Toleration of Head Injury by the Elderly

Neurosurgery ◽  
1987 ◽  
Vol 20 (6) ◽  
pp. 954-958 ◽  
Author(s):  
Loren A. Amacher ◽  
David E. Bybee
Keyword(s):  
Head Injury ◽  
Mortality Rate ◽  
Significant Proportion ◽  
The Elderly ◽  
Clinical Profile ◽  
Mechanism Of Injury ◽  
Medical Conditions ◽  
Contributing Factors ◽  
Old People ◽  
Principal Mechanism

Abstract Fifty-six patients 80 or more years of age, admitted because of head injury, provide a clinical profile of the effects of head injury upon an aging population. The mortality rate is high, even in those with good admission Glasgow coma scores. The incidence of intracranial mass hematoma is striking. Falls in the residence constitute the principal mechanism of injury, and preexisting medical conditions are important contributing factors. A significant proportion (60%) of old people may make a full recovery from head injury.

scholarly journals Elderly pedestrian neurotrauma: A descriptive study from a premier neurotrauma center in India

2013 ◽  
Vol 04 (01) ◽  
pp. 29-32 ◽  
Author(s):  
Ashok Munivenkatappa ◽  
Nupur Pruthi ◽  
Mariamma Philip ◽  
Bhagavatula I Devi ◽  
Sampath Somanna
Keyword(s):  
Head Injury ◽  
Mortality Rate ◽  
Ct Scan ◽  
Demographic Data ◽  
The Elderly ◽  
Clinical Findings ◽  
Subdural Hemorrhage ◽  
Elderly Age ◽  
Tertiary Center ◽  
The City

ABSTRACT Context: Experience with elderly pedestrian neurotrauma at a major neurotrauma tertiary center. Aims: To highlight the specific injuries and outcome of the elderly pedestrian neurotrauma patients within the city of Bangalore and its surrounding districts. Settings and Design: A retrospective study consisting of demographic data, clinical findings, radiological details, and outcomes. Materials and Methods: A study was conducted at the casualty services, in which 143 consecutive elderly pedestrian (age >60 years) head injury victims were studied from June to September 2009. The records from the hospital mortuary were analyzed from 2007 to 2009. An analysis of 77 elderly patients who died as a pedestrian in accidents during this period was performed. Statistical Analysis Used: SPSS 15. Results: The elderly pedestrians constituted 27% (143/529) of all pedestrian traumas. Two wheelers were the most common accident vehicle (56.6%, 81/143). Most of the injuries (38.5%, 55/143) occurred during peak traffic hours, that is, 4 pm to 9 pm. Majority sustained moderate to severe head injury (61%, 87/143). More than three‑fourths of patients required a computed tomography (CT) scan (77%, 110/143), in which there was a higher frequency of contusion (31.5%, 45/143), and subdural hemorrhage (23.1%, 33/143). Most of the injured (43.3%, 13/30) underwent surgery for intracranial hematoma. The mortality rate was 22.8% (8/35). Nearly one‑fourth of conducted postmortems among pedestrians belonged to the elderly age group (77/326, 23.6%). Conclusions: Elderly pedestrian neurotrauma patients sustain a more severe injury as evident by poorer Glasgow Coma Score (GCS) scores and CT scan findings, and hence have a higher mortality rate.

What Can We Learn from Sarcopenia with Curarisation in the Context of Cancer Surgery? A Review of the Literature

2019 ◽  
Vol 25 (28) ◽  
pp. 3005-3010
Author(s):  
Georges Samouri ◽  
Alexandre Stouffs ◽  
Lionel V. Essen ◽  
Olivier Simonet ◽  
Marc De Kock ◽  
...  
Keyword(s):  
Frail Elderly ◽  
Muscle Fibers ◽  
Motor Units ◽  
The Elderly ◽  
Hepatic Function ◽  
Volume Of Distribution ◽  
Neuromuscular Blocking ◽  
Cancer Surgery ◽  
Old People ◽  
Age Related

Introduction: The monitoring of the curarisation is a unique opportunity to investigate the function of the neuromuscular junction (NMJ) during cancer surgery, especially in frailty-induced and age-related sarcopenia. Method: We conducted a comprehensive literature review in PubMed, without any limit of time related to frailty, sarcopenia, age and response to neuromuscular blockers in the context of cancer surgery. Results: Several modifications appear with age: changes in cardiac output, a decrease in muscle mass and increase in body fat, the deterioration in renal and hepatic function, the plasma clearance and the volume of distribution in elderly are smaller. These changes can be exacerbated in cancer patients. We also find modifications of the NMJ: dysfunctional mitochondria, modifications in the innervation of muscle fibers and motor units, uncoupling of the excitation-contraction of muscle fibers, inflammation. : Neuromuscular blocking agents (NMBAs) compete with acetylcholine and prevent it from fixing itself on its receptor. Many publications reported guidelines for using NMBAs in the elderly, based on studies comparing old people with young people. : No one screened frailty before, and thus, no studies compared frail elderly and non-frail elderly undergoing cancer surgery. Conclusion: Despite many studies about curarisation in the specific populations, and many arguments for a potential interest for investigation, no studies investigated specifically the response to NMBAs in regard of the frailty-induced and age-related sarcopenia.

Predictors of Mortality in Board and Care Homes

1997 ◽  
Vol 36 (1) ◽  
pp. 77-87 ◽  
Author(s):  
Nicholas G. Castle
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Social Services ◽  
Long Term Care ◽  
Significant Proportion ◽  
The Elderly ◽  
Term Care ◽  
Care Facilities ◽  
Board And Care

Long-term care institutions have emerged as dominant sites of death for the elderly. However, studies of this trend have primarily examined nursing homes. The purpose of this research is to determine demographic, functional, disease, and facility predictors and/or correlates of death for the elderly residing in board and care facilities. Twelve factors are found to be significant: proportion of residents older than sixty-five years of age, proportion of residents who are chair- or bed-fast, proportion of residents with HIV, bed size, ownership, chain membership, affiliation with a nursing home, number of health services provided other than by the facility, the number of social services provided other than by the facility, the number of social services provided by the facility, and visits by Ombudsmen. These are discussed and comparisons with similar studies in nursing homes are made.

scholarly journals The effects of teaching methods of palliative care on life pattern of old women with chronic pain

2019 ◽  
Vol 29 (4) ◽  
Author(s):  
Elham Hesari ◽  
Zahra Sabzi ◽  
Shohreh Kolagari
Keyword(s):  
Chronic Pain ◽  
Palliative Care ◽  
Teaching Methods ◽  
Social Life ◽  
Educational Program ◽  
Elderly Women ◽  
Intervention Group ◽  
The Elderly ◽  
Old People ◽  
Life Pattern

Chronic pain is among problems of old people and causes changes in their life pattern and processes. Teaching palliative care can help old people suffering from chronic pain to live an active life. The aim of this research was to determine effects of educating of palliative care on life pattern of elderly women with chronic pain. The present study was a Quasi-experimental design with pre-test and post test was conducted on 30 elderly women suffering from chronic pain in 2018 in Iran. The Questionnaire for evaluating the Pattern of Life with Pain in the elderly was filled before the intervention, group educating of palliative care was carried out using an educational package, and the questionnaire was completed again immediately and one and three months after. The data was analyzed using mean, standard deviations, Fisher’s F test, and Greenhouse-Geisser and Bonferroni post-hoc test by employing SPSS- 16. Mean changes before teaching palliative care significantly differed from those of immediately and one and three months after the educational program (p = 0.0), (p = 0.004). There were significant differences between the stages of immediately and one month after the educational program and that of three months after it (p = 0.001), (p = 0.002). Concerning the personal life patterns, there were statistically significant differences between the stage immediately after the educational program and those before the intervention and three months after it (p = 0.005), (p = 0.000). Regarding the social life pattern, only the stage of one month after the educational program significantly differed from that of three months (p = 0.005). Mean growth in life pattern of the old women suffering from chronic pain in the stages after the intervention indicated the importance of and the necessity for palliative care during old age. Moreover, the success of this education three months after the educational program as compared to immediately and one month after it indicates that allocation of sufficient time plays a very important role in transferring information and in teaching methods of palliative care to old people.

Letter to the Editor: Craniopharyngiomas in the elderly: the crucial influence of tumor topography on surgical risk assessment

2021 ◽  
Author(s):  
José M. Pascual ◽  
Ruth Prieto
Keyword(s):  
Risk Assessment ◽  
Elderly Patients ◽  
Tumor Tissue ◽  
Significant Proportion ◽  
Wide Band ◽  
The Elderly ◽  
Surgical Risk ◽  
Definition Of ◽  
Weighted Sequences ◽  
Tumor Topography

Classifying CPs within the overly vague, uninformative category “suprasellar” prevents gaining any true insight regarding the risks associated with the surgical procedure employed. Routine MRI obtained with conventional T1- and T2-weighted sequences along the midsagittal and coronal trans-infundibular planes allow an accurate and reliable preoperative definition of CP topography. CPs developing primarily within the infundibulum and/or tuberal region of the hypothalamus, as well as those wholly located within the 3V, should be distinguished preoperatively from those lesions originally expanding beneath the 3V floor (3VF), the true suprasellar tumors. Among adult patients, about 40% of CPs correspond to infundibulo-tuberal tumors expanding primarily within the 3VF, above an intact pituitary gland and stalk. This subgroup of CPs shows strong adherences to the surrounding hypothalamus, as they are embedded within a wide band of reactive gliotic tissue, usually infiltrated by microscopic finger-like solid cords of tumor tissue. In elderly patients, a significant proportion of CPs correspond to papillary tumors developing above an intact 3VF, usually showing small pedicle-like or sessile-like attachments to the infundibulum. With the current diagnostic MRI workup routinely employed for CPs, it is possible, for the majority of lesions, to preoperatively differentiate these topographical variants and predict the type of CP-hypothalamus relationship that will be found during surgery.

scholarly journals Indigenous music learning in contemporary contexts: Nurturing learner identity, agency, and passion

2021 ◽  
pp. 1321103X2095454
Author(s):  
James Isabirye
Keyword(s):  
The Elderly ◽  
Transfer Of Knowledge ◽  
Contributing Factors ◽  
Music Learning ◽  
Learner Identity ◽  
School Settings ◽  
Indigenous Music ◽  
The Social ◽  
Musical Interactions ◽  
Successful Transfer

I studied the revival project that involved teaching and (re)learning of a nearly extinct music tradition of the Basoga people from Uganda, to find out what might be learnt about and from those learning processes, and insights that might be applicable in formal educational settings. The revival project activities were documented (with participants’ permission) and publicized through a large number of audio and audiovisual recordings, photographs, and reports from community and school settings. Treating this documentation as extant data, I engaged in a qualitative analysis of the social and musical interactions between and among the two surviving master musicians and the youths to understand the nature and meaning of these learning experiences. Emergent themes reflected that nurturing identity, agency, and joy-filled passion among the learners were the main contributing factors that facilitated a successful transfer of knowledge and skills from the elderly master musicians to multitudes of youths.

Outcome in an Urban Pediatric Trauma System with Unified Prehospital Emergency Medical Services Care

1995 ◽  
Vol 10 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Michael J. VanRooyen ◽  
Edward P. Sloan ◽  
John A. Barrett ◽  
Robert F. Smith ◽  
Hernan M. Reyes
Keyword(s):  
Head Injury ◽  
Mortality Rate ◽  
Trauma Center ◽  
Pediatric Trauma ◽  
Trauma System ◽  
Age Groups ◽  
Mortality Rates ◽  
Trauma Centers ◽  
Field Triage ◽  
Pediatric Trauma Center

AbstractHypothesis:Pediatric mortality is predicted by age, presence of head trauma, head trauma with a low Glasgow Coma Scale (GCS) score, a low Pediatric Trauma Score (PTS), and transport directly to a pediatric trauma center.Population:Studied were 1,429 patients younger than 16 years old admitted to or declared dead on arrival (DOA) in a pediatric trauma center from January through October, 1988. The trauma system, which served 3-million persons, included six pediatric trauma centers.Methods:Data were obtained by a retrospective review of summary statistics provided to the Chicago Department of Health by the pediatric trauma centers.Results:Overall mortality was 4.8% (68 of 1429); 32 of the patients who died (47.1%) were DOA. The in-hospital mortality rate was 2.6%. Head injury was the principal diagnosis in 46.2% of admissions and was a factor in 72.2% of hospital deaths. The mortality rate was 20.3% in children with a GCS≤10 and 0.4% when the GCS was >10 (odds ratio [OR] = 67.0, 95% CI = 15.0–417.4). When the PTS was ≤ 5, mortality was 25.6%; with a PTS > 5, the mortality was 0.2% (OR = 420.7, 95% CI = 99.3–2,520). Although transfers to a pediatric trauma center accounted for 73.6% of admissions, direct field triage to a pediatric trauma center was associated with a 3.2 times greater mortality risk (95% CI = 1.58–6.59). Mortality rates were equal for all age groups. Pediatric trauma center volume did not influence mortality rates.Conclusions:Head injury and death occur in all age groups, suggesting the need for broad prevention strategies. Specific GCS and PTS values that predict mortality can be used in emergency medical services (EMS) triage protocols. Although the high proportion of transfers mandates systemwide transfer protocols, the lower mortality in these patients suggests appropriate EMS field triage. These factors should be considered as states develop pediatric trauma systems.

scholarly journals Liver and Pancreatic Resection in the Elderly

HPB Surgery ◽  
1997 ◽  
Vol 10 (4) ◽  
pp. 259-261 ◽  
Author(s):  
O. J. Garden
Keyword(s):  
Survival Rate ◽  
Liver Resection ◽  
Mortality Rate ◽  
Elderly Patients ◽  
Complication Rate ◽  
Pancreatic Resection ◽  
The Elderly ◽  
Term Survival ◽  
Pancreatic Resections

Background: Liver resection, or pancreaticoduodenectomy, has traditionally been thought to have a high morbidity and. mortality rate among the elderly. Recent improvements in surgical and anesthetic techniques, an increasing number of elderly patients, and an increasing need to justify use of limited health care resources prompted an assessment of recent surgical outcomes.Methods: Five hundred seventy-seven liver resections (July 1985–July 1994) performed for metastatic colorectal cancer and 488 pancreatic resections (October 1983–July 1994) performed for pancreatic malignancies were identified in departmental data bases. Outcomes of patients younger than age 70 years were compared with those of patients age 70 years or older.Results: Liver resection for 128 patients age 70 years or older resulted in a 4% perioperative. mortality rate and a 42% complication rate. Median hospital stay was 13 days, and 8% of the patients required admission to the intensive care unit (ICU). Median survival was 40 months, and the 5-year survival rate was 35%. No difference were found between results for the elderly and those for younger patients who had undergone liver resection, except for a minimally shorter hospital stay fortheyoungerpatients (median, 12 days vs. 13 days p=0.003). Pancreatic resection for 138 elderly patients resulted in a mortality rate of 6% and a complication rate of 45%. Median stay was 20 days, and 19% of the patients required ICU admission, results identical to those for the younger cohort. Long-term survival was poorer for the elderly patients, with a 5-year survival rate of 21% compared with 29% for the younger cohort (p=0.03).Conclusions: Major liver or pancreatic resections can be performed for the elderly with acceptable morbidity and mortality rates and possible long-term survival. Chronologic age alone is not a contraindication to liver or pancreatic resection for malignancy.

Socioeconomic Variation of Multimorbidity in Colombian Older Adults

2021 ◽  
Author(s):  
Silvia Marcela Ballesteros ◽  
José Moreno-Montoya ◽  
Wilhelmus Johannes Andreas Grooten ◽  
Pedro Barrera-López ◽  
José A. De la Hoz-Valle
Keyword(s):  
Mortality Rate ◽  
Rural Areas ◽  
Urban Areas ◽  
Structural Equation ◽  
Strong Association ◽  
High Body Mass Index ◽  
Multidimensional Poverty ◽  
The Elderly ◽  
Cross Sectional ◽  
Multidimensional Poverty Index

Abstract BackgroundMultimorbidity prevalence in the elderly is increasing worldwide. Variations regarding the socioeconomic characteristics of the individuals and their context have been described, mostly in high-income scenarios. This study aims to assess the magnitude and the socioeconomic factors associated with variations on multimorbidity in Colombia.MethodsA cross-sectional multilevel study with a nationally representative sample of 23 694 Colombian adults aged 60 years and older was conducted. Individual socioeconomic, demographic, childhood and health related characteristics, as well as group level variables (multidimensional poverty index and infectious diseases mortality rate) were analyzed. A two-level stepwise structural equation model was used to simultaneously adjust the individual and contextual effects. ResultsMultimorbidity prevalence was 62.3% (95% CI 61.7–62.9). In the multilevel adjusted models, age, female sex, having functional limitations, non-white ethnicity, high body mass index, higher income, physical inactivity, poverty during childhood and living in urban areas were associated with multimorbidity. The mediation analysis showed that living in rural areas was significantly associated with infectious disease mortality rate and other individual associations with multimorbidity were mediated by the multidimensional poverty variable. ConclusionsThis paper demonstrates a strong association between multimorbidity and poverty in a low-middle income country. Differences in the factors involved in the etiology of multimorbidity are expected among wealthy and poor countries regarding availability and prioritization of health services.

Sign in / Sign up

Export Citation Format

Share Document