P3766New-onset peri-operative atrial fibrillation is associated with increased mortality in patients undergoing total knee and hip replacements

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
B Varon ◽  
L Kandel ◽  
G Rivkin ◽  
D Leibowitz
Keyword(s):  
Atrial Fibrillation ◽  
Renal Failure ◽  
Chronic Renal Failure ◽  
Elderly Patients ◽  
P Value ◽  
Hip Replacements ◽  
Clinical Surveillance ◽  
Total Knee ◽  
One Year ◽  
New Onset

Abstract Background Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are common surgeries performed in elderly patients with osteoarthritis. Limited data address the clinical significance of peri-operative atrial fibrillation (AF) in these patients. Purpose This study aimed to determine whether pre-existing or new onset AF is associated with increased 1-year mortality rates. Methods 280 patients over the age of 60 undergoing THA or TKA with peri-operative AF and 280 control matched patients were retrospectively identified, and their files reviewed. The primary endpoint was 1-year mortality from the date of the surgery. Results Of the 280 patients with peri-operative AF, 37 had new onset AF with a 1-year mortality rate of 10.8%. This mortality was significantly higher in patients with new-onset AF compared to patients without AF or patients with previous AF (10.8%, vs. 1.1% and 2.5%, respectively; p=0.005). On multivariate analysis, this difference remained significant after adjustment for risk factors associated with mortality. Variables associated with mortality Characteristic P value Adjusted Odds Ratio 95% confidence interval When AF type is included:   Chronic renal failure 0.004 7.64 1.91–30.64   Timing of AF (New onset) 0.005 9.95 1.99–49.77 When AF timing is included:   Chronic renal failure 0.005 7.47 1.83–30.40   Timing of AF (post-op) 0.0.1 7.59 1.62–35.62 AF, atrial fibrillation. Conclusion One-year mortality in elderly patients undergoing TKA or THA is significantly increased in patients with new postoperative AF. These patients warrant increased clinical surveillance following surgery.

scholarly journals New-Onset Perioperative Atrial Fibrillation Is Associated with Increased All-Cause Mortality in Elderly Patients Undergoing Total Knee and Hip Replacements

Gerontology ◽  
2021 ◽  
pp. 1-6
Author(s):  
Ben Varon ◽  
Leonid Kandel ◽  
Gurion Rivkin ◽  
David Leibowitz
Keyword(s):  
Atrial Fibrillation ◽  
Elderly Patients ◽  
The Elderly ◽  
Limited Data ◽  
All Cause Mortality ◽  
Hip Replacements ◽  
Clinical Surveillance ◽  
Total Knee ◽  
One Year ◽  
New Onset

<b><i>Introduction:</i></b> Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are common surgeries performed in elderly patients with osteoarthritis. Limited data address the clinical significance of perioperative atrial fibrillation (AF) in these patients. This study aimed to determine whether preexisting or new-onset AF is associated with increased 1-year all-cause mortality rates in the elderly population. <b><i>Methods:</i></b> 280 patients over the age of 60 undergoing THA or TKA with perioperative AF and 280 control-matched patients were retrospectively identified, and their files reviewed. The primary end point was 1-year all-cause mortality from the date of the surgery. <b><i>Results:</i></b> Of the 280 patients with perioperative AF, 37 had new-onset AF with a 1-year all-cause mortality rate of 10.8%. This mortality was significantly higher in patients with new-onset AF compared to patients without AF or patients with previous AF (10.8% vs. 1.1% and 2.5%, respectively; <i>p</i> = 0.005). On multivariate analysis, this difference remained significant after adjustment for risk factors associated with all-cause mortality. <b><i>Conclusions:</i></b> One-year all-cause mortality in elderly patients undergoing TKA or THA is significantly increased in the patients that develop new postoperative AF. These patients warrant increased clinical surveillance following surgery.

scholarly journals Hubungan Frekuensi Hemodialisis dengan Tingkat Stres pada Pasien Gagal Ginjal Kronik yang Menjalani Hemodialisis

2018 ◽  
Vol 1 (2) ◽  
pp. 139-153
Author(s):  
Fitri Rahayu ◽  
Topan Fernandoz ◽  
Rafika Ramlis
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Study Design ◽  
Significant Relationship ◽  
P Value ◽  
Analytic Method ◽  
Stress Levels ◽  
Almost All ◽  
Moderate Stress

The aim of this study was to determine whether there is a relationship between hemodialysis frequency stress levels in patients with chronic renal failure undergoing hemodialysis  at hemodialysis installation  of dr. M. Yunus hospital Bengkulu City 2016. The study design used was a descriptive analytic method to explain each variable studied. The results showed that there was a significant relationship between the frequency of hemodialysis with the level of stress in patients with chronic renal failure, almost all respondents often undergo hemodialysis in hemodialysis installation in dr. M.Yunus hospital in Bengkulu city, of a total of 67 respondents almost half of respondents suffered moderate stress levels and no significant association between HD frequency with the stress levels of patients with CKD in Haemodialysis installation with p value 0.041 smaller than 0.05. The results of this study are expected to add insight and knowledge about the disease of CKD, and and is expected to continue this research in the context of a deeper and broader variables. Keywords: Frequency, Hemodialysis, Stress Levels.  

scholarly journals Current possibilities of improving the results of kidney transplantation in patients of the older age group, including those with an aggravated urological history

2021 ◽  
Vol 13 (2) ◽  
pp. 165-178
Author(s):  
B. Z. Khubutiya ◽  
O. N. Rzhevskaya ◽  
A. A. Lisenok
Keyword(s):  
Renal Failure ◽  
Kidney Transplantation ◽  
Chronic Renal Failure ◽  
Elderly Patients ◽  
Kidney Transplant ◽  
Older Age ◽  
Long Term Results ◽  
Kidney Graft ◽  
Age Group ◽  
The World

Introduction. All over the world and in Russia, the number of patients requiring dialysis therapy and kidney transplantation for chronic renal failure in the end-stage of the renal disease is increasing. In many countries of the world, the number of dialysis patients over 60 years of age accounts for 30 to 45% of all patients with chronic renal failure. Meantime, taking into account the improved methods for early diagnosis of chronic renal failure and the treatment methods for chronic kidney disease, including the renal replacement therapy, we can expect an increase in the number of elderly potential kidney transplant recipients. The likelihood of receiving a renal graft in elderly patients is significantly lower than in young recipients. Elderly patients are known to have a higher risk of death while waiting for a kidney transplant due to higher morbidity and lethality on dialysis. For this reason, the urgency of increasing the availability of kidney transplantation in elderly patients is growing over time. One of the solutions can be the use of kidneys from suboptimal donors with a far from ideal graft quality, but which could meet the needs for transplant care of the older age group of patients. The older age of a recipient entails a certain risk of developing a graft dysfunction due to the presence of concomitant diseases, and the potential risk increases even more with kidney transplants from expanded criteria donors. If a reduced functional reserve of kidneys removed from donors with extended criteria is identified, two-kidney transplantation is possible, which provides fairly good long-term results. To reduce the risk of a kidney graft loss, a careful selection of recipients is necessary, taking into account their co-morbidities, including the presence of urological diseases that impair the function of the upper and lower urinary tract. Their timely identification and correction makes it possible to raise the availability of kidney transplantation for elderly patients and improve its results. This review presents the results of the studies conducted in various world transplant centers, covers the mortality rates, kidney graft and recipient survival rates.The study purpose was to summarize the actual data and the results of the study on kidney transplantation in elderly patients with urological pathology.

scholarly journals Prognostic value of biomarkers and co-morbidities in patients with acute heart failure: One-year follow-up study

2017 ◽  
Vol 145 (3-4) ◽  
pp. 118-123
Author(s):  
Dejan Petrovic ◽  
Marina Deljanin-Ilic ◽  
Sanja Stojanovic
Keyword(s):  
Heart Failure ◽  
Renal Failure ◽  
Chronic Renal Failure ◽  
Acute Heart Failure ◽  
Troponin I ◽  
Prognostic Significance ◽  
Systolic Pressure ◽  
High Sensitivity ◽  
Clinical Group ◽  
One Year

Introduction/Objective. Clinical risk stratification of patients hospitalized due to acute heart failure (AHF) applying B-type natriuretic peptide (BNP), troponin I (TnI), and high-sensitivity C-reactive protein (hsCRP) biochemical markers can contribute to early diagnosis of AHF and lower mortality rates. The aim of this study was to investigate the prognostic significance of biomarkers (BNP, TnI, and hsCRP) and co-morbidities concerning one-year mortality in patients with AHF. Methods. Clinical group comprised 124 consecutive unselected patients, age 60?80 years, treated at the Coronary Care Unit of the Niska Banja Institute, Nis. The patients were monitored for one year after the discharge. During the first 24 hours after admission, BNP, TnI, and hsCRP were measured in fasting serum. Results. Total one-year mortality was 29.8%. The levels of serum BNP were significantly higher in the group of non-survivors compared to the group of survivors (1353.8 ?} 507.8 vs. 718.4 ?} 387.6 pg/mL, p < 0.001). We identified several clinical and biochemical prognostic risk factors by univariate and multivariate analysis. Independent predictors of one-year mortality were the following: BNP, TnI, depression, hypotension, chronic renal failure, ejection fraction, and right-ventricle systolic pressure. Conclusion. The presence of BNP and TnI biomarkers and several co-morbidities such as depression or chronic renal failure have significant influence on one-year mortality in patients with AHF.

scholarly journals Coping Mechanisms and Stress Adaptation in Chronic Kidney Failure Patients Underwent Hemodialysis Therapy in RSUD Waled Kabupaten Cirebon

2020 ◽  
Vol 7 (2) ◽  
pp. 27-31
Author(s):  
Bambang Adi Purnomo ◽  
Yani Kamasturyani ◽  
Cecep Wahyudin
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Kidney Failure ◽  
Chronic Kidney Failure ◽  
Coping Mechanisms ◽  
Rank Test ◽  
Stress Adaptation ◽  
P Value ◽  
Cross Sectional ◽  
Spearman Rank

Chronic renal failure is a disease that results in a progressive and gradual decline in renal function that requires hemodialysis therapy. In Indonesia, there were 198,575 patients chronic kidney failure in 2018. The number of undergoing hemodialysis therapy is 132,142 patients. The hemodialysis routine causes tension, anxiety, stress and depression in patient. The purpose of this study was to determine the relationship between coping mechanisms and stress adaptation in chronic renal failure patients undergoing hemodialysis therapy ant Waled Hospital. The method of this research was descriptive correlational with a cross sectional approach. This research used purposive sampling technique amounted to 79 respondents. The instrument of this research was a questionnaire Jaloweic Coping Scale (JCS) and stress adaptation questionnaire. Data analysis used the spearman rank test. Place of research at Waled Hospital, Cirebon Regency during July 2020.  The result showed that most respondents had an adaptive category as many as 55 adaptation showed the results of most respondents had an adaptive category as many as 55 respondents with a percentage (69.6%). The spearman rank test showed p value <α and r<1, which means that there was a moderate an positive relationship between coping mechanisms and stress adaptation (p value=0,000 < α=0.05 and r=0.593). The is a relationship between coping mechanisms and stress adaptation in chronic renal failure patients undergoing hemodialysis therapy. The better coping mechanism is carries out, the adaptive stress that arises will be adaptive so that the patient can adjust and be able to cope with the stress he is experiencing.

scholarly journals Variable use of amiodarone is associated with a greater risk of recurrence of atrial fibrillation in the critically ill

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
N A Fahmy ◽  
S M Alfawal ◽  
H S Abdelsamie ◽  
A M Hassan
Keyword(s):  
Atrial Fibrillation ◽  
Prospective Observational Study ◽  
P Value ◽  
Loading Dose ◽  
Inclusion Criteria ◽  
Reactive Protein ◽  
Group A ◽  
Group B ◽  
Af Recurrence ◽  
New Onset

Abstract Background Atrial fibrillation (AF) is the most common sustained arrhythmia affecting humans. It is an electrical disturbance that leads to rapid, disorganized, and asynchronous contraction of the atrial muscle. In clinical practice, it accounts for approximately one-third of hospitalizations for cardiac rhythm disturbances. The incidence of AF increases from less than 0.1% per year in those under 40 years old to exceed 1.5% per year in women and 2% per year in men older than 80 years. Aim of the Work: to discuss the effect of variation in amiodarone use (including dosage and duration) on dysrhythmia recurrence in patients with new-onset AF in ICU. Patients and Methods This was a prospective observational study conducted over 6 months, 60 patients who fulfilled inclusion criteria were included in the study divided in two groups according to amiodarone dosage, each group is 30 patients: Group (A): received a loading dose of amiodarone followed by an infusion (1200mg amiodarone). Group (B): received a loading dose of amiodarone not followed by an infusion (300mg amiodarone). Results a significant positive correlation was observed between level of C-reactive protein (CRP) and the rate of AF recurrence. As regard effect of CRP on AF recurrence; in AF recurrent patients, mean is (191±77.3) with range from 15 to 352 which significantly differed from Non-recurrent AF patients, mean is (89±63) with range from 20 to 223 (p value &lt;0.001). AF recurrence was higher in group (B) than group (A),. In group (A) 8 patients had recurrent AF representing 26.7 % and in group (B) 19 patients had AF recurrence representing 63.3% (p value =0.004). Conclusion Patients with new-onset AF in (ICU) who are treated with amiodarone should receive a loading dose, immediately followed by an infusion.

Perioperative atrial fibrillation is associated with increased one-year mortality in elderly patients after repair of hip fracture

2017 ◽  
Vol 227 ◽  
pp. 58-60 ◽  
Author(s):  
David Leibowitz ◽  
Chen Abitbol ◽  
Ronny Alcalai ◽  
Gurion Rivkin ◽  
Leonid Kandel
Keyword(s):  
Atrial Fibrillation ◽  
Hip Fracture ◽  
Elderly Patients ◽  
One Year

scholarly journals THE RELATIONSHIP OF FAMILY SUPPORT REGARDING THE PATIENTS WITH CHRONIC KIDNEY FAILURE WHO HAVE HEMODIALIZED THERAPY TREATMENT IN PMI HOSPITAL BOGOR

2020 ◽  
Vol 10 (2) ◽  
pp. 80-88
Author(s):  
Sara Sara Tania Aprianty ◽  
Hani Siti Hanifatun Fajria
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Family Support ◽  
Patient Compliance ◽  
Kidney Failure ◽  
Statistical Test ◽  
Bivariate Analysis ◽  
P Value ◽  
Chi Square ◽  
Number Of Patients

Chronic Renal Failure (CRF) is a disease that has occurred after various diseases that damage the kidney nephrons period up to the point the two are not capable of functioning regulatory and ekstetoriknya to maintain homeostasis. Number of patients with kidney failure in Indonesia is estimated to reach 300.000 people. As many as 12.804 patients with renal failure undergoing hemodialysis. To determine correlation family support patient compliance with chronic renal failure undergo hemodialysis therapy in RS PMI Bogor. This type of research is descriptive quantitative analytical research with cross sectional design. How sampling in this study with purposive sampling with a sample of 152 respondents. The instrument used is questionnaire while data analysis techniques using univariate and bivariate analysis using statistical test Chi-Square. Of the 152 respondents with a family to support as many as 139 respondents (91.4%), adherent patients as many as 128 respondents (84.2%) and family support with adherent patients as many as 121 respondents (79.6%). Statistical test results using Chi-square test p value value 0,007 (p <0.05) and the value of OR 5.762. The conclusion of this research that, There is a correlation between family support patient compliance with chronic renal failure through hemodialysis therapy in PMI Hospital Bogor, 2016. The researchers recommend that increased family support by distributing leaflets to the patients and families about the importance of family support for compliance patients undergo hemodialysis therapy.

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