scholarly journals Equity in Postoperative Outcomes in Geriatric Patients Requiring Non-elective Colectomy in a High-density, Multilingual Hospital Setting

2021 ◽  
Vol 233 (5) ◽  
pp. e29
Author(s):  
Julie Hong ◽  
Amory De Roulet ◽  
Steven Chao
Keyword(s):  
Geriatric Patients ◽  
Hospital Setting ◽  
High Density ◽  
Postoperative Outcomes ◽  
Elective Colectomy

Impact of Preoperative Nutritional Indicator on Poor Postoperative Outcomes in Geriatric Patients with Colorectal Cancer

2021 ◽  
pp. 1-9
Author(s):  
Tomoyuki Nagata ◽  
Yuki Adachi ◽  
Akihiro Taniguchi ◽  
Yu Kimura ◽  
Daisuke Iitaka ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Geriatric Patients ◽  
Postoperative Outcomes ◽  
Nutritional Indicator

Propensity Score–matched Comparison of Postoperative Adverse Outcomes between Geriatric Patients Given a General or a Neuraxial Anesthetic for Hip Surgery

2015 ◽  
Vol 123 (1) ◽  
pp. 136-147 ◽  
Author(s):  
Chin-Chen Chu ◽  
Shih-Feng Weng ◽  
Kuan-Ting Chen ◽  
Chih-Chiang Chien ◽  
Ja-Ping Shieh ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Geriatric Patients ◽  
Propensity Scores ◽  
Conditional Logistic Regression ◽  
Adverse Outcomes ◽  
Postoperative Outcomes ◽  
Hip Surgery ◽  
General Anesthetic ◽  
Hospital Outcomes ◽  
Hospital Stays

Abstract Background: The effects of the mode of anesthesia on major adverse postoperative outcomes in geriatric patients are still inconclusive. The authors hypothesized that a neuraxial anesthetic (NA) rather than a general anesthetic (GA) would yield better in-hospital postoperative outcomes for geriatric patients undergoing hip surgery. Methods: The authors used data from Taiwan’s 1997–2011 in-patient claims database to evaluate the effect of anesthesia on in-hospital outcomes. The endpoints were mortality, stroke, transient ischemic stroke, myocardial infarction, respiratory failure, and renal failure. Of the 182,307 geriatric patients who had hip surgery, a GA was given to 53,425 (29.30%) and an NA to 128,882 (70.70%). To adjust for baseline differences and selection bias, patients were matched on propensity scores, which left 52,044 GA and 52,044 NA patients. Results: GA-group patients had a greater percentage and higher odds of adverse in-hospital outcomes than did NA-group patients: death (2.62 vs. 2.13%; odds ratio [OR], 1.24; 95% CI, 1.15 to 1.35; P < 0.001), stroke (1.61 vs. 1.38%; OR, 1.18, 95% CI, 1.07 to 1.31; P = 0.001), respiratory failure (1.67 vs. 0.63%; OR, 2.71; 95% CI, 2.38 to 3.01; P < 0.001), and intensive care unit admission (11.03 vs. 6.16%; OR, 1.95; 95% CI, 1.87 to 2.05; P < 0.001), analyzed using conditional logistic regression. Moreover, patients given a GA had longer hospital stays (10.77 ± 8.23 vs. 10.44 ± 6.67 days; 95% CI, 0.22 to 0.40; P < 0.001) and higher costs (New Taiwan Dollars [NT$] 86,606 ± NT$74,162 vs. NT$74,494 ± NT$45,264; 95% CI, 11,366 to 12,859; P < 0.001). Conclusion: For geriatric patients undergoing hip surgery, NA was associated with fewer odds of adverse outcomes than GA.

scholarly journals Is Laparoscopic Adrenalectomy for Pheochromocytoma a Safe and Effective Surgery in Geriatric Patients?

2021 ◽  
Author(s):  
Kadir Gunseren ◽  
Mehmet Çağatay Çiçek ◽  
Deniz Bolat ◽  
Sezgin Yeni ◽  
Hakan Vuruskan ◽  
...  
Keyword(s):  
Patient Population ◽  
Laparoscopic Adrenalectomy ◽  
Geriatric Patients ◽  
The Elderly ◽  
Postoperative Outcomes ◽  
World Health ◽  
Perioperative Outcomes ◽  
Histopathological Diagnosis ◽  
Single Side ◽  
Haemodynamic Changes

Objectives: In this study, we aimed to evaluate the haemodynamic changes of laparoscopic adrenalectomy (LA) in geriatric patients with pheochromocytoma (PHEO). To the best of our knowledge, it is the first study evaluating the haemodynamic outcomes of pure LA in this patient population. Methods: Between 2000-2020, data of 350 patients who underwent single-side transperitoneal LA were reviewed retrospectively. Patients with a histopathological diagnosis of PHEO were enrolled and classified into two groups according to their ages at the date of surgery. Older than 65 years were accepted as elderly according to the World Health Organisation recommendations. Results: Overall 54 patients underwent single side LA for PHEO. Fifteen patients were enrolled in the elderly group and 39 in the young group. There were no significant differences regarding the operation site (0.564) and tumour size (0.878). There were no statistically significant differences in terms of perioperative outcomes, such as mean anaesthesia and operation times, blood loss and haemodynamic changes. Regarding postoperative outcomes; there were no statistically significant differences in mean hospitalization and intensive care unit times. In 1 patient in each grade-1 (prolonged ileus, managed with medical treatment) and grade 2 complication (transfusion during surgery) observed in the elderly and young groups, respectively (p=0.498). Conclusion: Laparoscopic adrenalectomy in elderly patients with PHEO is as safe and effective as in younger patients. One of the most important conditions for achieving good perioperative and postoperative outcomes in the elderly patient population with this challenging surgery is the multidisciplinary approach.

Specific Factors Predict the Risk for Urgent and Emergent Colectomy in Patients Undergoing Surgery for Diverticulitis

2018 ◽  
Vol 84 (11) ◽  
pp. 1781-1786 ◽  
Author(s):  
Neda Valizadeh ◽  
Kunal Suradkar ◽  
Ravi P. Kiran
Keyword(s):  
Elective Surgery ◽  
Multivariable Analysis ◽  
Postoperative Outcomes ◽  
Functional Health ◽  
Smoking History ◽  
Comorbid Conditions ◽  
Steroid Use ◽  
Urgent Surgery ◽  
Elective Colectomy ◽  
Surgery Mortality

The aim of this study was to identify preoperative characteristics that may determine the need for emergency surgery for diverticulitis and assess postoperative outcomes for these patients when compared with elective surgery. All patients included in the ACS-NSQIP–targeted colectomy database from 2012 to 2013 who underwent colectomy with an underlying diagnosis of diverticulitis were included. Preoperative characteristics and 30-day postoperative outcomes were evaluated for patients who underwent elective versus emergent/urgent surgery using univariable and multivariable analyses. Of 8708 patients with diverticular disease, 28.1 per cent underwent emergent/urgent colectomy. Patients who underwent emergent/urgent colectomy had greater preoperative steroid use, diabetes mellitus, disseminated cancer, chronic renal failure, hypertension, chronic heart failure, chronic liver disease, COPD, and dependent functional health status ( P < 0001). There were more patients with age >65 years ( P < 0001), smoking history ( P < 0.05), and BMI < 18.5 kg/m2 ( P < 0001) in the emergent/urgent colectomy group. After performing multivariable analysis, preoperative steroid use, weight loss >10 per cent, BMI < 18 kg/m2, smoking, age > 65, and comorbid conditions were associated with a higher rate of emergent/urgent surgery. Mortality (5.2% vs 0.2%) and infectious and noninfectious complications were higher after nonelective colectomy. Emergent/urgent colectomy was also associated with longer hospital stay and reoperation. Emergency and urgent colectomy for diverticulitis is associated with significantly worse outcomes than after elective surgery, and patients with comorbid conditions who develop attacks of diverticulitis may in fact be the population that might best benefit from a lower threshold for an elective colectomy.

Maximizing the Functional Status of Geriatric Patients in an Acute Community Hospital Setting

1989 ◽  
Vol 29 (4) ◽  
pp. 524-528 ◽  
Author(s):  
P. Meissner ◽  
K. Andolsek ◽  
P. A. Mears ◽  
B. Fletcher
Keyword(s):  
Functional Status ◽  
Geriatric Patients ◽  
Community Hospital ◽  
Hospital Setting

scholarly journals VALIDITY OF MALNUTRITION UNIVERSAL SCREENING TOOL (MUST) IN GERIATRIC PATIENTS: APPROPRIATE SCREENING TOOL IN HOSPITAL; MUST OR FULL-MNA?

2019 ◽  
pp. 1-6
Author(s):  
S. Hormozi ◽  
M. Alizadeh-Khoei ◽  
F. Sharifi ◽  
M. Chehrehgosha ◽  
R. Esmaeili ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Universal Screening ◽  
Geriatric Patients ◽  
Screening Tool ◽  
Hospital Setting ◽  
Cross Sectional Study ◽  
Anthropometric Measures ◽  
Cross Sectional ◽  
Hospitalized Elderly ◽  
Loss Of Appetite

Background: Since malnutrition of geriatric hospitalized patients has an impact on treatment and care management, the aim was to define the accuracy of Malnutrition Universal Screening Test (MUST) for malnutrition screening in the Iranian hospitalized elderly. Methods: In this cross-sectional study elderly 60 ≥ years (N= 192) were selected from two hospitals, anthropometric measures (BMI, MAC, and CC), laboratory test (Albumin), and nutrition tool (Full-MNA) applied and analyzed at P<0.05 level. Results: Elderly participants had a mean age of 68.86 ± 7.46 years and BMI 24.08± 4.64. Elderly patients (28%) lost their weight (>10%) in the last six months and loss of appetite observed in (33.4%) participants. In MUST tool rating, high-risk elderly patients for malnutrition were 33.3%. The AUC for MUST, according to Full-MNA was obtained 90.41%, with sensitivity 90.0% and specificity 73.25%. The MUST showed the strongest correlation with Full-MNA (r = -0.7) and BMI (r = - 0.51); but, the lowest correlation observed with Alb (r= -0.274). Most AUC was belonging to weight loss (0.96) and BMI (0.94). NConclusion: The MUST tool like full-MNA could diagnose malnutrition in geriatric patients in the hospital setting.

Sign in / Sign up

Export Citation Format

Share Document