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geriatric intensive care

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https://www.readbyqxmd.com/read/28795663/-evaluation-function-of-intermedin-on-prognosis-of-elderly-patients-with-sepsis
#1
Yi Zhang, Fengxue Zhu, Weihuan Du, Yongmei He, Li Guo, Zhihong Yan, Hong Ji
OBJECTIVE: To investigate the predicting value of intermedin (IMD) for the prognosis of elderly sepsis patients. METHODS: A retrospective analysis was conducted. Forty-one patients with sepsis, aged ≥65 years, and admitted to geriatrics intensive care unit of Aerospace Center Hospital from April 2015 to December 2016 were enrolled. Thirty healthy patients were studied as control during the same time. The expression of C-reactive protein (CRP), procalcitonin (PCT) and IMD were tested within 24 hours during hospitalization, and the acute physiology and chronic health evaluation II (APACHE II) score and prognosis was evaluated...
August 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28776901/relating-factors-to-severe-injury-from-outdoor-falls-in-older-people
#2
Hey Youn Jung, Sun Hyu Kim, Sang Cheal Lee, Sunpyo Kim, Gyu Chong Cho, Min Joung Kim, Ji Sook Lee, Chul Han
AIM: The aim of the present study was to evaluate the clinical characteristics, including floor characteristics and factors, related to severe injury from outdoor falls in older adults. METHODS: Patients were divided into two groups based on injury severity: the severe group and non-severe group. The clinical and general characteristics were compared between the two groups, and factors associated with severe injury were investigated. RESULTS: Approximately 5% (364/7635) of older people involved in outdoor falls were classified into severe injury...
August 4, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28776066/-management-of-an-elderly-patient-in-the-emergency-room-at-the-end-of-life-a%C3%A2-medical-ethics-challenge
#3
G Michels, R Nies, S Ortmann, R Pfister, F Salomon
A 94-year-old patient with cardiogenic shock due to myocardial infarction was admitted via the emergency room. A coronary angiography and intensive care were requested. The need for care due to dementia was known. After case discussion in the interdisciplinary and multiprofessional treatment team, the decision for a palliative care concept in the form of symptom control was made in the emergency room, taking into account the patient's medical history, the current situation, and the presumed patient consent...
August 3, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28757227/post-intensive-care-syndrome-the-role-of-geriatric-psychiatry-in-research-practice-and-policy
#4
EDITORIAL
Leslie P Scheunemann, Elizabeth R Skidmore, Charles F Reynolds
No abstract text is available yet for this article.
June 29, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28743336/-analysis-of-factors-affecting-the-prognosis-of-icu-patients-by-multiple-logistic-regression-model-a-retrospective-cohort-study-of-1-299-patients-in-12-consecutive-years
#5
Jianfeng Liang, Zhiyong Li, Yan Zhang, Wei Zhang, Haishan Dong, Yun Zhang, Chang Xu, Maolong Gao
OBJECTIVE: To explore the prognostic factors of intensive care unit (ICU) patients. METHODS: A retrospective cohort study was conducted. The clinical data of patients admitted to ICU of Beijing Geriatric Hospital from January 2005 to December 2016 were collected. According to the prognosis, the patients were divided into death group and survival group, and the mortality trend with time and age was observed. Survival and death were treated as dependent variables, while the gender, age, reason of ICU admission, acute physiology and chronic health evaluation II (APACHE II) score, whether undergoing invasive mechanical ventilation (MV), invasive MV reason, duration of invasive MV, whether successful weaning, whether ICU nosocomial infection, hospital acquired pneumonia (HAP), central line-associated bloodstream infection (CLABSI), acute kidney injury (AKI) occurred, whether undergoing continuous blood purification (CBP), whether septic shock occurred, whether undergoing invasive hemodynamic monitoring or blood transfusion and length of ICU stay were used as the independent variables...
July 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28733982/postoperative-complications-in-individuals-aged-70-and-over-undergoing-elective-surgery-for-colorectal-cancer
#6
Katleen Fagard, Julie Casaer, Albert Wolthuis, Johan Flamaing, Koen Milisen, Jean-Pierre Lobelle, Hans Wildiers, Cindy Kenis
AIM: This study aims to describe the nature, incidence, severity and outcomes of in-hospital postoperative complications (POCs) in older patients undergoing elective surgery for colorectal cancer (CRC).. METHOD: Patients were identified from a prospectively collected database (2009-2015) focusing on the implementation of geriatric screening and assessment in patients with cancer. Medical and surgical POCs were retrieved retrospectively from the medical records, and the severity of the POCs was graded by the Clavien-Dindo (CD) grading system...
July 22, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28716375/aging-and-post-intensive-care-syndrome-a-critical-need-for-geriatric-psychiatry
#7
REVIEW
Sophia Wang, Duane Allen, You Na Kheir, Noll Campbell, Babar Khan
Because of the aging of the intensive care unit (ICU) population and an improvement in survival rates after ICU hospitalization, an increasing number of older adults are suffering from long-term impairments because of critical illness, known as post-intensive care syndrome (PICS). This article focuses on PICS-related cognitive, psychological, and physical impairments and the impact of ICU hospitalization on families and caregivers. The authors also describe innovative models of care for PICS and what roles geriatric psychiatrists could play in the future of this rapidly growing population...
June 1, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28699223/outcomes-of-head-and-neck-cancer-surgery-in-the-geriatric-population-based-on-case-volume-at-academic-centers
#8
Scharukh Jalisi, Samuel J Rubin, Kevin Y Wu, Diana N Kirke
OBJECTIVES/HYPOTHESIS: Evaluate the impact of case volume and other variables on cost and mortality after head and neck oncologic surgery in the geriatric population. STUDY DESIGN: Cross-sectional study. METHODS: The Vizient database was accessed for data on geriatric patients (age ≥65 years) who underwent surgery for head and neck cancers (excluding thyroid and skin cancer) at full member academic medical centers between 2009 and 2012. Multivariate, linear regression analyses, χ(2) tests, and analysis of variance were applied to evaluate significant associations between hospital case volume and independent variables including cost, cost index, mortality, mortality index, length of stay, length of stay index, and readmission rates...
July 12, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28698343/protocol-for-an-observational-study-of-delirium-in-the-post-anaesthesia-care-unit-pacu-as-a-potential-predictor-of-subsequent-postoperative-delirium
#9
Victoria Cui, Catherine M Tedeschi, Vanessa L Kronzer, Sherry L McKinnon, Michael S Avidan
INTRODUCTION: Postoperative delirium can be a serious consequence of major surgery, associated with longer hospital stays, readmission, cognitive and functional deterioration and mortality. Delirium is an acute, reversible disorder characterised by fluctuating course, inattention, disorganised thinking and altered level of consciousness. Delirium occurring in the hours immediately following anaesthesia and delirium occurring in the postoperative period of 1-5 days have been described as distinct clinical entities...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28685198/-geriatric-urology-increasingly-important-in-urological-care
#10
REVIEW
A Wiedemann
Urology will benefit by demographic change more than other disciplines in the next 10 years. Both number of patients and their intensity of treatment will increase. This implies the need of a reorientation of urology away from oncologic topics towards geriatric urology. Relevant issues are functional disorders of the lower urinary tract, infectiology, hematuria, and benign prostate hyperplasia. The legislature of North Rhine-Westphalia has already made the first step towards geriatric urology by the foundation of the ISAR screening for each geriatric patient outside geriatrics, which constitutes the possibility of beginning an early interdisciplinary dialogue...
August 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28675566/effects-of-two-different-glutamine-containing-enteral-supplements-on-stool-frequency-and-density-in-elderly-patients-recovering-from-acute-critical-illness
#11
Nobutoshi Fushimi, Munenori Yamada, Hiroki Hachiya, Shun Ito, Takashi Shibuya, Noritsugu Ohashi, Akihiro Mori
AIM: Glutamine has various beneficial functions in the gastrointestinal tract. The present study was designed to investigate the effect of two different glutamine supplements on bowel movement at the start of enteral feeding in elderly inpatients. METHODS: This was a double-blind, prospective, randomized comparison study. A total of 25 patients aged >75 years recovering from a critical illness in a non-intensive care unit and scheduled for tube feeding were recruited...
July 4, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28637554/the-g60-trauma-center-a-future-consideration
#12
Marko Bukur, Joshua Simon, Joseph Catino, Margaret Crawford, Ivan Puente, Fahim Habib
With a considerably increasing elderly population, we sought to determine whether the volume of elderly trauma patients treated impacted outcomes at two different Level I trauma centers. This is a retrospective review of all elderly patients (>60 years) at two state-verified Level I trauma centers over the past five years. The elderly trauma center (ETC) saw a greater proportion (52%) of elderly patients than the reference trauma center (30%, TC). Demographic and clinical characteristics were abstracted and stratified into ETC and TC groups for comparison...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28631455/the-prognostic-importance-of-chronic-end-stage-diseases-in-geriatric-patients-admitted-to-163-italian-icus
#13
Daniele Poole, Stefano Finazzi, Giovanni Nattino, Danilo Radrizzani, Giuseppe Gristina, Paolo Malacarne, Sergio Livigni, Guido Bertolini
BACKGROUND: The number of elderly patients undergoing major surgical interventions and then needing admission to intensive care unit (ICU) grows steadily. We investigated this issue in a cohort of 232,278 patients admitted in 5 years (2011-2015) to 163 Italian general ICUs. METHODS: Surgical patients older than 75 registered in the GiViTI MargheritaPROSAFE project were analysed. The impact on hospital mortality of important chronic conditions (severe COPD, NYHA class IV, dementia, end-stage renal disease, cirrhosis with portal hypertension) was investigated with two prognostic models developed yearly on patients staying in the ICU less or more than 24 hours...
June 14, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28620978/comparison-of-healthcare-utilization-and-life-sustaining-interventions-between-elderly-patients-with-dementia-and-those-with-cancer-near-the-end-of-life-a-nationwide-population-based-study-in-taiwan
#14
Yu-Han Chen, Chung-Han Ho, Chien-Cheng Huang, Ya-Wen Hsu, Yueh-Chun Chen, Ping-Jen Chen, Guan-Ting Chen, Jhi-Joung Wang
AIM: Little is known about the pattern of healthcare services for end-of-life patients with dementia (PwD) in East Asia. We compared this pattern between PwD and cancer patients in their last year of life in Taiwan. METHODS: Taiwan's National Health Insurance Research Database was applied for this case-control analysis. The records of patients who had dementia and died between 2002 and 2011 were reviewed. The control group was decedents with cancer. The utilization of hospitalization, emergency department visits and life-sustaining interventions during the last year of life between the two groups were compared...
June 16, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28612089/the-intensive-care-delirium-research-agenda-a-multinational-interprofessional-perspective
#15
REVIEW
Pratik P Pandharipande, E Wesley Ely, Rakesh C Arora, Michele C Balas, Malaz A Boustani, Gabriel Heras La Calle, Colm Cunningham, John W Devlin, Julius Elefante, Jin H Han, Alasdair M MacLullich, José R Maldonado, Alessandro Morandi, Dale M Needham, Valerie J Page, Louise Rose, Jorge I F Salluh, Tarek Sharshar, Yahya Shehabi, Yoanna Skrobik, Arjen J C Slooter, Heidi A B Smith
Delirium, a prevalent organ dysfunction in critically ill patients, is independently associated with increased morbidity. This last decade has witnessed an exponential growth in delirium research in hospitalized patients, including those critically ill, and this research has highlighted that delirium needs to be better understood mechanistically to help foster research that will ultimately lead to its prevention and treatment. In this invited, evidence-based paper, a multinational and interprofessional group of clinicians and researchers from within the fields of critical care medicine, psychiatry, pediatrics, anesthesiology, geriatrics, surgery, neurology, nursing, pharmacy, and the neurosciences sought to address five questions: (1) What is the current standard of care in managing ICU delirium? (2) What have been the major recent advances in delirium research and care? (3) What are the common delirium beliefs that have been challenged by recent trials? (4) What are the remaining areas of uncertainty in delirium research? (5) What are some of the top study areas/trials to be done in the next 10 years? Herein, we briefly review the epidemiology of delirium, the current best practices for management of critically ill patients at risk for delirium or experiencing delirium, identify recent advances in our understanding of delirium as well as gaps in knowledge, and discuss research opportunities and barriers to implementation, with the goal of promoting an integrated research agenda...
June 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28599140/instruments-to-evaluate-mobility-capacity-of-older-adults-during-hospitalization-a-systematic-review
#16
REVIEW
Karla Vanessa Rodrigues Soares Menezes, Claudine Auger, Weslley Rodrigues de Souza Menezes, Ricardo Oliveira Guerra
Independent mobility is a key factor in predicting morbidity and determining hospital discharge readiness for older patients. The main objective was identify and appraise relevant instruments for the measurement of mobility of hospitalized geriatric patients. A systematic review was performed in two consecutive steps. Based on the definition of mobility of the International Classification of Functioning (ICF). Step 1 identified mobility measurement instruments used to assess patients 60 years of age and over hospitalized in acute care or intensive geriatric rehabilitation unit...
September 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28573900/initial-therapy-for-acute-myeloid-leukemia-in-older-patients-principles-of-care
#17
Vijaya Raj Bhatt, Krishna Gundabolu, Thuy Koll, Lori J Maness
Older patients with acute myeloid leukemia (AML) frequently have significant comorbidities, geriatric syndromes, and high-risk leukemia that make them susceptible to high early mortality, chemotherapy-related toxicities, and poor long-term survival. The receipt of chemotherapy or hematopoietic cell transplantation is low, and the choices between intensive or low-intensity chemotherapy is often not clear. Geriatric and multidisciplinary interventions targeted to optimize functional status and improve management of comorbidities may enhance chemotherapy tolerance...
June 2, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28564710/-unreported-intentional-life-ending-acts-in-physicians-and-nurses
#18
Karl H Beine, Torben Schubert
Introduction Intentional life-ending acts (LA) including euthanasia and termination of life without explicit request are illegal in Germany and have not been extensively studied. In a pilot study, unreported LA administered by physicians and nurses in German health care were explored. Methods All hospitals and nursing homes registered in 2015 (n = 13 393) were contacted via mail or e-mail and physician and nursing staff were asked to complete an anonymous online-survey or the identical attached paper-pencil questionnaire...
July 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28472415/acupressure-for-frail-older-people-in-community-dwellings-a-randomised-controlled-trial
#19
Clara W C Chan, Pui Hing Chau, Angela Y M Leung, Kwai Ching Lo, Huafeng Shi, Tin Pui Yum, Yeuk Yiu Lee, Lei Li
Background: 'Frailty' is being increasing recognised as a geriatric syndrome of growing importance in the medical field. Acupressure is a non-pharmacological, non-invasive Traditional Chinese Medicine (TCM) treatment, which may serve to improve the quality of life (QOL) or prevent the progressive advancement of frailty in the aged population. Objective: to investigate the effects of a 12-week, TCM-principle guided acupressure intervention on the QOL of the frail older people living in the community...
May 2, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28467578/approach-to-inguinal-hernia-in-high-risk-geriatric-patients-should-it-be-elective-or-emergent
#20
Rıza Gürhan Işıl, Pınar Yazıcı, Uygar Demir, Cemal Kaya, Özgür Bostancı, Ufuk Oğuz İdiz, Canan Tülay Işıl, Mahmut Kaan Demircioğlu, Mehmet Mihmanlı
BACKGROUND: Elderly patients are more prone to have inguinal hernia due to weakened abdominal musculature. However, surgical repair of inguinal hernia (SRIH) may not be performed or may be delayed due to greater risk in presence of comorbidities. Present study is investigation of outcome of elective and emergency SRIH in geriatric patients. METHODS: Records of total of 384 high-risk (American Society of Anesthesiology classification III-IV) patients aged >65 years who underwent SRIH between January 2010 and December 2014 were reviewed...
March 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
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