scholarly journals A240 HOME PARENTERAL NUTRITION IN OLDER VERSUS YOUNGER PATIENTS: CLINICAL CHARACTERISTICS AND OUTCOMES

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 295-296
Author(s):  
D Daoud ◽  
E M S Cartagena ◽  
N Somlaw ◽  
K Schwenger ◽  
L Gramlich ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parenteral Nutrition ◽  
Older Patients ◽  
Clinical Characteristics ◽  
Karnofsky Performance Status ◽  
Group Versus ◽  
Home Parenteral Nutrition ◽  
Younger Patients ◽  
Line Sepsis

Abstract Background There is a demographic shift toward older patients receiving home parenteral nutrition (HPN) but there is little data on their clinical characteristics and outcomes versus younger HPN patients. Aims The objective of this study was to determine if there are any differences between older (> 60 years) and younger (18–59 years) HPN patients in regard to HPN indications, prescriptions and outcomes over the first 2 years receiving HPN. Methods This was a retrospective analysis of prospectively collected data from HPN adult patients entered in the password protected web-based Canadian HPN Registry. New HPN patients enrolled between 2003 and 2017 and receiving HPN for 2 years were selected from 8 participating programs across Canada. Data included demographics, anthropometrics, PN prescriptions, line sepsis events, survival and quality of life based on the Karnofsky Performance Status (KPS). Results 402 patients met the inclusion criteria: 184 patients were 60 years old or above (older group) and 219 patients were between 18 and 59 years old (younger group). Around 64% of both groups were female. There were no significant differences in the main indications for HPN, body mass index (BMI), and PN prescriptions at baseline. At 2-years, younger patients received more calories from PN than older patients (27.88 vs 19.56 Kcal/kg respectively, p <0.001) but BMI remained comparable between groups. There were less line sepsis in the older group versus the younger group (20% vs 36%, p=0.0023) but 78% of younger patients remained alive versus 69 % in the older group (p=0.0401). In those alive, the proportion of patients remaining on HPN was comparable (older group: 77%; younger; group 81%, p=0.4709) and the proportion of patients with a reasonable quality of life (KPS > 60) was similar (older group: 58%; younger group: 63%, p=0.2156). Conclusions Older HPN patients have similar clinical characteristics as younger patients but with reduced line sepsis events and higher 2-year mortality. Funding Agencies Ontario Medical Supply, Takeda, Fresenius Kabi and Baxter Inc

Abstract 17469: Comparing the Effect of CRT Implantation on Quality of Life in Older Patients Compared With Younger Patients: Systematic Review and Meta-Analysis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Praveen Ponnamreddy ◽  
Saeed Juggan ◽  
Lauren Gilstrap
Keyword(s):  
Quality Of Life ◽  
Older Patients ◽  
Meta Analysis ◽  
Nyha Class ◽  
Age Group ◽  
Walk Test ◽  
Younger Patients ◽  
Six Minute Walk Test ◽  
Minute Walk

Background: CRT had been accepted as standard of care for patients with HFrEF who qualify for the therapy. The pivotal CRT trials enrolled patients significantly younger than the typical HFrEF patients seen in the community. Benefits of CRT in older HFrEF patients is largely unknown. We sought to evaluate the change in quality of life in older patients undergoing CRT in comparison to younger patients. Hypothesis: CRT implantation is associated with comparable improvements in quality of life in younger patients (age <70) and older patients (age 70 and above). Methods: PubMed, The Cochrane Library, Scopus, and Web of Science were queried for comparative effectiveness studies of CRT in older HFrEF patients. We gathered data for Quality of life measurements including improvement in NYHA class, MLHFQ, Six minute walk test. MLHFQ, Six minute walk test data was analyzed qualitatively as data was insufficient to impute Standard deviation for mean change. Changes in NYHA class was analyzed quantitatively. Random effects meta-analysis of improvement in NYHA class and relative risk (RR) is reported along with estimates of heterogeneity Results: Seven studies [n=2494 for younger group and n=1035 for older group] were included in changes in NYHA class meta-analysis. Older age group patients had similar improvement in NYHA class compared to younger age group patients. Relative risk 0.99 with 95%CI 0.93-1.06 (figure). Five studies reported Baseline and follow up MLHFQ scores for both the groups. All the five studies reported improvements in MLHFQ in both the groups. Three studies reported change in six minute walk test in meters before and after CRT implantation. All the studies reported improvement in six minute walk test both in younger and older group. Conclusions: People older than 70 years of age with heart failure with reduced ejection fraction who qualify for CRT derive similar benefits with improvement in quality of life compared to patients aged less than 70 years of age.

scholarly journals How good is quality-of-life for children receiving home parenteral nutrition? – A pilot study

2019 ◽  
Vol 29 ◽  
pp. 119-124 ◽  
Author(s):  
Léa Chantal Tran ◽  
Gill Lazonby ◽  
Remy Morello ◽  
Dominique Pham ◽  
Donna Ellis ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pilot Study ◽  
Parenteral Nutrition ◽  
Home Parenteral Nutrition

scholarly journals Older Patients Are Less Affected by Radiochemotherapeutic Treatment than Younger

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Max J. Weiling ◽  
Wencke Losensky ◽  
Katharina Wächter ◽  
Teresa Schilling ◽  
Fabian Frank ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Elderly Patients ◽  
Cancer Patients ◽  
Older Patients ◽  
Normative Data ◽  
Age Groups ◽  
German Population ◽  
Younger Patients ◽  
Significant Difference

Purpose. The general assumption is that cancer therapy impairs the quality of life in elderly patients more than in younger ones. We were interested in the effects of radiochemotherapeutic treatment on the quality of life of elderly patients compared to younger patients and compared to normative data of a general German population. Methods and Materials. A total of 465 patients completed the EORTC QLQ-C30 questionnaire. Repetitive completion of the questionnaire over time led to 1407 datasets. Our patient cohort contained 197 (42.4%) patients with colorectal cancer followed by 109 (23.4%) patients with head and neck cancer, 43 (9.2%) patients with lung cancer, and 116 (25%) with other types of cancer. Patients were categorized into five age groups, the respective cut-offs being 40, 50, 60, and 70 years. Normative data were drawn from a population study of a general German population. Results. Functional scores and symptom scores were approximately stable between the different age groups. Our data does not suggest a significant difference between the investigated age groups. Advancing age evened out the differences between the normative data of the general German population and the cancer patients in 11 of 15 scores. Conclusions. The general belief about younger patients having fewer physical and psychological problems related to radiochemotherapy needs to be reconsidered. Overall resilience of older patients is apparently underestimated.

An Exploration of Quality of Life and the Experience of Living With Home Parenteral Nutrition

2010 ◽  
Vol 34 (4) ◽  
pp. 395-407 ◽  
Author(s):  
Marion F. Winkler ◽  
Elizabeth Hagan ◽  
Terri Wetle ◽  
Carol Smith ◽  
Julie O’Sullivan Maillet ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parenteral Nutrition ◽  
Home Parenteral Nutrition

Comprehensive Assessment of the Elderly Cancer Patient: The Feasibility of Self-Report Methodology

2002 ◽  
Vol 20 (3) ◽  
pp. 770-775 ◽  
Author(s):  
Sally S. Ingram ◽  
Pearl H. Seo ◽  
Robert E. Martell ◽  
Elizabeth C. Clipp ◽  
Martha E. Doyle ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Cancer Patients ◽  
Daily Living ◽  
Older Patients ◽  
Age Groups ◽  
Well Being ◽  
Self Report ◽  
Younger Patients

PURPOSE: Comprehensive geriatric assessment (CGA) has aided the medical community greatly in understanding the quality-of-life issues and functional needs of older patients. With its professional team assessment approach, however, CGA may be time consuming and costly. The goal of the present study was to assess the ability of cancer patients to complete a self-administered CGA and then to characterize cancer patients across multiple domains and age groups. PATIENTS AND METHODS: Two hundred sixty-six male outpatient oncology patients at the Durham Veterans Affairs Medical Center were asked to fill out a survey assessing 10 domains (demographics, comorbid conditions, activities of daily living, functional status, pain, financial well being, social support, emotional state, spiritual well-being, and quality of life). RESULTS: Seventy-six percent of the patients who received their surveys and kept their appointments returned the assessment tool. Older oncology patients had significantly less education (P < .0001), income (P = .05), frequent exercise (P = .01), and chance of being disease free (P = .003) than younger patients. Other findings in older patients were a higher rate of marriage (P = .02), more difficulty in taking medications (P = .05), and less cigarette (P = .03) and alcohol (P = .03) use. Members of all age cohorts reported a sense of social support, with younger patients deriving this more from family and friends than older patients, and older patients deriving social support more from membership in religious communities than younger patients. No differences were found across age groups for number and impact of comorbid illnesses, number of medications, basic and instrumental activities of daily living, pain, overall health rating, financial adequacy, anxiety, depression, and quality of life. CONCLUSION: CGA can be conducted in an outpatient cancer community using a self-report format. Despite the fact that this population varied demographically across age groups and is limited to veterans, this study demonstrated remarkable similarities between younger and older cancer patients in terms of functional status, health states, and quality of life.

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