scholarly journals Patient outcomes in Anteromedial Osteoarthritis Patients over 80 Years Old Undergoing Oxford Unicompartmental Knee Arthroplasty in China

2020 ◽  
Author(s):  
Jingbo Cheng ◽  
Mingli Feng ◽  
Guanglei Cao ◽  
Zheng Li ◽  
Shuai An ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Older Patients ◽  
Perioperative Complications ◽  
Womac Score ◽  
Younger Patients ◽  
Group 3 ◽  
Hss Score ◽  
Oxford Unicompartmental Knee Arthroplasty ◽  
Group 1

Abstract Background: Oxford Unicompartmental Knee Arthroplasty (UKA) has increased rapidly around the world, and the effectiveness and safety of a minimally invasive surgical approach for it demonstrate excellent outcome. Oxford UKA represents an interesting solution for older patients. The aim of our study is to evaluate the perioperative complications and short-term clinical outcome and analyze the safety for older patients who undergo Oxford UKA.Methods: A retrospective review was performed of all patients who underwent Oxford UKA between June 2015 and January 2018. We divided all patients into three groups (ages 60–69; ages 70-79; age over 80). We used the HSS score and WOMAC score to evaluate the general condition of the patients’ knees. We also recorded perioperative complications and long-term complications.Result:60 patients (60 knees) between the ages of 60 and 69 (Group 1), 70 patients (79 knees) between the ages of 70-79 (Group 2) and 65 patients (70 knees) over 80 years old (Group 3) were included in the study. The mean follow-up was 21.34±12.04, 22.08±11.38 and 21.76 ± 10.20 months in Group 1, 2 and 3, respectively. At last follow-up, the patients in Group 3 showed lower function scores as compared to group 1 and 2 (P <0.05), but both the HSS score and the WOMAC score were significantly improved in both groups after surgery. The rate of perioperative complications and other complications in elderly patients is the same as in younger patients.Conclusion: Oxford UKA is an effective and safe treatment for osteoarthritis, even in old adult patients in China. The knee joint pain symptoms of the elderly patients are relieved and the function is improved, but the function is still poor compared with the younger patients.

scholarly journals Curative effect and Safety in Anteromedial Osteoarthritis Patients over 80 Years Old Undergoing Oxford Unicompartmental Knee Arthroplasty (UKA) in China: A Single-Center Retrospective Study

2019 ◽  
Author(s):  
Jingbo Cheng ◽  
Mingli Feng ◽  
Guanglei Cao ◽  
Zheng Li ◽  
Shuai An ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Older Patients ◽  
Perioperative Complications ◽  
Womac Score ◽  
Younger Patients ◽  
Group 2 ◽  
Hss Score ◽  
Oxford Unicompartmental Knee Arthroplasty ◽  
Group 1

Abstract Background: Oxford Unicompartmental Knee Arthroplasty (UKA) has increased rapidly around the world, and the effectiveness and safety of a minimally invasive surgical approach for it demonstrate excellent outcome. Oxford UKA represents an interesting solution for older patients. The aim of our study is to evaluate the perioperative complications and short-term clinical outcome and analyze the safety for older patients who undergo Oxford UKA.Methods: A retrospective review was performed of all patients who underwent Oxford UKA between June 2015 and January 2018. We divided all patients into two groups (ages 60–80; age over 80). We used the HSS score and WOMAC score to evaluate the general condition of the patients’ knees. We also recorded perioperative complications and long-term complications. Result:130 patients (139 knees) between the ages of 60 and 80 (Group 1) and 65 patients (70 knees) over 80 years old (Group 2) were included in the study. The mean follow-up was 22.04 ± 11.04 and 21.76 ± 10.20 months in Group 1 and 2, respectively. At last follow-up, the patients in Group 2 showed lower function scores, but both the HSS score and the WOMAC score were significantly improved in both groups after surgery. The rate of perioperative complications and other complications in elderly patients is the same as in younger patients. Conclusion: Oxford UKA showed validity and safety for elderly patients in China. The knee joint pain symptoms of the elderly patients are relieved and the function is well restored, but the function is still poor compared with the younger patients.

scholarly journals Patient outcomes in Anteromedial Osteoarthritis Patients over 80 Years Old Undergoing Oxford Unicompartmental Knee Arthroplasty in China

2020 ◽  
Author(s):  
Jingbo Cheng ◽  
Mingli Feng ◽  
Guanglei Cao ◽  
Zheng Li ◽  
Shuai An ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Womac Score ◽  
Asian Patients ◽  
Unicompartmental Knee ◽  
Group 3 ◽  
Hss Score ◽  
Oxford Unicompartmental Knee Arthroplasty ◽  
Group 1

Abstract Background: The use of Oxford Unicompartmental Knee Arthroplasty (UKA) has increased rapidly both Western and Asian populations. And Oxford UKA also has excellent functional outcomes with high patient satisfaction. While previous evidence regarding clinical outcomes and survival rate after Oxford UKA based on studies in western populations, results may be different in Asian patients. Thus, the relevance of age for postoperative function after Oxford UKA is therefore still unclear. Hence, the aim of our study was to clarify the effectiveness and safety of Oxford UKA in Asian patients aged over 80 years. Methods: A retrospective review was performed of 195 patients (209 knees)who underwent OxfordUKA between June 2015 and January 2018. We divided all patients into threegroups (ages 60–69; ages 70-79; age over 80). We used the HSS score and WOMAC score to evaluate the general condition of the patients’ knees before surgery and at last follow-up.We also recorded perioperative complications and short-termcomplications. Result: 60 patients (60 knees) between the ages of 60 and 69 (Group 1), 70 patients (79 knees) between the ages of 70-79 (Group 2) and 65 patients (70 knees) over 80 years old (Group 3) were included in the study. The mean follow-up was 21.34±12.04, 22.08±11.38 and 21.76 ± 10.20 months in Group 1, 2 and 3, respectively.At last follow-up, the patients in Group 3 showed lower function scores as compared to group 1 and 2 ( P <0.05), butthe HSS score and the WOMAC score were significantly improved in three groups after surgery. In terms of perioperative and other complications, the three age groups did not differ significantly. Conclusion: Oxford UKA is an effective and safe treatment for osteoarthritis, even in old adult patients in China.Elderly patients have lower knee function scores than younger patients. But the knee joint pain symptoms of the elderly patients are relieved and the function is also improved compare to preoperative condition.

scholarly journals Patient Outcomes in Anteromedial Osteoarthritis Patients Over 80 Years Old Undergoing Oxford Unicompartmental Knee Arthroplasty in China

2020 ◽  
Author(s):  
Jingbo Cheng ◽  
Mingli Feng ◽  
Guanglei Cao ◽  
Zheng Li ◽  
Shuai An ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Asian Patients ◽  
Unicompartmental Knee ◽  
Group 3 ◽  
Group 2 ◽  
Oxford Unicompartmental Knee Arthroplasty ◽  
Group 1

Abstract Background: The use of Oxford Unicompartmental Knee Arthroplasty (UKA) has increased rapidly in both Western and Asian populations, with excellent functional outcomes and high patient satisfaction. While previous evidence regarding clinical outcomes and survival rates after Oxford UKA was based on studies in Western populations, the results may be different in Asian patients. The relevance of age for postoperative function after Oxford UKA also remains unclear. Hence, the aim of our study was to clarify the effectiveness and safety of Oxford UKA in Asian patients aged over 80 years.Methods: A retrospective review was performed and included 195 patients (209 knees) who underwent an Oxford UKA between June 2015 and July 2018. We divided the patients into three groups by age: Group 1, 60-69 years; Group 2, 70-79 years; and Group 3, over 80 years. We used the Hospital for Special Surgery (HSS) score and Western Ontario and McMaster (WOMAC) Universities Osteoarthritis Index score to evaluate the general condition of the patients’ knees before surgery and at last follow-up. We also recorded perioperative and short-term complications.Result: Group 1 consisted of 60 patients (60 knees); Group 2, 70 patients (79 knees); and Group 3, 65 patients (70 knees). The mean follow-up was 21.34 ± 12.04, 22.08 ± 11.38, and 21.76 ± 10.20 months in groups 1, 2, and 3, respectively. At last follow-up, the patients in Group 3 showed lower function scores compared to groups 1 and 2 (P <0.05), but the HSS scores and the WOMAC scores were significantly improved in all three groups. In terms of perioperative and other complications, the three age groups did not differ significantly.Conclusion: Oxford UKA is an effective and safe treatment for osteoarthritis, even in elderly patients in China. Elderly patients have lower knee function scores than younger patients. However, the knee joint pain of the elderly patients was relieved and function improved compared to the preoperative condition.

scholarly journals P813 Inflammatory bowel disease in older patients: experience at a single centre

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S634-S634
Author(s):  
M M Diaz Alcazar ◽  
P Martinez Tirado ◽  
B Vidal Vilchez ◽  
B Zuñiga de Mora Figueroa
Keyword(s):  
Inflammatory Bowel Disease ◽  
Elderly Patients ◽  
Bowel Disease ◽  
Older Patients ◽  
Hospital Admissions ◽  
Late Onset ◽  
Younger Patients ◽  
Inflammatory Bowel ◽  
Clinical Records

Abstract Background The characteristics of inflammatory Bowel Disease (IBD) seem different according to the age of the patient at diagnosis. Moreover, age influences the evolution of the disease. The aim of the study was to know the prevalence of IBD in patients older than 65 years old and the evolution of the disease at this age. Methods Retrospective descriptive study. Database from patients of the Hospital Universitario San Cecilio of Granada (Spain). 50 patients with 65 years old or more and 50 under this age have been randomly selected. Their electronic clinical records have been reviewed. Results The IBD Unit in our Hospital serves 1218 people with this disease, of whom 212 are elderly patients (17.4%). In the serie of 100 randomly selected patients, mean age is 58.42 years. The disease began before 65 years old in 74% of elderly patients. All the elderly patients continue follow-up, while 4 (8%) of the younger patients dropped out the follow-up in the IBD Unit. With regard to hospital admissions, 27 elderly patients (54%) have never required hospitalisation compared with 18 (36%) aged under 65 years. Corticosteroids were used at diagnosis in 27 (54%) of older vs. 28 (56%) of the younger patients. Meanwhile, topical treatment is used by 33 (66%) of older vs. 22 (44%) of the younger ones. The current treatment is summarised in Figure 1. Conclusion (1) The prevalence of IBD is increasing. IBD in older patients is also escalating due to the low mortality of the disease and the increase of patients with late-onset. In our serie, the prevalence in elderly patients is 17.4%. (2) UC is more frequent in older patients than in younger ones (70% vs. 42%). With regard to CD, penetrating disease is less frequent in older patients but stricturing pattern is more prevalent. (3) Adherence to follow-up in elderly patients is higher and they need fewer hospital admissions than younger patients. (4) In our serie, surgical and biological treatments are less frequent in elderly patients. Moreover, there are more patients above 65 years that do not take maintenance treatment or they only take mesalamine. (5) Chronological age is different from biological age. Older patients with a good quality of life should not be excluded from new treatments or clinical trials due to age. More evidence about older patients is needed to improve de diagnosis, the knowledge about the evolution and define better the treatment in this group of age.

Radical prostatectomy (RP) in extreme ages: Clinical and pathologic evaluation of localized prostate cancer (PC).

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 109-109
Author(s):  
A. A. Dettino ◽  
F. P. Fonseca ◽  
S. C. Zequi ◽  
C. A. Sacomani ◽  
J. Rinck ◽  
...  
Keyword(s):  
Biochemical Recurrence ◽  
Risk Group ◽  
Urinary Continence ◽  
Biochemical Relapse ◽  
Clinical Progression ◽  
Younger Patients ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

109 Background: Radical prostatectomy (RP) is the treatment of choice for patients with localized prostate cancer (PC). Previously, surgery was applied to patients with good clinical condition and aged <=70 years. Lately, with a better understanding of surgical technique, many centers have been performing RP in patients older than 70. Methods: The main objective of this cohort study is to evaluate clinical evolution according to localized PC submitted to RP in patients in extreme ages. We analysed age, PSA, ASA classification,pathological stages, Gleason scores, urinary continence, D'Amico risk classification (group 1:low; 2:intermediate; 3:high), biochemical recurrence and clinical progression. Descriptive analysis of the population was performed. Fisher's exact test or chi-square tests were used to evaluate association between clinicopathologic characteristics.Biochemical recurrence was defined by PSA more than 0.2 ng/mL post-RP. Results: In 262 patients, mean age was 63.4 years (SD 12.4; range: 41 to 83). In D'Amico's group 1 there were 96 patients (37.2%) with<=50 year old, and group 2 had 162 patients (62.8%) with age >=70. The mean follow-up in group 1 was 55.9 months (SD 41.7) and group 2 was 53.6 (SD 41.4), p=0.6770. Biochemical relapse occurred in 21 patients (15.44%) in D'Amico risk group 1, 27 (36.99%) in group 2 and 29 (59.18%) in group 3 (p<0.001). There was no difference among all the pathological variables evaluated (p>0.05). Clinical progression occurred in 2 patients (1.47%) in D'Amico risk group 1, in 3 patients (4.11%) in group 2 and in 3 patients (6.11%) in group 3 (p=0.230). There was no significant difference in relation to time to biochemical recurrence, as well as biochemical relapse rate and progression of this disease among the groups. Younger patients (in group 1) recovered earlier from urinary incontinence, as well as most were continent in final follow-up. Conclusions: Based on our results, the differences in younger or more aged patients with PC are not related to pathological variables, or rates of biochemical recurrence and clinical disease, but better preoperative clinical features and better recovery of urinary continence are seen in younger patients. No significant financial relationships to disclose.

A comparative study of bed usage by younger and older patients with depression

1984 ◽  
Vol 14 (2) ◽  
pp. 445-450 ◽  
Author(s):  
Elaine Murphy ◽  
Emily Grundy
Keyword(s):  
Elderly Patients ◽  
Old Age ◽  
Older Patients ◽  
Younger Patients ◽  
Depressed Patients ◽  
High Relapse Rate ◽  
Follow Up Studies ◽  
Bed Days ◽  
Psychiatric Beds

SynopsisRecent follow-up studies of depression in old age have highlighted the high relapse rate in older patients compared with younger patients. The consequences for the provision of acute psychiatric beds for elderly patients has been investigated by comparing the usage of beds by younger and older patients with depression over a 4-year period. Overall, elderly depressed patients consumed one and a half times as many bed days as younger depressed patients and a quarter of all acute bed days available in the hospital were used by elderly depressed patients.

ACUTE KIDNEY INJURY IN ELDERLY PATIENTS

2019 ◽  
Vol 72 (8) ◽  
pp. 1466-1472
Author(s):  
Grażyna Kobus ◽  
Jolanta Małyszko ◽  
Hanna Bachórzewska-Gajewska
Keyword(s):  
Acute Kidney Injury ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Elderly Patients ◽  
Older Patients ◽  
Age Groups ◽  
Kidney Injury ◽  
The Elderly ◽  
Younger Patients ◽  
Common Cause

Introduction: In the elderly, impairment of kidney function occurs. Renal diseases overlap with anatomic and functional changes related to age-related involutionary processes. Mortality among patients with acute renal injury is approximately 50%, despite advances in treatment and diagnosis of AKI. The aim: To assess the incidence of acute kidney injury in elderly patients and to analyze the causes of acute renal failure depending on age. Materials and methods: A retrospective analysis included medical documentation of patients hospitalized in the Nephrology Clinic during the 6-month period. During this period 452 patients were hospitalized in the clinic. A group of 77 patients with acute renal failure as a reason for hospitalization was included in the study. Results: The prerenal form was the most common cause of AKI in both age groups. In both age groups, the most common cause was dehydration; in the group of patients up to 65 years of age, dehydration was 29.17%; in the group of people over 65 years - 43.39%. Renal replacement therapy in patients with AKI was used in 14.29% of patients. In the group of patients up to 65 years of age hemodialysis was 16.67% and above 65 years of age. -13.21% of patients. The average creatinine level in the group of younger patients at admission was 5.16 ± 3.71 mg / dl, in the group of older patients 3.14 ± 1.63 mg / dl. The size of glomerular filtration GFR in the group of younger patients at admission was 21.14 ± 19.54 ml / min, in the group of older patients 23.34 ± 13.33 ml / min. Conclusions: The main cause of acute kidney injury regardless of the age group was dehydration. Due to the high percentage of AKI in the elderly, this group requires more preventive action, not only in the hospital but also at home.

scholarly journals Safety of High-Dose Dabigatran in Elderly and Younger Patients with a Low Bleeding Risk: A Prospective Observational Study

Cardiology ◽  
2021 ◽  
pp. 1-5
Author(s):  
Aharon Erez ◽  
Gregory Golovchiner ◽  
Robert Klempfner ◽  
Ehud Kadmon ◽  
Gustavo Ruben Goldenberg ◽  
...  
Keyword(s):  
Observational Study ◽  
Elderly Patients ◽  
Prospective Observational Study ◽  
Bleeding Risk ◽  
The Elderly ◽  
High Dose ◽  
World Population ◽  
Younger Patients ◽  
End Point

<b><i>Introduction:</i></b> In patients with atrial fibrillation (AF) at risk for stroke, dabigatran 150 mg twice a day (DE150) is superior to warfarin for stroke prevention. However, there is paucity of data with respect to bleeding risk at this dose in elderly patients (≥75 years). We aimed to evaluate the safety of DE150 in comparison to warfarin in a real-world population with AF and low bleeding risk (HAS-BLED score ≤2). <b><i>Methods:</i></b> In this prospective observational study, 754 consecutive patients with AF and HAS-BLED score ≤2 were included. We compared outcome of elderly patients (age ≥75 tears) to younger patients (age &#x3c;75 years). The primary end point was the combined incidence of all-cause mortality, stroke, systemic emboli, and major bleeding event during a mean follow-up of 1 year. <b><i>Results:</i></b> There were 230 (30%) elderly patients, 151 patients were treated with warfarin, and 79 were treated with DE150. Fifty-two patients experienced the primary endpoint during the 1-year follow-up. Among the elderly, at 1-year of follow-up, the cumulative event rate of the combined endpoint in the DE150 and warfarin was 8.9 and 15.9% respectively (<i>p</i> = 0.14). After adjustment for age and gender, patients who were treated with DE150 had a nonsignificant difference in the risk for the combined end point as patients treated with warfarin both among the elderly and among the younger population (HR 0.58, 95% C.I = 0.25–1.39 and HR = 1.12, 95% C.I 0.62–2.00, respectively [<i>p</i> for age-group-by-treatment interaction = 0.83). <b><i>Conclusions:</i></b> Our results suggest that Dabigatran 150 mg twice a day can be safely used among elderly AF patients with low bleeding risk.

scholarly journals Effects of posterior tibial slope on the mid-term results of medial unicompartmental knee arthroplasty

Arthroplasty ◽  
2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Zhijie Chen ◽  
Kaizhe Chen ◽  
Yufei Yan ◽  
Jianmin Feng ◽  
Yi Wang ◽  
...  
Keyword(s):  
Knee Flexion ◽  
Tibial Slope ◽  
Posterior Tibial ◽  
Significant Difference ◽  
Medial Unicompartmental Knee Arthroplasty ◽  
Group 3 ◽  
Group 2 ◽  
Postoperative Knee ◽  
Group 1

Abstract Objective To evaluate the effect of medial posterior tibial slope (PTS) on mid-term postoperative range of motion (ROM) and functional improvement of the knee after medial unicompartmental knee arthroplasty (UKA). Methods Medical records of 113 patients who had undergone 124 medial UKAs between April 2009 through April 2014 were reviewed retrospectively. The mean follow-up lasted 7.6 years (range, 6.2–11.2 years). Collected were demographic data, including gender, age, height, weight of the patients. Anteroposterior (AP) and lateral knee radiographs of the operated knees were available in all patients. The knee function was evaluated during office follow-up or hospital stay. Meanwhile, postoperative PTS, ROM, maximal knee flexion and Hospital for Special Surgery (HSS) knee score (pre−/postoperative) of the operated side were measured and assessed. According to the size of the PTS, patients were divided into 3 groups: group 1 (<4°), group 2 (4° ~ 7°) and group 3 (>7°). The association between PTS and the knee function was investigated. Results In our cohort, the average PTS was 2.7° ± 0.6° in group 1, 5.6° ± 0.9° in group 2 and 8.7° ± 1.2° in group 3. Pairwise comparisons showed significant differences among them (p < 0.01). The average maximal flexion range of postoperative knees in each group was 112.4° ± 5.6°, 116.4° ± 7.2°, and 117.5° ± 6.1°, respectively, with significant difference found between group 1 and group 2 (p < 0.05), and between group 1 and group 3 (p < 0.05). However, the gender, age, and body mass index (BMI) did not differ between three groups and there was no significant difference between groups in terms of pre−/postoperative HSS scores or postoperative knee ROM. Conclusion A mid-term follow-up showed that an appropriate PTS (4° ~ 7°) can help improve the postoperative flexion of knee. On the other hand, too small a PTS could lead to limited postoperative knee flexion. Therefore, the PTS less than 4° should be avoided during medial UKA.

The Relationship between Serum Ferritin Levels and 5-Year All-Cause Mortality in Hemodialysis Patients

2021 ◽  
pp. 1-7
Author(s):  
Emre Erdem ◽  
Ahmet Karatas ◽  
Tevfik Ecder
Keyword(s):  
Serum Ferritin ◽  
Hemodialysis Patients ◽  
Rank Test ◽  
Significant Difference ◽  
All Cause Mortality ◽  
Group 3 ◽  
Group 2 ◽  
The Relationship ◽  
Group 1

<b><i>Introduction:</i></b> The effect of high serum ferritin levels on long-term mortality in hemodialysis patients is unknown. The relationship between serum ferritin levels and 5-year all-cause mortality in hemodialysis patients was investigated in this study. <b><i>Methods:</i></b> A total of 173 prevalent hemodialysis patients were included in this study. The patients were followed for up to 5 years and divided into 3 groups according to time-averaged serum ferritin levels (group 1: serum ferritin &#x3c;800 ng/mL, group 2: serum ferritin 800–1,500 ng/mL, and group 3: serum ferritin &#x3e;1,500 ng/mL). Along with the serum ferritin levels, other clinical and laboratory variables that may affect mortality were also included in the Cox proportional-hazards regression analysis. <b><i>Results:</i></b> Eighty-one (47%) patients died during the 5-year follow-up period. The median follow-up time was 38 (17.5–60) months. The 5-year survival rates of groups 1, 2, and 3 were 44, 64, and 27%, respectively. In group 3, the survival was lower than in groups 1 and 2 (log-rank test, <i>p</i> = 0.002). In group 1, the mortality was significantly lower than in group 3 (HR [95% CI]: 0.16 [0.05–0.49]; <i>p</i> = 0.001). In group 2, the mortality was also lower than in group 3 (HR [95% CI]: 0.32 [0.12–0.88]; <i>p</i> = 0.026). No significant difference in mortality between groups 1 and 2 was found (HR [95% CI]: 0.49 [0.23–1.04]; <i>p</i> = 0.063). <b><i>Conclusion:</i></b> Time-averaged serum ferritin levels &#x3e;1,500 ng/mL in hemodialysis patients are associated with an increased 5-year all-cause mortality risk.

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