Acute ERCP in the elderly is an efficient procedure and carries a low risk for post-ERCP pancreatitis. A prospective registry based study from a single tertiary hospital

Pancreatology ◽  
2016 ◽  
Vol 16 (3) ◽  
pp. S110-S111
Author(s):  
Mika Ukkonen ◽  
Antti Siiki ◽  
Anne Antila ◽  
Tuula Tyrväinen ◽  
Juhani Sand ◽  
...  
Keyword(s):  
The Elderly ◽  
Tertiary Hospital ◽  
Low Risk ◽  
Efficient Procedure

scholarly journals Correlation Between Level of Depression and Risk of Suicide in Elderly at Purwodadi, Grobogan

2020 ◽  
Vol 1 (2) ◽  
pp. 27-31
Author(s):  
Rilla Fiftina Hadi ◽  
Titis Hadiati ◽  
Natalia Dewi Wardani
Keyword(s):  
Rating Scale ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Severe Depression ◽  
The Elderly ◽  
Low Risk ◽  
Cross Sectional ◽  
Severity Rating ◽  
Central Java ◽  
Cross Sectional Design

Abstract Background: According to WHO, the elderly people have physical and mental challenges, including depression. The incidence of depression lead to suicide on elderly is about 12.7%. In Grobogan Regency, Purwodadi, Central Java, there has been an increase of depression in the last 5 years. Purwodadi Subdistrict depends on the number of orders with the highest number of traffic cases and the elderly.Objective: To determine the correlation between depression level and the risk of suicide.Methods: This research is a quantitative study with cross sectional design in which all respondents were observed and variables were measured at one time. Samples were taken from elderly outpatient of primary health care and Posyandu lansia at Purwodadi, who met the inclusion and exclusion criterias. Research samples were selected based on nonprobability sampling method through purposive sampling. This research used the Indonesian version of the GDS (Geriatric Depression Scale) and CSSRS (Columbia Suicide Severity Rating Scale) questionnaire.Results: The prevalence of elderly depression is 63.3%, and a significant correlation was found between severe depression and low risk of suicide (p <0.05)Conclusion: significant correlation was found between severe depression and low risk of suicide

scholarly journals Moving From Heart Failure Guidelines to Clinical Practice: Gaps Contributing to Readmissions in Patients With Multiple Comorbidities and Older Age

2018 ◽  
Vol 12 ◽  
pp. 117954681880935 ◽  
Author(s):  
Pupalan Iyngkaran ◽  
Danny Liew ◽  
Christopher Neil ◽  
Andrea Driscoll ◽  
Thomas H Marwick ◽  
...  
Keyword(s):  
Heart Failure ◽  
New York ◽  
Congestive Heart Failure ◽  
Heart Association ◽  
Multidisciplinary Care ◽  
The Elderly ◽  
Tertiary Hospital ◽  
Chronic Obstructive ◽  
Common Denominator ◽  
Chronic Renal Impairment

This feature article for the thematic series on congestive heart failure (CHF) readmissions aims to outline important gaps in guidelines for patients with multiple comorbidities and the elderly. Congestive heart failure diagnosis manifests as a 3-phase journey between the hospital and community, during acute, chronic stable, and end-of-life (palliative) phases. This journey requires in variable intensities a combination of multidisciplinary care within tertiary hospital or ambulatory care from hospital outpatients or primary health services, within the general community. Management goals are uniform, ie, to achieve the lowest New York Heart Association class possible, with improvement in ejection fraction, by delivering gold standard therapies within a CHF program. Comorbidities are an important common denominator that influences outcomes. Comorbidities include diabetes mellitus, chronic obstructive airways disease, chronic renal impairment, hypertension, obesity, sleep apnea, and advancing age. Geriatric care includes the latter as well as syndromes such as frailty, falls, incontinence, and confusion. Many systems still fail to comprehensively achieve all aspects of such programs. This review explores these factors.

Risk stratifying chest pain patients in the emergency department using HEART, GRACE and TIMI scores, with a single contemporary troponin result, to predict major adverse cardiac events

2018 ◽  
Vol 35 (7) ◽  
pp. 420-427 ◽  
Author(s):  
Peter D W Reaney ◽  
Hamish I Elliott ◽  
Awsan Noman ◽  
Jamie G Cooper
Keyword(s):  
Chest Pain ◽  
High Sensitivity ◽  
Tertiary Hospital ◽  
Low Risk ◽  
Cardiac Events ◽  
Heart Score ◽  
Coronary Syndrome ◽  
C Statistic ◽  
Diagnostic Characteristics ◽  
Coronary Events

BackgroundThe majority of patients presenting to the ED with cardiac sounding chest pain have a non-diagnostic ECG and the problem of differentiating those suffering an acute coronary syndrome from those without is familiar to all ED clinical staff. To stratify risk in these patients, specific scores have been developed. Recent work has focused on incorporating newer high-sensitivity cardiac troponin (hs-cTn) assays; however, issues regarding performance and availability of these assays remain.AimProspectively compare HEART, Global Registry of Acute Coronary Events (GRACE) and Thrombolysis in Myocardial Infarction (TIMI) scores, using a single contemporary cTn at admission, to predict a major adverse cardiac event (MACE) at 30 days.MethodProspective observational cohort study performed in a UK tertiary hospital in patients with suspected cardiac chest pain and no significant ST elevation on initial ECG. Data collection took place 2 December 2014 to 8 February 2016. The treating clinician recorded risk score data real time and a single contemporary cTn taken at presentation was used in score calculation. The primary endpoint was 30-day MACE. C-statistic was determined for each score and diagnostic characteristics of high-risk and low-risk cut-offs were calculated.Results189/1000 patients in the study developed a 30-day MACE. The c-statistic of HEART for 30-day MACE (0.87 (95% CI 0.84 to 0.90)) was higher than TIMI (0.78 (95% CI 0.74 to 0.81)) and GRACE (0.74 (95% CI 0.70 to 0.78)).HEART score ≤3 identified low-risk patients with sensitivity 99.5% (95% CI 97.1% to 99.9%) and negative predictive value (NPV) 99.6% (95% CI 97.3% to 99.9%) exceeding TIMI 0 (sensitivity 97.4% (95% CI 93.9% to 99.1%) and NPV 97.8% (95% CI 94.8% to 99.1%)) and GRACE score 0–55 (sensitivity 95.2% (95% CI 91.1% to 97.8%) and NPV 95.8% (95% CI 92.2% to 97.7%)).ConclusionHEART outperformed both TIMI and GRACE in overall discriminative capacity for 30-day MACE. Using a single contemporary cTn at presentation, a HEART score of ≤3 demonstrated sensitivity and NPV of ≥99.5% for 30-day MACE. These results reach the threshold for a safe discharge strategy but should be interpreted thoughtfully in light of other work.

Minor head injury in the elderly at very low risk: a retrospective study of 6 years in an Emergency Department (ED)

2013 ◽  
Vol 31 (1) ◽  
pp. 37-41 ◽  
Author(s):  
Alessandro Riccardi ◽  
Flavio Frumento ◽  
Grazia Guiddo ◽  
Maria Beatrice Spinola ◽  
Luca Corti ◽  
...  
Keyword(s):  
Emergency Department ◽  
Retrospective Study ◽  
Head Injury ◽  
The Elderly ◽  
Low Risk ◽  
Minor Head Injury

scholarly journals Prevalence, Factors and Cost Comparison due to Potentially Inappropriate Medications (PIMs) of Elderly Outpatients in a State Hospital in Malaysia.

2021 ◽  
Vol 1 (1) ◽  
pp. 27-33
Author(s):  
Wei Chern Ang ◽  
Nur Syafiqah Zulkepli ◽  
Nur Safinaz Mukhtar ◽  
Nur Atikah Zulkefli
Keyword(s):  
The Elderly ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Cost Comparison ◽  
Potentially Inappropriate Medications ◽  
Cross Sectional ◽  
Prescription Cost ◽  
Factors Associated ◽  
Elderly Outpatients ◽  
Inappropriate Medications

Introduction: Malaysia will be a full aging nation by 2030. The elderly (aged >65 years old) population often has multiple comorbidities, which increases the risk of polypharmacy and potentially inappropriate medications (PIMs). This study aims to investigate the prevalence, factors associated with PIMs among elderly outpatients, and its burden of direct pharmacotherapy cost to the Ministry of Health Malaysia. Materials and method:  A cross-sectional study involving clinic prescriptions among the elderly with more than one-month prescribing duration received from a tertiary hospital specialist clinic pharmacy from March to April 2017. Patient identifiers were screened using the Pharmacy Information System (PhIS) by including prescriptions from other clinics while excluding multiple visits and duplicate prescriptions. Patients were categorised as PIM group and non-PIM groups using Beers Criteria 2015. Logistic regression analysis was conducted to examine the factors associated with PIMs. The median monthly prescription cost was compared between PIM and non-PIM groups by Mann-Whitney test. Results: Among 472 patients, 39.4% of patients had at least one PIM while 60.6% of patients did not receive any PIM. The number of medications prescribed was an independent risk factor contributing to PIMs (OR:2.04; 95% CI:1.40, 2.97). The median monthly prescription cost for the PIM group was MYR 29.50 (?USD 7.53) which was not statistically significant (p=0.735) compared with the non-PIM group which was MYR 28.50 (USD 7.28).  Conclusion: PIM was frequently prescribed in our setting with the number of medications as the only factor. However, the prescribing of PIM did not add nor reduce the direct cost of pharmacotherapy.

scholarly journals Accessibility of Elderly Citizens to Basic Facilities In Akure Metropolis in Nigeria

2020 ◽  
Vol 2 (2) ◽  
pp. 38-52
Author(s):  
Musilimu Adeyinka Adetunji
Keyword(s):  
Secondary Data ◽  
The Elderly ◽  
Tertiary Hospital ◽  
Long Distance ◽  
Health Care Centre ◽  
Transport Services ◽  
Basic Services ◽  
The Mean ◽  
Distance Travel ◽  
The City

This study examined the accessibility of elderly citizens to some basic services in Akure metropolis. This was carried out with a view to determine the patterns of distribution and accessibility of these services in the city. Primary and secondary data were employed for this study. Geographical Positioning System was used to capture the coordinates of important locations and of some basic facilities such as Public Tertiary Hospital, Primary Health care centre and banks in the city. Nearest Neighbour Analysis was used to calculate the mean distance travel to some basic services from 13 major localities in Akure metropolis. Descriptive and inferential statistics were employed to analyse the data. Finding reveals that some basic facilities are not evenly distributed across different localities in Akure. The mean distance travel to Public Tertiary Hospital is 3.36kms. The pattern of distribution of Public Tertiary Hospital is dispersed rather than random. More than 60% of the elderly rely on public transport services for their trip to access some basic facilities in the city. Traffic delay was ranked highest (66%) among the problems militating against the effective utilisation of urban facilities in Akure metropolis. The study recommends that more basic facilities should be provided in localities where such services are lacking. This would reduce long distance trip to these facilities in the city. The study concludes that better transport services should be made available at reasonable transport fares in order to promote accessibility of the elderly and other segments of the population to urban facilities in Akure and similar other cities in Nigeria.     

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