535 ELF 2: DEFINING THE DENOMINATOR ELF STUDY GROUP

2021 ◽  
Vol 50 (Supplement_2) ◽  
pp. ii1-ii4
Author(s):  
A Price ◽  
E Mclennan ◽  
J Boyle ◽  
Keyword(s):  
Decision Making ◽  
Data Collection ◽  
Older Adult ◽  
Adult Population ◽  
Emergency Laparotomy ◽  
Ageing Population ◽  
Prospective Data ◽  
Collaborative Project ◽  
Patient Will ◽  
Older Adult Population

Abstract Introduction The collaborative UK Emergency Laparotomy and Frailty (ELF) study was one of the first to investigate the older adult population undergoing emergency surgery. Despite accounting for almost half of emergency laparotomies and many considered high-risk, there remains a paucity of research in this population. One undefined area is the older patient who presents with acute abdominal pathology treatable by laparotomy but who do not undergo surgery. Aims The primary aim is to estimate the 90-day mortality in older patients presenting with acute abdominal pathology potentially treatable by emergency laparotomy who do not undergo surgery (NoLap). The secondary aims are characterisation of this group, including frailty and sarcopenia with comparison to those older adults that have undergone emergency laparotomy (NELA and ELLSA). In addition, the decision-making process will be explored. Method Multicentre prospective cohort study via established research collaboratives (Welsh Barbers, SSRG, OPSOC). ELF 2 requires at least 47 centres, recruiting 700 patients for 3 months prospective data collection via REDCap of NoLap patients with the same NELA inclusion/exclusion criteria. This data will be compared with a matched cohort from NELA and ELLSA. ELF2 data collection includes demographics, co-morbidities, frailty and sarcopenia. Each patient will be followed up for 90-day and 1-year mortality. Heuristics behind the decision will be analysed. Discussion This trainee led collaborative project aims to improve understanding of the older adult population being considered for emergency laparotomy. With the ageing population being the dominant health users of the future, defining the denominator is essential for shared decision-making.

scholarly journals EP.FRI.257 ELF 2: Defining the Denominator

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Elizabeth McLennan ◽  
Angeline Price ◽  
Jemma Boyle
Keyword(s):  
Decision Making ◽  
Data Collection ◽  
Older Adult ◽  
Adult Population ◽  
Emergency Laparotomy ◽  
Ageing Population ◽  
Prospective Data ◽  
Collaborative Project ◽  
Patient Will ◽  
Older Adult Population

Abstract Introduction The collaborative UK Emergency Laparotomy and Frailty (ELF) study was one of the first to investigate the older adult population undergoing emergency surgery. Despite accounting for almost half of emergency laparotomies and many considered high-risk, there remains a paucity of research in this population. One undefined area is the older patient who presents with acute abdominal pathology treatable by laparotomy but who do not undergo surgery. Aims The primary aim is to estimate the 90-day mortality in older patients presenting with acute abdominal pathology potentially treatable by emergency laparotomy who do not undergo surgery (NoLap). The secondary aims are the characterisation of this group, including frailty and sarcopenia with comparison to those older adults that have undergone emergency laparotomy (NELA and ELLSA). In addition, the decision-making process will be explored. Method Multicentre prospective cohort study via established research collaboratives (WelshBarbers, SSRG, OPSOC). ELF 2 requires at least 47 centres, recruiting 700 patients for 3months prospective data collection via REDCap of NoLap patients with the same NELA inclusion/exclusion criteria. This data will be compared with a matched cohort from NELA and ELLSA. ELF2 data collection includes demographics, co-morbidities, frailty and sarcopenia. Each patient will be followed up for 90-day and 1-year mortality. Heuristics behind the decision will be analysed. Discussion This trainee led collaborative project aims to improve understanding of the older adult population being considered for emergency laparotomy. With the ageing population being the dominant health users of the future, defining the denominator is essential for shared decision-making

Pressure injuries in the ageing population

2017 ◽  
pp. 401-408
Author(s):  
Cindy Kiely ◽  
Magdalena Pupiales
Keyword(s):  
Older Adult ◽  
Pressure Ulcers ◽  
Adult Population ◽  
Incidence Rates ◽  
Population Pressure ◽  
Ageing Population ◽  
Geriatric Population ◽  
Bony Prominence ◽  
Older Adult Population ◽  
The Impact

The prevalence of pressure ulcers has been reported to range from 4.1 to 32.2% in the older adult population. Pressure ulcers, also known as decubitus ulcers, bedsores, and pressure sores, are defined as localized injury to the skin and/or underlying structures, usually over a bony prominence as result of pressure or pressure in combination with shear. Within the geriatric population, prevalence and incidence rates tend to be high due to multifactorial risk factors such as comorbidities, changes in functional status, nutritional habits, medications affecting the skin, and physiological changes. The impact of pressure ulcers spans physical, emotional, social, and economic dimensions, and is of concern throughout the healthcare continuum. The aim of this chapter is to illustrate the aetiologic complexity of pressure ulcers in the geriatric population and summarize a comprehensive approach to prevention and management of pressure ulcers.

scholarly journals Hospital-induced Delirium among Medical Older Adults: Evaluating the Veracity of Prognostic Models

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1016-1017
Author(s):  
Urszula Snigurska ◽  
Ragnhildur Bjarnadottir ◽  
Robert Lucero
Keyword(s):  
Older Adults ◽  
Statistical Analysis ◽  
Data Collection ◽  
Older Adult ◽  
Systematic Reviews ◽  
Adult Population ◽  
Risk Of Bias ◽  
Prognostic Models ◽  
Qualitative Synthesis ◽  
Older Adult Population

Abstract Several prognostic models have been developed and validated for delirium prediction among older adults. However, model development and validation studies need to be evaluated for risk of bias to establish the veracity of the prognostic models. This is a critical step before they can be implemented in clinical practice. Multiple systematic reviews have evaluated prognostic models of hospital-induced delirium. However, none of the existing systematic reviews evaluated the validity of models for non-surgical, medical hospitalized older adults. We conducted a scoping review to evaluate the validity of existing prognostic models of hospital-induced delirium in medical older adults. CINAHL, PsycINFO, PubMed, and Web of Science were searched for original studies. The database search yielded 4,312 records. Five studies were included in the qualitative synthesis. All the studies claimed to have developed valid prognostic models. However, the risk of bias assessment revealed that existing prognostic models of hospital-induced delirium in medical older adults are at a high risk of bias. Collectively, the statistical analysis was the greatest source of bias. Notably, while we have seen a proliferation of prognostic models for use in the surgical older adult population, efforts at developing prognostic models in the medical older adult population seem to have declined since the early 1990s. Newer methods of data collection, such as data mining of electronic health records, and statistical analysis, such as machine learning, have shown promise in accurate prediction of hospital-induced delirium while overcoming many challenges associated with manual data collection and traditional statistical analyses.

Dental fear and anxiety in an older adult population

1991 ◽  
Vol 19 (2) ◽  
pp. 120-124 ◽  
Author(s):  
David Locker ◽  
Andree Liddell ◽  
David Burman
Keyword(s):  
Older Adult ◽  
Adult Population ◽  
Dental Fear ◽  
Fear And Anxiety ◽  
Older Adult Population

scholarly journals Why Are Native Hawaiians Underrepresented in Hawai‘i's Older Adult Population? Exploring Social and Behavioral Factors of Longevity

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Lana Sue Ka‘opua ◽  
Kathryn L. Braun ◽  
Colette V. Browne ◽  
Noreen Mokuau ◽  
Chai-Bin Park
Keyword(s):  
Older Adult ◽  
Native Hawaiian ◽  
Adult Population ◽  
Historical Trauma ◽  
Health Indicators ◽  
Native Hawaiians ◽  
Future Research ◽  
Behavioral Factors ◽  
Poverty Level ◽  
Older Adult Population

Native Hawaiians comprise 24.3% of Hawai‘i's population, but only 12.6% of the state's older adults. Few published studies have compared health indicators across ethnicities for the state's older adult population or focused on disparities of Native Hawaiian elders. The current study examines data from two state surveillance programs, with attention to cause of death and social-behavioral factors relevant to elders. Findings reveal that Native Hawaiians have the largest years of productive life lost and the lowest life expectancy, when compared to the state's other major ethnic groups. Heart disease and cancer are leading causes of premature mortality. Native Hawaiian elders are more likely to report behavioral health risks such as smoking and obesity, live within/below 100–199% of the poverty level, and find cost a barrier to seeking care. Indicated is the need for affordable care across the lifespan and health services continuum. Future research might explain behavioral factors as influenced by social determinants, including historical trauma on Native Hawaiian longevity.

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