Social support and long-term mortality in the elderly: Role of comorbidity

2010 ◽  
Vol 51 (3) ◽  
pp. 323-328 ◽  
Author(s):  
Francesca Mazzella ◽  
Francesco Cacciatore ◽  
Gianluigi Galizia ◽  
David Della-Morte ◽  
Marianna Rossetti ◽  
...  
Keyword(s):  
Social Support ◽  
The Elderly ◽  
Long Term Mortality

scholarly journals Surgery Is Underused in Elderly Patients With Left‐Sided Infective Endocarditis: A Nationwide Registry Study

2021 ◽  
Vol 10 (19) ◽  
Author(s):  
Sigurdur Ragnarsson ◽  
Sonsoles Salto‐Alejandre ◽  
Axel Ström ◽  
Lars Olaison ◽  
Magnus Rasmussen
Keyword(s):  
Infective Endocarditis ◽  
Elderly Patients ◽  
The Elderly ◽  
Registry Study ◽  
Term Survival ◽  
Younger Patients ◽  
Group 12 ◽  
Long Term Mortality

Background Infective endocarditis is associated with higher mortality in elderly patients, but the role of surgery in this group has not been fully evaluated. The aim of this study was to assess outcomes of left‐sided infective endocarditis in elderly patients and to determine the influence of surgery on mortality in the elderly. Methods and Results A nationwide retrospective study was performed of 2186 patients with left‐sided infective endocarditis recorded in the SRIE (Swedish Registry of Infective Endocarditis), divided into patients aged <65 years (n=864), 65 to 79 years (n=806), and ≥80 years (n=516). Survival analysis was performed using the Swedish National Population Registry, and propensity score matching was applied to assess the effect of surgery on survival among patients of all ages. The rate of surgery decreased with increasing age, from 46% in the <65 group to 6% in the ≥80 group. In‐hospital mortality was 3 times higher in the ≥80 group compared with the <65 group (23% versus 7%) and almost twice that of the 65 to 79 group (12%). In propensity‐matched groups, the mortality rate was significantly lower between the ages of 55 and 82 years in patients who underwent surgery compared with patients who did not undergo surgery. Surgery was also associated with better long‐term survival in matched patients who were ≥75 years (hazard ratio, 0.36; 95% CI, 0.24–0.54 [ P <0.001]). Conclusions The proportion of elderly patients with infective endocarditis who underwent surgery was low compared with that of younger patients. Surgery was associated with lower mortality irrespective of age. In matched elderly patients, long‐term mortality was higher in patients who did not undergo surgery, suggesting that surgery is underused in elderly patients.

scholarly journals Role of diuretics on long-term mortality may differ in volume status in patients with acute myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Kawai ◽  
D Nakatani ◽  
T Yamada ◽  
T Watanabe ◽  
T Morita ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Propensity Score ◽  
Plasma Volume ◽  
Cox Regression ◽  
Volume Status ◽  
Increased Risk ◽  
Long Term Mortality

Abstract Background Diuretics has been reported to have a potential for an activation of the renin-angiotensin-aldosterone system and the sympathetic nervous system, leading to a possibility of poor clinical outcome in patients with cardiovascular disease. However, few data are available on clinical impact of diuretics on long-term outcome in patients with acute myocardial infarction (AMI) based on plasma volume status. Methods To address the issue, a total of 3,416 survived patients with AMI who were registered to a large database of the Osaka Acute Coronary Insufficiency Study (OACIS) were studied. Plasma volume status was assessed with the estimated plasma volume status (ePVS) that was calculated at discharge as follows: actual PV = (1 − hematocrit) × [a + (b × body weight)] (a=1530 in males and a=864 in females, b=41.0 in males and b=47.9 in females); ideal PV = c × body weight (c=39 in males and c=40 in females), and ePVS = [(actual PV − ideal PV)/ideal PV] × 100 (%). Multivariable Cox regression analysis and propensity score matching were performed to account for imbalances in covariates. The endpoint was all-cause of death (ACD) within 5 years. Results During a median follow-up period of 855±656 days, 193 patients had ACD. In whole population, there was no significant difference in long-term mortality risk between patients with and without diuretics in both multivariate cox regression model and propensity score matching population. When patients were divided into 2 groups according to ePVS with a median value of 4.2%, 46 and 147 patients had ACD in groups with low ePVS and high ePVS, respectively. Multivariate Cox analysis showed that use of diuretics was independently associated with an increased risk of ACD in low ePVS group, (HR: 2.63, 95% confidence interval [CI]: 1.22–5.63, p=0.01), but not in high ePVS group (HR: 0.70, 95% CI: 0.44–1.10, p=0.12). These observations were consistent in the propensity-score matched cohorts; the 5-year mortality rate was significantly higher in patients with diuretics than those without among low ePVS group (4.7% vs 1.7%, p=0.041), but not among high ePVS group (8.0% vs 10.3%, p=0.247). Conclusion Prescription of diuretics at discharge was associated with increased risk of 5-year mortality in patients with AMI without PV expansion, but not with PV expansion. The role of diuretics on long-term mortality may differ in plasma volume status. Therefore, prescription of diuretics after AMI may be considered based on plasma volume status. Funding Acknowledgement Type of funding source: None

Mother, baby and Facebook makes three: does social media provide social support for new mothers?

2018 ◽  
Vol 168 (1) ◽  
pp. 122-139 ◽  
Author(s):  
Catherine Archer ◽  
Kai-Ti Kao
Keyword(s):  
Social Support ◽  
Social Media ◽  
Media Use ◽  
Long Term Effects ◽  
New Mothers ◽  
Social Media Use ◽  
Extreme Stress ◽  
Ability To Act

Many mothers can find themselves increasingly isolated and overwhelmed after giving birth to a new baby. This period can be a source of extreme stress, anxiety and depression, which can not only have an economic impact on national health services, but can also have long-term effects on the development of the child. At the same time, social media use among most new mothers has become ubiquitous. This research investigates the role of social media, potentially as a mechanism for social support, among Australian mothers of young children aged from birth to 4 years. The findings indicate that participants had mixed responses to their social media use. While social support was deemed a benefit, there were also some negative aspects to social media use identified. The findings highlight the need to critically interrogate social media’s ability to act as a source of social support for new mothers.

Mending Broken Hearts

2012 ◽  
Vol 53 (1) ◽  
pp. 33-49 ◽  
Author(s):  
Ellen L. Idler ◽  
David A. Boulifard ◽  
Richard J. Contrada
Keyword(s):  
Medical Records ◽  
Lower Risk ◽  
Adult Mortality ◽  
Men And Women ◽  
Never Married ◽  
The Social ◽  
Using Data ◽  
Long Term Mortality

Marriage has long been linked to lower risk for adult mortality in population and clinical studies. In a regional sample of patients ( n = 569) undergoing cardiac surgery, we compared 5-year hazards of mortality for married persons with those of widowed, separated or divorced, and never married persons using data from medical records and psychosocial interviews. After adjusting for demographics and pre- and postsurgical health, unmarried persons had 1.90 times the hazard of mortality of married persons; the disaggregated widowed, never married, and divorced or separated groups had similar hazards, as did men and women. The adjusted hazard for immediate postsurgical mortality was 3.33; the adjusted hazard for long-term mortality was 1.71, and this was mediated by married persons’ lower smoking rates. The findings underscore the role of spouses (both male and female) in caregiving during health crises and the social control of health behaviors.

Associate Members: A Life Worth Living

1986 ◽  
Vol 49 (11) ◽  
pp. 362-364 ◽  
Author(s):  
Jean Parker
Keyword(s):  
Elderly Patients ◽  
Long Term Care ◽  
The Elderly ◽  
Worth Living ◽  
Term Care ◽  
Life Worth Living ◽  
Meaningful Existence ◽  
Time And Energy

Long-term care patients need a meaningful existence. It is our responsibility to ensure that time and energy are channelled into purposeful solutions for the disease of ‘time with nothing to do’. The author has taken up this challenge. Working as an activities organizer with the elderly for 11 years, she was determined never to take the role of a baby-sitter. The recreation unit has grown from its first eight guests to a purpose-built unit with approximately 1,500 attendances per month. A busy happy atmosphere now prevails where once there was a sea of dead faces. The choice to retain a sense of dignity and purpose should be available to all elderly patients who require long-term care.

scholarly journals Long-Term Care in Indonesia: The Role of Integrated Service Post for Elderly

2018 ◽  
Vol 30 (10) ◽  
pp. 1556-1573 ◽  
Author(s):  
Aluisius Hery Pratono ◽  
Asri Maharani
Keyword(s):  
Local Community ◽  
Long Term Care ◽  
The Elderly ◽  
Community Health Services ◽  
Government Support ◽  
Self Report ◽  
Religious Activities ◽  
Term Care

Objective: This article aims to examine community long-term care (LTC) in Indonesia by drawing upon the five principles of human right provision: availability, accessibility, acceptability, quality, and universality. Method: We used a qualitative approach with exploratory multiple case studies in three different areas in East Java Province, Indonesia. This study gathered the initial evidence using a report card approach with self-report questionnaires. In-depth interviews and focus group discussions were carried out to understand factors that affect the efficacy of LTC services. Results: The Indonesia Government imposed a regulation that required each local community to make community health services available for the elderly. By managing the integrated post, the community provided LTC service for the elderly. Community leadership played a pivotal role to make LTC services available. Improving the services with religious activities was essential to improving the acceptability, but it also needed to take into consideration universality and nondiscrimination principles. Results show that LTC services are difficult to expand and quality standards are difficult to raise, due to challenges such as few community members volunteering their services, lack of support from religious leaders, limited resources, and inadequate volunteer training. Discussion: This study highlights the role of community engagement in LTC services and shows that it is difficult to succeed without adequate government support. Improving services with creative and culturally acceptable activities is necessary.

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