scholarly journals Factors associated with the goal of treatment in the last week of life in old compared to very old patients: a population-based death certificate survey

2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Tinne Smets ◽  
Rebecca Verhofstede ◽  
Joachim Cohen ◽  
Nele Van Den Noortgate ◽  
Luc Deliens
Keyword(s):  
Death Certificate ◽  
Population Based ◽  
Old Patients ◽  
Very Old ◽  
Factors Associated ◽  
Very Old Patients

Increased risk of bullous pemphigoid in male and very old patients: A population-based study on incidence

1999 ◽  
Vol 41 (2) ◽  
pp. 266-268 ◽  
Author(s):  
Martin Junga ◽  
Werner Kippesb ◽  
Gerald Messer ◽  
Detlef Zillikens ◽  
Berthold Rzany
Keyword(s):  
Bullous Pemphigoid ◽  
Population Based ◽  
Population Based Study ◽  
Old Patients ◽  
Very Old ◽  
Increased Risk ◽  
Very Old Patients

scholarly journals Factors associated with normal physical function in patients with rheumatoid arthritis of different ages

2021 ◽  
Author(s):  
Yoji Komiya ◽  
Takahiko Sugihara ◽  
Fumio Hirano ◽  
Takumi Matsumoto ◽  
Mari Kamiya ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Physical Function ◽  
Stage I ◽  
Middle Aged ◽  
Aged Patients ◽  
Old Patients ◽  
Very Old ◽  
Factors Associated ◽  
Very Old Patients

Abstract Background To investigate factors associated with normal physical function of middle-aged (55-64), old (65-74) or very old (75-84) patients with rheumatoid arthritis (RA). Methods Data from RA patients in the National Database of Rheumatic Diseases in Japan (NinJa) were extracted from April 2017 to March 2018. Factors associated with impaired physical function (Health Assessment Questionnaire Disability Index [HAQ-DI] >0.5) were analyzed by multivariable logistic regression. Association of glucocorticoids (GCs) and age with impaired physical function were presented as adjusted odds ratio (OR) for the 5 groups relative to middle-aged patients without GCs as the reference group. Results Low disease activity (3.3< simplified disease activity index [SDAI] ≤11) or remission (SDAI ≤3.3) was achieved in 3,466 (31.4%) or 3,021(27.4%) of 11,036 patients aged 55-84, respectively. To reduce the influence of joint destruction on HAQ-DI, we assessed the 3,708 patients in both SDAI ≤11 and Steinbrocker stage I/II. About half of the very old patients were receiving methotrexate, which was the lowest proportion amongst the three age groups. GCs were continued in 32.6% of very old patients, and the proportion was higher than in old and middle-aged patients. On the other hand, 16.2% of the very old patients received biological disease-modifying anti-rheumatic drugs (bDMARDs), and the proportions were similar among the three groups. SDAI was higher in patients with HAQ-DI >0.5 at all ages, and GCs was used more frequently in the old and very old patients with HAQ-DI >0.5, compared to those with HAQ-DI ≤0.5. To minimize the influence of disease activity on HAQ-DI, we selected the 2078 patients in both remission and stage I/II. Multivariable analysis revealed the use of GCs further increased the adjusted OR from 4.01 (95% confidence interval [CI] 2.30-6.99) to 6.81 (95%CI 3.65-12.7) in the very old patients, while the adjusted OR was 2.03 (95%CI 1.17-1.13) in the old patients without GCs, 2.22 (95%CI 1.13-4.36) in the old patients with GCs, and 0.73 (95%CI 0.21-2.56) in the middle-aged patients with GCs. Conclusions The negative impact of GCs was likely to most strongly influence physical function of very old patients than middle-aged or old patients.

scholarly journals Real-world long-term outcomes based on three therapeutic strategies in very old patients with three-vessel disease

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Deshan Yuan ◽  
Sida Jia ◽  
Ce Zhang ◽  
Lin Jiang ◽  
Lianjun Xu ◽  
...  
Keyword(s):  
Real World ◽  
Cardiac Death ◽  
Artery Bypass ◽  
Therapeutic Strategies ◽  
Old Patients ◽  
Very Old ◽  
Vessel Disease ◽  
Significant Difference ◽  
Very Old Patients

Abstract Background There are relatively limited data regarding real-world outcomes in very old patients with three-vessel disease (3VD) receiving different therapeutic strategies. This study aimed to perform analysis of long-term clinical outcomes of medical therapy (MT), coronary artery bypass grafting (CABG), and percutaneous coronary intervention (PCI) in this population. Methods We included 711 patients aged ≥ 75 years from a prospective cohort of patients with 3VD. Consecutive enrollment of these patients began from April 2004 to February 2011 at Fu Wai Hospital. Patients were categorized into three groups (MT, n = 296; CABG, n = 129; PCI, n = 286) on the basis of different treatment strategies. Results During a median follow-up of 7.25 years, 262 deaths and 354 major adverse cardiac and cerebrovascular events (MACCE) occurred. Multivariate Cox analysis showed that the risk of cardiac death was significantly lower for CABG compared with PCI (adjusted hazard ratio [HR] = 0.475, 95% confidence interval [CI] 0.232–0.974, P = 0.042). Additionally, MACCE appeared to show a trend towards a better outcome for CABG (adjusted HR = 0.759, 95% CI 0.536–1.074, P = 0.119). Furthermore, CABG was significantly superior in terms of unplanned revascularization (adjusted HR = 0.279, 95% CI 0.079–0.982, P = 0.047) and myocardial infarction (adjusted HR = 0.196, 95% CI 0.043–0.892, P = 0.035). No significant difference in all-cause death between CABG and PCI was observed. MT had a higher risk of cardiac death than PCI (adjusted HR = 1.636, 95% CI 1.092–2.449, P = 0.017). Subgroup analysis showed that there was a significant interaction between treatment strategy (PCI vs. CABG) and sex for MACCE (P = 0.026), with a lower risk in men for CABG compared with that of PCI, but not in women. Conclusions CABG can be performed with reasonable results in very old patients with 3VD. Sex should be taken into consideration in therapeutic decision-making in this population.

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