Younger Patients Do Not Develop More Advanced Polyps on Surveillance Colonoscopy Than Their Index Colonoscopy When Compared With Older Patients

Introduction: In the elderly, impairment of kidney function occurs. Renal diseases overlap with anatomic and functional changes related to age-related involutionary processes. Mortality among patients with acute renal injury is approximately 50%, despite advances in treatment and diagnosis of AKI. The aim: To assess the incidence of acute kidney injury in elderly patients and to analyze the causes of acute renal failure depending on age. Materials and methods: A retrospective analysis included medical documentation of patients hospitalized in the Nephrology Clinic during the 6-month period. During this period 452 patients were hospitalized in the clinic. A group of 77 patients with acute renal failure as a reason for hospitalization was included in the study. Results: The prerenal form was the most common cause of AKI in both age groups. In both age groups, the most common cause was dehydration; in the group of patients up to 65 years of age, dehydration was 29.17%; in the group of people over 65 years - 43.39%. Renal replacement therapy in patients with AKI was used in 14.29% of patients. In the group of patients up to 65 years of age hemodialysis was 16.67% and above 65 years of age. -13.21% of patients. The average creatinine level in the group of younger patients at admission was 5.16 ± 3.71 mg / dl, in the group of older patients 3.14 ± 1.63 mg / dl. The size of glomerular filtration GFR in the group of younger patients at admission was 21.14 ± 19.54 ml / min, in the group of older patients 23.34 ± 13.33 ml / min. Conclusions: The main cause of acute kidney injury regardless of the age group was dehydration. Due to the high percentage of AKI in the elderly, this group requires more preventive action, not only in the hospital but also at home.

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Clinical Characteristics and Prognostic Factors of Early-Onset Pancreatic Neuroendocrine Tumors

Cancer Control ◽

10.1177/1073274820986827 ◽

2021 ◽

Vol 28 ◽

pp. 107327482098682

Author(s):

Min Shi ◽

Biao Zhou

Keyword(s):

Prognostic Factors ◽

Neuroendocrine Tumors ◽

Early Onset ◽

Older Patients ◽

Clinical Characteristics ◽

Clinicopathological Characteristics ◽

Pancreatic Neuroendocrine Tumors ◽

Chi Square ◽

Younger Patients ◽

Significant Difference

Background: The incidence of pancreatic neuroendocrine tumors (PNETs) has increased significantly. The purpose of this study was to analyze the clinical characteristics and prognosis of patients under 50 years old. Methods: Patients with PNETs recorded in the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2015 were analyzed. The clinical characteristics were analyzed by Chi-square test. The Kaplan-Meier method was used to estimate overall survival (OS). Multivariate Cox proportional risk regression analysis was used to determine independent prognostic factors. Results: 2,303 patients included, of which 547 (23.8%) patients were younger than 50 years old. The number of younger patients has increased steadily, while the proportion in total PNETs decreased recently. Compared with older group, the proportion of the Black, grade I/II, and surgery were higher in early-onset PNETs. Liver was the most frequent metastatic site. There was no significant difference in the incidence of different metastatic sites between younger and older PNETs patients, while younger patients had better OS (P < 0.05). Grade, N stage, M stage, and surgery were independent prognostic factors for OS in early-onset PNETs. Conclusions: Younger patients have unique clinicopathological characteristics compared with older patients in PNETs. Better OS was observed in younger patients which might due to the higher proportion of well-differentiated tumor and surgery than older patients.

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Patients fifty years and older attending two sexually transmitted disease clinics in Baltimore, Maryland

International Journal of STD & AIDS ◽

10.1177/0956462416646687 ◽

2016 ◽

Vol 28 (4) ◽

pp. 330-344 ◽

Cited By ~ 5

Author(s):

Susan A Tuddenham ◽

Kathleen R Page ◽

Patrick Chaulk ◽

Erika B Lobe ◽

Khalil G Ghanem

Keyword(s):

Sexually Transmitted Infections ◽

Older Women ◽

Risk Behaviors ◽

Sexually Transmitted Disease ◽

Older Patients ◽

Transmitted Disease ◽

Transmitted Infection ◽

Younger Patients ◽

Sexually Transmitted ◽

Younger Men

Many individuals remain sexually active into their eighth decade. Surveillance data suggest that rates of sexually transmitted infections in older patients are increasing. We compared demographics, risk behaviors, and predictors of acute infections in patients 50 years and older versus younger patients attending sexually transmitted disease clinics in Baltimore, Maryland. This was a retrospective study from a large electronic database of visits to two urban sexually transmitted disease clinics between 2005 and 2010. Proportions were compared using the Chi square test. Logistic regression was used to assess predictors of acute sexually transmitted infections in older versus younger groups. It was found that patients over 50 were more likely than younger patients to report never using condoms (32.6% [CI 0.31–0.34] versus 24.1% [CI 0.23–0.25]). The overall prevalence of acute sexually transmitted infections was 18.1% (CI 0.17–0.19) in older and 25.8% (CI 0.25–0.27) in younger patients. Older women were more likely to be diagnosed with trichomoniasis (21.5% [CI 18.6–24.5] versus 13.1% [CI 11.5–14.8]). Black race was predictive of having an acute sexually transmitted infections in younger men (OR 2.2 [CI 1.47–3.35]) and women (OR 2.7 [CI 1.34–5.30]) but not in older men (OR 1.2 [CI 0.79–1.73]) or women (OR 1.2 [CI 0.43–3.15]). Older age was associated with a decreased risk of acute STI diagnosis in younger men and older women only, while having had sex for money or drugs in the past month was predictive only in younger women. Reporting symptoms and increasing numbers of sexual partners in the last six months was predictive of acute sexually transmitted infection diagnosis in all age groups. Older patients seeking care at sexually transmitted disease clinics engage in important risk behaviors. Race, a factor predictive of acute sexually transmitted infections in younger patients is not a significant predictor of sexually transmitted infections in older persons.

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Mortality of Public Mental Health Patients: A Singapore Experience

Australian & New Zealand Journal of Psychiatry ◽

10.3109/00048679309072121 ◽

1993 ◽

Vol 27 (1) ◽

pp. 36-41 ◽

Cited By ~ 5

Author(s):

Lionel Chee-Chong Lim ◽

Li-Ping Sim ◽

Peak-Chiang Chiam

Keyword(s):

Mental Health ◽

General Population ◽

Older Patients ◽

Public Mental Health ◽

Younger Patients ◽

Standardised Mortality Ratio ◽

Common Diagnosis ◽

Mental Health Patients ◽

Mortality Ratio ◽

Age And Sex

This study reports the Standardised Mortality Ratio (SMR) by age and sex among public mental health patients in Singapore. The authors also examine the differences between those who were classified as “inpatient deaths” and those who were classified as “outpatient deaths”. Mortality was 5.1 times that of the general population and the SMR was most accentuated in the younger, female patients. Of the 217 deaths documented over two years, schizophrenia was the most common diagnosis. Inpatient deaths (N = 120) occurred in older patients with prior physical illness who died of natural causes. In contrast, outpatient deaths (N = 97) involved younger patients with no previous illness and the majority jumped to their deaths. Mortality studies are necessary in monitoring the efficacy of mental health provisions.

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Benefits of Pravastatin on Cardiovascular Events and Mortality in Older Patients with Coronary Heart Disease Are Equal to or Exceed Those Seen in Younger Patients: Results from the LIPID Trial

Annals of Internal Medicine ◽

10.7326/0003-4819-134-10-200105150-00007 ◽

2001 ◽

Vol 134 (10) ◽

pp. 931 ◽

Cited By ~ 148

Author(s):

David Hunt ◽

Peta Young ◽

John Simes ◽

Wendy Hague ◽

Stewart Mann ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Cardiovascular Events ◽

Older Patients ◽

Younger Patients

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Characteristics, outcomes, and risk factors of ICANS after axicabtagene ciloleucel: Does age matter?

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e19556 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e19556-e19556

Author(s):

Kitsada Wudhikarn ◽

Radhika Bansal ◽

Arushi Khurana ◽

Matthew Hathcock ◽

Michael Ruff ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Older Patients ◽

Clinical Course ◽

International Prognostic Index ◽

Age Groups ◽

Central Nervous System Involvement ◽

Microvascular Disease ◽

B Cell Lymphoma ◽

Younger Patients

e19556 Background: CD19 chimeric antigen receptor T cell therapy possesses unique side effects including cytokine release syndrome (CRS) and immune effector cell associated neurotoxicity syndrome (ICANS). Age is a major risk factor for ICANS. However, whether ICANS in older patients is different compared to younger patients is unknown. Herein, we report clinical course, outcomes and risk factors for ICANS in older patients with large B cell lymphoma (LBCL) treated with axicabtagene ciloleucel (axi-cel). Methods: We comprehensively reviewed detailed clinical courses of ICANS in 78 adult patients with LBCL treated with axi-cel between June 2016 and October 2020. Incidence, manifestation, risk factors, treatment, and outcomes of ICANS were compared between patients age ≥60 (n=32) and <60 (n=46) years old. Results: Baseline characteristics were comparable between older and younger patients except higher proportion of high international prognostic index and underlying cerebral microvascular disease in older patients. ICANS was observed in 16 patients in the older and 24 patients in the younger age group, with a 30-day incidence of 52% and 50%, respectively. Median time to CRS and ICANS were similar between 2 age groups. The most common initial neurological findings included aphasia, dysgraphia and encephalopathy in both age groups. Table summarizes the characteristics, clinical course and interventions of ICANS in older and younger patients. In Cox regression model, the presence of CRS was the only factor associated with ICANS in both age groups. Age, history of central nervous system involvement and cerebral microvascular disease were not associated with ICANS. Importantly, all patients had complete resolution of ICANS. No elderly patients in our cohort experienced seizure as a manifestation of ICANS. Conclusions: In our study, older age was not a risk factor for ICANS. CRS was the only factor associated with ICANS in both younger and older patients. Incidence, clinical course and neurological outcomes of ICANS in older patients treated with axi-cel were comparable to younger patients. [Table: see text]

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Early prediction of hospital admission for emergency department patients: a comparison between patients younger or older than 70 years

Emergency Medicine Journal ◽

10.1136/emermed-2016-205846 ◽

2017 ◽

Vol 35 (1) ◽

pp. 18-27 ◽

Cited By ~ 11

Author(s):

Jacinta A Lucke ◽

Jelle de Gelder ◽

Fleur Clarijs ◽

Christian Heringhaus ◽

Anton J M de Craen ◽

...

Keyword(s):

Heart Rate ◽

Hospital Admission ◽

Older Patients ◽

Prediction Models ◽

Age Groups ◽

Vital Signs ◽

Area Under The Curve ◽

University Hospital ◽

Multivariable Logistic Regression Analysis ◽

Younger Patients

ObjectiveThe aim of this study was to develop models that predict hospital admission to ED of patients younger and older than 70 and compare their performance.MethodsPrediction models were derived in a retrospective observational study of all patients≥18 years old visiting the ED of a university hospital during the first 6 months of 2012. Patients were stratified into two age groups (<70 years old and ≥70 years old). Multivariable logistic regression analysis was used to identify predictors of hospital admission among factors available immediately after patient arrival to the ED. Validation of the prediction models was performed on patients presenting to the ED during the second half of the year 2012.Results10 807 patients were included in the derivation and 10 480 in the validation cohorts. The strongest independent predictors of hospital admission among the 8728 patients <70 years old were age, sex, triage category, mode of arrival, performance of blood tests, chief complaint, ED revisit, type of specialist, phlebotomised blood sample and all vital signs. The area under the curve (AUC) of the validation cohort for those <70 years old was 0.86 (95% CI 0.85 to 0.87). Among the 2079 patients ≥70 years, the same factors were predictive, except for gender, type of specialist and heart rate; the AUC was 0.77 (95% CI 0.75 to 0.79). The prediction models could identify a group of 10% of patients with the highest risk in whom hospital admission was predicted at ED triage, with a positive predictive value (PPV) of 71% (95% CI 68% to 74%) in younger patients and PPV of 87% (95% CI 81% to 92%) in older patients.ConclusionDemographic and clinical factors readily available early in the ED visit can be useful in identifying patients who are likely to be admitted to the hospital. While the model for the younger patients had a higher AUC, the model for older patients had a higher PPV in identifying the patients at highest risk for admission. Of note, heart rate was not a useful predictor in the older patients.

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Increasing Trends in the Use of Hospital Observation Services for Older Medicare Advantage and Privately Insured Patients

Medical Care Research and Review ◽

10.1177/1077558717718026 ◽

2017 ◽

Vol 76 (2) ◽

pp. 229-239 ◽

Cited By ~ 8

Author(s):

Keith D. Lind ◽

Claire M. Noel-Miller ◽

Lindsey R. Sangaralingham ◽

Nilay D. Shah ◽

Erik P. Hess ◽

...

Keyword(s):

Data Warehouse ◽

Older Patients ◽

Claims Data ◽

Veterans Affairs ◽

Inpatient Stay ◽

Medicare Advantage ◽

Younger Patients ◽

Insured Patients ◽

Increasing Trends ◽

Privately Insured

Policy and financial pressures have driven up use of observation stays for patients in traditional Medicare and the Veterans’ Affairs Healthcare System. Using claims data (2004-2014) from OptumLabs™ Data Warehouse, we examined whether people in private Medicare Advantage (MA) and commercial plans experienced similar changes. We found that use of observation increased rapidly for patients in MA plans—even though MA plans were not subject to the same pressures as government-run programs. In contrast, use of observation remained constant for people in commercial plans—except for enrollees 65 and older, for whom it increased somewhat. Privately insured patients returning to the hospital after an inpatient stay were increasingly likely to be placed under observation. Our results suggest that observation is rapidly replacing inpatient admissions and readmissions for many older patients in MA and commercial plans, while younger patients continue to be admitted as inpatients at relatively constant rates.

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