Frailty Among Elderly Patients on Chronic Maintenance Hemodialysis for ESRD: Not Simply a Matter of Chronological Age

2019 ◽  
pp. 163-169
Author(s):  
Macaulay Amechi Chukwukadibia Onuigbo ◽  
Nneoma Agbasi
Keyword(s):  
Elderly Patients ◽  
Chronological Age ◽  
Maintenance Hemodialysis

scholarly journals MON-305 CROSS-SECTIONAL STUDY OF NUTRITIONAL STATUS AND FRAILTY IN ELDERLY PATIENTS ON MAINTENANCE HEMODIALYSIS

2019 ◽  
Vol 4 (7) ◽  
pp. S424
Author(s):  
Z. AMREYEVA ◽  
G. Chingayeva ◽  
A. Kanatbayeva ◽  
A. Shepetov ◽  
M. Kulkayeva ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Elderly Patients ◽  
Cross Sectional Study ◽  
Maintenance Hemodialysis ◽  
Sectional Study ◽  
Cross Sectional

The Charlson Comorbidity Index (CCI) as a Mortality Predictor after Surgery in Elderly Patients

2016 ◽  
Vol 82 (1) ◽  
pp. 22-27 ◽  
Author(s):  
Anat Laor ◽  
Sari Tal ◽  
Vladimir Guller ◽  
Andrew P. Zbar ◽  
Eli Mavor
Keyword(s):  
Elderly Patients ◽  
Emergency Surgery ◽  
Charlson Comorbidity Index ◽  
Oldest Old ◽  
Chronological Age ◽  
Age Group ◽  
Emergency Operations ◽  
Comorbidity Index ◽  
The Impact ◽  
Surgery In Elderly

The increasing range of surgery in elderly patients reflects the changing demography where in the next 10 years one quarter of the population will be 65 years of age or older. There is presently no consensus concerning the optimal predictive markers for postoperative morbidity and mortality after surgery in older patients with an appreciation that physical frailty is more important than chronological age. In this retrospective analysis, we have compared the impact of age and the calculated preoperative Charlson Comorbidity Index (CCI) on early (30-day) and late (one-year) mortality in a group of patients >75 years of age dividing them into an “older old” cohort (75–84 years of age, Group A) and an “oldest old” group (≥85 years of age, Group B). Increased age was associated with a higher death rate after emergency surgery, with late deaths after elective surgery exceeding those after emergency operations. A higher mean CCI was noted in both age groups in early nonsurvivors after both elective and emergency surgery with a more significant effect of the preoperative CCI than chronological age for the prediction of late postoperative death for both groups after elective and emergency operations. Although the CCI was not designed to predict perioperative mortality in surgical cohorts, it correlates with a greater risk than age for perioperative death in the elderly.

The Effect of Combination Use of Hemodialysis and Hemoperfusion on Microinflammation in Elderly Patients with Maintenance Hemodialysis

2022 ◽  
pp. 1-8
Author(s):  
Jun Li ◽  
Hui Li ◽  
Wenjiao Deng ◽  
Lixin Meng ◽  
Wenya Gong ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Elderly Patients ◽  
Adverse Reactions ◽  
Statistical Significance ◽  
Continuous Treatment ◽  
Maintenance Hemodialysis ◽  
Control Group ◽  
Observation Group ◽  
Significant Difference

<b><i>Background:</i></b> Patients with maintenance hemodialysis (MHD) generally have a microinflammatory state. The aim of this study was to investigate the effects of hemodialysis (HD) combined with hemoperfusion (HP) on microinflammatory state in elderly patients with MHD. <b><i>Methods:</i></b> One hundred and fifty elderly patients with MHD were randomly divided into the control group and the observation group. The control group received simple HD treatment, and the observation group received combined HD + HP treatment on the basis of the control group. After 6 months of continuous treatment, the patients were evaluated to compare the quality of life, inflammation, adverse reactions, and nutritional indicators in the 2 groups before and after treatment. <b><i>Results:</i></b> There was no significant difference in the quality of life between the 2 groups before treatment. After treatment, the scores of psychological aspects, physiological aspects, social aspects, environmental aspects, and independent ability in the observation group were higher than those in the control group, with statistical significance (<i>p</i> &#x3c; 0.05). There was no statistical significance in the level of inflammation between 2 groups before treatment. After treatment, the levels of hs-CRP, Hcy, IL-6, and TNF-α in the observation group were significantly lower than those in the control group, with statistical significance (<i>p</i> &#x3c; 0.05). The incidence of dry mouth, skin reaction, neuritis, and subcutaneous tissue fibrosis in the observation group was lower than that in the control group, with statistical significance (<i>p</i> &#x3c; 0.05). There was no statistical significance in nutritional level indexes between 2 groups before treatment (<i>p</i><sub>1</sub> &#x3e; 0.05). After treatment, the levels of hemoglobin, total protein, albumin, and transferrin in the observation group were significantly higher than those in the control group, with statistical significance (<i>p</i> &#x3c; 0.05). <b><i>Conclusion:</i></b> The clinical effect of HD combined with HP in elderly MHD patients is significant, which can effectively reduce the incidence of adverse reactions and inflammation in the patients and improve the quality of life and nutritional indicators of the patients.

The Effects of Music as Therapy on the Overall Well-Being of Elderly Patients on Maintenance Hemodialysis

2011 ◽  
Vol 14 (3) ◽  
pp. 277-285 ◽  
Author(s):  
Yen-Ju Lin ◽  
Kuo-Cheng Lu ◽  
Ching-Min Chen ◽  
Chia-Chi Chang
Keyword(s):  
Elderly Patients ◽  
Adverse Reactions ◽  
Well Being ◽  
Complementary Therapy ◽  
Maintenance Hemodialysis ◽  
Control Group ◽  
Music Listening ◽  
Finger Temperature ◽  
Convenience Sample ◽  
Experimental Group

In this study, the authors explored the use of music during hemodialysis (HD) as a complementary therapy to improve overall well-being in elderly patients. The authors recruited a convenience sample of 88 patients on maintenance HD from a teaching hospital in northern Taiwan and randomly assigned them to either an experimental group ( n = 44) or a control group ( n = 44). In the first week, participants in the experimental group created their own music playlists. During the second week, these participants listened to music from their own playlists during each HD session (three times/week). The authors evaluated the effects of music as therapy by assessing its impact on perceived stressors and adverse reactions during HD (HD Adverse Reactions Self-Assessment Scale and HD Stressor Scale [HSS]) and measuring changes in physiological indices during the course of the music listening. After 1 week of the use of music as therapy during HD, the authors noted significant reductions in the frequency and severity of adverse reactions during dialysis and in scores on the HSS, p < .001. The authors also observed significantly decreased respiratory rate and significantly increased finger temperature and oxygen saturation, p < .001, during the same period. In conclusion, listening to music during HD may promote overall patient well-being. It may thus serve as a complementary form of therapy that facilitates care and delivery of adequate dialysis and thus improves overall patient well-being in the long run.

Nghiên cứu tình trạng suy yếu trên bệnh nhân cao tuổi suy thận mạn giai đoạn cuối lọc máu chu kỳ

2021 ◽  
Author(s):  
Xuan Thu Pham Thi
Keyword(s):  
Elderly Patients ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
The Elderly ◽  
Maintenance Hemodialysis ◽  
Geriatric Syndrome ◽  
Clinical Frailty Scale ◽  
Cross Sectional ◽  
Stage Renal Disease ◽  
End Stage

Giới thiệu: Suy yếu là một hội chứng lão hóa thường gặp, làm gia tăng các kết cục lâm sàng bất lợi ở người cao tuổi. Suy yếu đặc biệt chiếm tỷ lệ rất cao > 60% ở bệnh nhân cao tuổi suy thận mạn giai đoạn cuối lọc máu chu kỳ. Tuy nhiên, các nghiên cứu tại Việt Nam hiện nay chưa khảo sát trên đối tượng đặc biệt này. Mục tiêu: Xác định tỷ lệ suy yếu theo thang điểm suy yếu lâm sàng và các yếu tố liên quan trên bệnh nhân cao tuổi suy thận mạn giai đoạn cuối lọc máu chu kỳ. Đối tượng và phương pháp nghiên cứu: Cắt ngang mô tả và theo dõi dọc trên 175 bệnh nhân cao tuổi suy thận mạn giai đoạn cuối lọc máu chu kỳ ngoại trú tại Khoa Thận - Thận nhân tạo Bệnh viện Trưng Vương và Bệnh viện Thống Nhất từ 11/2020 đến 06/2021. Kết quả: Tỷ lệ suy yếu trên bệnh nhân cao tuổi suy thận mạn giai đoạn cuối lọc máu chu kỳ là 69,7%. Sau phân tích hồi quy đa biến, có mối liên quan giữa suy yếu và tuổi (PR = 1,23; KTC 95%: 1,12 - 1,35; p < 0,001); suy dinh dưỡng (SDD) (PR = 2,17; KTC 95%: 1,61 - 2,92; p < 0,001) và nguy cơ SDD theo thang điểm MNA - SF (PR = 1,47; KTC 95%: 1,27 - 1,71; p < 0,001); nguy cơ té ngã (PR = 1,63; KTC 95%: 1,28 - 2,07; p < 0,001). Kết luận: Suy yếu chiếm tỷ lệ rất cao ở bệnh nhân cao tuổi suy thận mạn giai đoạn cuối lọc máu chu kỳ và có mối liên quan độc lập với tuổi, tình trạng suy dinh dưỡng và té ngã. Từ khóa: Suy yếu, người cao tuổi, suy thận mạn giai đoạn cuối, lọc máu chu kỳ. ABSTRACT FRAILTY IN ELDERLY PATIENTS WITH END - STAGE KIDNEY DISEASE UNDERGOING HEMODIALYSIS Background: Frailty is a geriatric syndrome which is associated with an increased incidence of adverse clinical outcomes in the elderly. Frailty is particularly high > 60% in elderly patients with end - stage renal disease undergoing hemodialysis. However, research on frailty for this special populationhas not been done in Vietnam. Objective: To determine the prevalence of frailty according to the Canadian Clinical Frailty Scale (CFS) and investigate factors related to frailty in elderly patients with end - stage renal diseaseunder hemodialysis. Methods: Cross - sectional study and longitudinal follow - up, performed on 175 elderly patients with end - stage renal disease on maintenance hemodialysis at the Department of Nephrology at Trung Vuong Hospital and Thong Nhat Hospitalfrom November 2020 to June 2021. Results: The prevalence of frailty in elderly patients with end - stage renal disease on maintenance hemodialysis was 69.7%. After multivariate regression analysis, there was a relationship between frailty and age (PR = 1.23; 95% CI: 1.12 - 1.35; p < 0.001); malnutrition (PR = 2.17; 95% CI: 1.61 - 2.92; p < 0.001) and risk of malnutrition according to the MNA-SF scale (PR = 1.47; 95% CI: 1.27 - 1.71; p < 0.001); risk of falling (PR = 1.63; 95% CI: 1.28 - 2.07; p < 0.001). Conclusion: The prevalence of frailty was very high in elderly patients with end-stage renal disease on maintenance hemodialysis and frailty was independently associated with age, malnutrition, and falls. Keywords: Frailty, clinical frailty scale, elderly people, end - stage renal disease, hemodialysis

Is chronological age really not a contraindication to gastrectomy for very elderly patients?

Surgery Today ◽  
2018 ◽  
Vol 48 (10) ◽  
pp. 968-969
Author(s):  
Jiong-Jie Yu ◽  
Li-Yang Sun ◽  
Tian Yang
Keyword(s):  
Elderly Patients ◽  
Chronological Age ◽  
Very Elderly

scholarly journals Malnutrition screening tool, MNA-SF, significantly predicts mortality in elderly patients with maintenance hemodialysis

2014 ◽  
Vol 47 (6) ◽  
pp. 359-365
Author(s):  
Kozo Fujio ◽  
Yoshiko Manai ◽  
Masumi Ishii ◽  
Naomi Momotani ◽  
Syoji Fujii ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Screening Tool ◽  
Maintenance Hemodialysis

scholarly journals Survival of Elderly Patients on Maintenance Hemodialysis: A 6 Years? Experience from a Resource-Limited Country

2019 ◽  
Vol 9 (3) ◽  
Author(s):  
Danielle FMEH ◽  
Francois KF ◽  
Diana TTH ◽  
Patrice HM ◽  
George TD ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Maintenance Hemodialysis ◽  
Resource Limited

scholarly journals P1584FRAILTY IN MAINTENANCE HEMODIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Zauresh Amreyeva ◽  
Gulnar Chingayeva ◽  
Abay Shepetov ◽  
Assiya Kanatbayeva ◽  
Arina Yespotayeva
Keyword(s):  
Nutritional Status ◽  
Elderly Patients ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Measurement Tool ◽  
Frail Patients ◽  
Dialysis Vintage ◽  
Significant Difference ◽  
The Mean ◽  
Elderly Hemodialysis Patients

Abstract Background and Aims The population in Kazakhstan is rapidly aging, as a result the number of geriatric patients on maintenance hemodialysis (MHD) has been increasing. Frailty is prevalent in dialysis patients and is one of the common factors that can lead to increased morbidity and mortality. The primary objectives of this study were to evaluate the prevalence of frailty in elderly patients on MHD by using Edmonton Frailty Scale and assess their association with clinical and laboratory measurements. A secondary objective was to investigate the relationship between nutritional status and frailty. Method From July to September 2018, a total of 65 elderly patients undergoing HD in 7 dialysis facilities in Almaty, Kazakhstan were enrolled in this cross-sectional study. All participants were evaluated for the cognitive status through Mini-Mental State Examination (MMSE), nutritional status by using Mini Nutritional Assessment (MNA), Malnutrition-Inflammation Score (MIS), and anthropometric measurements (body mass index (BMI), triceps skinfold (TSF), mid-arm muscle circumference (MAMC)), functionality (Handgrip strength), as well biochemical data were collected from medical records. Frailty was defined in accordance with the Edmonton Frail scale (EFS). Results The study participants’ median age was 69 (range: 65–88) years old, and median dialysis vintage was 36 (IQR 15–60) months, 53.8% were female. The main comorbidities were hypertension (69.2%) and diabetes (35.4%). The prevalence of frailty assessed by the EFS was 23.1% (men: 13.3%; women: 86.7), 43.1% patients were non-frail (men: 64.3%; women: 35.7%), 33.8% patients were vulnerable (men: 45.5%; women: 54.5%). Based on MIS the prevalence of PEW was 73.8% and, according to MNA, the risk of malnutrition was detected in 47.7%, and 9.2% had malnutrition. No significant difference was observed between genders in the frequency of PEW. Mean body weight was 69.1±11.3kg, the mean BMI was slightly overweight 25.6±4.29kg/m2, while hand-grip strength was 21.33±3.36 in men and 15.5±5.51 in women, p=0.008, and it is lower than the normal population standard values. The frail patients group had a higher proportion of women 86.7% (p=0.001), worse nutritional status (93.3% and 86,7% had PEW evaluated by MIS (p=0.018) and MNA (p=0.035), respectively), more frequency of falls (p=0.01), anemia (p=0.038) when compared to group of non-frail and vulnerable patients. 66.7% of frail patients were widowed (p=0.005). The mean MMSE in this group of patients was 26.7±1.9. Conclusion The prevalence of frailty among elderly hemodialysis patients in this study was 23.1%, and we detected that 86.7% of them were female, as well PEW increased in frail patients. Also the study showed that protein-energy wasting is common among elderly hemodialysis patients. Its prevalence varies between 73.8% and 56.9% depending on the measurement tool used to evaluate the nutritional status. In our country with limited resources, EFS, MIS and MNA could help to follow elderly hemodialysis patients.

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