scholarly journals Descending necrotizing mediastinitis in the elderly patients

Open Medicine ◽  
2016 ◽  
Vol 11 (1) ◽  
pp. 449-460 ◽  
Author(s):  
Antonio Mazzella ◽  
Mario Santagata ◽  
Atirge Cecere ◽  
Ettore La Mart ◽  
Alfonso Fiorelli ◽  
...  
Keyword(s):  
Elderly Patient ◽  
Mortality Rate ◽  
Elderly Patients ◽  
High Mortality ◽  
Patient Population ◽  
The Elderly ◽  
Therapeutic Management ◽  
Descending Necrotizing Mediastinitis ◽  
Long Time

AbstractDescending Necrotizing Mediastinitis (DNM) is a polymicrobic, dangerous and often fatal process, arising from head or neck infections and spreading along the deep fascial cervical planes, descending into the mediastinum. It can rapidly progress to sepsis and can frequently lead to death. It has a high mortality rate, up to 40% in the different series, as described in the literature. Surgical and therapeutic management has been discussed for long time especially in an elderly patient population. The literature has been reviewed in order to evaluate different pathogenesis and evolution and to recognise a correct therapeutic management.

scholarly journals Safe Free Tissue Transfer in Patients Older than 90 Years

2021 ◽  
Vol 06 (02) ◽  
pp. e87-e92
Author(s):  
Marc H. Hohman ◽  
Aurora G. Vincent ◽  
Abdul R. Enzi ◽  
Yadranko Ducic
Keyword(s):  
Elderly Patient ◽  
Mortality Rate ◽  
Complication Rate ◽  
Patient Population ◽  
Tertiary Care ◽  
Free Tissue Transfer ◽  
The Elderly ◽  
Control Group ◽  
Partial Loss ◽  
Tissue Transfer

Abstract Objective This study aimed to evaluate the safety of microvascular free tissue transfer in the elderly patient population. Methods We performed a 20-year retrospective review at a tertiary care private practice of patients of ≥ 90 years of age who underwent microvascular free tissue transfer and had at least 6 months of follow-up. Similarly, we reviewed patients aged 70 to 89 years who underwent free tissue transfer between 2018 and 2020 as a control group. Records were examined for type of flap, defect site, pathology, and occurrence of complications. Results Overall 77 patients of 90 years or older met the inclusion criteria and 77 sequential patients aged 70 to 89 years were identified to serve as a control group. The overall complication rate among patients of ≥ 90 years of age was 18%, with flap-related complications in 4% (two partial flap loss and one total loss). The mortality rate was 1.3%. All patients of ≥ 90 years of age undergoing osteocutaneous reconstruction for osteoradionecrosis experienced complications, but only one was a flap complication (partial loss). Among patients aged 70 to 89 years, the overall complication rate was also 18%, with flap-related complications in 4% (two complete flap failures and one partial loss). The mortality rate in the control group was 2.6%. Conclusion Soft tissue free flaps are a safe option in the elderly patient population and should be offered to patients who are medically optimized prior to surgery, regardless of age. Osteocutaneous reconstruction for osteoradionecrosis must be undertaken with caution. This study reflects level of evidence 4.

Nonoperative Management of Olecranon Fractures in Elderly Patients: A Systematic Review

Hand ◽  
2020 ◽  
pp. 155894472094426
Author(s):  
Christina A. Alvara ◽  
Griffin Biedron ◽  
John C. Dunn
Keyword(s):  
Elderly Patient ◽  
Elderly Patients ◽  
Patient Population ◽  
English Language ◽  
Nonoperative Management ◽  
The Elderly ◽  
Pubmed Database ◽  
Language Data ◽  
The Mean ◽  
Olecranon Fractures

Background: Despite increased utilization of conservative measures for displaced olecranon fractures in elderly patients, in whom operative fixation may be complicated by coexisting comorbidities and declining bone quality, the noninferiority of nonoperative management has yet to be proven. The purpose of this study was to review nonoperative management of displaced olecranon fractures in the elderly patient population. Methods: A literature search of the PubMed database was performed using the term olecranon fracture. Papers included those with results for patients aged 65 years and older published between 1990 and 2018 in the English language. Data were pooled to analyze outcomes and complications of nonoperative management of olecranon fractures in the elderly patient population. Results: Four eligible studies combined for a total of 69 patients with 70 fractures with an average age of 83.8 years (71-95 years), female predominance of 88%, and a mean follow-up of 12.4 months who underwent nonoperative management of displaced olecranon fractures. While only 25% of fractures went on to radiographic union, the mean Disabilities of the Arm, Shoulder, and Hand score was 16.9 (0-59.6), the mean arc of motion was 138°, and 92% of patients achieved excellent results. One-quarter (26%) of the patients experienced complications: radial head subluxation (1), skin sore (1), degenerative arthropathy (1), pain on movement (2), click in movement of the elbow (5), and local pain (8). Conclusion: Displaced olecranon fractures in patients aged older than 70 years may be effectively managed with nonoperative measures to produce high satisfaction and functional range of motion.

Propofol Versus Midazolam/Fentanyl Sedation for Colonoscopy in the Elderly Patient Population

2017 ◽  
Vol 32 (3) ◽  
pp. 210-214 ◽  
Author(s):  
Pamela Lovett ◽  
Victoria Gómez ◽  
David O. Hodge ◽  
Beth Ladlie
Keyword(s):  
Elderly Patient ◽  
Patient Population ◽  
The Elderly

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.

scholarly journals The Relationship between the Acute Confusing State and the Comorbidities of the Elderly Patient

2019 ◽  
Vol 70 (7) ◽  
pp. 2415-2419 ◽  
Author(s):  
Valeria Carmen Albu ◽  
Raluca Elena Sandu ◽  
Andreea Lili Barbulescu ◽  
Elena-Anca Tartea ◽  
Emilia Burada ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Elderly Patient ◽  
Elderly Patients ◽  
Neurological Examination ◽  
The Elderly ◽  
Cardiovascular Pathology ◽  
Wide Range ◽  
Neurology Clinic ◽  
The Relationship ◽  
Hepatic Pathology

The aim of the study was to assess the correlations between the acute confusing syndrome and different comorbidities found in a group of 126 elderly patients with this diagnosis, who were admitted to the Neurology Clinic of the Neuropsychiatry Hospital of Craiova. The main syndromes highlighted at the neurological examination were confusing, pyramidal and vestibular syndromes. The acute confusing syndrome has a multifactorial etiology, due to the wide range of comorbidities encountered in elderly patients. In our study the most frequent comorbidities were cardiovascular pathology, diabetes mellitus, dyslipidemia, cerebrovascular renal, hepatic pathology.

Anaesthesia for the Elderly Patient (Oxford Anaesthsia Library)

2017 ◽  
Author(s):  
Chris Dodds ◽  
Chandra M. Kumar ◽  
Frédérique Servin
Keyword(s):  
Elderly Patient ◽  
Elderly Patients ◽  
Independent Living ◽  
Ethical Issues ◽  
Preoperative Assessment ◽  
The Elderly ◽  
Day Surgery ◽  
Gynaecological Surgery ◽  
Current State

This book provides a timely and authoritative synopsis of the current state of anaesthesia and the elderly patient at a time when the challenge of caring for the growing numbers of elderly patients is probably the greatest faced by healthcare across the globe. The book reviews important developments in the understanding of clinical practice serving the elderly. It describes the need for anaesthesia to deliver ‘best care’ to the elderly, with the aim to maintain their independent living. It then details the key features of ageing and the effect these have on physiology and pharmacology. Specific aspects of practice, including preoperative assessment; day surgery; emergency surgery; anaesthesia for orthopaedic, urological, and gynaecological surgery, as well as major abdominal surgery; neurosurgery; and critical care. Emphasis is placed on managing postoperative care and cognitive dysfunction (POCD), with additional discussion of ethical issues and the law pertaining to the elderly patient. A new chapter reviews the challenges of treating elderly patients in non-theatre environments.

scholarly journals Clinical evolution of adult, elderly and very elderly patients admitted in Intensive Care Units

2011 ◽  
Vol 19 (6) ◽  
pp. 1344-1351 ◽  
Author(s):  
Verônica Cunha Rodrigues de Oliveira ◽  
Lilia de Souza Nogueira ◽  
Rafaela Andolhe ◽  
Katia Grillo Padilha ◽  
Regina Marcia Cardoso de Sousa
Keyword(s):  
Intensive Care ◽  
Mortality Rate ◽  
Elderly Patients ◽  
Comparative Study ◽  
Clinical Outcomes ◽  
Intensive Care Units ◽  
The Elderly ◽  
Simplified Acute Physiology Score ◽  
Adult Patients ◽  
Very Elderly

This study compared clinical outcomes among adult, elderly and very elderly patients admitted to Intensive Care Units (ICUs) located in São Paulo, Brazil. This retrospective, longitudinal and comparative study included 279 adult (≥18 and <60 years), 216 elderly (≥60 and <80 years) and 105 very elderly (≥80 years) patients. Adult patients differed from other groups regarding the unit to which they were referred and severity, according to the Simplified Acute Physiology Score II. Adults were most frequently sent to hospitalization wards; elderly and very elderly patients who survived hospitalization in critical units showed sharper improvement before discharge. There were differences in relation to mortality between adult and elderly patients, with a higher rate in the elderly group; however, the mortality rate of very elderly and adult patients was similar. In general, the results indicated that older age was not associated with undesirable outcomes in ICUs.

scholarly journals The lack of professionalism and ethics in the treatment of an elderly patient / Nedostatak profesionalizma i etike u tretmanu starijeg pacijenta

2015 ◽  
Vol 2 (2) ◽  
pp. 33
Author(s):  
Tatjana Ivanković Zrnić
Keyword(s):  
Health Care ◽  
Elderly Patient ◽  
Elderly Patients ◽  
Medical Staff ◽  
Older Patients ◽  
Birth Rate ◽  
The Elderly ◽  
Pubmed Central ◽  
Personalized Care ◽  
Prolonged Life Expectancy

An apparent decline in the birth rate that accompanies the aging population with prolonged life expectancy requires greater investment in the health care of the elderly. It is necessary to identify the conditions that naturally carries the older times, expect a slower recovery in comparison to young people, but do not exclude recovery in treatment.In practice we often encounter indifference and neglect of an elderly patient by the medical staff, the assumption is that this is justified by insufficiently motivated patient.Searching PubMed, PubMed Central, Google Scholar and HINARI, we analyzed how this topic is present in nivioma protects the health and recognizing the importance of personalized care for older patients in the world.The results of many studies indicate that there is a neglect of elderly patients, resulting in poor outcome of care.Requires additional training of staff working with elderly patients to improving attitudes and extreme improve the treatment of these patients.Negative attitudes towards older patients contribute to business dissatisfaction medical staff.

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