scholarly journals Characteristics of fall‐related head injury versus non‐head injury in the older adults

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sun Hyu Kim ◽  
Sunpyo Kim ◽  
Gyu Chong Cho ◽  
Ji Hwan Lee ◽  
Eun Jung Park ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Head Injury ◽  
Daily Activity ◽  
Ground Level ◽  
Severe Injury ◽  
Fall Time ◽  
Factors Associated ◽  
Injury Group ◽  
Male Sex

Abstract Background This study aimed to examine the characteristics of older adults patients who suffered a head injury after a ground-level fall in comparison to non-head injury patients as well as the factors associated with severity in those with head injury only. Methods Patients were classified into two groups, the head injury group and the non-head injury group. The characteristics were compared and factors associated with head injury were evaluated. Factors relating to severe injury in the head injury group were also investigated. Results The head injury group comprised 42 % of a study subjects. Male sex; fall time of 18:00–23:59; fall location of medical facility, transportation area, and public or commercial facility; fall in an outdoor area; fall during daily activity; alcohol ingestion; fall from stairs; non-slippery floor conditions; concrete flooring; sloped flooring; and presence of obstacles on the floor were risk factors for head injury in the older adults after a ground-level fall. Male sex and age over 70 years; fall time of 00:00–05:59; fall in a residential facility; fall in an indoor area; fall during daily activity; fall from stairs; non-slippery floor conditions; and presence of obstacles on the floor were factors associated with severe injury in the head injury group. Conclusions Male sex with advanced age, indoor fall, and the presence of obstacles on the floor were risk factors for severe injury in the head injury group in older adults individuals who suffered a ground-level fall. It is necessary to develop appropriate ground-level fall prevention programs by evaluating the individual and environmental characteristics of older adults patients.

Higher-Than-Expected Rates of Distal Radioulnar Joint Fixation in Radial Shaft Fractures: Location of Fracture Matters

Hand ◽  
2021 ◽  
pp. 155894472110068
Author(s):  
Joanne Y. Zhang ◽  
Aneesh V. Samineni ◽  
David C. Sing ◽  
Alyssa Rothman ◽  
Andrew B. Stein
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Patient Characteristics ◽  
Distal Radioulnar Joint ◽  
Older Age ◽  
Radioulnar Joint ◽  
Factors Associated ◽  
Shaft Fractures ◽  
Male Sex ◽  
Preoperative Patient

Background: The purpose of this study was to evaluate rates of distal radioulnar joint (DRUJ) fixation based on location of the radial shaft fracture and risk factors associated with postoperative complications following radial shaft open reduction internal fixation (ORIF). Methods: Adult patients who underwent isolated radial shaft ORIF from 2014 to 2018 were identified from American College of Surgeons National Surgical Quality Improvement Program database and stratified by fracture location and by the presence or absence of DRUJ fixation. Preoperative patient characteristics and postoperative complications were compared to determine risk factors associated with DRUJ fixation. Results: We identified 1517 patients who underwent isolated radial shaft ORIF, of which 396 (26.1%) underwent DRUJ fixation. Preoperative patient characteristics and postoperative complications were similar between cohorts. Distal radioulnar joint fixation was performed in 50 (30.7%) of 163 distal radial shaft fractures, 191 (21.8%) of 875 midshaft fractures, and 3 (13.0%) of 23 proximal shaft fractures ( P = .025). Risk factors for patients readmitted include male sex (odds ratio [OR] = 12.76, P = .009) and older age (OR = 4.99, P = .035). Risk factors for patients with any postoperative complication include dependent functional status (OR = 6.78, P = .02), older age (50-69 vs <50) (OR = 2.73, P = .05), and American Society of Anesthesiologists (ASA) ≥3 (OR = 2.45, P = .047). Conclusions: The rate of DRUJ fixation in radial shaft ORIF exceeded previously reported rates of concomitant DRUJ injury, especially among distal radial shaft fractures. More distally located radial shaft fractures are significantly associated with higher rates of DRUJ fixation. Male sex is a risk factor for readmission, whereas dependent functional status, older age, and ASA ≥3 are risk factors for postoperative complications.

P0034IDENTIFICATION OF FACTORS ASSOCIATED WITH PROGRESSION, PROGNOSIS AND TOLVAPTAN INDICATION IN POLYCYSTIC KIDNEY DISEASE PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Myrto Kostopoulou ◽  
Michaela Louka ◽  
Stavros Fokas ◽  
Eirini Tigka ◽  
Angelos Drakopoulos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Disease ◽  
Polycystic Kidney Disease ◽  
Multivariable Analysis ◽  
Laboratory Data ◽  
Kidney Volume ◽  
Polycystic Kidney ◽  
Factors Associated ◽  
Affected Parent ◽  
Male Sex

Abstract Background and Aims The identification of possible risk factors for the progression of Autosomal Dominant Polycystic Kidney Disease (ADPKD) is an emerging field especially after the introduction of the first disease-specific treatment. The present study aims to explore the associations between epidemiological, clinical and imagining data in a large cohort of ADPKD patients. Method This study was from a single outpatient clinic following patients with ADPKD. Patients were included in the study if they had a recent Magnetic Resonance Imaging (MRI) for measurement of Total Kidney Volume (TKV), a validated biomarker for disease progression. For all patients, the Mayo Clinic Imagining Category (MCIC) and the respective prediction for End Stage Renal Disease (ESRD) were calculated. Patients eligible for tolvaptan treatment (MCIC 1C, 1D, 1E, age &lt; 55 years old and estimated-glomerular filtration rate (e-GFR) ≥ 25 ml/min) were identified. Characteristics including individual medical history, clinical and laboratory data were examined for possible associations with renal and imagining parameters using linear regression models. Results A total of 158 patients were included. Based on measurements of height-adjusted TKV (ht-TKV) and age, 5% of the patients were classified as 1A, 20% as 1B, 34% as 1C, 25% as 1D and 16% as 1E, MCIC. In multivariable analysis, patient’s age (p = 0.01), male sex (p &lt; 0.001), parent’s age at which ESRD was reached (adjusted for patient age) (p &lt; 0.001) and proteinuria (p = 0.04) were associated with ht-TKV. Parent’s age at ESRD differed significantly between the MCICs of the offspring (mean±(SD)), 70.83 (12.90) in 1A, 63.79 (11.39) in 1B, 57.32 (10.42) in 1C, 51.42 (9.18) in 1D and 47.94 (5.73) years old in 1E, (p &lt; 0.001). Similarly, there were significant differences in the presence and the age of hypertension onset (p =0.004 and p = 0.003, respectively). In 104 patients (50 females, 54 males) who were eligible for tolvaptan treatment age at ADPKD diagnosis, age at hypertension onset and parent’s age reaching at ESRD were all significantly lower (p &lt; 0.001 for all) when compared to non-eligible patients. Finally, factors associated with the prediction score of ESRD (e-GFR 10/ml/min) were hypertension, uric acid and the age at ESRD of the affected parent (p = 0.001, 0.02 and 0.01, respectively). Conclusion The age at which an affected parent had reached ESRD, as heritability estimator, was significantly associated with a worst phenotype, prognosis and tolvaptan indication. Early diagnosis of the disease, hypertension and its early onset, proteinuria and male sex are also possible risk factors for the progression of ADPKD.

Factors Associated With Multimorbidity Patterns in Older Adults in England: Findings From the English Longitudinal Study of Aging (ELSA)

2019 ◽  
Vol 32 (9) ◽  
pp. 1120-1132 ◽  
Author(s):  
Hai Nguyen ◽  
Kia-Chong Chua ◽  
Alexandru Dregan ◽  
Silia Vitoratou ◽  
Ivet Bayes-Marin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Longitudinal Study ◽  
Latent Class ◽  
Future Research ◽  
Factors Associated ◽  
Lifestyle Risk Factors ◽  
Class B ◽  
Lifestyle Risk ◽  
English Longitudinal Study

Objective: We aimed to identify the patterns of multimorbidity in older adults and explored their association with sociodemographic and lifestyle risk factors. Method: The sample included 9,171 people aged 50+ from Wave 2 of the English Longitudinal Study of Aging (ELSA). Latent Class Analysis (LCA) was performed on 26 chronic diseases to determine clusters of common diseases within individuals and their association with sociodemographic and lifestyle risk factors. Result: Three latent classes were identified: (a) a cardiorespiratory/arthritis/cataracts class, (b) a metabolic class, and (c) a relatively healthy class. People aged 70 to 79 were 9.91 times (95% Confidence Interval [CI] = [5.13, 19.13]) more likely to be assigned to the cardiorespiratory/arthritis/cataracts class, while regular drinkers and physically inactive people were 0.33 times (95% CI = [0.24, 0.47]) less likely to be assigned to this class. Conclusion: Future research should investigate these patterns further to gain more insights into the needs of people with multimorbidity.

scholarly journals Status Epilepticus among Older Adults in the United States

Geriatrics ◽  
2019 ◽  
Vol 4 (3) ◽  
pp. 45 ◽  
Author(s):  
Priya Mendiratta ◽  
Neeraj Dayama ◽  
Jeanne Y Wei ◽  
Pallavi Prodhan ◽  
Parthak Prodhan
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Ischemic Stroke ◽  
Status Epilepticus ◽  
Age Group ◽  
Brain Hemorrhage ◽  
Factors Associated ◽  
Hospitalized Elderly ◽  
Risk Of Mortality ◽  
Overall Mortality

Objective: This study aimed to identify temporal time trends and risk factors associated with mortality for hospitalized older adults with status epilepticus (SE). Design: A retrospective study was performed. Setting: Hospitalized patients were identified utilizing an administrative database—The Nationwide Inpatient Sample database from 1998 through September 2015. Patients: Patients were older adults 65 years and older with SE. Interventions: No interventions were undertaken. Measurements and Main Results: Demographic, temporal trends, clinical characteristics, and outcome data were abstracted. The results indicated that hospitalized elderly Americans with SE increased over the 11-year study period. Univariate and multivariate analyses were performed to evaluate risk factors associated with mortality in the study cohort. From the weighted sample, 130,109 subjects were included. Overall mortality was 19%. For age subgroups, the mortality was highest for the >85 years age group (24.1%) compared to the 65–75 years (19%) and 75–85 years (23%) age groups. Among investigated etiologies, the three most common causes of SE were acute ischemic stroke (11.2% of total) followed by non-traumatic brain hemorrhage (5.4%) and malignant brain lesions (4.9%). The highest mortality by etiology was noted for acute traumatic brain injury (TBI) (31.5%), non-traumatic brain hemorrhage (31%), and acute ischemic stroke (AIS) (30.1%). Multivariate analysis indicated that non-survivors when compared to survivors were more like to have the following characteristics: older age group, acute TBI, brain neoplasms, non-traumatic brain hemorrhage, AIS and central nervous system (CNS) infections, and utilization of mechanical ventilation. Associated conditions significantly increasing risk of mortality were sodium imbalance, cardiac arrest, anoxic brain injury, pneumonia, and sepsis. Comorbidities associated with increased risk of mortality included valvular heart disease, renal failure, liver disease, and neoplasms. Conclusions: The number of hospitalized elderly Americans with SE increased over the 11-year study period. Overall mortality was 19%, with even higher mortality among various patient subsets. Several demographic and co-morbid factors are associated with increased mortality in this age group.

scholarly journals Age Paradox: Depressive Symptomatology For Older Men and Women in Taiwan

2021 ◽  
Author(s):  
Ching-Ju Chiu ◽  
Chun-Yu Tsai ◽  
Tsung-Yu Tsai
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Depressive Symptoms ◽  
Social Participation ◽  
Protective Factor ◽  
Depressive Symptomatology ◽  
Depression Scale ◽  
Advanced Age ◽  
Men And Women ◽  
Factors Associated

Abstract Background: To discern if prevalence of depressive symptoms in adults aged 65 and above in Taiwan changed during the past decade and to identify if protective and risk factors of depressive symptomatology differ by gender. Method: Data of nationally representative older adults (65+) interviewed from the 2005, 2009 and 2013 National Health Interview Survey (NHIS) in Taiwan was analyzed (n=8,832). The Center for Epidemiologic Studies Depression Scale (CES-D) was used for the measurement of depressive symptomatology. Results: Age adjusted prevalence rate of depressive symptomatology among older adults in Taiwan reduced from 20.6% to 13.3% (X2=-7.5, p<.05) in the community. The most significant factors associated with higher depressive symptomatology in both gender was too much carbohydrates intake, which was significantly associated with 8.8 (95%CI=5.1-15.2) and 7.9 (95%CI=5.2-11.8) times depressive symptomatology in men and women respectively. Factors associated with lower depressive symptomatology in both gender include advanced age (over the age of 85), exercise and social participation. The advanced age for men and women reduced about 63% (AOR over the age of 85=0.4, 95%CI=0.2-0.9) and 62% (AOR over the age of 85=0.4, 95%CI=0.2-0.8) of depressive symptomatology for men and women respectively; Exercise reduced about 50% (AOR exercise=0.5, 95%CI=0.3-0.6) and 58% (AOR exercise=0.5, 95%CI=0.3-0.6) of depressive symptomatology for men and women respectively; social participation reduced about 55% (AOR social participation=0.5, 95%CI=0.3-0.7) and 36% (AOR social participation=0.6, 95%CI=0.5-0.9) of depressive symptomatology for men and women respectively.Conclusions: For adults aged over 65, advanced age, which is 85+ for men and 75+ for women, is a significant protective factor guarding against depressive symptoms. Carbohydrates, cognitive disorder, heart disease and falls were associated with higher depressive symptomatology in both gender. The pulmonary disease, underweight and educational level were risk factors for men; metabolic disease and milk intake were risks for women. Common factors associated with lower depressive symptomatology in both gender includes advanced age, exercise and social participation. Tea and coffee intake and married status were associated with lower depressive symptomatology for women.

scholarly journals Interim Analysis of Risk Factors for Severe Outcomes among a Cohort of Hospitalized Adults Identified through the U.S. Coronavirus Disease 2019 (COVID-19)-Associated Hospitalization Surveillance Network (COVID-NET)

2020 ◽  
Author(s):  
Lindsay Kim ◽  
Shikha Garg ◽  
Alissa O'Halloran ◽  
Michael Whitaker ◽  
Huong Pham ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Invasive Mechanical Ventilation ◽  
The United States ◽  
Surveillance Network ◽  
Adjusted Risk ◽  
Factors Associated ◽  
Icu Admission ◽  
Male Sex ◽  
Race Ethnicity

Background: As of May 15, 2020, the United States has reported the greatest number of coronavirus disease 2019 (COVID-19) cases and deaths globally. Objective: To describe risk factors for severe outcomes among adults hospitalized with COVID-19. Design: Cohort study of patients identified through the Coronavirus Disease 2019-Associated Hospitalization Surveillance Network. Setting: 154 acute care hospitals in 74 counties in 13 states. Patients: 2491 patients hospitalized with laboratory-confirmed COVID-19 during March 1-May 2, 2020. Measurements: Age, sex, race/ethnicity, and underlying medical conditions. Results: Ninety-two percent of patients had at least 1 underlying condition; 32% required intensive care unit (ICU) admission; 19% invasive mechanical ventilation; 15% vasopressors; and 17% died during hospitalization. Independent factors associated with ICU admission included ages 50-64, 65-74, 75-84 and 85+ years versus 18-39 years (adjusted risk ratio (aRR) 1.53, 1.65, 1.84 and 1.43, respectively); male sex (aRR 1.34); obesity (aRR 1.31); immunosuppression (aRR 1.29); and diabetes (aRR 1.13). Independent factors associated with in-hospital mortality included ages 50-64, 65-74, 75-84 and 85+ years versus 18-39 years (aRR 3.11, 5.77, 7.67 and 10.98, respectively); male sex (aRR 1.30); immunosuppression (aRR 1.39); renal disease (aRR 1.33); chronic lung disease (aRR 1.31); cardiovascular disease (aRR 1.28); neurologic disorders (aRR 1.25); and diabetes (aRR 1.19). Race/ethnicity was not associated with either ICU admission or death. Limitation: Data were limited to patients who were discharged or died in-hospital and had complete chart abstractions; patients who were still hospitalized or did not have accessible medical records were excluded. Conclusion: In-hospital mortality for COVID-19 increased markedly with increasing age. These data help to characterize persons at highest risk for severe COVID-19-associated outcomes and define target groups for prevention and treatment strategies.

scholarly journals Risk Factors for Serious Suicide Attempts: Difference Between Older and Younger Attempters in the Emergency Department

2021 ◽  
Vol 11 ◽  
Author(s):  
Dong Wook Kim ◽  
Seo Eun Cho ◽  
Jae Myeong Kang ◽  
Soo Kyun Woo ◽  
Seung-Gul Kang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Emergency Department ◽  
Suicide Attempt ◽  
Old Age ◽  
Rating Scale ◽  
Suicide Attempts ◽  
Interpersonal Stress ◽  
Suicide Attempters ◽  
Male Sex

Objective: Suicide attempts of the older adults are known to be more serious than that of the younger adults. Despite its major social impact in South Korea, the behavioral mechanism of serious suicide attempt (SSA) in old people remains to be elucidated. Thus, we investigated the risk factors for SSA in older and younger suicide attempters in the emergency department.Methods: Demographic data, clinical information, and the level of seriousness of suicide with Risk Rescue Rating Scale were compared between older (age ≥65) and younger (age &lt;65) adults who visited the emergency department for a suicide attempt. Regression analyses were performed to identify the risk factors for SSA in these two groups.Results: Among 370 patients, 37 were older adults (10%; aged 74.41 ± 6.78), more likely to have another medical disease (p &lt; 0.001), and a higher suicide completion rate (16.2 vs. 5.4%, p = 0.023). In the younger group, old age (B = 0.090, p &lt; 0.001), male sex (B = −0.038, p = 0.019), and impression of schizophrenia (B = 0.074, p = 0.027) were associated with a higher risk-rescue ratio and interpersonal stress condition was associated with a lower risk-rescue ratio (B = −0.045, p = 0.006). In the older group, however, no variables were included significant in the regression model for the Risk Rescue Rating Scale.Conclusions: Demographic and clinical factors such as old age, male sex, interpersonal stress, and impression of schizophrenia were associated with lethality in the younger suicide attempters. However, no factors were associated with SSA in the older adult group. Different mechanisms may underly the lethality in old age suicide.

scholarly journals Risk factors associated with cognitive frailty among community-dwelling older adults: A scoping review

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 824-825
Author(s):  
Sumi Lee ◽  
JuHee Lee
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Community Dwelling ◽  
Physical Factors ◽  
Inclusion Criteria ◽  
Cognitive Frailty ◽  
Factors Associated ◽  
Health Related ◽  
The Impact ◽  
Community Dwelling Older Adults

Abstract Objectives This study aimed to explore the risk factors associated with cognitive frailty(CF) among community-dwelling older adults, and to provide the impact of CF on health-related outcomes. Methods PubMed, EMBASE, Cochrane, PsycINFO, CINAHL, RISS, DBpia, NDSL, and KoreaMed databases were searched to retrieve studies. Two reviewers independently screened titles, abstracts and articles. The inclusion criteria are peer-reviewed articles written in English or Korean for community-dwelling older adults with both physical frailty and cognitive impairment present at the same time. Results A total of 3,513 were searched, and the final 33 were extracted according to the inclusion criteria. Physical factors affecting CF were the number of chronic disease, cardiovascular disease, activity of daily living(ADL), making telephone calls and shopping during instrumental ADL, and a Mini Nutrition Assessment–Short Form score. Psychological factor was depressive symptoms. Significant behavioral factors included self-reported physical activity, low vitamin D, smoking, frequent insomnia, and sedentary lifestyle. In social factors, social participation such as volunteering was identified as a protective factor. Mortality, followed by dementia was health related outcomes on CF, including ADL dependence, poor quality of life, and hospitalization. However, the CF-related fall was inconsistent. Conclusion A wide variety of factors have been presented in studies related to CF. In order to understand CF and improve health-related outcomes, older adults in CF should be screened as high-risk group. When the risk factors and protective factors of CF managed, better health-related outcomes will lead to successful aging of community-dwelling older adults.

scholarly journals Internet Survey of Risk Factors Associated With Training and Competition in Dogs Competing in Agility Competitions

2022 ◽  
Vol 8 ◽  
Author(s):  
Arielle Pechette Markley ◽  
Abigail B. Shoben ◽  
Nina R. Kieves
Keyword(s):  
Risk Factors ◽  
Injury Risk ◽  
Severe Injury ◽  
Secondary Outcome ◽  
Training Level ◽  
Factors Associated ◽  
Jump Training ◽  
Risk Of Injury ◽  
Competition Level ◽  
History Of

Objective: To describe risk factors associated with training and competition in relation to frequency and severity of injuries experienced by agility dogs.Procedures: An internet-based survey collected data on competition level variables and training level variables. The primary outcome was history of any injury and a secondary outcome considered history of severe injury (injury lasting &gt; 3 months). Logistic regression was used to estimate associations and final models were obtained via backward selection to identify the strongest associations within variables.Results: There were 4,197 dogs included in this analysis. Injury was reported for 1,737 (41.4%) dogs and severe injury was reported for 629 (15.0%). In the model with competition level factors, jumping 4” (OR: 1.50) or 2–4” (OR: 1.31) over shoulder height compared to jumping 0–2” lower and competing at national events was associated with increased injury risk, while competing 6+ times on rubber matting was associated with lower risk (OR: 0.62). Training level variables associated with injury risk were age starting jump, teeter, and weave training, with the highest risk observed for dogs starting jump training between 3 and 18 months but starting weave and teeter training after 18 months of age.Conclusion and Clinical Relevance: Many variables thought to be associated with injury risk were not significant in the final model. Starting jump training at an earlier age was associated with greater risk of injury relative to starting after 18 months. It is possible that the high impact of jump training before skeletal maturity may increase the risk of injuries or musculoskeletal conditions. The increased risk of injury in dogs that jump 2–4, or 4+ inches higher than shoulder height may be due to increased biomechanical forces during takeoff and landing. Faster dogs may be at higher risk of injury; handlers planning competition around big events or competing at the national level are likely to have faster dogs, and may be less likely to compete on rubber matting. These data provide valuable current insight into the possible effects that training and competition variables may have on injury risk in agility dogs.

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