Implementation and Findings On A One-Minute Sit-Stand Test for Prehospital Triage in Patients With Suspected COVID-19 - A Pilot Project

Abstract Introduction: During the initial Coronavirus Disease 2019 (COVID-19) pandemic wave, sparse personal protection equipment made telephone triage of suscpeted COVID-19 patients for ambulance transport necessary. To spare resources, stable patients were often treated and released on-scene, but reports from Italy suggested that some later detoriated. We implemented a prehospital sit-stand test to identify patients in risk for detoriation. Methods The test was implemented as part of a new guideline in stable suspected COVID-19 patients younger than 70 years with no risk factors for serious disease triaged by general practitioners to ambulance response in the Central Denmark Region. Data were collected from April 6th to July 6th 2020. This was a two-part study evaluating guideline adherence and results of the sit-stand test. The primary outcome of each separate part was 1) the proportion of patients sit-stand tested before treat-and-released and 2) the proportion of patients treated with oxygen within 7 days among patients decompensating and not decompensation during the test. Results Data on 156 patients triaged to ambulance response by general practioners were analysed. In total 86/156 (55%) were tested with the sit-stand test, among these 30/86 (47%) were either older than 70 or had risk factors for serious disease. Of those treated and released, 50/52 (96%) were tested. In total, 17/86 (20%) decompensated during the test and of these, 9/17 (53%) were treated with oxygen compared to 2/69 (3%) in patients who did not decompensate (p < 0.001). This difference was only significant in the elderly group of patients with risk factors for serious disease. 10/156 (6%) of patients had a positive COVID-19-test. Conclusion The sit-stand test was implemented in 96% of patients treated and released on-scene, but was also used in elderly patients with risk factors for serious disease. Decompensation was observed in 20% of patients and was associated with oxygen treatment within 7 days – but only in the elderly group of patients with risk factors for serious disease. These findings are hypotheses-generating and suggest that physical exercise testing may be usefull for decision making in emergency settings.

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Age-Related Differences in the Time Course of Coagulation and Fibrinolytic Parameters in Patients with Traumatic Brain Injury

International Journal of Molecular Sciences ◽

10.3390/ijms21165613 ◽

2020 ◽

Vol 21 (16) ◽

pp. 5613

Author(s):

Ryuta Nakae ◽

Yu Fujiki ◽

Yasuhiro Takayama ◽

Takahiro Kanaya ◽

Yutaka Igarashi ◽

...

Keyword(s):

Risk Factors ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Propensity Score ◽

Older Patients ◽

Multivariate Logistic Regression Analysis ◽

The Elderly ◽

Elderly Group ◽

Post Injury ◽

D Dimer

Coagulopathy and older age are common and well-recognized risk factors for poorer outcomes in traumatic brain injury (TBI) patients; however, the relationships between coagulopathy and age remain unclear. We hypothesized that coagulation/fibrinolytic abnormalities are more pronounced in older patients and may be a factor in poorer outcomes. We retrospectively evaluated severe TBI cases in which fibrinogen and D-dimer were measured on arrival and 3–6 h after injury. Propensity score-matched analyses were performed to adjust baseline characteristics between older patients (the “elderly group,” aged ≥75 y) and younger patients (the “non-elderly group,” aged 16–74 y). A total of 1294 cases (elderly group: 395, non-elderly group: 899) were assessed, and propensity score matching created a matched cohort of 324 pairs. Fibrinogen on admission, the degree of reduction in fibrinogen between admission and 3–6 h post-injury, and D-dimer levels between admission and 3–6 h post-injury were significantly more abnormal in the elderly group than in the non-elderly group. On multivariate logistic regression analysis, independent risk factors for poor prognosis included low fibrinogen and high D-dimer levels on admission. Posttraumatic coagulation and fibrinolytic abnormalities are more severe in older patients, and fibrinogen and D-dimer abnormalities are negative predictive factors.

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Prevalence and Risk Factors of Chronic Rhinosinusitis in the Elderly Population of Korea

American Journal of Rhinology and Allergy ◽

10.1177/1945892418813822 ◽

2018 ◽

Vol 33 (3) ◽

pp. 240-246 ◽

Cited By ~ 6

Author(s):

Chi Sang Hwang ◽

Hye Sun Lee ◽

Si Nae Kim ◽

Ji Hyung Kim ◽

Dong-Joon Park ◽

...

Keyword(s):

Risk Factors ◽

Allergic Rhinitis ◽

Chronic Rhinosinusitis ◽

Large Scale ◽

Epidemiologic Study ◽

Epidemiological Data ◽

The Elderly ◽

Elderly Group ◽

Health And Nutrition ◽

Increased Risk

Background Although a significant number of the clinical features and pathophysiologic mechanisms of chronic rhinosinusitis (CRS) have been described, only a few studies have been published on characterization of CRS in the field of aging. Objective We investigated the prevalence and risk factors of CRS in elderly (≥65 years old) Koreans using large-scale nationwide epidemiological data and compared the risk factors of elderly with those of younger adult participants (19–64 years old). Methods Data from 25 529 participants who completed the 2008–2012 Korean National Health and Nutrition Examination Survey were analyzed. Diagnosis of CRS was done according to the EP3OS 2012 guideline for epidemiologic study. Risk factors of CRS were compared in the aspects of sociodemographics, general health behaviors, clinical characteristics, and comorbidities of participants. Results The prevalence of CRS was significantly higher in 5590 elderly than in 19 939 younger adults (6.55% vs 5.69%; P = .016. Some variables of socioeconomic status and mental health in the adult group were associated with increased risk of CRS but did not show association in the elderly group. We observed a significant association between CRS prevalence and comorbid allergic rhinitis, asthma, and atopic dermatitis in both groups ( P < .05). However, in the elderly group, the associations were significantly weaker with regard to allergic rhinitis ( P-interaction = .03) and asthma ( P-interaction = .002). Conclusion These results suggest that elderly populations have distinct pathophysiology and clinical presentations from adult CRS, and management for elderly patients with CRS may require different or additional therapeutic approaches.

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The Impact of Age on Mortality in Chronic Haemodialysis Popu-Lation with COVID-19

Journal of Clinical Medicine ◽

10.3390/jcm10143022 ◽

2021 ◽

Vol 10 (14) ◽

pp. 3022

Author(s):

Ander Vergara ◽

Mireia Molina-Van den Bosch ◽

Néstor Toapanta ◽

Andrés Villegas ◽

Luis Sánchez-Cámara ◽

...

Keyword(s):

Risk Factors ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Mortality Risk ◽

The Elderly ◽

Elderly Group ◽

High Risk Population ◽

Cox Regression Analysis ◽

Risk Of Death ◽

The Impact

Age and chronic kidney disease have been described as mortality risk factors for coronavirus disease 2019 (COVID-19). Currently, an important percentage of patients in haemodialysis are elderly. Herein, we investigated the impact of age on mortality among haemodialysis patients with COVID-19. Data was obtained from the Spanish COVID-19 chronic kidney disease (CKD) Working Group Registry. From 18 March 2020 to 27 August 2020, 930 patients on haemodialysis affected by COVID-19 were included in the Registry. A total of 254 patients were under 65 years old and 676 were 65 years or older (elderly group). Mortality was 25.1% higher (95% CI: 22.2–28.0%) in the elderly as compared to the non-elderly group. Death from COVID-19 was increased 6.2-fold in haemodialysis patients as compared to the mortality in the general population in a similar time frame. In the multivariate Cox regression analysis, age (hazard ratio (HR) 1.59, 95% CI: 1.31–1.93), dyspnea at presentation (HR 1.51, 95% CI: 1.11–2.04), pneumonia (HR 1.74, 95% CI: 1.10–2.73) and admission to hospital (HR 4.00, 95% CI: 1.83–8.70) were identified as independent mortality risk factors in the elderly haemodialysis population. Treatment with glucocorticoids reduced the risk of death (HR 0.68, 95% CI: 0.48–0.96). In conclusion, mortality is dramatically increased in elderly haemodialysis patients with COVID-19. Our results suggest that this high risk population should be prioritized in terms of protection and vaccination.

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FC 026COVID-19 IMPACT ON ELDERLY HEMODIALYSIS POPULATION: RESULTS FROM THE SPANISH COVID-19 CKD WORKING GROUP REGISTRY

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab145.002 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Ander Vergara Arana ◽

Mireia Molina ◽

Andrés Villegas ◽

Luis Alberto Sã¡nchez Cã¡mara ◽

Patricia De Sequera Ortiz ◽

...

Keyword(s):

Risk Factors ◽

Mortality Risk ◽

Working Group ◽

The Elderly ◽

Hemodialysis Patients ◽

Elderly Group ◽

Factors Associated ◽

Risk Of Death ◽

The Impact ◽

Elderly Hemodialysis Patients

Abstract Background and Aims Age and chronic kidney disease have been described as mortality risk factors for coronavirus disease 2019 (COVID-19). Currently, an important percentage of patients in hemodialysis are elderly. This study aimed to investigate the impact of COVID-19 in this population and to determine risk factors associated with mortality. Method Data was obtained from the Spanish COVID-19 CKD Working Group Registry, that included patients in renal replacement therapy (dialysis and kidney transplantation) infected by COVID-19. From March 18, 2020, to August 27, 2020, 1165 patients on hemodialysis affected by COVID-19 were included in the Registry. A total of 328 patients were under 65 years-old and 837 were 65 years old or older (elderly group). Results Mortality was 18.6% higher (95% confidence interval (CI): 13.8%-23.4%) in the elderly hemodialysis patients compared to the non-elderly group (see figure). Death from COVID-19 infection was increased 5.5-fold in hemodialysis patients compared to mortality in the general population for a similar period, and there was an age-associated mortality increase in both populations (see figure 1). In multivariate Cox regression analysis, age (hazard ratio (HR) 1.58, 95% CI: 1.31-1.92), dyspnea at presentation (HR 1.61, 95% CI: 1.20-2.16), pneumonia (HR 1.76, 95% CI: 1.12-2.75) and admission to hospital (HR 4.13, 95% CI: 1.92-8.88) were identified as independent mortality risk factors in the elderly hemodialysis population. Treatment with glucocorticoids reduced the risk of death (HR 0.71, 95% CI: 0.51-0.98) in aged patients on hemodialysis. Conclusion Mortality is dramatically increased in elderly hemodialysis patients affected by COVID-19. Age, dyspnea at presentation, pneumonia or hospitalization are factors associated with a worse prognosis, after adjusting dialysis population to other confounding factors. Treatment with glucocorticoids could be a therapeutic option for this specific population.

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788 Risk factors for rehospitalization in the elderly with chronic heart failure with preserved and impaired systolic function

European Journal of Heart Failure Supplements ◽

10.1016/s1567-4215(07)60509-8 ◽

2007 ◽

Vol 6 (1) ◽

pp. 180-180

Author(s):

S BOZINOVIC ◽

A GRDINIC ◽

D STAMENKOVIC ◽

M STOJADINOVIC ◽

I MARKOVIC ◽

...

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Chronic Heart Failure ◽

Systolic Function ◽

The Elderly

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Current Status and Policy Recommendations of the Elderly group home in the long term care insurance - from an community-friendly perspective -

Journal of community welfare ◽

10.15300/jcw.2020.75.4.165 ◽

2020 ◽

Vol 75 (4) ◽

pp. 165-194

Author(s):

Sanghee Park ◽

Seyoung Park

Keyword(s):

Long Term Care ◽

Group Home ◽

The Elderly ◽

Elderly Group ◽

Current Status ◽

Policy Recommendations ◽

Term Care ◽

Long Term Care Insurance

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Differences in physical function and metabolic syndrome risk factors according to the level of physical activity in elderly Korean men: a pilot study

10.31083/jomh.v17i1.200 ◽

2020 ◽

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Metabolic Syndrome ◽

Physical Function ◽

Vigorous Physical Activity ◽

Density Lipoprotein ◽

The Elderly ◽

Berg Balance Scale ◽

Lower Percentage ◽

Mineral Density

Background and objective: Managing the decrease in physical function in the elderly is a major task in aging societies globally. Here, we aimed to compare the physical function and metabolic syndrome (MetS) risk factors according to levels of physical activity (PA). Material and methods: We measured PA in 77 elderly Korean men (74.21 ± 6.26 years old) with an accelerometer and recorded body composition, physical function, and MetS-related risk factors. Participants were divided into three groups based on daily moderate-vigorous physical activity (MVPA): low (under 60 min), middle (60-120 min), and high (over 120 min). The groups were compared using a one-way analysis of variance and the Scheffe post hoc test. Odds ratios (OR) were calculated by logistic regression analysis. Results: Signiﬁcant differences were found between the groups for sedentary behavior time (P < 0.001), light PA (P < 0.05), moderate PA (P < 0.001), vigorous PA (P < 0.05), and total energy expenditure (P < 0.001). The high PA group showed a signiﬁcantly lower percentage of body fat and fat mass and higher muscle mass than did the low and middle PA groups (P < 0.05). The 6-min walk test was signiﬁcantly better in the high PA group than in the low and middle PA groups (P < 0.05). Grip strength and the Berg balance scale were also signiﬁcantly better in the high PA group (P < 0.05). Bone mineral density (BMD) and high-density lipoprotein cholesterol (HDL-C) were signiﬁcantly higher in the high PA group than in the low PA group (P < 0.05). Systolic blood pressure (SBP) was signiﬁcantly higher in the middle PA group than in the low PA group (P < 0.05). Participants with more than three MetS criteria showed an OR of 0.09 (95% conﬁdence interval 0.01-0.82) in the high PA group as compared with the low PA group (P < 0.05). Conclusions: Moderate-vigorous physical activity of more than 120 min daily showed better physical function and lower OR of MetS than did lower MVPA levels in elderly Korean men.

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