P4517Heart failure in elderly and very elderly hospitalized patients: an epidemiological analysis from the REPOSI registry

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Proietti ◽  
A M Marra ◽  
A Salzano ◽  
G F Romiti ◽  
P M Mannucci ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Elderly Patients ◽  
Hospital Admission ◽  
Functional Status ◽  
Rating Scale ◽  
Depression Scale ◽  
Hospitalized Patients ◽  
Clinical Factors ◽  
Very Elderly ◽  
Elderly Hospitalized Patients

Abstract Introduction Epidemiological data about heart failure (HF) in the elderly and, in particular, very elderly patients are lacking. Purpose To provide the epidemiological profile of elderly and very elderly HF patients in terms of prevalence, associated clinical factors, burden of multimorbidity and functional status. Methods Overall cohort of the REgistro POliterapie SIMI (REPOSI) was used to assess study aims. REPOSI is an Italian Nationwide Registry of elderly hospitalized patients in Internal Medicine and Geriatric wards. HF diagnosis was assessed at hospital admission according to ICD-9 code 428.XX. Results Among the 7003 patients originally enrolled, a total of 1095 (15.6%) patients reported a diagnosis of HF at hospital admission. Prevalence of HF progressively increased according to age strata, up to 26.8% in patients ≥90 [Figure]. A logistic regression analysis found that increasing age, body mass index and total cumulative illness rating scale (CIRS) were associated with HF (Table). Moreover, atrial fibrillation, chronic kidney disease, chronic obstructive pulmonary disease and polypharmacy (≥5 drugs) were associated with HF, while liver disease and neoplasm were inversely associated (Table). According to CIRS severity index and comorbidity index quartile, HF patients reported more likely values in the highest quartile than those without HF (47.4% vs. 26.6%, p<0.001 and 34.4% vs. 18.5%, p<0.001 respectively). According to short blessed test, geriatric depression scale and Barthel index, patients with HF had significantly more cognitive impairment and dementia, depression and dependent from others in daily activities than those without HF (all p<0.001). Prevalence of HF according to Age Strata Conclusions In a cohort of elderly patients hospitalized in Internal Medicine and Geriatric wards HF was highly prevalent, in particular in those very elderly. HF was associated with several clinical factors, emphasizing a stronger clinical complexity. HF patients were more burdened with multimorbidity and showed an impaired functional status. Acknowledgement/Funding None

scholarly journals Hyperglycemia at admission, comorbidities, and in-hospital mortality in elderly patients hospitalized in internal medicine wards: data from the RePoSI Registry

2021 ◽  
Author(s):  
Salvatore Corrao ◽  
Alessandro Nobili ◽  
Giuseppe Natoli ◽  
Pier Mannuccio Mannucci ◽  
Francesco Perticone ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Elderly Patients ◽  
Hospital Mortality ◽  
Barthel Index ◽  
Rating Scale ◽  
Depression Scale ◽  
Cognitive Status ◽  
Hospital Death ◽  
Glycemia Level ◽  
Male Sex

Abstract Aims The association between hyperglycemia at hospital admission and relevant short- and long-term outcomes in elderly population is known. We assessed the effects on mortality of hyperglycemia, disability, and multimorbidity at admission in internal medicine ward in patients aged ≥ 65 years. Methods Data were collected from an active register of 102 internal medicine and geriatric wards in Italy (RePoSi project). Patients were recruited during four index weeks of a year. Socio-demographic data, reason for hospitalization, diagnoses, treatment, severity and comorbidity indexes (Cumulative Illness rating Scale CIRS-SI and CIRS-CI), renal function, functional (Barthel Index), and cognitive status (Short Blessed Test) and mood disorders (Geriatric Depression Scale) were recorded. Mortality rates were assessed in hospital 3 and 12 months after discharge. Results Of the 4714 elderly patients hospitalized, 361 had a glycemia level ≥ 250 mg/dL at admission. Compared to subjects with lower glycemia level, patients with glycemia ≥ 250 mg/dL showed higher rates of male sex, smoke and class III obesity. These patients had a significantly lower Barthel Index (p = 0.0249), higher CIRS-SI and CIRS-CI scores (p = 0.0025 and p = 0.0013, respectively), and took more drugs. In-hospital mortality rate was 9.2% and 5.1% in subjects with glycemia ≥ 250 and < 250 mg/dL, respectively (p = 0.0010). Regression analysis showed a strong association between in-hospital death and glycemia ≥ 250 mg/dL (OR 2.07; [95% CI 1.34–3.19]), Barthel Index ≤ 40 (3.28[2.44–4.42]), CIRS-SI (1.87[1.27–2.77]), and male sex (1.54[1.16–2.03]). Conclusions The stronger predictors of in-hospital mortality for older patients admitted in general wards were glycemia level ≥ 250 mg/dL, Barthel Index ≤ 40, CIRS-SI, and male sex.

scholarly journals Informal Caregiving in Amyotrophic Lateral Sclerosis (ALS): A High Caregiver Burden and Drastic Consequences on Caregivers’ Lives

2021 ◽  
Vol 11 (6) ◽  
pp. 748
Author(s):  
Pavel Schischlevskij ◽  
Isabell Cordts ◽  
René Günther ◽  
Benjamin Stolte ◽  
Daniel Zeller ◽  
...  
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Functional Status ◽  
Disease Severity ◽  
Caregiver Burden ◽  
Rating Scale ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Daily Routine ◽  
Work Lives ◽  
Lateral Sclerosis

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease that causes progressive autonomy loss and need for care. This does not only affect patients themselves, but also the patients’ informal caregivers (CGs) in their health, personal and professional lives. The big efforts of this multi-center study were not only to evaluate the caregivers’ burden and to identify its predictors, but it also should provide a specific understanding of the needs of ALS patients’ CGs and fill the gap of knowledge on their personal and work lives. Using standardized questionnaires, primary data from patients and their main informal CGs (n = 249) were collected. Patients’ functional status and disease severity were evaluated using the Barthel Index, the revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R) and the King’s Stages for ALS. The caregivers’ burden was recorded by the Zarit Burden Interview (ZBI). Comorbid anxiety and depression of caregivers were assessed by the Hospital Anxiety and Depression Scale. Additionally, the EuroQol Five Dimension Five Level Scale evaluated their health-related quality of life. The caregivers’ burden was high (mean ZBI = 26/88, 0 = no burden, ≥24 = highly burdened) and correlated with patients’ functional status (rp = −0.555, p < 0.001, n = 242). It was influenced by the CGs’ own mental health issues due to caregiving (+11.36, 95% CI [6.84; 15.87], p < 0.001), patients’ wheelchair dependency (+9.30, 95% CI [5.94; 12.66], p < 0.001) and was interrelated with the CGs’ depression (rp = 0.627, p < 0.001, n = 234), anxiety (rp = 0.550, p < 0.001, n = 234), and poorer physical condition (rp = −0.362, p < 0.001, n = 237). Moreover, female CGs showed symptoms of anxiety more often, which also correlated with the patients’ impairment in daily routine (rs = −0.280, p < 0.001, n = 169). As increasing disease severity, along with decreasing autonomy, was the main predictor of caregiver burden and showed to create relevant (negative) implications on CGs’ lives, patient care and supportive therapies should address this issue. Moreover, in order to preserve the mental and physical health of the CGs, new concepts of care have to focus on both, on not only patients but also their CGs and gender-associated specific issues. As caregiving in ALS also significantly influences the socioeconomic status by restrictions in CGs’ work lives and income, and the main reported needs being lack of psychological support and a high bureaucracy, the situation of CGs needs more attention. Apart from their own multi-disciplinary medical and psychological care, more support in care and patient management issues is required.

Benefits of Cardiac Rehabilitation on Functional Status and Mood Disorders in Elderly and Very Elderly Patients

2021 ◽  
Vol 41 (2) ◽  
pp. 113-115
Author(s):  
Felipe Cañas ◽  
German C. Giraldo ◽  
Angela Murillo ◽  
Pablo E. Perafán ◽  
Orlando Quintero
Keyword(s):  
Elderly Patients ◽  
Cardiac Rehabilitation ◽  
Functional Status ◽  
Mood Disorders ◽  
Very Elderly

scholarly journals Baseline Functional Status and One-year Mortality After Hospital Admission in Elderly Patients: a prospective cohort study

2020 ◽  
Vol 77 (3) ◽  
pp. 143-148
Author(s):  
Victoria Sáenz ◽  
Nicolas Zuljevic ◽  
Cristina Elizondo ◽  
Iñaki Martin Lesende ◽  
Diego Caruso
Keyword(s):  
Cohort Study ◽  
Elderly Patients ◽  
Hospital Admission ◽  
Functional Status ◽  
Prospective Cohort ◽  
Functional Decline ◽  
Long Term Outcomes ◽  
One Year

Introduction: Hospitalization represents a major factor that may precipitate the loss of functional status and the cascade into dependence. The main objective of our study was to determine the effect of functional status measured before hospital admission on survival at one year after hospitalization in elderly patients. Methods: Prospective cohort study of adult patients (over 65 years of age) admitted to either the general ward or intensive Care units (ICU) of a tertiary teaching hospital in Buenos Aires, Argentina. Main exposure was the pre-admission functional status determined by means of the modified “VIDA” questionnaire, which evaluates the instrumental activities of daily living. We used a multivariate Cox proportional hazards model to estimate the effect of prior functional status on time to all-cause death while controlling for measured confounding. Secondarily, we analyzed the effect of post-discharge functional decline on long-term outcomes. Results: 297 patients were included in the present study. 12.8% died during hospitalization and 86 patients (33.2%) died within one year after hospital discharge. Functional status prior to hospital admission, measured by the VIDA questionnaire (e.g., one point increase), was associated with a lower hazard of all-cause mortality during follow-up (Hazard Ratio [HR]: 0.96; 95% Confidence Interval [CI]: 0.94–0.98). Finally, functional decline measured at 15 days after hospital discharge, was associated with higher risk of all-cause death during follow-up (HR: 2.19, 95% CI: 1.09–4.37) Conclusion: Pre-morbid functional status impacts long term outcomes after unplanned hospitalizations in elderly adults. Future studies should confirm these findings and evaluate the potential impact on clinical decision-making.

scholarly journals Demographic and clinical variables as differentiating predictors of cognitive disorders in Parkinson’s disease

2019 ◽  
Vol 22 (1) ◽  
Author(s):  
Núbia Isabela Macêdo Martins ◽  
Nadja Maria Jorge Asano ◽  
Carla Cabral dos Santos Accioly Lins ◽  
Maria das Graças Wanderley de Sales Coriolano
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Elderly Patients ◽  
Executive Functions ◽  
Rating Scale ◽  
Depression Scale ◽  
Cognitive Disorders ◽  
Work Activity ◽  
Clinical Variables

Abstract Objective: to analyze demographic and clinical variables as predictors of cognitive disorders in Parkinson’s disease (PD). Method: a cross-sectional descriptive study was carried out at the Pro-Parkinson Program of the Hospital das Clínicas of the Federal University of Pernambuco. The instruments used were the Mini Mental State Examination (MMSE), Scales for Outcomes in Parkinson’s disease - Cognition (SCOPA-COG), the Hoehn & Yahr Staging Scale (HY), the Unified Parkinson’s Disease Rating Scale part 3 (UPDRS-III), and the 15-item Yesavage Geriatric Depression Scale (GDS-15). A multiple linear regression model was used for the predictive outcome and the Mann-Whitney test was used to compare the elderly and the non-elderly groups. Results: the sociodemographic data of 85 people were collected and the participants underwent a cognitive profile evaluation (MMSE and SCOPA-COG) and clinical evaluation (HY, UPDRS-III, GDS-15). Multiple regression analysis found significant results for age, work activity, and tremor index, explaining 59% of the variability of SCOPA-COG. There was an inverse correlation with age and work activity and a direct correlation with tremors. The SCOPA-COG and MEEM scores were significantly lower in elderly patients, with an emphasis on executive functions. Conclusion: the predictors of cognitive impairment were age, work activity, and tremors. Cognitive impairment was greater in elderly patients with PD, especially for executive functions.

A Preliminary Study of the Effects of the Tilburg Frailty Indicator, Frailty Phenotype, and Silver Nanoparticle-Silver Needle Therapy in Senile Inpatients with Frailty

2020 ◽  
Vol 20 (10) ◽  
pp. 6518-6524
Author(s):  
Jun Xie ◽  
Qigui Yu ◽  
Linlin Yang ◽  
Yuanyuan Sun
Keyword(s):  
Elderly Patients ◽  
Silver Nanoparticle ◽  
Hospitalized Patients ◽  
Assessment Methods ◽  
Average Score ◽  
Frailty Phenotype ◽  
Tilburg Frailty Indicator ◽  
Frailty Indicator ◽  
Needle Acupuncture ◽  
Elderly Hospitalized Patients

This study aimed to determine the effects of Tilburg Frailty Indicator (TFI) and frailty phenotype (FP) in senile inpatients with frailty and provide a reference for the clinical evaluation of debilitating elderly patients. The effect of silver nanoparticle (AgNP)-silver needle acupuncture was also evaluated. Overall, 48 elderly inpatients with an average age of 69.5±6.2 years were included in the study. The results of two weakness assessment methods in screening the same elderly population were compared, and the correlation or consistency between the two methods was analyzed. A AgNPsilver needle was used for acupuncture treatment. The TFI score ranged from 0 to 12, with an average score of 4.0±0.7 (frailty [TFI>5] in 22 elderly patients [45.8%] and non-frailty in 26 patients [54.2%]). FP was presented in different stages, and the FP score ranged from 0 to 5, with an average score of 2.1±1.4, including non-frailty in 12 (25%) patients and pre-frailty in 19 (39.6%) patients. Moreover, 17 patients (35.4%) were debilitated. The two assessment methods showed that the degree of debilitation increased with advancing age in the elderly. The TFI score was positively associated with the defined stage of FP (r = 0.911, P <0.001). The consistency of TFI grading with phenotypic definition kappa value was 0.786 (P <0.001), and the area under the curve was 0.872 (95% confidence interval, 0.834–1.000; P <0.05). After acupuncture and moxibustion, the patient’s condition evidently improved. In this study, the proportion of non-debilitating elderly hospitalized patients was higher than that of debilitating elderly hospitalized patients, and the degree of debilitating increased with advancing age. The TFI score was positively associated with the stage of phenotypic definition, and TFI frailty assessment was highly sensitive. Both methods had screening value, but TFI was more effective in screening patients with pre-frailty than FP, resulting in the early intervention and treatment of debilitating elderly hospitalized patients. A silver needle acupuncture can be used for treating senile frailty, providing a new idea for the clinical treatment of frailty.

Relationship between NT-proBNP levels and serum lipid profile in very elderly hospitalized patients

2017 ◽  
Vol 263 ◽  
pp. e189
Author(s):  
Francesco Spannella ◽  
Federico Giulietti ◽  
Guido Cocci ◽  
Paolo Balietti ◽  
Marica Bordicchia ◽  
...  
Keyword(s):  
Lipid Profile ◽  
Serum Lipid ◽  
Hospitalized Patients ◽  
Serum Lipid Profile ◽  
Very Elderly ◽  
Elderly Hospitalized Patients

scholarly journals Clinical characterization and risk factors of Clostridium difficile infection in elderly patients in a Chinese hospital

2015 ◽  
Vol 9 (04) ◽  
pp. 381-387 ◽  
Author(s):  
Zhang Lihua ◽  
Dong Danfeng ◽  
Jiang Cen ◽  
Wang Xuefeng ◽  
Peng Yibing
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Elderly Patients ◽  
Clinical Features ◽  
Clostridium Difficile Infection ◽  
Gastrointestinal Disease ◽  
Statistical Tests ◽  
The Elderly ◽  
Hospitalized Patients ◽  
Elderly Hospitalized Patients

Introduction: Clostridium difficile is a common cause of nosocomial diarrhea, especially in elderly patients. This study aimed to analyze the clinical features and assess the risk factors associated with Clostridium difficile infection (CDI) in elderly hospitalized patients. Methodology: A retrospective case-control study was conducted among elderly hospitalized patients (> 60 years of age) in a Chinese tertiary hospital between 2010 and 2013. Fifty-two CDI patients and 150 randomly selected non-CDI patients were included in the study. Clinical features of CDI and non-CDI patients were compared by appropriate statistical tests. Logistic regression analyses were performed on a series of factors to determine the risk factors for CDI among the elderly hospitalized patients. Results: The elderly CDI patients showed higher leukocyte counts, lower serum albumin levels, longer duration of hospital stay, and higher mortality compared to the non-CDI patients. The proportion of patients admitted to the intensive care unit or exposed to gastric acid suppressants was also significantly different (p < 0.05) between the two groups. Multivariate analysis indicated that serum creatinine (OR 1.004; 95% CI 1.001–1.008), surgical intervention (OR 6.132; 95% CI 2.594–14.493), the number of comorbidities (OR 2.573; 95% CI 1.353–4.892), gastrointestinal disease (OR 4.670; 95% CI 2.002–10.895), and antibiotic use (OR 6.718; 95% CI 2.846–15.859) were independently associated with CDI. Conclusions: This study revealed several risk factors for CDI among elderly hospitalized patients. These findings will increase the knowledge concerning this disease and provide information regarding the control and prevention of CDI in the elderly.

A new formula for correction of total calcium level into ionized serum calcium values in very elderly hospitalized patients

2007 ◽  
Vol 45 (2) ◽  
pp. 151-157 ◽  
Author(s):  
Pierre Pfitzenmeyer ◽  
Isabelle Martin ◽  
Philippe d’Athis ◽  
Yolande Grumbach ◽  
Marie-Claude Delmestre ◽  
...  
Keyword(s):  
Serum Calcium ◽  
Calcium Level ◽  
Hospitalized Patients ◽  
Total Calcium ◽  
Very Elderly ◽  
New Formula ◽  
Elderly Hospitalized Patients

The role of continuity of systematic treatment and rehabilitation in patients with metastatic colorectal cancer in elderly and senile age.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16041-e16041
Author(s):  
Iuliia Vladimirovna Alekseeva ◽  
Tatiana Semiglazova ◽  
Elena Tkachenko ◽  
Boris Kasparov ◽  
Nadezhda Brish ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Elderly Patients ◽  
Metastatic Colorectal Cancer ◽  
Rating Scale ◽  
Elderly Person ◽  
Depression Scale ◽  
Mini Nutritional Assessment ◽  
Older Age ◽  
Medical Rehabilitation ◽  
Age Group

e16041 Background: The concomitant pathology, cancer and geriatric status affect the organism of a sick elderly person. In routine clinical practice elderly patients require comprehensive geriatric assessment (CGO). Despite many treatment strategies for elderly patients with metastatic colorectal cancer (mCRC), there are no use of rehabilitation programs and the assessment of their impact on the treatment tolerability and survival. Methods: The study includes patients with newly diagnosed mCRC stage IV, receiving the first line of chemotherapy (FOLFOX). Patients are given CGO before starting chemotherapy and in dynamics.The following scales are used for geriatric examination: Cumulative Illness Rating Scale for Geriatrics (CIRS-G); Activities of Daily Living (ADL); Daily instrumental activity scale (IADL); Mini nutritional assessment (MNA); Clock Drawing Test (CDT); Geriatric depression scale (GDS). Results: At the moment 29 patients are included in the study. According the results of CGO we determined that elderly and middle-aged patients are similar in cognitive, mental, and nutritional status, but they have statistically significant differences on the MMSE scale (P=0,014). In both groups patients have a decrease in IADL and cognitive functions, the presence of depression. Elderly patients (> 60 years old) are more likely to experience chronic pain (P<0.05) and increased blood pressure (P<0.05) (Table). Conclusions: The management tactics of patients with mCRC in elderly age shouldn't be based only on chronological age, ECOG or the Karnovsky index, that don't reflect functional disorders in patients of the older age group. It is necessary to define algorithms for medical rehabilitation in cancer patients of the older age group. A CGO is aimed at developing a medical rehabilitation plan together with an elderly patient and his environment, and an algorithm for supporting his health status during and after specialized treatment. [Table: see text]

Sign in / Sign up

Export Citation Format

Share Document