Statin therapy is associated with reduced mortality across all age groups of individuals with significant coronary disease mortality, including very elderly patients

2003 ◽  
Vol 12 (2) ◽  
pp. 39-40
Author(s):  
C.A. Maycock ◽  
J.B. Muhlestein ◽  
B.D. Horne
Keyword(s):  
Elderly Patients ◽  
Statin Therapy ◽  
Coronary Disease ◽  
Age Groups ◽  
Very Elderly ◽  
Disease Mortality

scholarly journals Statin therapy is associated with reduced mortality across all age groups of individuals with significant coronary disease, including very elderly patients

2002 ◽  
Vol 40 (10) ◽  
pp. 1777-1785 ◽  
Author(s):  
Chloe A Allen Maycock ◽  
Joseph B Muhlestein ◽  
Benjamin D Horne ◽  
John F Carlquist ◽  
Tami L Bair ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Statin Therapy ◽  
Coronary Disease ◽  
Age Groups ◽  
Very Elderly

Current Outcome of Esophagectomy in the Very Elderly: Experience of a German High-volume Center

2013 ◽  
Vol 79 (8) ◽  
pp. 754-763 ◽  
Author(s):  
Michael Schweigert ◽  
Norbert Solymosi ◽  
Attila Dubecz ◽  
Rudolf J. Stadlhuber ◽  
Dietmar Ofner ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Elderly Patients ◽  
Esophageal Carcinoma ◽  
Anastomotic Leakage ◽  
Surgical Complications ◽  
Operative Procedure ◽  
Fatal Outcome ◽  
Age Groups ◽  
Very Elderly ◽  
Tertiary Referral Hospital

Operative management of esophageal carcinoma in the very elderly is still controversially discussed. It is not yet decided whether the risk warrants the procedure. The aim of this study is to analyze the outcome of esophagectomy for esophageal cancer in the very elderly. Factors influencing the clinical course and determining the outcome are identified. A retrospective study 292 consecutive cases of esophagectomy for nonmetastatic esophageal cancer at a German tertiary referral hospital between 2004 and 2011 were reviewed. Two age groups (75 years or older and younger than 75 years) were formed. The mean age was 63 years. Altogether 45 patients were 75 years or older. There were no significant differences in American Society of Anesthesiologists score, operative procedure, or in the frequency of anastomotic leakage between the age groups. However, very elderly patients with anastomotic leak had an eight times higher risk for fatal outcome than the very elderly without leak (odds ratio [OR], 8.54; 95% confidence interval [CI], 1.0 to 112.18; P = 0.025). Moreover, the odds for postoperative death were five times higher in very elderly patients with leak than in younger patients sustaining anastomotic leakage (OR, 5.67; 95% CI, 0.67 to 73.83; P = 0.046). In general, the very elderly had a three times higher risk for a fatal outcome (OR, 3.30; 95% CI, 1.37 to 7.86; P = 0.008). In-hospital mortality of the very elderly was 11 out of 45 compared with 8 per cent (20 of 247) in the younger group. Fatal outcome was more often caused by medical (seven) than by surgical complications (four cases). The remaining 34 patients recovered well. Very elderly patients undergoing esophagectomy have no elevated risk for occurrence of surgical complications, whereas the mortality of these complications is much higher. Improved outcome is achievable by timely management of postoperative surgical as well as medical complications. Notwithstanding the increased mortality, esophagectomy should be considered in thoroughly selected very elderly patients with curable esophageal carcinoma.

Functional outcomes of inpatient rehabilitation in very elderly patients with stroke: differences across three age groups

2018 ◽  
Vol 25 (4) ◽  
pp. 269-275 ◽  
Author(s):  
Hitoshi Mutai ◽  
Tomomi Furukawa ◽  
Ayumi Wakabayashi ◽  
Akihito Suzuki ◽  
Tokiji Hanihara
Keyword(s):  
Elderly Patients ◽  
Functional Outcomes ◽  
Age Groups ◽  
Inpatient Rehabilitation ◽  
Very Elderly

scholarly journals Time trends in hospital admissions in very elderly patients (≥85 years-old) in Spain: data from the Spanish National Discharge Database (2000 - 2015)

2021 ◽  
Author(s):  
Sergio Palacios Fernández ◽  
Mario Salcedo ◽  
Gregorio Gonzalez-Alcaide ◽  
Jose-Manuel Ramos-Rincon
Keyword(s):  
Length Of Stay ◽  
Elderly Patients ◽  
Hospital Admissions ◽  
Age Groups ◽  
Chronic Obstructive ◽  
Percentage Increase ◽  
Very Elderly ◽  
Data Set ◽  
Obstructive Pulmonary Disease ◽  
Neck Fracture

Abstract Background The aging population is an increasing concern in Western hospital systems. The aim of this study was to describe the main characteristics and hospitalization patterns in very elderly inpatients (≥ 85 years) in Spain from 2000 to 2015.Methods Retrospective observational study analyzing data from the minimum basic data set, an administrative registry recording each hospital discharge in Spain since 1997. We collected administrative, economic and clinical data for all discharges between 2000 and 2015 in patients aged 85 years and older, reporting results in three age groups and four time periods to assess differences and compare trends.Results There were 4,387,326 admissions in very elderly patients in Spain from 2000 to 2015, representing 5.32% of total admissions in 2000–2003 and 10.42% in 2012–2015. The pace of growth was faster in older age groups, with an annual percentage increase of 6% in patients aged 85–89 years, 7.79% in those aged 90–94 years, and 8.06% in those aged 95 and older. The proportion of men also rose (37.3% to 39.7%, p<0.001), and they had a higher risk of hospitalization than women (385 discharges/1000 men versus 280 discharges/1000 women in 2012–2015).Mortality decreased from 14.64% in 2000–2003 to 13.83% in 2012–2015 (p<0.001), and mean length of stay from 9.98 days in 2000–2003 to 8.34 days in 2012–2015. Costs per hospital stay increased from 2000 to 2011, from EUR 4611 in 2000–2003 to EUR 5212 in 2008–2011, before dropping to EUR 4824 in 2012–2015. The 10 most frequent discharge diagnoses in the period 2000-2003 were: femoral neck fracture (8.07%), heart failure (7.84%), neoplasms (7.65%), ischemic encephalopathy (6.97%), pneumonia (6.36%), chronic obstructive pulmonary disease (4.23%), ischemic cardiomyopathy (4.2%), other respiratory diseases (3.87%), other alterations of urethra and the urinary tract (3.08%), and cholelithiasis (3.07%). Conclusions The very elderly population is growing in Spanish hospitals, and within this group, patients are getting older and more frequently male. M ean length of stay, cost of stay, and mortality are decreasing. Decompensation of chronic diseases, neoplasms and infections are the most common causes of admission.

scholarly journals Impact of comorbidities and delay in diagnosis in elderly patients with pulmonary hypertension

2018 ◽  
Vol 4 (4) ◽  
pp. 00100-2018 ◽  
Author(s):  
Marylise Ginoux ◽  
Ségolène Turquier ◽  
Nader Chebib ◽  
Jean-Charles Glerant ◽  
Julie Traclet ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Elderly Patients ◽  
Age Groups ◽  
Young Patients ◽  
Age At Diagnosis ◽  
Very Elderly ◽  
Patient Age ◽  
Delay In Diagnosis ◽  
Patient Âgé ◽  
Time To Diagnosis

Patient age at diagnosis of pulmonary hypertension is steadily increasing. The present study sought to analyse clinical characteristics, time to diagnosis and prognosis of pulmonary hypertension in elderly and very elderly patients.A study was conducted in a French regional referral centre for pulmonary hypertension. All consecutive patients diagnosed with pre-capillary pulmonary hypertension were included and categorised according to age: <65 years (“young”), 65–74 years (“elderly”) and ≥75 years (“very elderly”).Over a 4-year period, 248 patients were included: 101 (40.7%) were young, 82 (33.1%) were elderly and 65 (26.2%) were very elderly. The median age at diagnosis among the total population was 68 years. Compared with young patients, elderly and very elderly patients had a longer time to diagnosis (7±48, 9±21 and 16±32 months, respectively; p<0.001). Patients ≥75 years also more often had group 4 pulmonary hypertension. The median overall survival was 46±1.4 months, but was only 37±4.9 months in elderly patients and 28±4.7 months in very elderly patients. Survival from the first symptoms and survival adjusted to comorbidity was similar across age groups.Patient age should be taken into account when diagnosing pulmonary hypertension as it is associated with a specific clinical profile and a worse prognosis. The difference in prognosis is likely to be related to a delay in diagnosis and a greater number of comorbidities.

scholarly journals A prospective study of hepatic safety of statins used in very elderly patients

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Meizi Guo ◽  
Junli Zhao ◽  
Yingjiu Zhai ◽  
Panpan Zang ◽  
Qing Lv ◽  
...  
Keyword(s):  
Liver Disease ◽  
Hepatitis B ◽  
Elderly Patients ◽  
Prospective Study ◽  
Statin Therapy ◽  
Statin Treatment ◽  
Hepatitis B Infection ◽  
Very Elderly ◽  
Significant Difference ◽  
The Impact

Abstract Background Statins play an important role in the care of patients with cardiovascular disease and have a good safety record in clinical practice. Hepatotoxicity is a barrier that limits the ability of primary care physicians to prescribe statins for patients with elevated liver transaminase values and/or underlying liver disease. However, limited population-based data are available on the use of statin therapy and on the hepatotoxicity of statins in very elderly patients. This prospective study evaluated the liver enzyme elevation during statin therapy in very elderly patients (≥80 years old). Methods Patients with hypercholesterolemia (LDL-C levels ≥3.4 and < 5.7 mmol/L), atherosclerosis, coronary heart disease (CHD), or a CHD-risk equivalent were enrolled and received once-daily statin treatment. Multivariate logistic regression models were used to study the impact of age, gender, hepatitis B infection, fatty liver disease, biliary calculus, other chronic diseases, drug kinds, alcohol abuse, statin variety, and statin dose variables. Results A total of 515 consecutive patients ranging from 80 to 98 years old were included in the analysis. These patients were treated with simvastatin, fluvastatin, pravastatin, rosuvastatin, or atorvastatin. Twenty-four patients (4.7, 95% CI 2.7–6.6) showed an increase in their hepatic aminotransferase levels. No significant difference of hepatic aminotransferase elevation rates was observed in different statin treatment groups. The incidence of mild, moderate, and severe elevation of aminotransferase levels was 62.5% (15/24), 29.2% (7/24), and 8.3% (2/24), respectively. None of the patients developed hepatic failure. Nine patients with moderate or severe aminotransferase elevations discontinued therapy. The time of onset of hepatic aminotransferase elevation ranged from 2 weeks to 6 months after statin treatment. The onset of hepatic aminotransferase elevation was within 1 month for 70.8% of patients. The patients took 2 weeks to 3 months to recover their liver function after statin therapy cessation. Multivariate analysis identified chronic hepatitis B infection and alcohol consumption as independent factors associated with the hepatic response to statins: OR, 12.83; 95% CI (4.36–37.759) and OR, 2.736; 95% CI (1.373–5.454), respectively. Conclusion The prevalence of elevated transaminases was higher than published data in very elderly patients. Overall, statin treatment is safe for patients ≥80 years old.

Real-world effectiveness and the safety of anticoagulant treatment in elderly non-valvular atrial fibrillation in the ANAFIE registry, the largest real-world elderly AF registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Yamashita ◽  
H Inoue
Keyword(s):  
Elderly Patients ◽  
Major Bleeding ◽  
Real World ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Age Groups ◽  
Funding Source ◽  
Anticoagulant Treatment ◽  
Very Elderly ◽  
Private Company

Abstract Background The optimal anticoagulant regimen for elderly AF has not been well elucidated, because this population, especially the very elderly (≥85 years), have not been sufficiently represented in most randomized controlled clinical trials for stroke prevention in non-valvular AF (NVAF). Purpose The ANAFIE registry was designed to evaluate the real-world anticoagulant treatment status of elderly (≥75 years) NVAF patients including &gt;8,000 very elderly patients. In this main analysis of the ANAFIE, the incidence of stroke or systemic embolic events (stroke/SEE), and major bleeding were compared between warfarin (WF) and direct oral anticoagulants (DOACs). Methods A total of 33,018 NVAF patients aged ≥75 years was enrolled in the ANAFIE, and followed for 2 years. The incidence of stroke/SEE and major bleeding by type of anticoagulants (WF and all DOACs) was estimated using Kaplan-Meier method. Hazard ratio (HR) and 95% confidence interval (95% CI) were calculated by Cox proportional hazard model. Results In the analysis set of 32,099 patients, the mean age was 81.5 years. 23,738 (74%) were &lt;85 years and 8,361 (26.0%) were ≥85 years. 92.5% of the whole population used anticoagulants including WF (27.6%) or DOACs (72.3%). The ratio of each DOAC was dabigatran 7.8%, rivaroxaban 21.5%, apixaban 26.9% and edoxaban 16.1%. Stroke/SEE and major bleeding was observed in 396 patients (1.24/100 patient-years [py]) and 279 patients (0.87/100py). The time in therapeutic range for patients &lt;85 years and ≥85 years in the WF group was 76.7% and 72.2%, respectively. The incidence of stroke/SEE was numerically lower in patients taking any DOAC vs. WF regardless of age group (&lt;85 years [HR 0.83] and ≥85 years [HR 0.71]). Major bleeding was also lower vs. WF in both age groups (&lt;85 years [HR 0.60] and ≥85 years [HR 0.65]). Conclusion In elderly NVAF patients enrolled in the ANAFIE registry, the incidence of stroke/SEE and major bleeding was lower in patients taking a DOAC compared with WF for all patients ≥75 years, even for very elderly patients. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Daiichi Sankyo Co., Ltd.

Impact of old and very old age on outcomes in patients with acute ischemic stroke undergoing endovascular therapy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Proietti ◽  
A.P Mascolo ◽  
F Maramma ◽  
D Morosetti ◽  
V Da Ros ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Elderly Patients ◽  
Acute Ischemic Stroke ◽  
Age Groups ◽  
Sensitivity Analyses ◽  
Composite Outcome ◽  
Very Elderly ◽  
Risk Of Death ◽  
Increased Risk

Abstract Background and purpose Only a restricted number of elderly patients has been included in the majority of recent endovascular stroke trials. We provided an analysis about differences in outcomes after mechanical thrombectomy (MT) according to age. Methods A retrospective analysis of an observational registry of patients with anterior large vessel acute ischemic stroke was performed. Main analysis was performed comparing patients &lt;80 vs. ≥80 years old. A sensitivity analysis was performed comparing 3 age groups: i) &lt;80 years; ii) 80–84 years; iii) ≥85 years. Outcomes were: i) any hemorrhagic infarction; ii) alive with disability; iii) death; iv) a composite outcome of alive with disability/death. Results 615 patients were identified. 227 (36.9%) patients were ≥80 years old, with 115 (18.5%) ≥85 years old. Elderly (≥80 years) patients showed a higher modified Rankin Scale (mRS) at discharge and 3-months follow-up (F=9.819, p=0.001) [Figure 1]. Comparing the three groups (&lt;80 years, 80–84 years, ≥85 years) a progressively higher mRS was found at discharge and 3 months follow-up (F=4.899, p=0.008). A progressively higher rate of death and composite outcome between the age groups was found, both in the main and sensitivity analyses. In the logistic regression analysis age ≥80 years was found associated with an increased risk of death (odds ratio [OR]: 2.25, 95% confidence interval [CI]: 1.27–4.00) and showed a trend in higher risk for composite outcome (OR: 1.61, 95% CI: 0.92–2.281). No difference was found between 80–84 years and &lt;80 years patients, while very elderly (≥85 years) had an increased risk of death (OR: 2.85, 95% CI: 1.60–5.10) and composite outcome (OR: 2.37, 95% CI: 1.30–4.33). Conclusions In our analysis elderly patients have an increased risk of death and composite outcome of disability and death. In particular, this risk appears to be significantly higher in very elderly patients (≥85 years old). Figure 1. mRS according to main analysis Funding Acknowledgement Type of funding source: None

scholarly journals Safety and Efficacy of Pancreaticoduodenectomy in Octogenarians

2021 ◽  
Vol 8 ◽  
Author(s):  
Yeqian Huang ◽  
Ramesh Damodaran Prabha ◽  
Terence C. Chua ◽  
Jennifer Arena ◽  
Krishna Kotecha ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Objective Assessment ◽  
Age Groups ◽  
Exclusion Criterion ◽  
Very Elderly ◽  
Major Morbidity ◽  
Safety And Efficacy ◽  
Specialized Unit ◽  
Overall Mortality ◽  
Two Age Groups

Backgrounds: Pancreaticoduodenectomy (PD) remains the only hope of a cure in selected patients with pancreatic adenocarcinoma (PAC). With an aging population, there will be an increasing number of very elderly patients being diagnosed with PAC of whom a selected proportion would be suitable for PD. However, the literature on outcomes of elderly patients after PD remains ambiguous. Therefore, the aim of this study was to examine the safety and efficacy of PD in octogenarians with PAC.Methods: A retrospective analysis of 304 patients with PAC undergoing PD. Patients were divided into two age groups using age of 80 years old as the cut-off.Results: Overall mortality and major morbidity rates were 0.5 and 18.5%, respectively. The octogenarian group had a higher rate of mortality (6.3%, n = 1, p &lt; 0.001), a higher rate of major morbidity (37.5%, n = 6, p = 0.042) and a longer hospital stay (p = 0.035). However, median survival of octogenarians was 15.6 months. Multivariate analysis showed age was not identified as a prognostic factor for major morbidity and overall survival.Conclusion: Age alone should not be an exclusion criterion for consideration of PD. With careful selection, PD can be safely performed in octogenarians. Elderly patients should be referred to a specialized unit for an objective assessment to determine the suitability for this aggressive but potential curative approach.

Sign in / Sign up

Export Citation Format

Share Document