scholarly journals Comorbid conditions related to readmissions of Chinese older patients

2022 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Chunyang Li ◽  
Hyokyoung G. Hong ◽  
Zhiye Ying ◽  
Xiaoxi Zeng ◽  
Yi Li
Keyword(s):  
Older Patients ◽  
Comorbid Conditions

scholarly journals Validating SPICES as a Screening Tool for Frailty Risks among Hospitalized Older Adults

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Harriet Udin Aronow ◽  
Jeff Borenstein ◽  
Flora Haus ◽  
Glenn D. Braunstein ◽  
Linda Burnes Bolton
Keyword(s):  
Older Adult ◽  
Older Patients ◽  
Screening Tool ◽  
Adverse Outcomes ◽  
Patient Harm ◽  
Comorbid Conditions ◽  
Care Plans ◽  
Screening Protocol ◽  
Hospitalized Older Adults ◽  
Almost All

Older patients are vulnerable to adverse hospital events related to frailty. SPICES, a common screening protocol to identify risk factors in older patients, alerts nurses to initiate care plans to reduce the probability of patient harm. However, there is little published validating the association between SPICES and measures of frailty and adverse outcomes. This paper used data from a prospective cohort study on frailty among 174 older adult inpatients to validate SPICES. Almost all patients met one or more SPICES criteria. The sum of SPICES was significantly correlated with age and other well-validated assessments for vulnerability, comorbid conditions, and depression. Individuals meeting two or more SPICES criteria had a risk of adverse hospital events three times greater than individuals with either no or one criterion. Results suggest that as a screening tool used within 24 hours of admission, SPICES is both valid and predictive of adverse events.

scholarly journals Identifying Patterns of Comorbidities with Cancers of the Colon and Rectum, as Related to age at Diagnosis

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Kazzem Gheybi ◽  
David Roder ◽  
Elizabeth Buckley ◽  
Agnes Virty
Keyword(s):  
Rectal Cancer ◽  
Gastroesophageal Reflux ◽  
Older Patients ◽  
Heart Diseases ◽  
South Australia ◽  
Gastric Disease ◽  
Hospital Inpatient ◽  
Comorbid Conditions ◽  
Colon And Rectal Cancer ◽  
Rectal Cancers

IntroductionAustralians have a high incidence of Colorectal cancer (CRC) and it is the second leading cause of cancer death. CRC patients experience more comorbid conditions such as diabetes and heart diseases than expected from population norms. It is anticipated that older patients with CRC will have even more comorbidities. ApproachData from South Australia Cancer Registry were linked with hospital inpatient separations (public and private) and Pharmaceutical Benefit Scheme data to acquire a detailed dataset of CRC patients in South Australia. We have investigated the prevalence of different comorbidities by age and subsite (colon vs rectal) in the 12 months period prior to CRC diagnosis using the chronic comorbid conditions used by Charlson and RX-risk indices. ResultsOf 11,656 CRCs diagnosed in 2003-2013, a significant higher prevalence of comorbidity presented in colon than rectal cancer patients using either indices. The most prevalent comorbidities for colon and rectal cancers respectively were: hypertension (25.9%, 22.0%), diabetes (17.3%, 15.6%) and gastric disease (11.4%, 12.4%). Common medications for colon and rectal cancers respectively were: hyperlipidaemia (38.4%, 33.7%), hypertension (38.0%, 31.7%) and gastroesophageal reflux diseases (36.2%, 26.8%). In younger patients (<50 years) with colon and rectal cancer anaemia (9.1%) and diabetes (7.4%) were the most prevalent comorbidities and gastroesophageal reflux medications (17.1%) and opioids (14.5%) were used most frequently whereas, in older patients (>79 years) hypertension (36.7%, 32.7%) was the most prevalent comorbid condition and hypertensive drugs (52.23%, 51,72%)were the most frequently used medication respectively. ConclusionAlthough often regarded as a single disease (CRC), colon and rectal cancers have different predisposing factors and clinical features. As expected, older patients have a higher prevalence of comorbid chronic diseases. We observe, however, that colon and rectal cancer have different comorbidity patterns by age.

Cardiovascular

2012 ◽  
pp. 255-310
Author(s):  
Lesley K Bowker ◽  
James D Price ◽  
Sarah C Smith
Keyword(s):  
Myocardial Infarction ◽  
Chest Pain ◽  
Cardiovascular System ◽  
Stable Angina ◽  
Acute Coronary Syndromes ◽  
Older Patients ◽  
Hypertension Treatment ◽  
Comorbid Conditions ◽  
Coronary Syndromes

The ageing cardiovascular system 256 Chest pain 258 Stable angina 260 HOW TO . . . Rationalize antianginals in older patients 261 Acute coronary syndromes 262 Myocardial infarction 266 Hypertension 268 Hypertension: treatment 270 HOW TO . . . Use antihypertensives in a patient with comorbid conditions 271 Arrhythmia: presentation 272...

scholarly journals Incidental hip fracture in an outpatient clinic: the importance of patient-centred assessment

2018 ◽  
Vol 10 (2) ◽  
pp. 176 ◽  
Author(s):  
Lloyd David Hughes ◽  
Gavin Love
Keyword(s):  
Hip Fracture ◽  
Hip Fractures ◽  
Outpatient Clinic ◽  
Older Patients ◽  
Femur Fracture ◽  
Comorbid Conditions ◽  
Diagnostic Challenge ◽  
Neck Of Femur ◽  
Neck Of Femur Fracture

ABSTRACT Although many patients presenting with hip fractures have classic symptoms, other patients may present atypically with referred knee pain and reasonably unremarkable clinical examination following initial presentation. Older patients commonly have comorbid conditions such as arthritis, stroke and dementia that can complicate history and examination, making the diagnosis of subtle fractures difficult. Multimorbidity represents an important diagnostic challenge to both primary and secondary care. This case study discusses a 90-year-old lady who was found to have an old right neck of femur fracture after attendance at an geriatric outpatient clinic for a discussion about anticoagulation, after GP referral.

Low-grade gliomas in older patients.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 2093-2093
Author(s):  
Adewale Alade Fawole ◽  
Lizbeth Robles Irizarry ◽  
Neda Hashemi-Sadraei ◽  
Mital Patel ◽  
Manmeet Singh Ahluwalia
Keyword(s):  
Older Patients ◽  
Independent Predictor ◽  
Performance Status ◽  
Univariate Analysis ◽  
Multivariable Analysis ◽  
Cleveland Clinic ◽  
Prior History ◽  
Low Grade ◽  
Comorbid Conditions ◽  
Low Grade Gliomas

2093 Background: Low grade gliomas account for 10-20% of all primary brain tumors. The outcomes of older patients with low-grade glioma (LGG) are not well known. Methods: After obtaining IRB approval, the Cleveland Clinic Brain Tumor and Neuro-Oncology Center’s database was used to identify older patients defined as those >55 years of age with histologically confirmed grade 2 glioma at the time of diagnosis. Multivariable analysis was conducted with use of a Cox proportional hazards model and a stepwise selection algorithm that used p<.10 as the criteria for entry and p<0.05 as retention in the model to identify independent predictors of survival. Results: Chart records of 61 patients diagnosed between 1991 and 2010 were included for final analysis. In contrast to patients ≤55 years, older patients are more likely to be male (p=.06), have poorer performance status at presentation (p<.0001), more comorbid conditions (p<.0001), present with more neurologic symptoms (p<.0001), have a prior history of cancer (p<.0001). They are more likely to have astrocytic histology (p=.008) and present with multifocal tumors more frequently (p=.001). Older patients received radiation (RT) upfront more frequently (p=.07) and undergo gross total resection less frequently (p=.003). Median Progression free survival (PFS) and median overall survival (OS) was 1.9 and 4.3 years, respectively in these patients. On univariate analysis, patients with poor performance status have worse PFS (p=.01) and OS (p=.003). Patients with memory impairment have worse PFS (p=.009) and OS (p=.0001). Patients treated with adjuvant chemotherapy had better OS (p=.01). Tumor related characteristics associated with poor survival included, "pure" or mixed astrocytoma histology (OS, p=.06), multifocal tumors (OS, p=.08), left-sided tumors (p=.07). In multivariable analysis, performance status was the only independent predictor of either PFS or OS. Conclusions: Older patients with low grade gliomas have less favorable outcomes as compared to younger patients. They have more comorbid conditions and symptoms at presentation. Use of chemotherapy in this patient group was associated with improved survival. Performance status was the only independent predictor of either PFS or OS.

scholarly journals How I treat the older patient with acute myeloid leukemia

Blood ◽  
2015 ◽  
Vol 125 (5) ◽  
pp. 767-774 ◽  
Author(s):  
Gert Ossenkoppele ◽  
Bob Löwenberg
Keyword(s):  
Acute Myeloid Leukemia ◽  
Older Patients ◽  
Myeloid Leukemia ◽  
Treatment Options ◽  
Comorbid Conditions ◽  
Older Patient ◽  
Molecular Features ◽  
Clinical Vignettes ◽  
Clinical Biology ◽  
Acute Myeloid

Abstract Acute myeloid leukemia (AML) in older patients presents a notable therapeutic challenge to the clinical hematologist. The clinical biology of AML among patients is highly heterogeneous. Interpatient variations are relevant for prognosis and treatment choice. Outcome of treatment for patients of advanced age is often compromised by comorbid conditions and an enhanced susceptibility to toxicities from therapy. Here we present selected clinical vignettes that highlight distinct representative situations derived from clinical practice. The vignettes are specifically discussed in light of the perspective of treating older patients with leukemia. We review the clinical significance of various cytogenetic and molecular features of the disease, and we examine the various currently available treatment options as well as the emerging prognostic algorithms that may offer guidance in regard to personalized therapy recommendations. The dilemmas in tailoring treatment selection in this category of patients with AML are the central theme in this discussion.

Systematic Review of Barriers to the Recruitment of Older Patients With Cancer Onto Clinical Trials

2005 ◽  
Vol 23 (13) ◽  
pp. 3112-3124 ◽  
Author(s):  
Carol A. Townsley ◽  
Rita Selby ◽  
Lillian L. Siu
Keyword(s):  
Clinical Trials ◽  
Functional Status ◽  
Older Patients ◽  
Tumor Biology ◽  
Physician Education ◽  
Cancer Clinical Trials ◽  
Comorbid Conditions ◽  
Eligibility Criteria ◽  
Patients With Cancer ◽  
Significant Barrier

Purpose Older patients are significantly underrepresented in cancer clinical trials. A literature review was undertaken to identify the barriers that impede the accrual of this vulnerable population onto clinical trials and to determine what specific strategies are needed to improve the representation of older patients in research studies. Methods A systematic literature search was undertaken using several different strategies to identify relevant articles. Results Nine of 31 relevant papers from 159 citations were included. Age is a significant barrier to recruitment; only a quarter to one third of potentially eligible older patients are enrolled onto trials. Physicians' perceptions, protocol eligibility criteria with restrictions on comorbid conditions, and functional status to optimize treatment tolerability are the most important reasons resulting in the exclusion of older patients. Other barriers include the lack of social support and the need for extra time and resources to enroll these patients. Conversely, older patients do not view their age as an important reason for refusing trials. Conclusion Specific clinical trials confined to older patients should be conducted to evaluate tumor biology, treatment tolerability, and the effect of comorbid conditions. Protocol designs need to stratify for age and be less restrictive with respect to exclusions on functional status, comorbidity, and previous cancers, such that results are generalizable to older patients. Physician education to dispel unfounded perceptions, improved access to available clinical trials, and provision of personnel and resources to accommodate the unique requirements of an older population are possible solutions to remove the barriers of ageism.

Aging and Autism

2012 ◽  
Vol 17 (2) ◽  
pp. 69-75 ◽  
Author(s):  
Pamela A. Smith
Keyword(s):  
Health Care ◽  
Autism Spectrum Disorders ◽  
Patient Group ◽  
Older Patients ◽  
Geriatric Patients ◽  
Recent Literature ◽  
Communication Disorders ◽  
Autism Spectrum ◽  
Need For Support ◽  
Spectrum Disorders

In this article, I will review the available recent literature about the aging population with autism, a patient group that researchers know little about and a group that is experiencing a growing need for support from communication disorders professionals. Speech-language pathologists working with geriatric patients should become familiar with this issue, as the numbers of older patients with autism spectrum disorders is likely to increase. Our profession and our health care system must prepare to meet the challenge these patients and residents will present as they age.

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