scholarly journals The effect of patient age, the presence of infection and neoplastic disease on the occurrence of dehiscence laparotomy

2011 ◽  
Vol 58 (4) ◽  
pp. 89-92
Author(s):  
Milorad Paunovic
Keyword(s):  
Prospective Study ◽  
General Surgery ◽  
T Test ◽  
Neoplastic Disease ◽  
Patient Age ◽  
Younger Patients ◽  
Neoplastic Diseases ◽  
Abdominal Organs ◽  
Patient Âgé ◽  
The Impact

Background/Aim. Dehiscence after laparotomy is one of the major complications of laparotomy. Laparotomy is a partial or complete wound with disruption and evisceratio abdominal organs and require urgent reintervention. The aim of this study was to determine the impact of age, infection and neoplastic disease on the occurrence of dehiscence laparotomy. Methods. A retrospective-prospective study were included 826 patients operated at the Clinic for General Surgery in Nis in the period from January 2008 to December 2009. The effect of patient age, the presence of infection and neoplastic disease on the occurrence of dehiscence laparotomy. Results are displayed numerically and in percentages. Results. Of the total 32 patients with dehiscence laparotomy, 20 patients were male or 62.5% and 12 female patients, or 37.5%. Patients with dehiscence laparotomy were significantly younger than patients without dehiscence laparotomy (T-test t=3.237, p<0.05). The average age of respondents with dehiscence was 57.93 years, while patients without dehiscence 63.97 years. There is a statistically highly significant correlation between laparotomy dehiscence and infection (X2=62.024, p<0,01). There was a statistically significant association between dehiscence laparotomy and neoplastic diseases (X2 =42,196; p<0,01). Conclusion. With respect to age, dehiscence laparotomy is significantly more common in younger patients. Infection was significantly more frequent in patients with dehiscence laparotomy. In patients with neoplastic diseases dehiscence laparotomy is common.

scholarly journals The effect of neoplastic disease and systemic disease of connective tissue on the occurrence of dehiscence laparotomy

2013 ◽  
Vol 60 (1) ◽  
pp. 65-68 ◽  
Author(s):  
Milorad Paunovic
Keyword(s):  
Connective Tissue ◽  
Prospective Study ◽  
General Surgery ◽  
Systemic Disease ◽  
Neoplastic Disease ◽  
Neoplastic Diseases ◽  
Female Patients ◽  
Abdominal Organs ◽  
A Prospective Study ◽  
The Impact

Dehiscence after laparotomy is one of the major complications of laparotomy. This is a partial or complete wound with disruption and evisceratio abdominal organs and require urgent reintervention. The aim of this study was to determine the impact of neoplastic disease and systemic disease of connective tissue on the occurrence of dehiscence laparotomy. A prospective study were included 612 patients operated at the Clinic for General Surgery in Nis in the period from January 2009 to December 2010. The effect of neoplastic disease and the presence of systemic disease of connective tissue on the occurrence of dehiscence laparotomy. Results are displayed numerically and in percentages. Of the total 24 patients with dehiscence laparotomy, 15 patients were male or 62.5% and 9 female patients, or 37,5%. There was a statistically significant association between dehiscence laparotomy and neoplastic diseases (c2 =42,196; p<0,01). There was no statistically significant association between dehiscence laparotomy and systemic disease of connective tissue (c2= 0,028; p>0,05). In patients with neoplastic diseases dehiscence laparotomy is common, and in patients suffering from systemic disease of connective tissue dehiscence laparotomy occurs less frequently.

scholarly journals Age Is Just a Number: Patient Age Does Not Affect Outcome Following Surgery for Osteoporotic Vertebral Compression Fractures

2020 ◽  
pp. 219256822094145
Author(s):  
Anmol Gupta ◽  
Thomas Cha ◽  
Joseph Schwab ◽  
Harold Fogel ◽  
Daniel Tobert ◽  
...  
Keyword(s):  
Surgical Complications ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Readmission Rates ◽  
Patient Age ◽  
Younger Patients ◽  
Compression Fractures ◽  
Patient Âgé ◽  
The Impact ◽  
The Relationship

Study Design: Retrospective study. Objective: Multiple studies have shown that osteoporotic patients are at an increased risk for medical and surgical complications, making optimal management of these patients challenging. The purpose of this study was to determine the relationship between patient age and the likelihood of surgical complications, mortality, and 30-day readmission rates following surgery for osteoporotic vertebral compression fractures (OVCFs). Methods: A retrospective analysis of the American College of Surgeons National Surgery Quality Improvement Project (ACS-NSQIP) database from 2007 to 2014 identified 1979 patients who met inclusion criteria. A multivariate logistic regression analysis was conducted to calculate odds ratios (OR), with corresponding P values and 95% confidence intervals, of the relationship between age (treated as a continuous variable) and perioperative mortality, surgical complications, and 30-day readmission rates. Results: Younger patients were statistically more likely to endure a minor (OR = 0.98; P = .002) or major complication (OR = 0.97; P = .009). The older a patient was, on the other hand, the higher the likelihood that patient would be readmitted within 30 days of surgery (OR =1.02; P = .004). Mortality within the 30-day perioperative period was not statistically correlated with age. Conclusions: The impact of age on adverse outcomes following surgery for OVCF is mixed. While younger patients are more likely to endure complications, older patients are more likely to be readmitted within 30 days following surgery. Patient age showed no correlation with mortality rates. In the setting of surgical treatment for an OVCF, a patient’s age can help determine the risk of complications and the rate of readmission following intervention.

Age at Diagnosis and Outcome for Women With Ductal Carcinoma-In-Situ of the Breast: A Critical Review of the Literature

2002 ◽  
Vol 20 (11) ◽  
pp. 2736-2744 ◽  
Author(s):  
Frank A. Vicini ◽  
Abram Recht
Keyword(s):  
Carcinoma In Situ ◽  
Older Patients ◽  
Ductal Carcinoma ◽  
Age At Diagnosis ◽  
Careful Attention ◽  
Patient Age ◽  
Younger Patients ◽  
Patient Âgé ◽  
The Impact

PURPOSE: Patients younger than 35 to 45 years old at the time of diagnosis of invasive breast cancer have been found to have a worse prognosis than older patients in many studies. However, the impact of patient age at diagnosis on the outcome of treatment with either lumpectomy and radiation therapy (RT) or mastectomy for patients with ductal carcinoma-in-situ (DCIS) of the breast has not been extensively analyzed. MATERIALS AND METHODS: Articles addressing the effect of patient age at diagnosis on the outcome of treatment of DCIS with lumpectomy and RT or mastectomy were identified through the MEDLINE and CancerLit databases and reference lists of relevant articles. Studies were reviewed to determine the impact of patient age at diagnosis on clinical and pathologic features of DCIS, the influence of age on outcome after lumpectomy and RT, and the impact of age on outcome after mastectomy. RESULTS: DCIS in younger patients more frequently contains adverse prognostic pathologic factors and extends over a greater distance in the breast than in older patients. In series with adequate follow-up, younger patients treated with lumpectomy and RT had a significantly higher rate of local recurrence than older patients, especially for invasive local recurrences. Some studies have suggested that careful attention to margin status and excising larger volumes of tissue can reduce this difference substantially. No available data show that younger patients have better long-term cancer-free survival rates if treated by mastectomy rather than lumpectomy and RT. CONCLUSION: Successful treatment of younger patients with DCIS with lumpectomy and RT requires careful attention to patient evaluation, selection, and surgical technique. When this is done, age at diagnosis should not be a contraindication to breast-conserving therapy.

The impact of patient age and procedure type on postoperative opioid use following ambulatory pediatric urologic procedures

2021 ◽  
Author(s):  
Michael F. Basin ◽  
Zoë G. Baker ◽  
Melissa Trabold ◽  
Terry Zhu ◽  
Lorraine I. Kelley-Quon ◽  
...  
Keyword(s):  
Opioid Use ◽  
Patient Age ◽  
Patient Âgé ◽  
The Impact ◽  
Procedure Type

scholarly journals Anti-tumor necrosis factor therapy in patients with inflammatory bowel disease; comorbidity, not patient age, is a predictor of severe adverse events

2020 ◽  
Vol 35 (12) ◽  
pp. 2331-2338
Author(s):  
Vera E. R. Asscher ◽  
◽  
Quirine van der Vliet ◽  
Karen van der Aalst ◽  
Anniek van der Aalst ◽  
...  
Keyword(s):  
Tumor Necrosis Factor ◽  
Adverse Events ◽  
Older Patients ◽  
Tumor Necrosis ◽  
Patient Age ◽  
Younger Patients ◽  
Patient Âgé ◽  
Serious Infections ◽  
Severe Adverse Events ◽  
Necrosis Factor

Abstract Purpose To assess safety and effectiveness of anti-tumor necrosis factor (anti-TNF) therapy in IBD patients ≥ 60 years. Methods Ninety IBD patients ≥ 60 years at initiation of anti-TNF therapy, 145 IBD patients ≥ 60 years without anti-TNF therapy and 257 IBD patients < 60 years at initiation of anti-TNF therapy were retrospectively included in this multicentre study. Primary outcome was the occurrence of severe adverse events (SAEs), serious infections and malignancies. Secondary outcome was effectiveness of therapy. Cox regression analyses were used to assess differences in safety and effectiveness. In safety analyses, first older patients with and without anti-TNF therapy and then older and younger patients with anti-TNF therapy were assessed. Results In older IBD patients, the use of anti-TNF therapy was associated with serious infections (aHR 3.920, 95% CI 1.185–12.973, p = .025). In anti-TNF-exposed patients, cardiovascular disease associated with serious infections (aHR 3.279, 95% CI 1.098–9.790, p = .033) and the presence of multiple comorbidities (aHR 9.138 (1.248–66.935), p = .029) with malignancies, while patient age did not associate with safety outcomes. Effectiveness of therapy was not affected by age or comorbidity. Conclusion Older patients receiving anti-TNF therapy have a higher risk of serious infections compared with older IBD patients without anti-TNF therapy, but not compared with younger patients receiving anti-TNF therapy. However, in anti-TNF-exposed patients, comorbidity was found to be an indicator with regards to SAEs. Effectiveness was comparable between older and younger patients.

Chondrocyte Viability After Intra-articular Calcaneal Fractures in Humans

2007 ◽  
Vol 28 (6) ◽  
pp. 665-668 ◽  
Author(s):  
Scott T. Ball ◽  
Kyle Jadin ◽  
R. Todd Allen ◽  
Alexandra K. Schwartz ◽  
Robert L. Sah ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Calcaneal Fractures ◽  
Patient Age ◽  
Chondrocyte Viability ◽  
Articular Fractures ◽  
Patient Âgé ◽  
Post Traumatic ◽  
The Impact ◽  
Traumatic Arthritis ◽  
Time From Injury

Background: Chondral damage from the impact of injury may contribute to the high incidence of post-traumatic arthritis after calcaneal fractures, but this has yet to be proven. We sought to study the effect of intra-articular calcaneal fractures on chondrocyte viability and to correlate these effects with injury severity, time from injury to surgery, and patient age and co-morbidities. Methods: Irreducible osteochondral fragments from 12 patients undergoing operative treatment for intra-articular calcaneal fractures were analyzed. Control cartilage was obtained from four tissue donors who died of unrelated causes. The cartilage was assessed for chondrocyte viability through the full thickness of tissue using a Live/Dead assay followed by laser scanning confocal microscopy. Patient demographics including injury classification and severity, time from injury to surgery, and patient age were recorded. Results: Chondrocyte viability from fracture patients averaged 72.8% ± 12.9% (range 53% to 95%), which was significantly lower than the 94.8% ± 1.5% viability observed in the control specimens ( p = 0.005). Chondrocyte viability declined with higher energy injuries ( p = 0.13), time from injury to surgery ( p = 0.07), and increasing patient age ( p = 0.07). However, none of these factors reached a level of statistical significance. Conclusions: A significant decline in chondrocyte viability occurs after intra-articular fractures of the calcaneus. This may contribute to the development of post-traumatic arthritis.

Prehospital Emergency Medical Services Departure Interval: Does Patient Age Matter?

2016 ◽  
Vol 31 (6) ◽  
pp. 608-613 ◽  
Author(s):  
Bruno Schnegg ◽  
Mathieu Pasquier ◽  
Pierre-Nicolas Carron ◽  
Bertrand Yersin ◽  
Fabrice Dami
Keyword(s):  
Response Time ◽  
Emergency Medical Services ◽  
Time Of Day ◽  
Medical Services ◽  
Time Interval ◽  
Patient Age ◽  
Emergency Medical ◽  
Patient Âgé ◽  
Prehospital Emergency ◽  
The Impact

AbstractIntroductionThe concept of response time with minimal interval is intimately related to the practice of emergency medicine. The factors influencing this time interval are poorly understood.ProblemIn a process of improvement of response time, the impact of the patient’s age on ambulance departure intervals was investigated.MethodThis was a 3-year observational study. Departure intervals of ambulances, according to age of patients, were analyzed and a multivariate analysis, according to time of day and suspected medical problem, was performed.ResultsA total of 44,113 missions were included, 2,417 (5.5%) in the pediatric group. Mean departure delay for the adult group was 152.9 seconds, whereas it was 149.3 seconds for the pediatric group (P =.018).ConclusionA statistically significant departure interval difference between missions for children and adults was found. The difference, however, probably was not significant from a clinical point of view (four seconds).SchneggB, PasquierM, CarronPN, YersinB, DamiF. Prehospital Emergency Medical Services departure interval: does patient age matter?Prehosp Disaster Med. 2016;31(6):608–613.

Mortality rates in geriatric patients with spinal cord injuries

2007 ◽  
Vol 7 (3) ◽  
pp. 277-281 ◽  
Author(s):  
Daniel R. Fassett ◽  
James S. Harrop ◽  
Mitchell Maltenfort ◽  
Shiveindra B. Jeyamohan ◽  
John D. Ratliff ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Mortality Rate ◽  
Geriatric Patients ◽  
Spinal Cord Injuries ◽  
Mortality Rates ◽  
Neurological Injury ◽  
Patient Age ◽  
Younger Patients ◽  
Patient Âgé ◽  
Chi Square Analysis

Object The authors undertook this study to evaluate the incidence of spinal cord injury (SCI) in geriatric patients (≥ 70 years of age) and examine the impact of patient age, extent of neurological injury, and spinal level of injury on the mortality rate associated with traumatic SCI. Methods A prospectively maintained SCI database (3481 patients) at a single institution was retrospectively studied for the period from 1978 through 2005. Parameters analyzed included patient age, admission American Spinal Injury Association (ASIA) motor score, level of SCI, mechanism of injury, and mortality data. The data pertaining to the 412 patients 70 years of age and older were compared with those pertaining to the younger cohort using a chi-square analysis. Results Since 1980, the number of SCI-related hospital admissions per year have increased fivefold in geriatric patients and the percentage of geriatric patients within the SCI population has increased from 4.2 to 15.4%. In comparison with younger patients, geriatric patients were found to be less likely to have severe neurological deficits (greater percentage of ASIA Grades C and D injuries), but the mortality rates were higher in the older age group both for the period of hospitalization (27.7% compared with 3.2%, p < 0.001) and during 1-year follow-up. The mortality rates in this older population directly correlate with the severity of neurological injury (1-year mortality rate, ASIA Grade A 66%, Grade D 23%, p < 0.001). The mortality rate in elderly patients with SCI has not changed significantly over the last two decades, and the 1-year mortality rate was greater than 40% in all periods analyzed. Conclusions Spinal cord injuries in older patients are becoming more prevalent. The mortality rate in this patient group is much greater than in younger patients and should be taken into account when aggressive interventions are considered and in counseling families regarding prognosis.

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