDermott, Michael E Miller, Russell P Tracy, Jeremy D Walston, Barbara Radziszewska, Jane Lu, Cindy Stowe, Samuel Wu, Anne B Newman, Walter T Ambrosius, Marco Pahor
OBJECTIVES: To test two interventions to reduce interleukin (IL)-6 levels, an indicator of low-grade chronic inflammation and an independent risk factor for impaired mobility and slow walking speed in older adults. DESIGN: The ENabling Reduction of low-Grade Inflammation in SEniors (ENRGISE) Pilot Study was a multicenter, double-blind, placebo-controlled randomized pilot trial of two interventions to reduce IL-6 levels. SETTING: Five university-based research centers...
July 22, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28733716/osteosarcopenia-where-bone-muscle-and-fat-collide
#18
REVIEW
H P Hirschfeld, R Kinsella, G Duque
As the world's population ages, the prevalence of chronic diseases increases. Sarcopenia and osteoporosis are two conditions that are associated with aging, with similar risk factors that include genetics, endocrine function, and mechanical factors. Additionally, bone and muscle closely interact with each other not only anatomically, but also chemically and metabolically. Fat infiltration, a phenomenon observed in age-related bone and muscle loss, is highly prevalent and more severe in sarcopenic and osteoporotic subjects...
July 22, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28732817/severity-and-features-of-frailty-in-systemic-sclerosis-associated-interstitial-lung-disease
#19
Sabina A Guler, Joanne M Kwan, Tiffany A Winstone, Kathryn M Milne, James V Dunne, Pearce G Wilcox, Christopher J Ryerson
BACKGROUND: Systemic sclerosis-associated interstitial lung disease (SSc-ILD) is characterized by multiple symptoms and comorbidities. The cumulative impact of these deficits can be summarized using the concept of frailty; however, frailty has not been characterized in patients with SSc-ILD. METHODS: Patients with SSc-ILD and non-CTD fibrotic ILD were recruited from specialized clinics. Frailty was assessed using a 42-item patient-reported Frailty Index, calculated as the proportion of reported deficits divided by the total number of surveyed items...
August 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28731943/the-impact-of-polypharmacy-on-patient-outcomes-in-older-adults-with-cancer
#20
Ginah Nightingale, Emily Skonecki, Manpreet K Boparai
Polypharmacy is prevalent in older adults with cancer and may be advantageous for the management of certain chronic disease states, but uncertainty exists regarding potential hazards and consequences. Cancer-related therapy adds to the prevalence of polypharmacy, which can lead to compromised cancer management plans (i.e., postoperative complications, treatment delays, and/or premature treatment discontinuation). Polypharmacy has been identified as one of the domains commonly included in the Comprehensive Geriatric Assessment likely because of the potential influence on health outcomes...
July 2017: Cancer Journal
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