scholarly journals Safety of High-Dose Dabigatran in Elderly and Younger Patients with a Low Bleeding Risk: A Prospective Observational Study

Cardiology ◽  
2021 ◽  
pp. 1-5
Author(s):  
Aharon Erez ◽  
Gregory Golovchiner ◽  
Robert Klempfner ◽  
Ehud Kadmon ◽  
Gustavo Ruben Goldenberg ◽  
...  
Keyword(s):  
Observational Study ◽  
Elderly Patients ◽  
Prospective Observational Study ◽  
Bleeding Risk ◽  
The Elderly ◽  
High Dose ◽  
World Population ◽  
Younger Patients ◽  
End Point

<b><i>Introduction:</i></b> In patients with atrial fibrillation (AF) at risk for stroke, dabigatran 150 mg twice a day (DE150) is superior to warfarin for stroke prevention. However, there is paucity of data with respect to bleeding risk at this dose in elderly patients (≥75 years). We aimed to evaluate the safety of DE150 in comparison to warfarin in a real-world population with AF and low bleeding risk (HAS-BLED score ≤2). <b><i>Methods:</i></b> In this prospective observational study, 754 consecutive patients with AF and HAS-BLED score ≤2 were included. We compared outcome of elderly patients (age ≥75 tears) to younger patients (age &#x3c;75 years). The primary end point was the combined incidence of all-cause mortality, stroke, systemic emboli, and major bleeding event during a mean follow-up of 1 year. <b><i>Results:</i></b> There were 230 (30%) elderly patients, 151 patients were treated with warfarin, and 79 were treated with DE150. Fifty-two patients experienced the primary endpoint during the 1-year follow-up. Among the elderly, at 1-year of follow-up, the cumulative event rate of the combined endpoint in the DE150 and warfarin was 8.9 and 15.9% respectively (<i>p</i> = 0.14). After adjustment for age and gender, patients who were treated with DE150 had a nonsignificant difference in the risk for the combined end point as patients treated with warfarin both among the elderly and among the younger population (HR 0.58, 95% C.I = 0.25–1.39 and HR = 1.12, 95% C.I 0.62–2.00, respectively [<i>p</i> for age-group-by-treatment interaction = 0.83). <b><i>Conclusions:</i></b> Our results suggest that Dabigatran 150 mg twice a day can be safely used among elderly AF patients with low bleeding risk.

Cochlear implantation in elderly patients: stability of outcome over time

2016 ◽  
Vol 130 (8) ◽  
pp. 706-711 ◽  
Author(s):  
O Hilly ◽  
E Hwang ◽  
L Smith ◽  
D Shipp ◽  
J M Nedzelski ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Cochlear Implantation ◽  
Short Form ◽  
Age Groups ◽  
The Elderly ◽  
Long Term Results ◽  
Profound Hearing Loss ◽  
Younger Patients ◽  
Over Time

AbstractBackground:Cochlear implantation is the standard of care for treating severe to profound hearing loss in all age groups. There is limited data on long-term results in elderly implantees and the effect of ageing on outcomes. This study compared the stability of cochlear implantation outcome in elderly and younger patients.Methods:A retrospective chart review of cochlear implant patients with a minimum follow up of five years was conducted.Results:The study included 87 patients with a mean follow up of 6.8 years. Of these, 22 patients were older than 70 years at the time of implantation. Hearing in Noise Test scores at one year after implantation were worse in the elderly: 85.3 (aged under 61 years), 80.5 (61–70 years) and 73.6 (aged over 70 years;p= 0.039). The respective scores at the last follow up were 84.8, 85.1 and 76.5 (p= 0.054). Most patients had a stable outcome during follow up. Of the elderly patients, 13.6 per cent improved and none had a reduction in score of more than 20 per cent. Similar to younger patients, elderly patients had improved Short Form 36 Health Survey scores during follow up.Conclusion:Cochlear implantation improves both audiometric outcome and quality of life in elderly patients. These benefits are stable over time.

scholarly journals Homeopathic treatment of elderly patients - a prospective observational study with follow-up over a two year period

2010 ◽  
Vol 10 (1) ◽  
Author(s):  
Michael Teut ◽  
Rainer Lüdtke ◽  
Katharina Schnabel ◽  
Stefan N Willich ◽  
Claudia M Witt
Keyword(s):  
Observational Study ◽  
Elderly Patients ◽  
Prospective Observational Study ◽  
Homeopathic Treatment

Metastatic melanoma in the elderly: Case series of clinical outcome and immune characteristics

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20018-e20018
Author(s):  
U. P. Hegde ◽  
N. Chakraborty ◽  
A. Chhabra ◽  
S. Ray
Keyword(s):  
Immune System ◽  
Clinical Outcome ◽  
Elderly Patients ◽  
Metastatic Melanoma ◽  
Cutaneous Melanoma ◽  
Proliferative Activity ◽  
The Elderly ◽  
High Dose ◽  
The Impact

e20018 Background: Cutaneous melanoma incidence is rapidly rising in the elderly population. Imbalances of the immune system are described due to aging associated changes between CD4+, CD8+, T helper (Th) 1, Th 2 and T regulatory and T effector lymphocytes (lym). We describe clinical outcome in 10 elderly patients (pts) with cutaneous metastatic melanoma (CMM) and results of the immune studies done in a subgroup. Methods: Between October 2002 and October 2008, 10 elderly pts with treatment naïve CMM, 6 males and 4 female, median ages 76, range 57–84 years were treated at the University of Connecticut Health Center. Metastatic sites included soft tissue in 2 patients (pts), lung and/or liver with lymph node (LN) involvement (6 pts) and distant LN metastasis (2pts). Eight pts opted for treatment and received single or combination chemotherapy (5pts), high dose Interleukin 2 (2 pts), complete tumor resection followed by tumor derived heat shock protein vaccine (1 pt on clinical trial) and bio chemotherapy (1pt). One patient declined treatment (included in follow up). In vitro immune characteristics were studied in HLA-A2 positive subgroup (5pts) and included cytotoxic T lym (CTL) generation against self and non self peptides (Mart-1 27–35 and influenza MP derived peptide flu 58–66), proliferative activity of CD4+ lym in response to anti CD3 antibody under Th1 and Th2 conditions and regulatory T lym activity of CD4+CD25+ lym against CTL. Results: All patients tolerated treatments well resulting in 1 complete response, 4 partial responses, and 4 stable diseases. During 6 year follow up period, 6 patients died while 4 patients are living (one with disease). The median survival of all patients is 28.1 month (mo) while in those surviving (4pts) is 72 mo. Immune studies revealed preserved proliferative activity of CD4+ lym with stronger Th1 induction than Th2. The CTL responses to self and non self antigens were preserved while regulatory T lym showed weak activity against CTL. Conclusions: Some elderly patients with metastatic melanoma demonstrate improved outcomes and favorable immune characteristics. Further studies are needed to understand the impact of aging immune system on cutaneous melanoma. No significant financial relationships to disclose.

Microvascular decompression for trigeminal neuralgia in elderly patients

2008 ◽  
Vol 108 (4) ◽  
pp. 689-691 ◽  
Author(s):  
Raymond F. Sekula ◽  
Edward M. Marchan ◽  
Lynn H. Fletcher ◽  
Kenneth F. Casey ◽  
Peter J. Jannetta
Keyword(s):  
Trigeminal Neuralgia ◽  
Elderly Patients ◽  
Microvascular Decompression ◽  
The Elderly ◽  
Outcome Data ◽  
Control Group ◽  
Younger Patients ◽  
Telephone Interviews ◽  
Second Tier

Object Although microvascular decompression (MVD) for patients with medically refractory trigeminal neuralgia (TN) is widely accepted as the treatment of choice, other “second-tier” treatments are frequently offered to elderly patients due to concerns regarding fitness for surgery. The authors sought to determine the safety and effectiveness of MVD for TN in patients older than 75 years of age. Methods The authors performed a retrospective review of medical records and conducted follow-up telephone interviews with the patients. The outcome data from 25 MVD operations for TN performed in 25 patients with a mean age of 79.4 years (range 75–88 years) were compared with those of a control group of 25 younger patients with a mean age of 42.3 years (range 17–50 years) who underwent MVDs during the same 30-month period from July 2000 to December 2003. Results Initial pain relief was achieved in 96% of the patients in both groups (p = 1.0). There were no operative deaths in either group. After an average follow-up period of 44 and 52 months, 78 and 72% of patients in the elderly and control groups, respectively, remained pain free without medication (p = 0.74). Conclusions Microvascular decompression is an effective treatment for elderly patients with TN. The authors' experience suggests that the rate of complications and death after MVD for TN in elderly patients is no different from the rate in younger patients.

The Comparison of the Dietary Intake Loss Between Elderly and Non-elderly Patients after Gastrectomy for Gastric Cancer

2021 ◽  
Author(s):  
Masato Nakazono ◽  
toru aoyama ◽  
Keisuke Komori ◽  
Hayato Watanabe ◽  
kazuki kano ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Observational Study ◽  
Elderly Patients ◽  
Dietary Intake ◽  
Prospective Observational Study ◽  
The Elderly ◽  
Elderly Group ◽  
Nutritional Intake ◽  
Curative Gastrectomy ◽  
Major Nutrients

Abstract Background/Aim: The present study quantified the changes in the dietary and nutritional intake after gastrectomy between elderly and non-elderly patients. Patients and Methods: This prospective observational study enrolled patients who underwent curative gastrectomy for gastric cancer. Results: 23 patients ≥75 years old were classified into the elderly group, and127 patients <75 years old were classified into the non-elderly group. The respective median % dietary intake losses at one and three months postoperatively were -12.4% and -5.3% in the elderly group and -8.3% and -2.8% in the non-elderly group (p=0.075 and 0.080). On comparing the intake loss of three major nutrients, the respective median % lipid intake losses at 1 and 3 months postoperatively were -13.5% and -5.8% in the elderly group and -7.3% and 0% in the non-elderly group (p=0.029 and 0.045). Conclusion: Our results suggested that elderly patients experienced more serious lipid intake loss after gastrectomy than non-elderly patients.

Abstract 12127: Integrated Flow-Mediated Vasodilation Response Predicts Cardiovascular Events in Elderly Patients at Cardiovascular Risk Factor

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Tomoyuki Kabutoya ◽  
Satoshi Hoshide ◽  
Yukiyo Ogata ◽  
Kazuo Eguchi ◽  
Kazuomi Kario
Keyword(s):  
Risk Factor ◽  
Cardiovascular Risk ◽  
Elderly Patients ◽  
Cardiovascular Risk Factor ◽  
Cardiovascular Events ◽  
The Elderly ◽  
Detection Algorithm ◽  
Younger Patients ◽  
Flow Mediated Vasodilation

Introduction: The integrated flow-mediated vasodilation (FMD) response was shown to be associated with cardiovascular risk factors, but the association between the integrated FMD response and consequent cardiovascular events has been unclear. Hypothesis: We assessed the hypothesis that the integrated FMD response predicts consequent cardiovascular events. Methods: We enrolled 575 patients who had at least one cardiovascular risk factor (hypertension, dyslipidemia, diabetes, or smoking). We measured the FMD magnitude of the percentage change in peak diameter (ΔFMD), and we measured the integrated FMD response calculated as the area under the dilation curve during a 120-sec dilation period (FMD-AUC 120 ) using a semiautomatic edge-detection algorithm. The primary outcome was defined as any cardiovascular event (a composite of cardiovascular death, and hospitalization for myocardial infarction, stroke, or heart failure). Results: The mean duration of follow-up was 35±22 months (range: 1-74 months). During the follow-up period, 34 cardiovascular events were recorded. Among the elderly patients (age[[Unable to Display Character: &#8201;]]≥[[Unable to Display Character: &#8201;]]65 yrs, n[[Unable to Display Character: &#8201;]]=[[Unable to Display Character: &#8201;]]281), the patients with the lowest tertile of FMD-AUC 120 (FMD-AUC 120 <[[Unable to Display Character: &#8201;]]5.6) suffered a higher incidence of cardiovascular events compared with the patients with the higher two tertiles (FMD-AUC 120 ≥[[Unable to Display Character: &#8201;]]5.6) (log rank 4.16, p=0.041). The association remained significant after adjusting for age, gender and office systolic blood pressure (hazard ratio 1.25, p=0.039). In the younger patients (age[[Unable to Display Character: &#8201;]]<[[Unable to Display Character: &#8201;]]65 yrs, n[[Unable to Display Character: &#8201;]]=[[Unable to Display Character: &#8201;]]294), cardiovascular events were similar among the patients with the lowest tertile and those with the higher two tertiles of FMD-AUC 120 . Cardiovascular events were also similar in the patients with the lowest tertile and the higher two tertiles of ΔFMD in both the elderly and younger patients. Conclusions: The integrated FMD response, but not ΔFMD, predicted cardiovascular events in elderly patients with a cardiovascular risk factor.

Use of High-dose Opioids as a Treatment for Elderly Patients with Moderate to Severe Cancer Pain: A Prospective Observational Study

2016 ◽  
Vol 17 (1) ◽  
pp. 29-38
Author(s):  
Jung Eun Kim ◽  
Youn Seon Choi ◽  
Kyung Hee Lee ◽  
Jun Suk Kim ◽  
Su-Jin Koh ◽  
...  
Keyword(s):  
Observational Study ◽  
Elderly Patients ◽  
Cancer Pain ◽  
Prospective Observational Study ◽  
High Dose

scholarly journals Efficacy of endoscopic retrograde cholangiopancreato-graphy in elderly patients

2016 ◽  
Vol 45 (1) ◽  
pp. 44-46
Author(s):  
Chittaranjan Das ◽  
Ashis Saha ◽  
Faruk Hossain ◽  
Md Mokhlesur Rahman ◽  
Rakibul Hasan ◽  
...  
Keyword(s):  
Observational Study ◽  
Elderly Patients ◽  
Biliary Tract ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Prospective Observational Study ◽  
The Elderly ◽  
Therapeutic Use ◽  
Data Sheet ◽  
Endoscopic Retrograde ◽  
Therapeutic Ercp

The incidence of biliary tract pathologies increases as the population ages leading to an increase in the demand of therapeutic use of endoscopic retrograde cholangiopancreatography (ERCP). This study was carried out to assess the effectiveness of therapeutic ERCP in elderly patients. It was a prospective observational study. Patients aged 65 years or more referred for therapeutic ERCP from July 2007 to June 2008 were reviewed by a preformed data sheet which included all the relevant details of the procedure. It was collected at the time of ERCP & before discharge. Of 67 patients audited, successful therapeutic ERCP was performed in 91.04% cases. Our study showed that ERCP was effective in the elderly patients.Bangladesh Med J. 2016 Jan; 45 (1): 44-46

scholarly journals Prospective observational study in elderly patients with non-valvular atrial fibrillation: Rationale and design of the All Nippon AF In the Elderly (ANAFIE) Registry

2018 ◽  
Vol 72 (4) ◽  
pp. 300-306 ◽  
Author(s):  
Hiroshi Inoue ◽  
Takeshi Yamashita ◽  
Masaharu Akao ◽  
Hirotsugu Atarashi ◽  
Takanori Ikeda ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Observational Study ◽  
Elderly Patients ◽  
Prospective Observational Study ◽  
The Elderly
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