scholarly journals Nitrogen Balance and Its relation with Energy and Protein Intake in Criticaly Ill Elderly Patients

2017 ◽  
Vol 1 (1) ◽  
pp. 1
Author(s):  
Niken Churrniadita ◽  
Luciana Budiati Sutanto ◽  
Rudyanto Sedono
Keyword(s):  
Elderly Patients ◽  
Critically Ill ◽  
Nitrogen Balance ◽  
Protein Intake ◽  
The Elderly ◽  
Elderly Subjects ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Positive Correlation ◽  
Consecutive Sampling

Introduction:Nitrogen balance in criticaly ill patients has the tendency to be negative due to stress response. In the elderly patients, the metabolic changes risk to worsening nitrogen balance. The aim of this study was to determine nitrogen balance and its correlation with energy and protein intake in critically ill elderly patients within 48 hours in ICU.Methods: The method was cross sectional, consecutive sampling on 26 critically ill elderly subjects. Inclusion criteria were patients admitted to ICU, age >60 years old, male/female, whose family/relatives agreed to join this study. Patients who had urine output <0,5 mL/kg/hours were excluded. Data collected were energy and protein intake, urinary urea nitrogen (UUN), and nitrogen balance during 24 hours I and II of admission.Results: The median age was 70 (61 – 85)  years old, body mass index was 22. 9 ­+  2.7 kg/m2, most of the subjects were surgical patients. In  24 hours I and II, the nitrogen balances were -5.2 (-31.2 − -4.1) and  -4.5 + 4.6 respectively, energy intakes were not significantly different; 78.8 + 45.0% and 91.1 + 50.2% respectively, and protein intakes were significantly different; 34.1 + 19.3 g/d and  41.2 + 21.3 g/d respectively. There was positive correlation between nitrogen balance and energy intake; r=0.6 and r=0.5, and also between protein intake; r=0.5 and r=0.4, in 24 hours I and II respectively.Conclusion: There were significantly positive correlation between nitrogen balance with energy and protein intake.

scholarly journals Comparison of Sarcopenia with Modified Frailty Index as a Predictor of Adverse Outcomes in Critically Ill Elderly Patients

2021 ◽  
pp. 200-206
Author(s):  
Shrirang Bhurchandi ◽  
Sachin Agrawal ◽  
Sunil Kumar ◽  
Sourya Acharya
Keyword(s):  
Elderly Patients ◽  
Critically Ill ◽  
Health Care Cost ◽  
Frailty Index ◽  
The Elderly ◽  
Time Frame ◽  
Adverse Outcomes ◽  
Cross Sectional ◽  
Parametric Data ◽  
Modified Frailty Index

Background: Ageing is a global fact affecting both developed and developing countries.It brings out various catabolic changes in body resulting in frailty(i.e. the person is not able to with stand minor stresses of the environment, due to reduced reserves in psychologicalreserve of several organ system).Thus causing a great burden of disease, dependence & health care cost. Sarcopenia is the leading component for frailty in the elderly population, but very few studies have been done in India for correlating frailty with sarcopenia. Aim: To compare sarcopenia with modified frailty index (MFI) as a predictor of adverse outcomes in critically ill elderly patients. Methodology: Cross-sectional study will be performed on all the critically ill geriatric subjects/patients coming to all the ICU's of AVBRH, Sawangi (M), Wardha who will satisfy various inclusion and exclusion criteria for selection and all standard parametric & non-parametric data will be assessed by using standard descriptive & inferential statistics. Expected Results: In our study, we are anticipating that the Modified frailty index to be a better predictor of adverse outcomes in terms of mortality as compared to sarcopenia in the critically ill elderly patients. Also, we are anticipating that sarcopenia to be the most important contributor of frailty in critically ill elderly patients and the prevalence of frailty will be high in critically ill elderly patients. Limitation: Due to limited time frame & resources we will not be able to follow up the patients.

Medication-Use Behavior of Elderly Patients in Baghdad City: A Cross-Sectional Study

2021 ◽  
Vol 1 ◽  
pp. 72-77
Author(s):  
Massara Salah Abbas ◽  
Marwa Jamal ◽  
Mustafa Mohammed Sabri ◽  
Zainab Abdulrahman ◽  
Saad Abdulrahman Hussain
Keyword(s):  
Side Effects ◽  
Elderly Patients ◽  
Product Information ◽  
Medication Use ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Elderly Subjects ◽  
Sectional Study ◽  
Cross Sectional ◽  
Survey Form

Background: As our society ages, the incidence of chronic diseases increases, and so does drug use and polypharmacy. Aim: To evaluate the medication use behaviors of selected elderly patients who lived in Baghdad city. Methods: This cross-sectional study included 225 subjects aged >60 years who lived in Baghdad city and consumed chronically prescribed medications. Data were collected using a survey form, and the survey was conducted through face-to-face interviews. The data are presented as numbers, percentages, and averages. Results: The majority were treated through polypharmacy, using various drugs. The most commonly used drugs included those used to treat cardiovascular diseases, DM, and dyslipidemia. 74.6% did not know about the side effects of the drugs they used, and 55.6% did not read the product information leaflet (PIL) of the drugs. Also, 70.7% said that the health care personnel did not educate them about their drugs. Of the elderly who were informed about their drugs, 128 obtained the information from the physician and 91 from the pharmacist. Conclusion: The majority of the elderly subjects used more than one drug, and the main drug class used was the cardiovascular agents. they are unaware of the side effects of the prescribed agents.

Protein Requirements in the Elderly

2011 ◽  
Vol 81 (23) ◽  
pp. 109-119 ◽  
Author(s):  
Dorothee Volkert ◽  
Cornel Christian Sieber
Keyword(s):  
Body Weight ◽  
Nitrogen Balance ◽  
Protein Intake ◽  
Muscle Protein ◽  
The Elderly ◽  
Elderly Subjects ◽  
Elderly Persons ◽  
Current Recommendation ◽  
Healthy Elderly ◽  
Increased Risk

Adequate protein intake and the maintenance of nitrogen equilibrium are of particular importance in the elderly because this age group is at increased risk of illness and malnutrition. The current recommendation for protein intake of healthy elderly subjects is 0.8 g/kg body weight/day, the same as for younger adults. Nitrogen balance studies in the elderly, however, revealed conflicting results; some studies suggest that not all elderly can achieve a nitrogen balance with a protein intake of 0.8 g/kg body weight/day, particularly if energy supply is not adequate. Beyond the amount of protein needed for nitrogen balance, the optimal protein intake for preservation of lean body mass, body functions, and health is of paramount interest. At present, there is insufficient longer-term research with defined health outcomes to derive recommendations in this regard. Very little is also known about the protein needs of frail and unhealthy elderly. Until more evidence is available, it seems reasonable to ensure a protein intake of at least 0.8 g/kg body weight/day in all elderly persons, particularly in those at risk of malnutrition (e.g., frail and multimorbid elderly). In addition to ascertaining adequate protein and energy intake, physical activity should be encouraged in order to increase energy expenditure and food intake and to facilitate muscle protein anabolism.

scholarly journals Elderly victims of falls seen by prehospital care: gender differences

2014 ◽  
Vol 17 (1) ◽  
pp. 3-16 ◽  
Author(s):  
William Campo Meschial ◽  
Dorotéia Fátima Pelissari de Paula Soares ◽  
Nelson Luiz Batista de Oliveira ◽  
Alice Milani Nespollo ◽  
Wesley Alexandre da Silva ◽  
...  
Keyword(s):  
Gender Differences ◽  
Elderly Patients ◽  
Exploratory Study ◽  
Prehospital Care ◽  
The Elderly ◽  
Cross Sectional ◽  
Significance Level ◽  
Care Services ◽  
Preventive Actions ◽  
Type Of Injury

OBJECTIVE: To identify elderly who are victims of falls, according to gender, who received care from prehospital services of Maringá, Paraná. METHODS: A cross-sectional exploratory study carried out with 1,444 elderly patients who suffered falls in Maringá in the period from 2006 to 2008. Data were gathered from prehospital care services, typed and processed using the Epi Info 6.04d(r). The χ² test was used to compare the falls in relation to gender (significance level = 0.05). RESULTS: The number of falls according to gender presented similar percentages, 51.0% for males and 49.0% for females. Significant differences between genders were observed regarding age (p < 0.001), presence of alcohol breath (p < 0.001), type of fall (p < 0.001), place of fall (p < 0.001), treatment at hospital (p = 0.023), number of injuries (p = 0.014), type of injury (p < 0.001) and injury location (p <0.001). CONCLUSION: These results show that falls happen differently among the elderly when considering gender. It highlights the importance of understanding these differences in detail and the circumstances in which the fall occurred, since this knowledge is key to plan preventive actions.

scholarly journals Association of protein intake with the outcomes of critically ill patients: a post hoc analysis of the PermiT trial

2018 ◽  
Vol 108 (5) ◽  
pp. 988-996 ◽  
Author(s):  
Y M Arabi ◽  
H M Al-Dorzi ◽  
S Mehta ◽  
H M Tamim ◽  
S H Haddad ◽  
...  
Keyword(s):  
Propensity Score ◽  
Critically Ill ◽  
Nitrogen Balance ◽  
Critically Ill Patients ◽  
Protein Intake ◽  
Nitrogen Excretion ◽  
Post Hoc Analysis ◽  
Lower Protein ◽  
Protein Group ◽  
Post Hoc

ABSTRACT Background The optimal amount of protein intake in critically ill patients is uncertain. Objective In this post hoc analysis of the PermiT (Permissive Underfeeding vs. Target Enteral Feeding in Adult Critically Ill Patients) trial, we tested the hypothesis that higher total protein intake was associated with lower 90-d mortality and improved protein biomarkers in critically ill patients. Design In this post hoc analysis of the PermiT trial, we included patients who received enteral feeding for ≥3 consecutive days. Using the median protein intake of the cohort as a cutoff, patients were categorized into 2 groups: a higher-protein group (>0.80 g · kg–1 · d–1) and a lower-protein group (≤0.80 g · kg–1 · d–1). We developed a propensity score for receiving higher protein. Primary outcome was 90-d mortality. We also compared serial values of prealbumin, transferrin, 24-h urinary nitrogen, and 24-h nitrogen balance on days 1, 7, and 14. Results Among the 729 patients included in this analysis, the average protein intake was 0.8 ± 0.3 g · kg–1 · d–1 [1.0 ± 0.2 g · kg–1 · d–1 in the higher-protein group (n = 365) and 0.6 ± 0.2 g · kg–1 · d–1 in the lower-protein group (n = 364); P < 0.0001]. There was no difference in 90-d mortality between the 2 groups [88/364 (24.2%) compared with 94/363 (25.9%), propensity score–adjusted OR: 0.80; 95% CI: 0.56, 1.16; P = 0.24]. Higher protein intake was associated with an increase in 24-h urea nitrogen excretion compared with lower protein intake, but without a significant change in prealbumin, transferrin, or 24-h nitrogen balance. Conclusions In the PermiT trial, a moderate difference in protein intake was not associated with lower mortality. Higher protein intake was associated with increased nitrogen excretion in the urine without a corresponding change in prealbumin, transferrin, or nitrogen balance. Protein intake needs to be tested in adequately powered randomized controlled trials targeting larger differences in protein intake in high-risk populations.

scholarly journals HUBUNGAN PANDEMI COVID-19 DAN PSBB DENGAN GANGGUAN DEPRESI PADA LANSIA DI PANTI WREDA HANA CIPUTAT JAKARTA

2021 ◽  
Vol 1 (1) ◽  
pp. 66
Author(s):  
Anggun Tsabitah Rachmah ◽  
Noer Saelan Tadjudin
Keyword(s):  
Nursing Home ◽  
Large Scale ◽  
Depressive Disorders ◽  
The Elderly ◽  
Elderly Subjects ◽  
Research Subjects ◽  
Chi Square ◽  
Cross Sectional ◽  
The Government ◽  
The Impact

Pemerintah Indonesia selama pandemi COVID-19 menerapkan PSBB (Pembatasan Sosial Berskala Besar) dimana PSBB tersebut membuat aktivitas masyarakat dibatasi, dampaknya juga bisa dirasakan pada lansia di Panti Wreda sehingga dapat menyebabkan timbulnya gangguan depresi. Penelitian ini bertujuan untuk mengetahui hubungan pandemi COVID-19 dan PSBB dengan gangguan depresi pada lansia di Panti Wreda Hana Ciputat Jakarta. Penelitian ini menggunakan metode analitik observational dengan desain studi cross sectional. Penelitian ini dilakukan di Panti Wreda Hana Ciputat Jakarta terhadap lansia sejumlah 56 subjek penelitian yang terdiri dari perempuan 48 orang dan laki-laki 8 orang. Dari 56 subjek penelitian jumlah laki-laki 8 (14,3%) dan perempuan 48 (85,7%). Sebelum terjadinya pandemi COVID-19 dan PSBB, subjek penelitian yang tidak depresi sejumlah 49 subjek (87,5 %), kemungkinan besar depresi 6 subjek (10,7%), dan yang mengalami depresi 1 subjek (1,8%). Selama pandemi COVID19 dan PSBB, subjek penelitian yang tidak depresi 38 subjek (67,9%), kemungkinan besar depresi 14 subjek (25%), dan yang mengalami depresi 4 subjek (7,1%). Berdasarkan hasil uji Chi-square nilai p= 0,000. Dapat disimpulkan terdapat hubungan pandemi COVID-19 dan PSBB dengan gangguan depresi pada lansia di Panti Wreda Hana Ciputat Jakarta. The Government of Indonesia during the COVID-19 pandemic implemented PSBB (Large-Scale Social Restrictions) where the PSBB made community activities restricted, the impact can also be felt on the elderly in nursing home so that it can cause depressive disorders. This research was done in order to determine the relationship of the COVID-19 pandemic and PSBB with depressive disorders in the elderly at the Ciputat Hana Nursing Home in Jakarta. This study used an observational analytic method with a cross sectional study design. The research was conducted at the Ciputat Hana Nursing Home in Jakarta for 56 elderly subjects. In the nursing home consist of 48 women and 8 men. In 56 research subjects, there were 8 (14,3%) men and 48 (85,7%) women. Before the Pandemic of COVID-19 and PSBB, there were 49 (87,5%) research subjects who were not depressed, 6 (10,7%) research subjects who were most likely depressed, and 1 (1,8%) research subject who were depressed. During the Pandemic of COVID-19 and PSBB, there were 38 (67,9%) research subjects who were not depressed, 14 (25%) research subjects who were most likely depressed, and 4 (7,1%) research subjects who were depressed. Based on Chi-Square test result, the value of P = 0,000. In conclusion, there is a correlation between the pandemic of COVID-19 and PSBB with depression disorder in the elderly at Ciputat Hana Nursing Home in Jakarta.

scholarly journals Faktor-Faktor yang Mempengaruhi Depresi pada Lansia Pensiunan di Kecamatan Jekan Raya Kota Palangka Raya

2019 ◽  
Vol 5 (1) ◽  
pp. 209-220
Author(s):  
Syam'ani Syam'ani
Keyword(s):  
Elderly People ◽  
Employment Status ◽  
Selection Criteria ◽  
Age Groups ◽  
Sampling Technique ◽  
The Elderly ◽  
Cross Sectional ◽  
Consecutive Sampling ◽  
The World ◽  
Day By Day

The population of the population in the world is increasing day by day. One of the age groups that have a significant increase in the elderly group. Projections and data found about the elderly are a concern that is of interest to the whole world because along with the increase in population it is accompanied by physical and psychological problems that accompany it. This study aims to identify factors that affect depression in retired elderly people. The design used in this study uses a research design: "CROSS-SECTIONAL". In this study, the population is elderly retirees who live in the area of Jekan Raya Subdistrict, Palangka Raya City. The sampling technique in this study uses consecutive sampling technique, which is the best type of non-probability sampling, that is, all objects that come sequentially and meet the selection criteria are included in the study until the number of subjects needed is fulfilled, namely as many as 100 people. The results showed that there was no significant relationship between sex (p: 0.671), employment status (p: 0.994), marital status (p: 0.726), education (p: 0.988), and the level of depression in retired civil servants in Jekan Subdistrict Raya Kota Palangka Raya. This research is expected to contribute positively to the management of elderly people with depression so that they are able to adapt to changes that occur due to the aging process.

scholarly journals Health Problems of Elderly Patients attending Combined Military Hospital, Dhaka

2017 ◽  
Vol 13 (1) ◽  
pp. 8-12
Author(s):  
SM Humayun Kabir ◽  
Md Ziaul Islam ◽  
Masuda Begum ◽  
Masud Ahmed ◽  
Mohammad Mohsin ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Health Care Providers ◽  
Family Income ◽  
Sampling Technique ◽  
Armed Forces ◽  
The Elderly ◽  
Health Problems ◽  
Military Hospital ◽  
Care Providers ◽  
Cross Sectional

Introduction: Health problems of elderly are an emerging health burden throughout the world. Bangladesh is currently undergoing a demographic transition and the proportion of the population of 60 years and older is increasing rapidly. Health care providers and policymakers are highly concerned with this burning issue. Objective: To know the disease pattern among the elderly patients in Combined Military Hospital, Dhaka. Materials and Methods: This cross-sectional study was carried out from July 2015 to June 2016 among 152 elderly patients above 60 years of age admitted in Combined Military Hospital (CMH), Dhaka Cantonment. Data were collected by face-to-face interview with semi-structured questionnaire and checklist following purposive sampling technique. Analysis of data was done by Statistical Package for Social Science (SPSS, version 20.0). Results: Mean age of the elderly was 72.06±4.56 years with the range of 60-80 years and majority (90.8%) of the elderly was male. Out of total 152 elderly patients, by occupation majority (31.6%) were in the business group followed by 30.3% in the retired group and 9.2 % in the housewife group. Average monthly family income was BDT 17927.63±7360.75 with the range of BDT 6000-35000. With initial complaints elderly patients reported to doctors in private chamber (38.2%), private hospital (25.6%) and Govt hospital (5.9%). Among all of the elderly patients, majority (21.1%) had Diabetes Mellitus followed by Rheumatoid Arthritis (17.6%), Asthma (12.5%), Cataract (11.2%), ENT problem (6.6%), Malignancy (5.9%) and Benign Enlargement of Prostate 8(5.3%). Conclusion: The number of elderly people is expanding rapidly; it also presents multifaceted health problems and thus creates unique challenges for the national healthcareservices. Early identification of problem and ensuring the availability of health with economic and social support can have a control over the elderly health problems. Journal of Armed Forces Medical College Bangladesh Vol.13(1) 2017: 8-12

scholarly journals Fatores de risco para doenças cardiovasculares em idosos

2017 ◽  
Vol 11 (12) ◽  
pp. 4895
Author(s):  
Jerry Deyvid Freires Ferreira ◽  
Rafaella Pessoa Moreira ◽  
Tibelle Freitas Maurício ◽  
Paula Alves de Lima ◽  
Tahissa Frota Cavalcante ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Diseases ◽  
Cardiovascular Health ◽  
The Elderly ◽  
Elderly Subjects ◽  
Modifiable Risk Factors ◽  
Patient Identification ◽  
Chi Square ◽  
Cross Sectional ◽  
Factores De Riesgo

RESUMOObjetivos: avaliar as condições de saúde cardiovascular e identificar os fatores de risco modificáveis para doenças cardiovasculares em idosos. Método: estudo quantitativo, transversal e descritivo com 246 idosos. Aplicou-se um formulário com questões abertas, referentes à identificação do paciente, relacionando dados sociodemográficos, fatores de risco e informações sobre as condições de saúde. Para análise dos dados, realizou-se o teste Qui-Quadrado de Pearson. Resultados: 75,7% dos participantes eram mulheres, 94,3% aposentados. O uso de bebidas alcoólicas, fumo ativo e passivo foram referidos, respectivamente, por 8,9%, 11,8% e 18,3% dos entrevistados. A pressão arterial esteve alterada em 58,6% dos idosos na primeira avaliação, 81,8% na segunda e 74,3% na terceira. Conclusão: foi possível traçar o perfil da saúde cardiovascular e dos fatores de risco modificáveis para as doenças cardiovasculares na população idosa, que subsidiarão de base para intervenções voltadas à promoção da saúde e prevenção dos agravos. Descritores: Enfermagem; Idosos; Doenças Cardiovasculares.ABSTRACTObjectives: to evaluate cardiovascular conditions and to identify modifiable risk factors for cardiovascular diseases in the elderly. Method: descriptive, cross-sectional and quantitative study with 246 elderly subjects. A questionnaire with open questions regarding patient identification was applied, relating sociodemographic data, risk factors and information on health conditions. For data analysis, the Pearson Chi-Square test was performed. Results: 75.7% of the participants were women, 94.3% were retired. Alcohol consumption, active and passive smoking were reported, respectively, by 8.9%, 11.8% and 18.3% of respondents. Changes in blood pressure were identified in 58.6% of the elderly in the first evaluation, 81.8% in the second and 74.3% in the third evaluation. Conclusion: it was possible to outline the profile of cardiovascular health status and of modifiable risk factors for cardiovascular diseases in the elderly population, which will support interventions aimed at health promotion and disease prevention. Descriptors: Nursing; Elderly; Cardiovascular Diseases.RESUMENObjetivos: evaluar las condiciones de salud cardiovascular e identificar los factores de riesgo modificables para enfermedades cardiovasculares en ancianos. Método: estudio cuantitativo, transversal y descriptivo con 246 ancianos. Se aplicó un formulario con preguntas abiertas, referentes a la identificación del paciente, relacionando datos sociodemográficos, factores de riesgo e informaciones sobre las condiciones de salud. Para análisis de los datos, se realizo el test Chi-Cuadrado de Pearson. Resultados: 75,7% de los participantes eran mujeres, 94,3% jubialdos. El uso de bebidas alcohólicas, fumador activo y pasivo fueron referidos, respectivamente, por 8,9%, 11,8% y 18,3% de los entrevistados. La presión arterial estuvo alterada en 58,6% de los ancianos en la primera evaluación, 81,8% en la segunda y 74,3% en la tercera. Conclusión: fue posible trazar el perfil de la salud cardiovascular y de los factores de riesgo modificables para las enfermedades cardiovasculares en la población anciana, que subsidiarán de base para intervenciones dirigidas ala promoción de la salud y prevención de los problemas. Descriptores: Enfermería; Los Ancianos; Enfermedades Cardiovasculares.

scholarly journals MEDICATION BURDEN AND INAPPROPRIATE PRESCRIPTION RISK AMONG ELDERLY WITH ADVANCED CHRONIC KIDNEY DISEASE

2019 ◽  
Author(s):  
Clarisse Roux-Marson ◽  
Jean-Baptiste Baranski ◽  
Coraline Fafin ◽  
Guillaume Extermann ◽  
Cecile Vigneau ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Elderly Patients ◽  
Healthcare Providers ◽  
Antihypertensive Agents ◽  
The Elderly ◽  
Anticholinergic Drugs ◽  
Cross Sectional ◽  
French Study ◽  
Sectional Analysis

Abstract Background Elderly patients with chronic kidney disease (CKD) frequently present comorbidities that put them at risk of polypharmacy and medication-related problems. This study aims to describe the overall medication profile of patients aged ≥ 75 years with advanced CKD from a multicenter French study and specifically the renally (RIMs) and potentially inappropriate-for-the-elderly medications (PIMs) that they take. Methods This is a cross-sectional analysis of medication profiles of individuals aged ≥ 75 years with eGFR < 20 ml/min/1.73m2 followed by a nephrologist, who collected their active prescriptions at the study inclusion visit. Medication profiles were analyzed according to route of administration, therapeutic classification, and their potential inappropriateness for these patients, according to Beers' criteria. Results We collected 5196 individual medication prescriptions for 556 patients, for a median of 9 daily medications [7-11]. Antihypertensive agents, antithrombotics, and antianemics were the classes most frequently prescribed. Moreover, 88% of patients had at least 1 medication classified as a RIM, and 21% of those were contraindicated drugs. At least 1 PIM was taken by 68.9%. The prescriptions most frequently requiring reassessment due to potential adverse effects were for proton pump inhibitors and allopurinol. The PIMs for which deprescription is especially important in this population are rilmenidine, long-term benzodiazepines, and anticholinergic drugs such as hydroxyzine. Conclusion We showed potential drug-related problems in elderly patients with advanced CKD. Healthcare providers must reassess each medication prescribed for this population, particularly the specific medications identified here.

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