Mortality in healthy elderly patients after ICU admission

2008 ◽  
Vol 35 (3) ◽  
pp. 550-555 ◽  
Author(s):  
Emilio Sacanella ◽  
Joan Manel Pérez-Castejón ◽  
Josep Maria Nicolás ◽  
Ferran Masanés ◽  
Marga Navarro ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Icu Admission ◽  
Healthy Elderly

scholarly journals Assessment of Functions of the Autonomic Nervous System in the Elderly with Different Comorbid Factors

2020 ◽  
Author(s):  
Sushma S. ◽  
Medha Y Rao ◽  
Shaikh Mohammed Aslam
Keyword(s):  
Elderly Patients ◽  
Predictive Value ◽  
The Elderly ◽  
Common Symptom ◽  
Deep Breathing ◽  
Isometric Handgrip ◽  
Male Predominance ◽  
Healthy Elderly ◽  
Sensitivity Specificity ◽  
Deep Breathing Test

Abstract Background Studies in healthy elderly patients have shown the prevalence of autonomic dysfunction (AD) in the range of 20 to 30%. However, there is paucity in data pertaining to AD in the elderly in the Indian context. Objective To assess the prevalence of AD in the elderly irrespective of their comorbidity status. Methods A total of 141 elderly patients with or without comorbidities/symptoms of AD were included. Demographic and clinical details of the patients were recorded. Autonomic function tests (AFTs) such as deep breathing test, Valsalva ratio, orthostatic heart rate (OHR), isometric handgrip test, and orthostatic blood pressure were performed based on Ewing’s battery of tests. The sensitivity, specificity, positive predictive value, negative predictive value, and the accuracy of AFTs were evaluated. Results Most patients (n = 85) were aged between 60 and 69 years, with a male predominance (58.87%). Hypertension and diabetes mellitus were the most common comorbidities. Postural hypotension was the most common symptom of AD. With advancing age, symptoms of AD manifested significantly more. Overall, 73.8% of patients had AD, of whom 45.4% had early AD. Number of AD symptoms, glycated hemoglobin (HbA1c) level, and comorbid factors (diabetes and hypertension) were significantly associated with the results of AFTs (p < 0.05). AFTs were highly significant with respect to the results obtained (p < 0.001). Deep breathing test, abnormal in majority of study patients, has a sensitivity of 93.3% and OHR has a specificity of 81.1% to determine AD. Conclusion The study concludes that age itself is an independent predictor of AD, which increases in severity if associated with comorbidities.

scholarly journals Energy Requirement Equations in Elderly Patients: A Systematic Review (P01-002-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Dario Gregori ◽  
Honoria Ocagli ◽  
Corrado Lanera ◽  
Giulia Lorenzoni
Keyword(s):  
Systematic Review ◽  
Elderly Patients ◽  
Indirect Calorimetry ◽  
Gold Standard ◽  
Web Application ◽  
The Elderly ◽  
Energy Requirements ◽  
Elderly Subjects ◽  
Predictive Equation ◽  
Healthy Elderly

Abstract Objectives Elderly patients are at risk of malnutrition and need an appropriate assessment of energy requirements. In the clinical setting, predictive equations are widely used to estimate the Resting Energy Expenditure (REE). Although easy to use, these equations are not always validated for the elderly and, even if validated, they often provide different outputs of energy requirements for the same subject. This study aimed at doing a systematic review of the equations for the estimation of REE in the elderly with the final aim of developing a web-based application helping clinicians in finding out the most appropriate equation for estimating the REE for each subject. Methods The systematic review was carried out using PubMed and Scopus following PRISMA guidelines. Studies in subjects older than 65 years of age, testing the performance of a predictive equation for the estimation of REE vs. a gold standard (indirect calorimetry or doubly labeled water) were included in the review. Studies performed in critically ill elderly patients were excluded. Results The initial search identified 2035 studies. The final review included 50 studies. Included studies were mainly observational, conducted in healthy elderly subjects enrolled in the outpatient setting, and using indirect calorimetry as gold standard. The 50 studies included in the review corresponded to 189 different equations. Several parameters were included in the equations and they can be divided as following: anthropometric characteristics, body composition parameters, environmental measures, laboratory tests, presence of comorbidities, and physical activity frequency. Conclusions The assessment of the energy requirements in the elderly is crucial for the management of nutritional problems in this population group since nutritional problems are related to worse health outcomes. The present study showed a wide use of different type of equations for the estimation of REE in the elderly highlighting the need of choosing the most appropriate predictive equation according to the subject characteristics and health status. The web application that is currently under development will help clinicians in doing that. Funding Sources Unit of Biostatistics, Epidemiology and Public Health, University of Padova, Padova, Italy.

Mild Traumatic Brain Injury in Elderly Patients: Is Routine ICU Admission Necessary?

2015 ◽  
Vol 221 (4) ◽  
pp. S82-S83 ◽  
Author(s):  
Amy Gore ◽  
Christine Y. Mau ◽  
Charles J. Prestigiacomo ◽  
Ziad C. Sifri
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Elderly Patients ◽  
Mild Traumatic Brain Injury ◽  
Icu Admission

LONG-TERM SURVIVAL, AND FUNCTIONAL AND COGNITIVE OUTCOME AFTER ICU ADMISSION IN VERY ELDERLY PATIENTS.

2005 ◽  
Vol 33 ◽  
pp. A83 ◽  
Author(s):  
Evert de Jonge ◽  
Sophia E de Rooij ◽  
Marcel M Levi ◽  
Johanna C Korevaar
Keyword(s):  
Elderly Patients ◽  
Cognitive Outcome ◽  
Very Elderly ◽  
Term Survival ◽  
Long Term Survival ◽  
Icu Admission

scholarly journals Prospective evaluation of protein bound vitamin B12(cobalamin) malabsorption in the elderly using trout flesh labelled in vivo with 57Co-cobalamin

Gut ◽  
1997 ◽  
Vol 41 (4) ◽  
pp. 475-479 ◽  
Author(s):  
I Aimone-Gastin ◽  
H Pierson ◽  
C Jeandel ◽  
J P Bronowicki ◽  
F Plénat ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Pancreatic Insufficiency ◽  
Intrinsic Factor ◽  
Elderly Subjects ◽  
Blood Levels ◽  
Vitamin B ◽  
Healthy Elderly ◽  
Schilling Test ◽  
Hospitalised Patients

Background—The frequency of dietary protein bound vitamin B12 malabsorption in elderly patients remains controversial.Aims—To evaluate this malabsorption in elderly hospitalised patients using a modified Schilling test.Patients—Fourteen elderly patients with low B12 blood levels were prospectively selected from 394 hospitalised patients.Methods—The modified Schilling test was performed with trout labelled in vivo.Results—The test was normal in five healthy elderly subjects, in 7/8 patients with pancreatic insufficiency, and in nine non-elderly patients with antral gastritis. The low decision limit was established at 3.3% (median 4.8%). From the 14 elderly patients with low B12 prospectively selected from 394 hospitalised patients, seven had a real deficiency with anaemia and an increased homocysteine and/or methylmalonate serum level. The modified Schilling test showed malabsorption in five of these patients, including two in which the standard Schilling test was normal, and three in which the standard Schilling test was partially corrected by an intrinsic factor.Conclusions—Protein bound vitamin B12malabsorption was detected in at least 0.5% of elderly hospitalised patients, using the labelled trout flesh absorption test.

scholarly journals Quantification of CYP3A and Drug Transporters Activity in Healthy Young, Healthy Elderly and Chronic Kidney Disease Elderly Patients by a Microdose Cocktail Approach

2021 ◽  
Vol 12 ◽  
Author(s):  
Punyabhorn Rattanacheeworn ◽  
Stephen J Kerr ◽  
Wonngarm Kittanamongkolchai ◽  
Natavudh Townamchai ◽  
Suwasin Udomkarnjananun ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Elderly Patients ◽  
Half Life ◽  
Dabigatran Etexilate ◽  
Organic Anion ◽  
Maximum Plasma ◽  
Cyp3a Activity ◽  
Cancer Resistance ◽  
Healthy Elderly

Background: Ageing and chronic kidney disease (CKD) affect pharmacokinetic (PK) parameters. Since mechanisms are related and remain unclear, cytochrome P450 (CYP) 3A and drug transporter activities were investigated in the elderly with or without CKD and compared to healthy adults using a microdose cocktail.Methods: Healthy young participants (n = 20), healthy elderly participants (n = 16) and elderly patients with CKD (n = 17) received, in study period 1, a single dose of microdose cocktail probe containing 30 µg midazolam, 750 µg dabigatran etexilate, 100 µg atorvastatin, 10 µg pitavastatin, and 50 µg rosuvastatin. After a 14-day wash-out period, healthy young participants continued to study period 2 with the microdose cocktail plus rifampicin. PK parameters including area under the plasma concentration-time curve (AUC), maximum plasma drug concentration (Cmax), and half-life were estimated before making pairwise comparisons of geometric mean ratios (GMR) between groups.Results: AUC and Cmax GMR (95% confidence interval; CI) of midazolam, a CYP3A probe substrate, were increased 2.30 (1.70–3.09) and 2.90 (2.16–3.88) fold in healthy elderly and elderly patients with CKD, respectively, together with a prolonged half-life. AUC and Cmax GMR (95%CI) of atorvastatin, another CYP3A substrate, was increased 2.14 (1.52–3.02) fold in healthy elderly and 4.15 (2.98–5.79) fold in elderly patients with CKD, indicating decreased CYP3A activity related to ageing. Associated AUC changes in the probe drug whose activity could be modified by intestinal P-glycoprotein (P-gp) activity, dabigatran etexilate, were observed in patients with CKD. However, whether the activity of pitavastatin and rosuvastatin is modified by organic anion transporting polypeptide 1B (OATP1B) and of breast cancer resistance protein (BCRP), respectively, in elderly participants with or without CKD was inconclusive.Conclusions: CYP3A activity is reduced in ageing. Intestinal P-gp function might be affected by CKD, but further confirmation appears warranted.Clinical Trial Registration:http://www.thaiclinicaltrials.org/ (TCTR 20180312002 registered on March 07, 2018)

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