scholarly journals Sarcopenia and Charlson Comorbidity Index are Risk Factors for Short-Term Postoperative Prognosis of Elderly Patients with Gastrointestinal Tumor: A Retrospective Study

2021 ◽  
Author(s):  
Jiaqiu Wang ◽  
Liqian Xu ◽  
Shunmei Huang ◽  
Quan Hui ◽  
Xuexue Shi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Charlson Comorbidity Index ◽  
Older Patients ◽  
Gastrointestinal Tumor ◽  
Short Term ◽  
Postoperative Prognosis ◽  
History Of ◽  
Comorbidity Index ◽  
Independent Risk Factors

Abstract Background Sarcopenia is one of the most common syndromes in the older adults. Gastrointestinal tumor is a malignant disease with high incidence. This study aimed to investigate the risk factors of sarcopenia in older adults with gastrointestinal tumor, the prognostic indicators of and short-term outcomes after resection for gastrointestinal tumor, and to explore the relationship between sarcopenia and short-term postoperative prognosis.Method A total of 247 older patients with gastrointestinal tumors who underwent radical resection in 2019 were included in this study. Relevant indexes were calculated using L3 slice image of computed tomography (CT) to evaluate sarcopenia. Short-term postoperative complications and length of stay were considered as short-term outcome of this study.Results Advanced age, lower higher body mass index (BMI), lower hemoglobin, having history of abdominal surgery and higher visceral fat index (VFI) were risk factors of sarcopenia, while higher BMI and lower subcutaneous fat index (SFI) were protective factors of sarcopenia. Further multivariate logistic regression analysis showed that having history of abdominal surgery, advanced age and lower BMI were independent risk factors. Sarcopenia and higher Charlson comorbidity index were independent risk factors of short-term postoperative complications in the elderly with gastrointestinal tumor. Higher Charlson comorbidity index gave rise to longer length of stay.ConclusionsSarcopenia and higher Charlson comorbidity index predict poor short-term prognosis of older patients undergoing gastrointestinal tumor resection.

scholarly journals Low muscle mass and Charlson comorbidity index are risk factors for short-term postoperative prognosis of elderly patients with gastrointestinal tumor: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiaqiu Wang ◽  
Liqian Xu ◽  
Shunmei Huang ◽  
Quan Hui ◽  
Xuexue Shi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Muscle Mass ◽  
Charlson Comorbidity Index ◽  
Older Patients ◽  
Gastrointestinal Tumor ◽  
Short Term ◽  
History Of ◽  
Comorbidity Index ◽  
Independent Risk Factors

Abstract Background Sarcopenia is one of the most frequent syndromes in older adults and one of its main characteristics is low muscle mass. Gastrointestinal tumor is a malignant disease with high incidence. This study aimed to investigate the risk factors of low muscle mass in older adults with gastrointestinal tumor, the prognostic indicators of and short-term outcomes after resection for gastrointestinal tumor, and to explore the relationship between low muscle mass and short-term postoperative prognosis. Method A total of 247 older patients with gastrointestinal tumors who underwent radical resection in 2019 were included in this study. Relevant indexes were calculated using L3 slice image of computed tomography (CT) to evaluate low muscle mass. Short-term postoperative complications and length of stay were considered as short-term outcomes of this study. Results Advanced age, lower higher body mass index (BMI), lower hemoglobin, having history of abdominal surgery and higher visceral fat index (VFI) were risk factors of low muscle mass, while higher BMI and lower subcutaneous fat index (SFI) were protective factors of low muscle mass. Further multivariate logistic regression analysis showed that having history of abdominal surgery, advanced age and lower BMI were independent risk factors. Low muscle mass and higher Charlson comorbidity index were independent risk factors of short-term postoperative complications in older adults with gastrointestinal tumor. Higher Charlson comorbidity index gave rise to longer length of stay. Conclusions Low muscle mass and higher Charlson comorbidity index predict poor short-term prognosis of older patients undergoing gastrointestinal tumor resection.

Using Charlson Comorbidity Index to Predict Short-Term Clinical Outcomes in Hospitalized Older Adults

2019 ◽  
Vol 41 (3) ◽  
pp. 146-153 ◽  
Author(s):  
Liron Sinvani ◽  
Roshini Kuriakose ◽  
Sara Tariq ◽  
Andrzej Kozikowski ◽  
Vidhi Patel ◽  
...  
Keyword(s):  
Older Adults ◽  
Clinical Outcomes ◽  
Charlson Comorbidity Index ◽  
Short Term ◽  
Comorbidity Index ◽  
Hospitalized Older Adults

The Effect of Seromuscular-Dermal and All Layer-Dermal Suturing on the Rate of Early Stomal Mucocutaneous Separation: A Retrospective Study

2021 ◽  
Vol 67 (3) ◽  
pp. 21-28
Author(s):  
Yusuke Ohara ◽  
Tsuyoshi Enomoto ◽  
Yohei Owada ◽  
Daichi Kitaguchi ◽  
Katsuji Hisakura ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Retrospective Study ◽  
Odds Ratio ◽  
Suture Technique ◽  
Short Term ◽  
Steroid Use ◽  
Surgical History ◽  
History Of ◽  
Independent Risk Factors

BACKGROUND: Stomal mucocutaneous separation (SMS) is a serious and common short-term and long-term complication of ostomy surgery, but optimal methods to help prevent it have not been established. The authors hypothesized that seromuscular-dermal (SM-D) suturing may be better than all layer-dermal (AL-D) suturing to help prevent SMS. METHODS: This retrospective study evaluated the short-term SMS rate of patients who underwent colostomy or ileostomy surgery between 2015 and 2019. Patient demographics, medical and surgical history variables, as well as SMS outcomes were abstracted. Postoperative SMS severity was categorized by extent as follows: grade A (mild), grade B (moderate), and grade C (severe). RESULTS: In total, 105 patients (AL-D group, 45 patients; SM-D group, 60 patients) were enrolled in the study. SMS occurred in 24 patients (23%). The overall SMS rate was 18% (n = 11) in the SM-D group and 29% (n = 13) in the AL-D group (P = .202). The occurrence of severe (grade C) or moderate and severe SMS (grades B + C) in the SM-D compared with the AL-D group was significantly different (2% vs 16% [P = .011] and 10% vs 24% [P = .047], respectively). A history of steroid use was a risk factor for moderate and severe SMS (P = .016, odds ratio 5.694). Stomal height ≤1 cm was a a risk factor for all cases of SMS (P = .037, odds ratio 2.650). AL-D suture technique and a history of steroid use were independent risk factors for severe and moderate plus severe SMS (P = .021, odds ratio 12.844 and P = .027, odds ratio 4.808, respectively). CONCLUSION: In this study, use of the AL-D suturing technique and a history of steroid use were independent risk factors for the short-term development of moderate or severe SMS. Patients whose stoma was secured using the SM-D technique had a significantly lower rate of moderate or severe SMS.

Association of Short-Term Mortality of Venous Thromboembolism with Family History of Venous Thromboembolism and Charlson Comorbidity Index

2018 ◽  
Vol 119 (01) ◽  
pp. 048-055 ◽  
Author(s):  
Bengt Zöller ◽  
MirNabi Pirouzifard ◽  
Jan Sundquist ◽  
Kristina Sundquist
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thromboembolism ◽  
Family History ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Charlson Comorbidity Index ◽  
Short Term ◽  
Short Term Mortality ◽  
History Of ◽  
Comorbidity Index

AbstractStudies on short-term prognosis of venous thromboembolism (VTE) that take family history of VTE and Charlson Comorbidity Index (CCI) into account are sparse. The aim was to investigate the importance of family history of VTE and CCI for short-term mortality after a first episode of VTE. Using Swedish medical databases, we conducted a 90-day nationwide cohort study of 41,700 Swedish born patients with a first-time VTE (July 2005–August 2012). Patients diagnosed with VTE and prescribed anticoagulant treatment were included. Mortality hazard ratios (HRs) with 95% confidence intervals (CIs) were determined with Cox regression. Patients with first-degree (sibling/parent) family history of VTE (n = 11,405, 27.4%) had significantly lower CCI than those without family history. Independent risk factors for 90-day mortality in the adjusted model were: female sex (HR = 1.19, 95% CI: 1.09–1.29), increasing age (HR = 1.02, 95% CI: 1.01–1.02 per year), pulmonary embolism (HR = 1.21, 95% CI: 1.11–1.32) or combined pulmonary embolism and deep venous thrombosis (HR = 1.60, 95% CI: 1.27–2.01) compared with deep venous thrombosis, CCI = 1 (HR = 2.93, 95% CI: 2.32–3.72), CCI = 2 (HR = 8.65, 95% CI: 7.16–10.46) or CCI = 3 (HR = 22.25, 95% CI: 18.73–26.44) compared with CCI = 0. Having one or two or more affected first-degree relatives with VTE was associated with lower mortality, HR = 0.83 (95% CI: 0.74–0.92) and HR = 0.65 (95% CI: 0.51–0.85), respectively. The mortality rate was 0.70% in patients with a CCI of zero. In receiver operating characteristic (ROC) analysis, the area under the ROC curve for CCI was 0.84 (0.83–0.95). Family history of VTE is associated with lower mortality while CCI is a strong predictor for short-term mortality in VTE. Co-morbidities are important for risk assessment of VTE.

scholarly journals Fall Patterns Are Independent Risk Factors for Mortality After Hip Fracture in Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A246-A246
Author(s):  
Namki Hong ◽  
Seungwon Burm ◽  
Yumie Rhee
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Hip Fracture ◽  
Data Science ◽  
Major Health Problem ◽  
Mortality And Morbidity ◽  
Severance Hospital ◽  
Weight Shift ◽  
Comorbidity Index ◽  
Independent Risk Factors

Abstract Hip fracture is becoming a major health problem with high mortality and morbidity in older adults. However, whether specific fall patterns could act as independent risk factors for predicting mortality after hip fracture remains unknown. We aimed to investigate whether fall patterns can serve as an independent risk factor for mortality after hip fracture. Electronic medical records (EMR) of individuals who visited emergency room or admitted to the Severance hospital, Seoul, Korea, between January 2005 to December 2019 were reviewed to categorize fall patterns. Fall patterns were categorized upon review of explanatory description in EMR, using modified classification based on motion analysis of video-captured falls in a prior study. Among 1,991 study subjects (mean age 77 years, 71% women), 211 patients died (10.6%; median survival 296 days). Fall location was divided into home (67.4%) and outdoor (32.6%) with mortality rate of 11.9% and 8.0% (p=0.009), respectively. Fall patterns were specified by “cause of fall” (6 categories; slip [29.6%], trip or stumble [17.5%], etc.) and by “activity at time of fall” (6 categories; walking [54.8%], getting up or rising [14.1%], etc). Among the combinations of both causes and activities, individuals who sustained hip fracture during “incorrect weight shift while sitting down or lowering”(hazard ratio [HR] 3.35, p=0.003), “collapsed during unclassified activity”(HR 2.37, p=0.006), “incorrect weight shift while getting up or rising”(HR 2.13, p=0.003), and “slipped while walking”(HR 1.83, p=0.004) had increased mortality after hip fracture compared to those with outdoor falls, after adjustment for age, sex, and Charlson comorbidity index. Specific fall patterns in individuals who sustained hip fracture predicted excess mortality in older adults, independent of age, sex, and comorbidities. Acknowledgement: We thank Doori Cho of the the SENTINEL (Severance ENdocrinology daTa scIeNcE pLatform) team (4-2018-1215) for the data acquisition process. Conflict of Interest: SB, NH, and YR have nothing to declare.

The Relationship Between Fear of Falling and Functional Fitness among Older Adults Living in Rest Home

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
H Tuna ◽  
Ö Bozan ◽  
B Gürpınar ◽  
N İlçin
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Dynamic Balance ◽  
Upper Body ◽  
Functional Fitness ◽  
Fall Risk Factors ◽  
Rest Home ◽  
History Of

Objective: This study aimed to report the fear of falling and assess its associations with several fall-related characteristics and functional fitness parameters among older adults living in the rest home. Methods: Seventy-eight older adults aged between 65-94 years were included in the study. History of falling and the number of risk factors for falling were recorded. Fear of falling was evaluated with The Falls Efficacy ScaleInternational. Functional fitness was assessed with Senior Fitness Test, including tests for the functional measurement of strength, flexibility, aerobic endurance and dynamic balance. Result: The mean age of participants was 78.46±7.16 years. There were correlations exist between fear of falling and number of fall risk factors, dynamic balance, upper body flexibility and aerobic endurance (p<0.05). Multiple linear regression analysis showed that the parameters with the highest determinants of fear of falling were the dynamic balance and history of falling (p<0.05). Conclusions: In our study, history of falling, number of fall risk factors, flexibility for the upper body, aerobic endurance and dynamic balance were parameters related to fear of falling among older adults, but the most influential factors in fear of falling were dynamic balance and history of falling.

scholarly journals Differences in initial versus recurrent diabetic foot ulcers at a specialized tertiary diabetic foot care center in China

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098739
Author(s):  
Yuxia Cheng ◽  
Ping Zu ◽  
Jie Zhao ◽  
Lintao Shi ◽  
Hongyan Shi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diabetic Foot ◽  
Blood Glucose Control ◽  
Diabetes Duration ◽  
Chinese Patients ◽  
Foot Care ◽  
Vascular Intervention ◽  
History Of ◽  
Independent Risk Factors ◽  
Recurrence Group

Objective To investigate the characteristics of diabetic foot ulcer (DFU) recurrence. Methods A total of 573 patients with DFUs were recruited and divided into an initial group (395 patients) and a recurrence group (178 patients). The factors related to recurrence were analyzed using multivariate regression. Results The recurrence group had longer diabetes duration (odds ratio [OR] 192; 95% confidence interval 120, 252 vs. 156; 96, 240); lower glycated hemoglobin levels (OR 8.1; 95% CI 6.8, 9.6 vs. 9.1; 7.4, 10.5), and higher rates than the initial group of amputation (37.5% vs. 2.0%), history of vascular intervention (21.3% vs. 3.9%), retinopathy (77.7% vs. 64.7%), callus (44.4% vs. 20.8%), foot deformity (51.2% vs. 24.6%), and outdoor sports shoe wearing (34.0% vs. 21.2%). Multiple factor logistic regression analysis showed that diabetes duration (OR 1.004), callus (OR 2.769), vascular intervention (OR 2.824) and amputation (OR 22.256) were independent risk factors for DFU recurrence. Conclusion Diabetes duration, callus, history of vascular intervention, and amputation were independent risk factors for recurrent DFUs in a cohort of Chinese patients with active DFU. The prevention and treatment of DFUs, especially callus treatment, foot care, and blood glucose control, should be improved in China.

scholarly journals Stroke prediction in patients presenting with isolated dizziness in the emergency department

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
June-sung Kim ◽  
Hong Jun Bae ◽  
Muyeol Kim ◽  
Shin Ahn ◽  
Chang Hwan Sohn ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Multivariate Analysis ◽  
Acute Stroke ◽  
Neurological Deficits ◽  
Cerebrovascular Injury ◽  
Risk Patients ◽  
History Of ◽  
Independent Risk Factors ◽  
Record Review

AbstractDiagnosing stroke in patients experiencing dizziness without neurological deficits is challenging for physicians. The aim of this study was to evaluate the prevalence of acute stroke in patients who presented with isolated dizziness without neurological deficits at the emergency department (ED), and determine the relevant stroke predictors in this population. This was an observational, retrospective record review of consecutive 2215 adult patients presenting with dizziness at the ED between August 2019 and February 2020. Multivariate analysis was performed to identify risk factors for acute stroke. 1239 patients were enrolled and analyzed. Acute stroke was identified in 55 of 1239 patients (4.5%); most cases (96.3%) presented as ischemic stroke with frequent involvement (29.1%) of the cerebellum. In the multivariate analysis, the history of cerebrovascular injury (odds ratio [OR] 3.08 [95% confidence interval {CI} 1.24 to 7.67]) and an age of > 65 years (OR 3.01 [95% CI 1.33 to 6.83]) were the independent risk factors for predicting acute stroke. The combination of these two risks showed a higher specificity (94.26%) than that of each factor alone. High-risk patients, such as those aged over 65 years or with a history of cerebrovascular injury, may require further neuroimaging workup in the ED to rule out stroke.

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