Bipolar hemiarthroplasty in unstable intertrochanteric fractures in elderly patients. The predictive value of the Charlson Comorbidity Index in 1-year mortality

Background: The successful treatment of unstable intertrochanteric fractures of the femur in elderly patients is a challenge. Due to complications associated with internal fixation, primary hemiarthroplasty is increasingly becoming an alternative treatment to achieve early mobilisation. A transtrochanteric approach could potentially decrease the complications associated with primary hemiarthroplasty. Aim of the study is to document the postoperative outcome and complications associated with this treatment.Methods: In this retrospective study, all elderly patients with unstable trochanteric fractures, treated by primary hemiarthroplasty through a transtrochanteric approach, in a tertiary care centre, from September 2017 to December 2019, were enrolled. Their data from hospital records were analysed and results compared to literature.Results: 48 patients underwent the procedure. Average age was 85 years. One year mortality was 31.25%. Average duration of surgery is 85 min. 58.3% were ambulant at one year. One case of dislocation secondary to surgical site infection was present.Conclusions: Primary hemiarthroplasty as a primary treatment in this group of patients enables early mobilization and prevents complications associated with prolonged immobilization. Transtrochanteric approach reduces the duration of surgery. Achieving early ambulation is the key to successful treatment.

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Elderly Patients with Locally Advanced and Unresectable Non-Small-Cell Lung Cancer May Benefit from Sequential Chemoradiotherapy

Cancers ◽

10.3390/cancers13184534 ◽

2021 ◽

Vol 13 (18) ◽

pp. 4534

Author(s):

Magdalena Zaborowska-Szmit ◽

Marta Olszyna-Serementa ◽

Dariusz M. Kowalski ◽

Sebastian Szmit ◽

Maciej Krzakowski

Keyword(s):

Lung Cancer ◽

Weight Loss ◽

Elderly Patients ◽

Charlson Comorbidity Index ◽

Older Patients ◽

Locally Advanced ◽

Small Cell ◽

Small Cell Lung ◽

Stage Iiia ◽

Comorbidity Index

Concurrent chemoradiotherapy is recommended for locally advanced and unresectable non-small-cell lung cancer (NSCLC), but radiotherapy alone may be used in patients that are ineligible for combined-modality therapy due to poor performance status or comorbidities, which may concern elderly patients in particular. The best candidates for sequential chemoradiotherapy remain undefined. The purpose of the study was to determine the importance of a patients’ age during qualification for sequential chemoradiotherapy. The study enrolled 196 patients. Older patients (age > 65years) more often had above the median Charlson Comorbidity Index CCI > 4 (p < 0.01) and Simplified Charlson Comorbidity Index SCCI > 8 (p = 0.03), and less frequently the optimal Karnofsky Performance Score KPS = 100 (p < 0.01). There were no significant differences in histological diagnoses, frequency of stage IIIA/IIIB, weight loss, or severity of smoking between older and younger patients. Older patients experienced complete response more often (p = 0.01) and distant metastases less frequently (p = 0.03). Univariable analysis revealed as significant for overall survival: age > 65years (HR = 0.66; p = 0.02), stage IIIA (HR = 0.68; p = 0.01), weight loss > 10% (HR = 1.61; p = 0.04). Multivariable analysis confirmed age > 65years as a uniquely favorable prognostic factor (HR = 0.54; p < 0.01) independent of lung cancer disease characteristics, KPS = 100, CCI > 4, SCCI > 8. Sequential chemoradiotherapy may be considered as favorable in elderly populations.

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Comparison between the Results of Internal Fixation Using Proximal Femur Nail Anti-rotation and Bipolar Hemiarthroplasty in Treatment of Unstable Intertrochanteric Fractures of Elderly Patients

The Journal of the Korean Hip Society ◽

10.5371/jkhs.2012.24.1.45 ◽

2012 ◽

Vol 24 (1) ◽

pp. 45 ◽

Cited By ~ 3

Author(s):

Sung-Hwan Kim ◽

Soo-Won Lee ◽

Gyu-Min Kong ◽

Mid-Um JeaGal

Keyword(s):

Elderly Patients ◽

Internal Fixation ◽

Proximal Femur ◽

Bipolar Hemiarthroplasty ◽

Intertrochanteric Fractures ◽

Proximal Femur Nail

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Mid-term survivals of cemented calcar-replacement bipolar hemiarthroplasty for unstable intertrochanteric fractures in elderly patients

Injury ◽

10.1016/j.injury.2019.10.023 ◽

2019 ◽

Vol 50 (12) ◽

pp. 2277-2281

Author(s):

Adem Cobden ◽

Yalkin Camurcu ◽

Serda Duman ◽

Ahmet Kocabiyik ◽

Mehmet Kıs ◽

...

Keyword(s):

Elderly Patients ◽

Bipolar Hemiarthroplasty ◽

Intertrochanteric Fractures

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Surgery for elderly patients with resectable pancreatic cancer, a comparison with non-surgical treatments: a retrospective study outcomes of resectable pancreatic cancer

BMC Cancer ◽

10.1186/s12885-019-6255-3 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 3

Author(s):

Hyeong Min Park ◽

Sang-Jae Park ◽

Sung-Sik Han ◽

Seoung Hoon Kim

Keyword(s):

Pancreatic Cancer ◽

Overall Survival ◽

Retrospective Study ◽

Elderly Patients ◽

Surgical Resection ◽

Charlson Comorbidity Index ◽

Resectable Pancreatic Cancer ◽

Surgery Group ◽

Comorbidity Index ◽

High Charlson Comorbidity Index

Abstract Background We designed a retrospective study to compare prognostic outcomes based on whether or not surgical resection was performed in elderly patients aged(≥75 years) with resectable pancreatic cancer. Methods We retrospectively analyzed 49 patients with resectable pancreatic cancer (surgery group, resection was performed for 38 cases; no surgery group, resection was not performed for 11 cases) diagnosed from January 2003 to December 2014 at the National Cancer Center, Korea. Results There was no significant difference in demographics between the two groups. The surgery group showed significantly better overall survival after diagnosis than the no surgery group (2-year survival rate, 40.7% vs. 0%; log-rank test, p = 0.015). Multivariate analysis revealed that not having undergone surgical resection [hazard ratio (HR) 2.412, P = 0.022] and a high Charlson comorbidity index (HR 5.252, P = 0.014) were independent prognostic factors for poor overall survival in elderly patients with early stage pancreatic cancer. Conclusions In the present study, surgical resection resulted in better prognosis than non-surgical resection for elderly patients with resectable pancreatic cancer. Except for patients with a high Charlson comorbidity index, an aggressive surgical approach seems to be beneficial for elderly patients with resectable pancreatic cancer.

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