scholarly journals Can Routine Preoperative Data Predict Adverse Outcomes in the Elderly? Development and Validation of a Simple Risk Model Incorporating a Chart-Derived Frailty Score

2014 ◽  
Vol 219 (4) ◽  
pp. 684-694 ◽  
Author(s):  
Levana G. Amrock ◽  
Mark D. Neuman ◽  
Hung-Mo Lin ◽  
Stacie Deiner
Keyword(s):  
Risk Model ◽  
The Elderly ◽  
Adverse Outcomes ◽  
Development And Validation ◽  
Frailty Score

scholarly journals Incidence and predictors of hospitalization in patients with atrial fibrillation: results from the Chinese atrial fibrillation registry study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhaojie Dong ◽  
Xin Du ◽  
Shangxin Lu ◽  
Chao Jiang ◽  
Shijun Xia ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiovascular Diseases ◽  
Risk Model ◽  
Age Groups ◽  
Gastrointestinal Disorder ◽  
The Elderly ◽  
Chronic Obstructive ◽  
Unique Identifier ◽  
Clinical Registry

Abstract Background Patients with atrial fibrillation (AF) underwent a high risk of hospitalization, which has not been paid much attention to in practice. Therefore, we aimed to assess the incidence, causes and predictors of hospitalization in AF patients. Methods From August 2011 to December 2017, a total number of 20,172 AF patients from the Chinese Atrial Fibrillation Registry (China-AF) Study were prospectively selected for this study. We described the incidence, causes of hospitalization by age groups and sex. The Fine-Gray competing risk model was employed to identify predictors of first all-cause and first cause-specific hospitalization. Results After a mean follow-up of 37.3 ± 20.4 months, 7,512 (37.2%) AF patients experienced one or more hospitalizations. The overall incidence of all-cause hospitalization was 24.0 per 100 patient-years. Patients aged < 65 years were predominantly hospitalized for AF (42.1% of the total hospitalizations); while patients aged 65–74 and ≥ 75 years were mainly hospitalized for non-cardiovascular diseases (43.6% and 49.3%, respectively). We found patients complicated with heart failure (HF)[hazard ratio (HR) 1.10, 95% confidence interval (CI) 1.02–1.18], established coronary artery disease (CAD) (HR 1.24, 95%CI 1.17–1.33), ischemic stroke/transient ischemic attack (TIA) (HR 1.22, 95%CI 1.15–1.30), diabetes (HR 1.14, 95%CI 1.08–1.20), chronic obstructive pulmonary disease (COPD) (HR 1.28, 95%CI 1.02–1.62), gastrointestinal disorder (HR 1.37, 95%CI 1.21–1.55), and renal dysfunction (HR 1.24, 95%CI 1.09–1.42) had higher risks of hospitalization. Conclusions More than one-third of AF patients included in this study were hospitalized at least once during over 3-year follow-up. The main cause for hospitalization among the elderly patients (≥ 65 years) is non-cardiovascular diseases rather than AF. Multidisciplinary management of comorbidities should be advocated to reduce hospitalization in AF patients older than 65 years old. Clinical Registryhttp://www.chictr.org.cn/showproj.aspx?proj=5831. Unique identifier: ChiCTR-OCH-13003729. The registration date is October 22, 2013.

scholarly journals Comparison of Sarcopenia with Modified Frailty Index as a Predictor of Adverse Outcomes in Critically Ill Elderly Patients

2021 ◽  
pp. 200-206
Author(s):  
Shrirang Bhurchandi ◽  
Sachin Agrawal ◽  
Sunil Kumar ◽  
Sourya Acharya
Keyword(s):  
Elderly Patients ◽  
Critically Ill ◽  
Health Care Cost ◽  
Frailty Index ◽  
The Elderly ◽  
Time Frame ◽  
Adverse Outcomes ◽  
Cross Sectional ◽  
Parametric Data ◽  
Modified Frailty Index

Background: Ageing is a global fact affecting both developed and developing countries.It brings out various catabolic changes in body resulting in frailty(i.e. the person is not able to with stand minor stresses of the environment, due to reduced reserves in psychologicalreserve of several organ system).Thus causing a great burden of disease, dependence & health care cost. Sarcopenia is the leading component for frailty in the elderly population, but very few studies have been done in India for correlating frailty with sarcopenia. Aim: To compare sarcopenia with modified frailty index (MFI) as a predictor of adverse outcomes in critically ill elderly patients. Methodology: Cross-sectional study will be performed on all the critically ill geriatric subjects/patients coming to all the ICU's of AVBRH, Sawangi (M), Wardha who will satisfy various inclusion and exclusion criteria for selection and all standard parametric & non-parametric data will be assessed by using standard descriptive & inferential statistics. Expected Results: In our study, we are anticipating that the Modified frailty index to be a better predictor of adverse outcomes in terms of mortality as compared to sarcopenia in the critically ill elderly patients. Also, we are anticipating that sarcopenia to be the most important contributor of frailty in critically ill elderly patients and the prevalence of frailty will be high in critically ill elderly patients. Limitation: Due to limited time frame & resources we will not be able to follow up the patients.

scholarly journals Sarcopenia, obesity, osteoporosis and old age

2021 ◽  
Vol 11 (4) ◽  
pp. 23-35
Author(s):  
S. V. Topolyanskaya
Keyword(s):  
Body Composition ◽  
The Elderly ◽  
Adverse Outcomes ◽  
Mineral Density ◽  
Term Care ◽  
Visceral Fat Accumulation ◽  
Age Related ◽  
Diagnostic Approaches

Modern concepts about body composition in the elderly are described in the review. Particular attention is paid to possible causes and pathogenetic aspects of sarcopenia, as well as modern diagnostic approaches to its recognition. The ageing process is inevitably combined with diverse changes in body composition. This age-related evolution can be described by three main processes: a decrease in the growth and mineral density of bone tissue (osteopenia and osteoporosis); progressive decrease in muscle mass; an increase in adipose tissue (sarcopenia and sarcopenic obesity) with its redistribution towards central and visceral fat accumulation. Sarcopenia and osteoporosis are considered the main geriatric syndromes. These pathological conditions contribute to a significant decrease in the quality of life in the elderly; create conditions for the loss of independence and require long-term care, increase the frequency of hospitalizations and ultimately result in adverse outcomes.

FC 117TIME TRENDS IN PROBABILITY OF STARTING HOME DIALYSIS OVER A 20 YEAR PERIOD: A DUTCH REGISTRY STUDY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Anna Bonenkamp ◽  
Tiny Hoekstra ◽  
Marc Hemmelder ◽  
Anita Van Eck van der Sluijs ◽  
Alferso C Abrahams ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
The Netherlands ◽  
Risk Model ◽  
The Elderly ◽  
Dialysis Patients ◽  
Dialysis Treatment ◽  
Home Dialysis ◽  
System Utilization ◽  
Number Of Patients ◽  
Kidney Transplantations

Abstract Background and Aims A growing number of patients suffers from End Stage Kidney Disease(ESKD), causing a logistical and economic burden to the healthcare system. Utilization of home dialysis is low in many countries worldwide, although home dialysis has several advantages including higher quality of life and possibly lower costs. The aim of this study is to explore time trends in the use of home dialysis in the Netherlands. Method Anonymized registry data from the Dutch Renal Registry (RENINE) were used for this study. All dialysis episodes of adult patients who started dialysis treatment between 1997 through 2016 in the Netherlands were included, including those who previously underwent kidney transplantation. Dialysis episodes shorter than 90 days were excluded. The probability of starting home dialysis between 1997 through 2016 was evaluated in time periods of 5 years, using logistic regression analysis. Home dialysis was defined as start with peritoneal dialysis or home haemodialysis, or transfer to either within 2 years after dialysis start. A logistic multilevel model was used to adjust for clustering at patient level. The cumulative incidence function of start of home dialysis in incident patients was estimated with a competing risk model with recovery of kidney function, kidney transplantations, and all-cause mortality as competing events. All analyses were stratified for age categories at dialysis start: 20-44 years, 45-64 years, 65-74 years and ≥75 years. Results A total of 33,340 dialysis episodes in 31,569 patients were evaluated. Between 1997 and 2016, mean age at start of dialysis treatment increased from 62.5±14.0 to 65.5±14.5 years in in-centre haemodialysis patients, whereas it increased from 51.9±15.1 to 62.5±14.6 years in home dialysis patients. In patients &lt; 65 years, the probability of starting home dialysis was significantly lower during each 5-year period compared to the previous period, and kidney transplantation occurred more often. In patients ≥ 65 years, incidence of home dialysis remained constant, whereas mortality decreased. Conclusion In patients &lt; 65 years, the overall probability of starting home dialysis declined consistently over the past 20 years. The age of home dialysis patients increased more rapidly than that of in-centre dialysis patients, implying that pre-dialysis education and organization of home dialysis must be adapted to the needs of the elderly patient. These developments have a significant impact on the organisation of home dialysis for patients with ESKD.

Future Ultrasound Biomarkers for Sarcopenia: Elastography, Contrast-Enhanced Ultrasound, and Speed of Sound Ultrasound Imaging

2020 ◽  
Vol 24 (02) ◽  
pp. 194-200 ◽  
Author(s):  
Slavcho Ivanoski ◽  
Violeta Vasilevska Nikodinovska
Keyword(s):  
Speed Of Sound ◽  
Elderly Population ◽  
The Elderly ◽  
Adverse Outcomes ◽  
Muscle Quality ◽  
Clinical Settings ◽  
Contrast Enhanced ◽  
The Future ◽  
Ultrasound Technology ◽  
Future Evaluation

AbstractSarcopenia is the advanced and generalized loss of muscle mass and strength among the elderly population and is a cause of adverse outcomes. Methods used for the diagnosis of sarcopenia are either unavailable or expensive in everyday clinical settings. Ultrasound presents an inexpensive, convenient, and available method that offers advantages for the evaluation of skeletal muscle. Muscle quality will probably be the most important factor in defining sarcopenia in the future. Different features of muscle quality, including muscle elasticity, microcirculation and muscle perfusion during rest and physical activity, and the content of intramuscular adipose tissue can be measured using emerging and promising ultrasound techniques such as elastography, contrast-enhanced imaging, and speed of sound ultrasound technology. This article reviews the recent evidence on the use of ultrasound techniques in the assessment of muscle quality and the possibilities for the future evaluation of sarcopenia.

scholarly journals Development and Validation of a Scale for Rating Motor Compensations Used for Reaching in Patients With Hemiparesis: The Reaching Performance Scale

2004 ◽  
Vol 84 (1) ◽  
pp. 8-22 ◽  
Author(s):  
Mindy F Levin ◽  
Johanne Desrosiers ◽  
Danielle Beauchemin ◽  
Nathalie Bergeron ◽  
Annie Rochette
Keyword(s):  
Upper Extremity ◽  
Performance Test ◽  
Movement Analysis ◽  
The Elderly ◽  
Movement Strategies ◽  
Individual Scale ◽  
Development And Validation ◽  
Interrater Reliability Coefficients ◽  
Performance Scale ◽  
Stroke Assessment

Abstract Background and Purpose. Recent movement analysis studies have described compensatory movement strategies used by people with hemiparesis secondary to stroke during reaching and grasping tasks. The purpose of this article is to describe the development of a new scale—the Reaching Performance Scale (RPS)—for assessing compensatory movements for upper-extremity reaching in people with hemiparesis secondary to stroke. Subjects. Twenty-eight individuals with hemiparesis, with a mean age of 54.9 years (SD=18.6), participated. Methods. The study design involved scale development with expert panels and criterion standards for validity. Participants were evaluated on the new scale as well as other clinical tests for validity. They were videotaped while performing reaching and grasping movements. Results. The RPS scores correlated with measurements of grip force and Chedoke-McMaster Stroke Assessment and Upper Extremity Performance Test for the Elderly (TEMPA) scores. The RPS discriminated patients with different impairment levels according to the Chedoke-McMaster Stroke Assessment. Preliminary intrarater and interrater reliability coefficients were acceptable for the whole scale. Mean kappa values on individual scale components for 3 raters represented a mean of 67% (SD=13.5%) agreement. Discussion and Conclusion. Although the RPS shows some types of validity, more rigorous tests of reliability are needed for meaningful conclusions. This study is a first step in validating the scale to assess efficacy of intervention for motor recovery of the arm.

Prescribing in the elderly

2016 ◽  
Vol 10 (2) ◽  
pp. 96-104
Author(s):  
Lucy Webber
Keyword(s):  
Functional Ability ◽  
Older Patients ◽  
Systematic Approach ◽  
Cumulative Effect ◽  
The Elderly ◽  
Adverse Outcomes ◽  
Healthcare Team ◽  
Ageing Population ◽  
Slow Disease Progression ◽  
Unique Challenge

Prescribing in the elderly is a unique challenge faced by every GP. As the ageing population grows, more patients are presenting to GPs with an array of co-morbidities. The cumulative effect of this growth in morbidity is an increase in the prescribing of multiple medications. Although the use of appropriate medication can improve functional ability, slow disease progression and improve symptoms; medication can also cause adverse outcomes. Older patients are at particularly high risk of adverse outcomes, necessitating a rational and systematic approach to prescribing in the elderly. This article focuses on the challenges and pitfalls of prescribing in the elderly, and the ways in which GPs and the wider primary healthcare team can improve their practices for this group of patients.

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