Effect of Age on the Outcome of Hospital Treated Depression

1996 ◽  
Vol 168 (1) ◽  
pp. 76-81 ◽  
Author(s):  
T. A. Tuma
Keyword(s):  
Age Groups ◽  
Significant Proportion ◽  
The Elderly ◽  
Adult Patients ◽  
Hospital Treatment ◽  
Melancholic Depression ◽  
Residual Symptoms ◽  
Duration Of Illness ◽  
One Year ◽  
The Uk

BackgroundDepression affects a significant proportion of the expanding elderly population in the UK. Reports of a poorer prognosis for older than for younger adult patients have been challenged by recent papers.MethodThe casenotes of 56 adults (mean age 47.8 years) and 54 elderly (mean age 72.9 years) patients with primary depression were assessed one year after receiving hospital treatment. Outcome measures were compared with earlier reported findings and factors possibly influencing outcome were explored.ResultsThe pattern of outcome in both age groups was broadly similar, thus: adults v. elderly: recovered 44.6% v. 44.4%; relapsed and recovered 23.2% v. 24%; residual symptoms 19.6% v. 13% and chronic depression 7.1% v. 5.5%. In the adults there were two natural deaths and one suicide. In the elderly there were two cases of dementia and five natural deaths, which was double the expected death rate. Predictors of poor outcome were melancholic depression in adults and longer duration of illness at intake and an increasing number of previous episodes of affective disorder in the elderly.ConclusionThe outcome of treated depressive illnesses appears similar in elderly and adult patients. Associated physical ill health did not adversely affect outcome in the elderly group.

scholarly journals Intensive care–treated cardiac arrest: A retrospective study on the impact of extended age on mortality, neurological outcome, received treatments and healthcare-associated costs

2021 ◽  
Author(s):  
Ester Elisabet Holmström ◽  
Ilmar Efendijev ◽  
Rahul Raj ◽  
Pirkka T. Pekkarinen ◽  
Erik Litonius ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Intensive Care ◽  
Retrospective Study ◽  
Cost Effectiveness ◽  
Neurological Outcome ◽  
Age Groups ◽  
The Elderly ◽  
Treatment Intensity ◽  
One Year ◽  
Healthcare Associated

Abstract Background: Cardiac arrest (CA) is a leading cause of death worldwide. As population ages, the need for research focusing on CA in elderly increases. This study investigated treatment intensity, 12-month neurological outcome, mortality and healthcare-associated costs for patients aged over 75 years treated for CA in an intensive care unit (ICU) of a tertiary hospital. Methods: This single-centre retrospective study included adult CA patients treated in a Finnish tertiary hospital’s ICU between 2005 and 2013. We stratified the study population into two age groups: <75 and 75 years. We compared interventions defined by the median daily therapeutic scoring system (TISS-76) between the age groups to find differences in treatment intensity. We calculated cost-effectiveness by dividing the total one-year healthcare-associated costs of all patients by the number of survivors with a favourable neurological outcome. Favourable outcome was defined as a cerebral performance category (CPC) of 1–2 at 12 months after cardiac arrest. Logistic regression analysis was used to identify independent association between age group, mortality and neurological outcome. Results: This study included a total of 1,285 patients, of which 212 (16%) were 75 years of age. Treatment intensity was lower for the elderly compared to the younger group, with median TISS scores of 116 and 147, respectively (p < 0.001). The effective cost in euros for patients with a good one-year neurological outcome was €168,000 for the elderly and €120,000 for the younger group. At 12 months after CA 24% of the patients in the elderly group and 47% of the patients in the younger group had a CPC of 1-2 (p < 0.001). Age was an independent predictor of mortality (multivariate OR = 3.36, 95% CI:2.21-5.11, p < 0.001) and neurological outcome (multivariate OR = 3.27, 95% CI: 2.12-5.03, p < 0.001). Conclusions: The elderly ICU-treated CA patients in this study had worse neurological outcomes, higher mortality and lower cost-effectiveness than younger patients. Further efforts are needed to recognize the tools for assessing which elderly patients benefit from a more aggressive treatment approach in order to improve the cost-effectiveness of post-CA management.

What do adolescents want from their ED? An evaluation on the preferences and opinions of adolescents attending local EDs

2018 ◽  
pp. emermed-2017-207249
Author(s):  
Anna Bryans ◽  
Julian Camilleri-Brennan ◽  
Lei Hua ◽  
Nandesh Patel ◽  
Rebecca Price ◽  
...  
Keyword(s):  
Age Groups ◽  
Significant Proportion ◽  
Likert Scale ◽  
Young Person ◽  
Additional Insight ◽  
Adolescent Population ◽  
Clear Explanation ◽  
Adolescent Patients ◽  
The Uk ◽  
Insight Into

IntroductionThe adolescent population comprises a significant proportion of attendances to the ED. Despite adolescent patients reporting lower levels of healthcare satisfaction compared with other age groups, their opinions are under-represented in existing literature. This prospective study investigated adolescents’ expectations and preferences regarding the ED service.MethodsA questionnaire designed by the investigators was distributed to children aged 12–16 years over a 6-month period in 2015 at two EDs in the UK. The questionnaire explored themes such as same-sex and similar-age areas, staff communication and environment. Interviews based on the questionnaire template were also conducted and guardians were permitted to accompany the participant. Verbal informed consent was obtained from both the young person and their guardian to participate in the study.ResultsThere were 254 respondents, which represented 8.8% of adolescent attendances in the study period. ‘Cleanliness’ was rated the most important factor within the ED setting with 94.8% of respondents selecting 4 or 5 on a 5-point Likert scale. This was followed by ‘feeling comfortable’, ‘clear explanation’ and ‘staff communication’ (91.2%, 90.8% and 90.4% rating these 4 or 5, respectively). However, when participants were asked to select a single most important factor, being ‘seen quickly’ was selected most frequently (95/206, 46.1%). ‘Entertainment’ was regarded the least important with only 17.0% selecting 4 or 5 on the Likert scale. Preference for being treated in an adult ED compared with a child ED increased with age.ConclusionsBeing ‘seen quickly’ was considered the single most important factor by adolescent patients in the ED. Notably, ‘cleanliness’ and aspects of communication also rated highly, with ‘entertainment’ regarded as least important. The additional insight into the healthcare preferences of the adolescent population provides a platform on which the future ED services can be tailored to the needs of young people.

scholarly journals Ten-year survival of Finnish lower limb amputees

1998 ◽  
Vol 22 (1) ◽  
pp. 10-16 ◽  
Author(s):  
T. Pohjolainen ◽  
H. Alaranta
Keyword(s):  
Median Survival ◽  
Lower Limb ◽  
Social Insurance ◽  
Age Groups ◽  
Vascular Diseases ◽  
The Elderly ◽  
Limb Amputation ◽  
Diabetic Patients ◽  
Trauma Patients ◽  
One Year

Data on mortality for the ten years following lower limb amputation were obtained from all the 16 surgical units in Southern Finland and the National Social Insurance Institution. In Southern Finland during the period 1984-1985, amputations of the lower limb were performed on 705 patients, of whom 382 (54%) were women and 323 (46%) men. The majority of the amputations, 47%, were performed for vascular diseases and 41% were performed for diabetes mellitus. The overall survival was 62% at one year after amputation, 49% at two years, 27% at five years and 15% at ten years. The median survival after amputation was 1 yr 5 mth for the women and 2 yr 8 mth for the men. Of the arteriosclerotics, 43% died within one postoperative year while 43% lived longer than two years and 23% longer than five years. The median survival of arteriosclerotics was 1 yr 6 mth. The corresponding figure for patients with diabetes was 1 yr 11 mth. Of the diabetics, 38% died within one postoperative year while 47% lived longer than two years and 20% longer than five years. Of the trauma patients, 86% lived longer than five years and 71% longer than ten years. Of the trans-femoral amputees, 54% lived longer than one year, 36% over two years, 18% over five years and 8% over ten years. The corresponding figures for trans-tibial amputees were 70%. 53%, 21% and 4%. Many elderly vascular and diabetic patients undergoing amputation have a reduced physiological reserve and high mortality. The more proximal the amputation, the greater the risk that the patient will never be able to walk or that the duration of use of the prosthesis will be short. If a prosthesis seems to be a reasonable option for the elderly amputee, any delays in prosthetic fitting should be avoided in older age groups.

scholarly journals Human Sapovirus among Outpatients with Acute Gastroenteritis in Spain: A One-Year Study

Viruses ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 144 ◽  
Author(s):  
Miguel F Varela ◽  
Enrique Rivadulla ◽  
Alberto Lema ◽  
Jesús L Romalde
Keyword(s):  
Acute Gastroenteritis ◽  
Age Groups ◽  
The Elderly ◽  
Mean Value ◽  
Early Spring ◽  
Clinical Samples ◽  
Late Winter ◽  
Viral Pathogen ◽  
One Year ◽  
Different Strains

Viral agents of human gastroenteritis affect people of all ages across the globe. As a mainly self-limiting disease, it is difficult to evaluate the real prevalence of etiological agents circulating in each region. Many of the analyzed outbreaks are caused by viruses of the family Caliciviridae, especially the genus Norovirus (NoV). Most studies have focused on other enteric viruses, leaving sapovirus (SaV) underestimated as an important emerging human threat. This one-year study analyzed clinical samples from hospital outpatients with acute gastroenteritis in Spain, with the aim of revealing the importance of human SaV as an emerging viral pathogen. A total of 2667 stools were tested using reverse transcription (RT)-qPCR to detect and quantify SaV. Sapovirus was detected in all age groups, especially in infants, children, and the elderly. The prevalence was 15.64% (417/2667), and was slightly higher in 0–2- and 3–5-year-olds (19.53% and 17.95%, respectively) and much lower in 13–18-year-olds (9.86%). Positive samples were detected throughout the year, with peaks of detection during autumn and the late winter to early spring months. The mean value for the quantified samples was 6.5 × 105 genome copies per gram of stool (GC/g) (range 2.4 × 103–6.6 × 1011 GC/g). RT-nested PCR and sequencing were used for further genotyping. Genetic characterization showed a predominance of genogroup I (GI), followed by GII and GIV. The detection of multiple genotypes suggests the circulation of different strains without any clear tendency. The results obtained suggest SaV as the second major gastroenteritis agent after NoV in the region.

scholarly journals Survival Analysis of Hospitalized Elderly People with Fractures in Brazil Over One Year

Geriatrics ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. 10
Author(s):  
Brenda Kelly Gonçalves Nunes ◽  
Brunna Rodrigues de Lima ◽  
Lara Cristina da Cunha Guimarães ◽  
Rafael Alves Guimarães ◽  
Claci Fátima Weirich Rosso ◽  
...  
Keyword(s):  
Elderly People ◽  
Cox Regression ◽  
Age Groups ◽  
The Elderly ◽  
Diabetic Patients ◽  
Related Factors ◽  
Hospitalized Elderly ◽  
Study Results ◽  
One Year ◽  
The Impact

Objective: This study analyzes the causes of death, survival, and other related factors in hospitalized elderly people with fractures over the course of one year. Methods: We followed 376 fracture patients for one year in a prospective cohort study to a reference hospital in central Brazil. The Cox regression model was used to analyze factors associated with survival. Results: The results indicate that the one-year mortality rate was high (22.9%). The independent factors linked to lower overall survival were as follows: patients aged ≥80 years with previous intensive care unit (ICU) admission and presence of comorbidities (diabetes mellitus [DM] and dementia). Conclusion: Our study results may contribute to a better understanding of the impact of fractures on the elderly population and reinforce the need to oversee age-groups, diabetic patients, and patients with complications during hospitalization.

Prevalence and characteristics of diagnostic groups amongst 1034 patients seen in ENT practices for dizziness

2014 ◽  
Vol 128 (2) ◽  
pp. 128-133 ◽  
Author(s):  
M Lüscher ◽  
S Theilgaard ◽  
B Edholm
Keyword(s):  
Multicentre Study ◽  
Study Design ◽  
Benign Paroxysmal Positional Vertigo ◽  
Age Groups ◽  
Significant Proportion ◽  
The Elderly ◽  
The Other ◽  
Night Time ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

AbstractObjective:To determine the prevalence and characteristics of various diagnostic groups amongst patients referred to ENT practices with the primary complaint of dizziness.Study design:A prospective, observational, multicentre study.Methods:Consecutive patients presenting with dizziness to the participating ENT practices were enrolled. Seven ENT specialists at three clinics participated.Results:Benign paroxysmal positional vertigo was diagnosed in 53.3 per cent of the 1034 study patients. Fifty-nine per cent of these experienced night-time awakening with dizziness, which was a significant proportion in comparison to the other diagnostic groups. Benign paroxysmal positional vertigo was the most frequent diagnosis in all age groups, including those over 70 years.Conclusion:In this study of patients referred to ENT for dizziness, benign paroxysmal positional vertigo was the dominant diagnostic entity, in all age groups and overall. All clinicians in contact with dizzy patients must consider benign paroxysmal positional vertigo, especially in the elderly.

Systemic immune-inflammation index to predict prognosis of elderly patients with newly diagnosed solid tumors.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e14517-e14517
Author(s):  
Chan Li ◽  
Wei Tian ◽  
Feng Zhao ◽  
Meng Li ◽  
Qin Ye ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Solid Tumors ◽  
Age Groups ◽  
Blood Platelet ◽  
The Elderly ◽  
Newly Diagnosed ◽  
Individual Values ◽  
Aged Patients ◽  
Immune Inflammation ◽  
One Year

e14517 Background: Cancer in the elderly has become a common problem due in part to the increase in life expectancy. Compared to younger counterparts, the biological characteristics of tumors and their responsiveness to therapy may differ in elderly patients, and the elderly also can have a decreased tolerance to anticancer therapy. In addition, there is less evidence from clinical trials to guide physicians in treating aged patients with solid tumors. It would be highly useful to have a simple and powerful indicator of their prognosis. In this paper we evaluated the predictive value of the Systemic Immune-inflammation Index, SII, in determining the one-year survival in elderly patients with newly diagnosed solid tumors. Methods: Data from 118 patients, 70 to 89 years of age with newly diagnosed solid tumors in 2014 were retrospectively analyzed. The patients were divided into two groups according to age: (1) 70-75 years of age and (2) over 75 years of age. We calculated SII from the equation, SII = P x N/L, where P, N and L are the preoperative peripheral blood platelet, neutrophil and lymphocyte counts per liter respectively. The optimum cutoff point for SII for a favorable prognosis was determined to be 390×109 cells/L. For evaluation of SII as a prognostic indicator, the patients were divided into high SII ( > 390×109 cells /L) and low SII (≤ 390×109 cells/L) groups. Individual values were used to determine the relationship between SII and one-year survival in the two age groups. Results: A high SII > 390×109 cells/L was correlated with poor one-year survival (χ² = 7.658, P = 0.006). Patients with low SII had improved survival. Conclusions: SII was a robust indicator of one-year survival in elderly patients with newly diagnosed solid tumors. Patients in the high SII group showed poor prognosis compared to patients with a low SII score. [Table: see text]

scholarly journals Senior Registrar Training in Old Age Psychiatry in the United Kingdom

1988 ◽  
Vol 12 (6) ◽  
pp. 233-234
Author(s):  
J. P. Wattis
Keyword(s):  
Old Age ◽  
The Elderly ◽  
Psychiatric Training ◽  
Senior Registrar ◽  
The United Kingdom ◽  
Old Age Psychiatry ◽  
One Year ◽  
The Uk ◽  
Special Responsibility ◽  
Registrar Training

The Joint Committee on Higher Psychiatric Training (JCHPT) requires senior registrars (SRs) training for special responsibility posts in old age psychiatry to spend between one year and 18 months in higher training posts in which psychiatry of old age forms the major part of the work. Although only about a third of consultants in a recent survey had such training, there was strong evidence that more recently appointed consultants were likely to have recommended training. The availability of suitable training ‘slots’ seems likely to play a major role in how quickly specialised psychiatric services for old people can develop in response to the rising challenge posed by demographic changes. Jolley has already demonstrated how developments have been delayed by a shortage of properly trained candidates. Despite this the situation has now been reached where over two-thirds of the elderly population of the UK are served by specialised consultants albeit sometimes at inadequate manpower levels.

scholarly journals The etiology of viral gastroenteritis in patients requiring hospitalization: Differences between rotavirus and norovirus infections - practical or only academic significance?

2017 ◽  
Vol 145 (9-10) ◽  
pp. 498-502
Author(s):  
Radoslava Doder ◽  
Dajana Lendak ◽  
Svetlana Ilic ◽  
Nadica Kovacevic ◽  
Slavica Tomic ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Age Groups ◽  
Clinical Manifestations ◽  
The Elderly ◽  
Polymerase Chain Reaction Method ◽  
Hospitalized Patients ◽  
Hospital Treatment ◽  
Viral Gastroenteritis ◽  
Clinical Center ◽  
Novi Sad

Introduction/Objective. Viral gastroenteritides (VGEs) have great infectious potential and may occur in all age groups. Loss of fluid due to vomiting and diarrhea represent a special risk, and may result in a more severe clinical presentation in children, the elderly, and people with chronic diseases. The aim of the study was to explore the causes of VGEs among hospitalized patients, as well as to evaluate the severity of clinical symptoms in rotavirus and norovirus infections. Methods. The observational prospective study included 191 patients aged 2?88 years who were treated at the Clinic for Infectious Diseases, Clinical Center of Vojvodina, Novi Sad, over a two-year period. Testing of stool samples for viral agents was done by the reverse-transcription polymerase chain reaction method. Positive findings were found in 59 patients. Results. Of 59 patients with confirmed viral gastroenteritis, in 31 (52.5%) it was caused by rotavirus, in 17 (28.8%) by norovirus, three patients (5.1%) had other viral causes, while co-infection with two viruses was found in eight (13.5%) patients. The severity of clinical manifestations as expressed with Vesikari score did not differ with regard to infectious agents (p = 0.353). However, patients with rotavirus infection had a higher incidence of fever (p = 0.043), longer duration of diarrhea (p = 0.015) and dehydration (p = 0.014), and longer need for hospital treatment (p = 0.030). Conclusion. The most common cause of VGEs in our hospitalized patients was rotavirus. There was no difference in the severity of clinical symptoms between rotavirus and norovirus infections.

FLUNARIZINE IN PRIMARY HEADACHE DISORDERS

2015 ◽  
Vol 86 (11) ◽  
pp. e4.174-e4
Author(s):  
Nazia Karsan ◽  
David Palethorpe ◽  
Ria Bhola ◽  
Juana Marin, Peter Goadsby
Keyword(s):  
Chronic Migraine ◽  
Significant Proportion ◽  
Primary Headache ◽  
Clinical Excellence ◽  
Familial Hemiplegic Migraine ◽  
Hemiplegic Migraine ◽  
Primary Headache Disorders ◽  
One Year ◽  
Randomised Controlled ◽  
The Uk

BackgroundFlunarizine is a widely used migraine preventive not licensed in the UK. In September 2014, the National Institute for Clinical Excellence (NICE) published supportive guidelines for flunarizine use in migraine based on available randomised controlled evidence.AimTo collect data for an audit of flunarizine use from our tertiary headache practice in the UK over twenty years, to try to establish indications for its use, typical doses, short and long term side effects, and treatment outcomes, including changes in acute treatment use and change in frequency and intensity of headache on treatment.ResultsFor the first 30 patients audited the most common indication for flunarizine was chronic migraine, followed by migraine with aura, sporadic hemiplegic migraine and familial hemiplegic migraine and then new persistent daily headache of a migrainous type. Doses up to 15mg were generally well tolerated, with only five patients stopping treatment due to adverse effects. Flunarizine is generally effective; with only three patients reporting no clinical effect: two had hemiplegic migraine and one chronic migraine. The commonest dose used was 10mg and a significant proportion of patients continued treatment for more than one year.ConclusionFlunarizine is an effective, well tolerated migraine preventive that can be used for extended periods in a range of migraine sub-types.

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