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Geriatric prognosis

Ayako Kunimura, Hideki Ishii, Tadayuki Uetani, Toshijirou Aoki, Kazuhiro Harada, Kenshi Hirayama, Yosuke Negishi, Yohei Shibata, Takuya Sumi, Kazuhiro Kawashima, Yosuke Tatami, Toshiki Kawamiya, Dai Yamamoto, Susumu Suzuki, Tetsuya Amano, Toyoaki Murohara
BACKGROUND: The association between malnutrition and cardiovascular prognosis in patients with stable coronary artery disease remains unclear. The aim of this study was to evaluate the association between Geriatric Nutritional Risk Index (GNRI), a simple tool to assess nutritional risk, and long-term outcomes after elective percutaneous coronary intervention (PCI). METHODS: This study consisted of 802 patients (age, 70±10 years, male, 69%) who underwent elective PCI...
October 7, 2016: Journal of Cardiology
Sami Hamdan Alzahrani, Ismail Abdelmoneim El Sayed, Sarah Mohammed Alshamrani
BACKGROUND: Malnutrition is highly prevalent among the elderly and is associated with poor clinical prognosis, decreased functional status, and increased morbidity and mortality. OBJECTIVE: To estimate the prevalence of geriatric malnutrition among outpatients of a geriatric clinic and to determine factors associated with malnutrition. DESIGN: Cross-sectional study. SETTING: Geriatric outpatient clinic of the King Abdul Aziz University Hospital, Jeddah...
September 2016: Annals of Saudi Medicine
Daniel Sevilla-Sanchez, Núria Molist-Brunet, Jordi Amblàs-Novellas, Pere Roura-Poch, Joan Espaulella-Panicot, Carles Codina-Jané
PURPOSE: Adverse drug events (ADEs) lead to adverse clinical outcomes such as hospitalization. There is little information about the characteristics of ADEs in patients with advanced chronic conditions and have a prognosis of limited life expectancy. This study aimed to evaluate (i) the prevalence of ADEs at the time of admission to hospital, (ii) the causality, severity, and preventability of the ADEs, and (iii) the clinical and pharmacological characteristics associated with the ADEs...
October 4, 2016: European Journal of Clinical Pharmacology
Joanna Lamkin, Phuong T Nguyen, John H Coverdale, Mollie R Gordon
Self-neglect, although frequently studied in geriatric populations, has received only limited attention in psychiatric populations. To address this gap, we utilize a behavioral framework to present a set of case examples in order to illustrate the complex relationship between self-neglect behaviors and conditions and various psychiatric illness. Cases are discussed with respect to ascending severity of presentations of self-neglect in adult non-geriatric inpatient psychiatric populations. Self-neglect is conceptualized as a range of behaviors, as well as an overall condition that affects an individual's functioning in several major domains...
September 28, 2016: Psychiatric Quarterly
Kathleen O'Connell, Ronald Maier
PURPOSE OF REVIEW: The benefits of palliative care for critically ill patients are well recognized, yet acceptance into surgical culture is lagging. With the increasing proportion of geriatric trauma patients, integration of palliative medicine within daily intensive care services to facilitate goal-concordant care is imperative. RECENT FINDINGS: Misconceptions of palliative medicine as it applies to trauma patients linger among trauma surgeons and many continue to practice without routine consultation of a palliative care service...
September 21, 2016: Current Opinion in Critical Care
Yaara Leibovici-Weissman, Alaa Atamna, Agata Schlesinger, Noa Eliakim-Raz, Jihad Bishara, Dafna Yahav
AIM: Most cases of Clostridium difficile infections (CDI) occur in patients aged 65 years and older. Older age is associated with increased mortality. Risk factors for mortality in patients aged 80 years and older are not well recognized. METHODS: We analyzed retrospective data including 184 patients aged 80 years and older hospitalized with CDI during 2009-2014. We aimed to delineate risk factors for short- and long-term mortality. RESULTS: The 30-day mortality was 33...
September 20, 2016: Geriatrics & Gerontology International
Andrea Ticinesi, Fulvio Lauretani, Antonio Nouvenne, Emanuela Porro, Guido Fanelli, Marcello Maggio, Tiziana Meschi
The physiology of inflammatory response is modified by the aging process and is substantially affected by multimorbidity and disability. Infection is the most frequent cause of acute inflammation in both adult and older subjects. C-reactive protein (CRP) is the most used biomarker of inflammation, and a substantial amount of literature has demonstrated its importance and clinical usefulness in adult subjects. However, the clinical significance of serum CRP determination has not been completely clarified in older subjects with acute infection, especially in the light of the age-related rearrangements in immunity and cytokine production...
September 1, 2016: European Journal of Internal Medicine
Sherise D Ferguson, Joanne Xiu, Shiao-Pei Weathers, Shouhao Zhou, Santosh Kesari, Stephanie E Weiss, Roeland G Verhaak, Raymond J Hohl, Geoffrey R Barger, Sandeep K Reddy, Amy B Heimberger
BACKGROUND: Geriatric glioblastoma (GBM) patients have a poorer prognosis than younger patients, but IDH1/2 mutations (more common in younger patients) confer a favorable prognosis. We compared key GBM molecular alterations between an elderly (age ≥ 70) and younger (18 < = age < = 45) cohort to explore potential therapeutic opportunities. RESULTS: Alterations more prevalent in the young GBM cohort compared to the older cohort (P < 0.05) were: overexpression of ALK, RRM1, TUBB3 and mutation of ATRX, BRAF, IDH1, and TP53...
August 25, 2016: Oncotarget
M Thaeter, M Knobe, M Vande Kerckhove, F Böhle, J Herold, E Verhaven, H-C Pape
PURPOSE: Interleukin-6 is a mainly proinflammatory interleukin and an indicator for the magnitude of surgery. The IL-6 serum concentration correlates with injury severity, the extent of tissue trauma and has negative impact on prognosis. To date it is unclear whether the immunologic changes assessed are age dependent. The aim of this study is to compare the surgical inflammatory response in different age groups. METHODS: Data were collected at a level-1 university trauma center in a prospective, consecutive cohort study...
October 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Lorenzo M Donini, Eleonora Poggiogalle, Alessio Molfino, Aldo Rosano, Andrea Lenzi, Filippo Rossi Fanelli, Maurizio Muscaritoli
INTRODUCTION: Malnutrition plays a major role in clinical and functional impairment in older adults. The use of validated, user-friendly and rapid screening tools for malnutrition in the elderly may improve the diagnosis and, possibly, the prognosis. The aim of this study was to assess the agreement between Mini-Nutritional Assessment (MNA), considered as a reference tool, MNA short form (MNA-SF), Malnutrition Universal Screening Tool (MUST), and Nutrition Risk Screening (NRS-2002) in elderly institutionalized participants...
October 1, 2016: Journal of the American Medical Directors Association
Christine S Ritchie, Amy S Kelley, Irena Stijacic Cenzer, Alexander K Smith, Margaret L Wallhagen, Kenneth E Covinsky
CONTEXT: Most hip fracture care models are grounded in curative models where the goal is to return the patient to independent function. In many instances, however, hip fractures contribute to continued functional decline and mortality. Although the negative impact of hip fractures is appreciated once they have occurred, what is less understood is what proportion of older adults have high illness burden before experiencing hip fracture and might benefit from geriatric palliative care. OBJECTIVES: Using data from the Health and Retirement Study linked to Medicare claims (January 1992 through December 2010), we sought to understand the extent of premorbid illness burden before hip fracture...
August 9, 2016: Journal of Pain and Symptom Management
F Vogt, S Wicklein, K Singler, S Pfeiffer, T Fischlein, J Schwab, M Pauschinger, J Jessl
The treatment of severe symptomatic aortic valve stenosis by conventional aortic valve replacement (AVR) or by transcatheter aortic valve implantation (TAVI) has a good perinterventional prognosis even for patients of advanced age. Having a heart team select the best management strategies based on current guidelines for each individual patient is essential for success. Especially in elderly and increasingly multimorbid patients with sometimes severe preconditions, the detection of functional deficits is relevant not only for the mortality but also for perioperative and postoperative complications as well as the functional outcome...
October 2016: Zeitschrift Für Gerontologie und Geriatrie
Krzysztof A Świerzy, Robert Pudlo, Bartosz Wesołowski, Marcin Garbacz, Michał Morawski, Izabela Jaworska, Mariusz Sołtysik, Marian Zembala
Confusion on a somatic basis is a dangerous problem mainly related with aging of the population. Data says that consciousness disorders concern 10-15% of patients in general wards, and up to 50% of patients admitted to geriatric wards. The persistence of the symptoms of confusion results in increase of agitation, disorganization, fear, which increases the risk of self-injuries of patients, it causes the need for parenteral feeding and hydratation, as well as maintaining water balance, and also disturbs cooperation, worsening the course and prognosis of the primary disease...
June 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
Emi Oishi, Satoko Sakata, Takuya Tsuchihashi, Mitsuhiro Tominaga, Koji Fujii
Objective The purpose of the present study was to assess the prevalence of orthostatic hypotension (OH) and elucidate its associations with the demographic characteristics and the prognosis in elderly subjects with dementia who visited a hospital for elderly daycare. Methods A total of 64 outpatients (44 females) with a mean age of 84±6 years who visited a hospital for daycare were enrolled in the study. The prevalence of OH and demographic characteristics were examined. Then, the subjects were followed up for 1 year...
2016: Internal Medicine
Naheed Rajabali, Darryl Rolfson, Sean M Bagshaw
Frailty is a clearly emerging theme in acute care medicine, with obvious prognostic and health resource implications. "Frailty" is a term used to describe a multidimensional syndrome of loss of homeostatic reserves that gives rise to a vulnerability to adverse outcomes after relatively minor stressor events. This is conceptually simple, yet there has been little consensus on the operational definition. The gold standard method to diagnose frailty remains a comprehensive geriatric assessment; however, a variety of validated physical performance measures, judgement-based tools, and multidimensional scales are being applied in critical care, cardiology, and cardiac surgery settings, including open cardiac surgery and transcatheter aortic value replacement...
September 2016: Canadian Journal of Cardiology
Sushma Jonna, Leslie Chiang, Jingxia Liu, Maria B Carroll, Kellie Flood, Tanya M Wildes
PURPOSE: Survival in older adults with cancer varies given differences in functional status, comorbidities, and nutrition. Prediction of factors associated with mortality, especially in hospitalized patients, allows physicians to better inform their patients about prognosis during treatment decisions. Our objective was to analyze factors associated with survival in older adults with cancer following hospitalization. METHODS: Through a retrospective cohort study, we reviewed 803 patients who were admitted to Barnes-Jewish Hospital's Oncology Acute Care of Elders (OACE) unit from 2000 to 2008...
November 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Eneida Mioshi, Emma Flanagan, David Knopman
OBJECTIVE: To investigate the psychometric properties of the Clinical Dementia Scale-frontotemporal lobar degeneration (CDR-FTLD) psychometric properties using Rasch analysis and its sensitivity distinguishing disease progression between FTLD and Alzheimer's disease (AD). METHODS: Of 603 consecutive patients from the National Alzheimer Coordinating Center dataset (FTLD = 350; AD = 253), 120 FTLDs were included in a Rasch analysis to verify CDR-FTLD psychometric properties; 483 (FTLD = 230; AD = 253) were included to analyse disease progression, with 195 (FTLD = 82; AD = 113) followed-up (24 months)...
July 28, 2016: International Journal of Geriatric Psychiatry
Jonathan Afilalo, Russell Steele, Warren J Manning, Kamal R Khabbaz, Lawrence G Rudski, Yves Langlois, Jean-Francois Morin, Michael H Picard
BACKGROUND: The age cutoff to define elderly is controversial in cardiac surgery, empirically ranging from ≥65 to ≥80 years. Beyond semantics, this has important implications as a starting point for clinical care pathways and inclusion in trials. We sought to characterize the relationship between age and adverse outcomes in patients undergoing cardiac surgery and to derive and validate prognosis-based age cutoffs. METHODS AND RESULTS: Six thousand five hundred seventy one consecutive adult patients undergoing cardiac surgery at 3 hospitals in the United States and Canada were included in the cohort...
July 2016: Circulation. Cardiovascular Quality and Outcomes
Oriol Alegre, Albert Ariza-Solé, María T Vidán, Francesc Formiga, Manuel Martínez-Sellés, Héctor Bueno, Juan Sanchís, Ramón López-Palop, Emad Abu-Assi, Àngel Cequier
The incidence of acute coronary syndromes (ACS) is high in the elderly. Despite a high prevalence of frailty and other aging-related variables, little information exists about the optimal clinical management in patients with coexisting geriatric syndromes. The aim of the LONGEVO-SCA registry (Impacto de la Fragilidad y Otros Síndromes Geriátricos en el Manejo y Pronóstico Vital del Anciano con Síndrome Coronario Agudo sin Elevación de Segmento ST) is to assess the impact of aging-related variables on clinical management, prognosis, and functional status in elderly patients with ACS...
July 2016: Clinical Cardiology
T Shiraki, O Iida, M Takahara, M Masuda, S Okamoto, T Ishihara, K Nanto, T Kanda, M Fujita, M Uematsu
OBJECTIVES: Patients with critical limb ischemia (CLI) have poor overall and limb prognosis. Although nutritional status influences overall prognosis, and the Geriatric Nutritional Risk Index (GNRI) is a widely used, simple and well established nutritional status screening method, the association between the GNRI and the overall and limb prognosis of patients with CLI following endovascular therapy (EVT) has not been explored. METHODS: Clinical outcomes were retrospectively evaluated in 473 consecutive patients (74 ± 10 years; 59% male) with CLI who underwent EVT...
August 2016: European Journal of Vascular and Endovascular Surgery
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