The elderly emergency surgical patient: Risk factors that alter perioperative management

Introduction The average age of the surgical patient in the UK is increasing. Frailty and cognitive impairment have been shown to be important risk factors in elderly patients with surgical pathology. Limited work has previously assessed the outcomes of acute pancreatitis in the elderly population and the usefulness of current severity scoring methods. We aimed to assess the mortality rates in this cohort and identify any factors that may influence patient outcome. Methods All patients ≥ 80 years admitted with acute pancreatitis between 1 January 2014 and 31 May 2018 were retrospectively identified. Disease severity scores were measured by a modified Ranson score, and patients' co-morbidities were quantified with the Charlson Comorbidity Index. Primary endpoint was whether the patient was alive at discharge; multilevel logistic regression was used to identify any independent risk factors for patient outcomes. Results Eighty-seven patients were included, with an average age of 86 years. The most common aetiology was gallstones. Nine patients died during admission, and ITU admission was the only predictor of mortality (p = 0.027). Twenty-three patients had died by one year. Endoscopic retrograde cholangiopancreatography was more common in patients with gallstone disease who were alive at one year (p = 0.029). Discussion Risk severity and co-morbidity scores are not predictive of outcomes in elderly patients with acute pancreatitis. The use of endoscopic retrograde cholangiopancreatography should be considered in elderly patients with acute gallstone pancreatitis where suitable. Further work is needed to identify improved mortality prediction tools in the elderly with acute pancreatitis and optimal management strategies.

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788 Risk factors for rehospitalization in the elderly with chronic heart failure with preserved and impaired systolic function

European Journal of Heart Failure Supplements ◽

10.1016/s1567-4215(07)60509-8 ◽

2007 ◽

Vol 6 (1) ◽

pp. 180-180

Author(s):

S BOZINOVIC ◽

A GRDINIC ◽

D STAMENKOVIC ◽

M STOJADINOVIC ◽

I MARKOVIC ◽

...

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Chronic Heart Failure ◽

Systolic Function ◽

The Elderly

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Differences in physical function and metabolic syndrome risk factors according to the level of physical activity in elderly Korean men: a pilot study

10.31083/jomh.v17i1.200 ◽

2020 ◽

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Metabolic Syndrome ◽

Physical Function ◽

Vigorous Physical Activity ◽

Density Lipoprotein ◽

The Elderly ◽

Berg Balance Scale ◽

Lower Percentage ◽

Mineral Density

Background and objective: Managing the decrease in physical function in the elderly is a major task in aging societies globally. Here, we aimed to compare the physical function and metabolic syndrome (MetS) risk factors according to levels of physical activity (PA). Material and methods: We measured PA in 77 elderly Korean men (74.21 ± 6.26 years old) with an accelerometer and recorded body composition, physical function, and MetS-related risk factors. Participants were divided into three groups based on daily moderate-vigorous physical activity (MVPA): low (under 60 min), middle (60-120 min), and high (over 120 min). The groups were compared using a one-way analysis of variance and the Scheffe post hoc test. Odds ratios (OR) were calculated by logistic regression analysis. Results: Signiﬁcant differences were found between the groups for sedentary behavior time (P < 0.001), light PA (P < 0.05), moderate PA (P < 0.001), vigorous PA (P < 0.05), and total energy expenditure (P < 0.001). The high PA group showed a signiﬁcantly lower percentage of body fat and fat mass and higher muscle mass than did the low and middle PA groups (P < 0.05). The 6-min walk test was signiﬁcantly better in the high PA group than in the low and middle PA groups (P < 0.05). Grip strength and the Berg balance scale were also signiﬁcantly better in the high PA group (P < 0.05). Bone mineral density (BMD) and high-density lipoprotein cholesterol (HDL-C) were signiﬁcantly higher in the high PA group than in the low PA group (P < 0.05). Systolic blood pressure (SBP) was signiﬁcantly higher in the middle PA group than in the low PA group (P < 0.05). Participants with more than three MetS criteria showed an OR of 0.09 (95% conﬁdence interval 0.01-0.82) in the high PA group as compared with the low PA group (P < 0.05). Conclusions: Moderate-vigorous physical activity of more than 120 min daily showed better physical function and lower OR of MetS than did lower MVPA levels in elderly Korean men.

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