scholarly journals Ambulatory and Social Performance Status After Transfemoral Prosthetic Rehabilitation Regarding Age, Gender, and Marital Status

2021 ◽  
Vol 19 (4) ◽  
pp. 369-378
Author(s):  
Shafiq ur Rehman ◽  
◽  
Aqeel Ahmed Khan ◽  
Muhammad Kamran ◽  
Ghulam Saqulain ◽  
...  

Objectives: This study aims to determine the association of ambulatory and social performance status of transfemoral prosthetic users with their age, gender, and marital status. Methods: A cross-sectional study was conducted on 400 transfemoral prosthesis users. A sample was recruited from both genders aged 10-60 years using the prosthesis for at least one year. They were selected using the non-probability convenience sampling method from the Pakistan Institute of Prosthetic and Orthotic Sciences from July 2019 to December 2019. Lower extremity functional scale and short form-36 health survey questionnaire (SF-36) were used for data collection, followed by statistical analysis. Results: Ambulatory status (as measured by the total lower extremity functional scale) revealed significant association (P<0.001) with age. The highest score belonged to the 10-30 years age group. Also, there was a significant association (P=0.003) with marital status with the highest scores for unmarried ones. However, no significant (P=0.705) gender association was noted though scores were higher for the male gender. As regards, the social performance was measured by SF-36. The findings revealed a significant association (P<0.05) of most domains of SF-36 with age groups, with the highest scores for the age group of 10-30 years. Also, a significant association with the gender with higher scores in females was noted in most domains. In contrast, no significant association with marital status was reported in most domains. Discussion: Ambulatory status has a significant association with age and marital status with no significant gender association. While social performance has a significant association with gender, most domains had significant associations with age groups. However, no association with marital status was present.

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1315-1315 ◽  
Author(s):  
Fabiana Ostronoff ◽  
Megan Othus ◽  
Soheil Meshinchi ◽  
John E. Godwin ◽  
Kenneth J. Kopecky ◽  
...  

Abstract Introduction Younger acute myeloid leukemia (AML) patients with a NPM1 mutation but without FLT3-ITD (NPM1+/FLT3-ITD-) have favorable prognosis, but the prognostic significance of these mutations in patients older than 55 years is less clear. Therefore, we evaluated the prognostic impact of the NPM1+/FLT3-ITD- in older AML patients. Methods Samples were obtained from AML patients enrolled onto SWOG trials S9333, S9031, S9500 and S0106 who were ³55 years and received “7+3 like” induction regimens. Cytarabine/daunorubicin (S9031 and S9033) or HiDAC (9500 and S0106) were used for consolidation. Gemtuzumab ozogamicin, either during induction, consolidation, and/or post-consolidation, was administered to some patients enrolled onto S0106. Samples were examined for FLT3, NPM1, DNMT3A, IDH1/2 mutations using previously reported techniques. Results A total of 1,239 patients enrolled in these trials, and pre-treatment samples were available for 156 patients who were older than 55 years (median age of 60 years, range 55-83). NPM1 and FLT3-ITD mutations were present in 33% and 24% of the patients, respectively. The complete remission (CR) rate, 2-year overall survival (OS) and relapse-free survival (RFS) for the entire cohort were 62%, 31% and 32%, respectively. Increased age, unfavorable cytogenetics and FLT3-ITD were associated with a worse OS and RFS. NPM1 mutations were not significantly associated with OS or RFS. Patients were then divided into two age groups, 55-65 and >65 years, based on previous data that favorable prognostic factors such as good-risk cytogenetics have not been shown to be associated with favorable outcomes for AML patients age >65. Both age groups displayed similar patient characteristics (in regards to white blood cell count, bone marrow blast %, cytogenetics, secondary AML, sex and ECOG performance status), with the exception that >65 years group did not include any patients from S0106 or S9500 due to age restrictions for these trials. Patients >65 had a higher relapse rate (P =0.001) and significantly worse OS (P<0.001) and RFS (P=0.007) than those aged 55-65. FLT3-ITD retained its unfavorable prognostic significance for patients age 55-65, while patients >65 years had such a uniformly poor prognosis that this mutation lost much of its prognostic significance. NPM1 mutations were not significantly associated with either OS or RFS in either age group. We then examined the most favorable NPM1+/FLT3-ITD- genotype, which is currently being used to risk-stratify AML patients. NPM1+/FLT3-ITD- was associated with an improved OS in the 55-65 age group (P<0.001), which was similar to previously described results in younger patients (Figure 1A). Additional analyses showed that the favorable impact of this genotype was not due to the inclusion of patients enrolled onto S0106 and S9500 (Figure 1B). In contrast, patients >65 years with the NPM1+/FLT3-ITD- had a low CR rate and high 1-year relapse rate, which translated into a relatively poor 5-year OS (<30%, Figure 1C) that was not significantly different from patients >65 without this genotype (P=0.33). Since mutations in DNMT3A, IDH1/2 have been associated with adverse outcomes for patients with NPM1 mutations, samples with the NPM1+/FLT3-ITD- genotype were examined for these mutations. The frequencies for DNMT3A, IDH1/2 mutations were similar in both age groups, indicating that these mutations were not responsible for the age-dependent findings. Furthermore, multivariate models adjusting for known prognostic covariates showed that the NPM1+/FLT3-ITD- remained independently associated with improved OS for patients age 55-65 but not those >65. Conclusions This study represents one of the largest investigations on the prognostic significance of NPM1+/FLT3-ITD- in older AML patients. The NPM1+/FLT3-ITD- genotype remains a favorable-risk factor for AML patients age 55-65 years but may not be a favorable-risk factor for patients >65 years, at least not for those treated with standard induction followed by conventional consolidation. Disclosures: No relevant conflicts of interest to declare.


2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 109-109
Author(s):  
Zafar Malik ◽  
Giuseppe di Lorenzo ◽  
Sergio Bracarda ◽  
Alexandros Ardavanis ◽  
Mert Basaran ◽  
...  

109 Background: Cbz + P demonstrated an overall survival benefit vs mitoxantrone + P in pts with mCRPC in the Phase III TROPIC trial. The CUP (CABAZ_C_05005) and EAP (NCT01254279) (both funded by Sanofi) were established to allow access to Cbz ahead of commercial availability. The programs are also evaluating Cbz safety in a real-world population. Data analyzed by age group (≤75 and >75 years) are presented here. Methods: Expected enrolment across both programs is 1,450 pts from 236 centres worldwide. Pts received Cbz 25 mg/m2 IV Q3W + P 10 mg QD until disease progression, death, unacceptable toxicity or physician/pt decision. G-CSF is administered as per ASCO guidelines. Results: As of May 30, 2012, 1,301 pts have enrolled (≤75 years: 1,061 pts [81.6%]; >75 years: 240 pts [18.4%]). Eastern Cooperative Oncology Group performance status and incidence of visceral metastases were generally balanced between treatment groups. The most frequent reasons for discontinuation were disease progression (46.8%) followed by adverse events (AEs; 24.4%) in pts ≤75 years, and AEs (36.4%) followed by disease progression (31.1%) in pts >75 years. Time from initial diagnosis to inclusion was greater in pts >75 years (median 79.66 months) than in pts ≤75 years (median 53.94 months), but time from mCRPC diagnosis to inclusion was approximately equivalent (>75 years: median 22.6 months; ≤75 years: median 20.94 months). G-CSF use was more frequent in pts >75 years (cycle 1: 62.9% of pts) compared with pts ≤75 years (cycle 1: 52.2% of pts). AEs of clinical concern were more frequent in the older age group (Grade ≥3 AEs: >75 years 64.2%; ≤75 years 54.8%). Grade ≥3 neutropenia was observed in 25.8% of pts >75 years and in 17.0% of pts ≤75 years. Conclusions: We observed several differences between age groups in baseline and on-treatment parameters, suggesting differences in the natural history of mCRPC (faster disease progression in pts ≤75 years than in pts >75 years) and secondary to treatment (AEs more frequent in pts >75 years compared with pts ≤75 years). Clinical trial information: NCT01254279.


Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 1477-1477
Author(s):  
Lene Sofie Granfeldt Ostgard ◽  
Mette Nørgaard ◽  
Henrik Sengeløv ◽  
Lars Kjeldsen ◽  
Lone S. Friis ◽  
...  

Abstract Abstract 1477 Previous studies have documented the underrepresentation of women and elderly patients in American clinical trials of leukemia. If, characteristics of patients included in clinical protocols differ markedly from the characteristics of the majority of patients treated outside protocols the external validity of clinical trials may be threatened. Methods: The Danish National Acute Leukaemia Database (ALDB) includes detailed data on a large well-defined non-selected population of 2729 AML patients (covering >95% of AML patients diagnosed since Jan 2000). Since 2000 Danish AML patients have been included in 3 different British protocols (AML15, 16 and 17). We analysed a cohort of 2624 patients diagnosed with AML in Denmark since Jan. 2000 (105 APL-patients were excluded). We compared patients treated with curative intent according to the British protocols with patients treated with curative intent off-protocol with regard to characteristics, possible prognostic factors, CR-rate, and survival. For comparable groups we divided patients into 2 age groups (<60 and ≥60 years) and further excluded patients diagnosed before protocol inclusion was possible for the given age group. Results: 813 patients were treated with curative intent (517 pts < 60 years (96% of all patients <60y) vs. 296 pts ≥60 year, (35 % of all patients >60y). Of these, 391 pts (232 pts <60 years, 44.9 % vs. 159 pts ≥60 years, 53.7 %) were treated according to protocols. For both age groups WHO performance status score (WHO PS) was found to be significantly lower in the on-protocol group. Presence of secondary AML (sAML) was found more frequent in the off-protocol groups, but was only statistically significant in the group under 60 years. In patients 60 years or older, a significantly higher LDH-level and WBC was found in the on-protocol groups. We did not find any difference in distribution of sex, age, cytogenetic changes, presence of extra medullary leukemia (EML) or blast counts. Allogeneic transplantation (alloHCT) was significantly more often performed in the protocol groups (table 1). For patients under 60 years of age overall survival (OS) was superior in the on-protocol group (fig. 1). For the older age group OS was similar in the on- and off-protocol group (fig. 2). After controlling for possible prognostic factors protocol participation seemed to be associated with longer OS in patients under 60 years (HR 0.66, 95%CI 0.48–0.99, p=0.02), but not in patients 60 years or older (HR 1.17, 95%CI 0.87–1.57). The unevenly distributed characteristics; LDH-level, sAML, WHO PS, performance of alloHCT were all found to be of significant importance to OS. Conclusions: AML patients included in the British AML trials in Denmark had a more favorable profile than patients treated with standard regimens. We found a superior survival in on-protocol patients under 60 years. This could not be fully explained by an uneven distribution of prognostic factors. A beneficial effect of the protocol treatments and confounding by co-morbidity are suggested. Population-based studies may thus have an important role in examining some aspects of prognosis in AML. In this context the Danish ALDB has proven to be a valuable data source. Disclosures: No relevant conflicts of interest to declare.


1979 ◽  
Vol 9 (3) ◽  
pp. 469-479 ◽  
Author(s):  
Norman Kreitman ◽  
M. Schreiber

SynopsisBetween 1968 and 1975 there was a marked, non-artefactual rise in the numbers of young female parasuicides admitted to the Regional Poisoning Treatment Centre in Edinburgh. The greatest increase in rates occurred among girls aged 15–19 (for events, persons and ‘first-ever’ episodes). Among teenagers the most marked increase occurred for those who were married: this group also reported a greater increase than did the non-married in the frequency of physical violence and Serious debt. ‘Marginal’ social-sexual roles have also become progressively more common in this age group. The 20- to 24-year group showed a more modest increase in rates, similar for the married and the non-married. In this age group there was no consistent pattern of change for reported violence or debt over the study period, nor were changes in these variables related to marital status. An increase in consumption of alcohol before parasuicide was noted for both age groups.


2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 16-16 ◽  
Author(s):  
Cora N. Sternberg ◽  
Johann Sebastian De Bono ◽  
Kim N. Chi ◽  
Karim Fizazi ◽  
Peter Mulders ◽  
...  

16 Background: Enzalutamide (ENZA) inhibits multiple steps in the androgen receptor signaling pathway (Tran et al, Science. 2009;324:787). The phase III AFFIRM trial demonstrated that ENZA increased median overall survival (OS) by 4.8 months with a 37% reduction in the risk of death (P <0.001, HR 0.63) vs placebo (PBO) in post-docetaxel mCRPC patients (pts) (Scher et al, NEJM 2012; 367:1187). In a post-hoc analysis, the effect of ENZA on outcomes in elderly (≥ 75 yrs) vs younger (< 75 yrs) pts in the AFFIRM trial was assessed. Methods: The AFFIRM trial was a Phase III multinational, randomized, double-blind study in post-docetaxel mCRPC pts. Randomization was 2:1 to ENZA 160 mg/day or PBO, stratified by baseline ECOG performance status and mean pain score. Statistics are presented by age group (≥75, yrs <75 yrs) for efficacy outcomes of OS, radiographic progression-free survival (rPFS), and time to prostate-specific antigen (PSA) progression. Top line safety results are also presented for both age groups. Results: Elderly pts comprised 25% (199/800) of ENZA pts and 26% (104/399) of PBO pts. Improved outcomes with ENZA treatment were observed in both elderly and younger pts, with similar safety profiles in each age group. Conclusions: ENZA significantly improved outcomes in both elderly (≥ 75yrs) and younger pts (< 75yrs). Safety and tolerability findings were comparable between the two age groups. Clinical trial information: NCT00974311. [Table: see text]


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kosaku Nitta ◽  
Shigeru Nakai ◽  
Ikuto Masakane ◽  
Norio Hanafusa ◽  
Shunsuke Goto ◽  
...  

AbstractAccording to the annual survey of the Japanese Society for Dialysis Therapy Renal Data Registry (JRDR) conducted at the end of 2018, there were a total of 339,841 patients receiving dialysis (hereinafter, dialysis patients) in Japan. The survey included questions regarding the presence/absence of dementia, the performance status (PS), and the exercise habits of individual patients. The survey revealed that 10.8% of all dialysis patients had dementia (1.8% in the age group of less than 65 years, 6.8% in the age group of 65–74 years, and 22.7% in the age group of 75 years or older). These prevalences of dementia were approximately equal to those estimated from the survey conducted in 2010. Regarding PS, the percentage of patients with lower activity levels tended to be relatively high among patients who were less than 15 years old and those who were 60 years old or older. Concerning the exercise habits of dialysis patients, the percentage of patients who were classified as “not at all or hardly” in response to the question about exercise habit was the highest (60–80%) of all the exercise habit classifications in each of the age groups analyzed.


2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 3569-3569
Author(s):  
Aalok Kumar ◽  
Hagen F. Kennecke ◽  
Howard John Lim ◽  
Daniel John Renouf ◽  
Sharlene Gill ◽  
...  

3569 Background: High-risk stage II CC is defined as those presenting with T4 stage, obstruction or perforation, <12 lymph nodes retrieved, positive resection margins, and lymphovascular or perineural invasion. Our prior findings suggest that improved outcomes from AC are limited to specific high risk features, such as T4 disease (Kumar et al, ASCO 2012). It is unclear if this benefit is seen across all ages. Our aim was to compare patterns of AC use and outcomes in YP and EP with high risk stage II CC. Methods: All patients diagnosed with high risk stage II CC from 1999 to 2008 and evaluated at any 1 of 5 regional cancer centers in British Columbia were categorized into YP (age <70 years) or EP (age >/=70 years). Kaplan-Meier methods and Cox regression were used to correlate receipt of AC with overall survival (OS), disease specific (DSS) and relapse free survival (RFS), stratified by age group. Results: A total of 1,236 patients were identified: 636 (51%) YP and 600 (49%) EP among whom 363 (57%) and 85 (14%) received AC, respectively. Individuals who received AC in either age group had better performance status than those who did not (ECOG 0/1 47% vs. 34%, p=0.02). After adjusting for known prognostic factors, a significant advantage in OS, but not DSS or RFS, from AC was observed for both YP and EP (Table). The impact of AC on these outcomes was similar across age groups (p interaction of age and treatment = 0.46, 0.64 and 0.69 for OS, DSS and RFS, respectively). In the entire cohort, individuals with T4 lesions had significantly improved OS (HR 0.50, 95%CI 0.33-0.77, p=0.002), DSS (HR 0.59, 95%CI 0.37-0.93, p=0.03), and RFS (HR 0.63, 95%CI 0.42-0.95, p=0.03). The effect of AC in the T4 subgroup was also similar for both YP and EP in terms of OS, DSS and RFS (p interaction of age and treatment = 0.41, 0.71 and 0.77, respectively). Conclusions: In this population-based cohort of high risk stage II CC, improvements in outcomes from AC were seen mainly in those with T4 disease, regardless of age. [Table: see text]


2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 398-398
Author(s):  
Aalok Kumar ◽  
Hagen F. Kennecke ◽  
Howard John Lim ◽  
Daniel John Renouf ◽  
Sharlene Gill ◽  
...  

398 Background: High-risk stage II CC is defined as those presenting with T4 stage, obstruction or perforation, <12 lymph nodes retrieved, positive resection margins, and lymphovascular or perineural invasion. Our prior findings suggest that improved outcomes from AC are limited to specific high-risk features, such as T4 disease (Kumar et al, ASCO 2012). It is unclear if this benefit is seen across all ages. Our aim was to compare patterns of AC use and outcomes in YP and EP with high-risk stage II CC. Methods: All patients diagnosed with high-risk stage II CC from 1999 to 2008 and evaluated at any 1 of 5 regional cancer centers in British Columbia were categorized into YP (age <70 years) or EP (age >/=70 years). Kaplan-Meier methods and Cox regression were used to correlate receipt of AC with overall survival (OS), disease specific (DSS), and relapse-free survival (RFS), stratified by age group. Results: A total of 1,236 patients were identified: 636 (51%) YP and 600 (49%) EP among whom 363 (57%) and 85 (14%) received AC, respectively. Individuals who received AC in either age group had better performance status than those who did not (ECOG 0/1 47% vs. 34%, p=0.02). After adjusting for known prognostic factors, a significant advantage in OS, but not DSS or RFS, from AC was observed for both YP and EP (Table). The impact of AC on these outcomes was similar across age groups (p interaction of age and treatment = 0.46, 0.64, and 0.69 for OS, DSS, and RFS, respectively). In the entire cohort, individuals with T4 lesions had significantly improved OS (HR 0.50, 95%CI 0.33-0.77, p=0.002), DSS (HR 0.59, 95%CI 0.37-0.93, p=0.03), and RFS (HR 0.63, 95%CI 0.42-0.95, p=0.03). The effect of AC in the T4 subgroup was also similar for both YP and EP in terms of OS, DSS and RFS (p interaction of age and treatment = 0.41, 0.71, and 0.77, respectively). Conclusions: In this population-based cohort of high-risk stage II CC, improvements in outcomes from AC were seen mainly in those with T4 disease, regardless of age. [Table: see text]


2019 ◽  
Vol 8 (6) ◽  
pp. 275-287 ◽  
Author(s):  
N. D. Clement ◽  
M. Bardgett ◽  
K. Merrie ◽  
S. Furtado ◽  
R. Bowman ◽  
...  

Objectives Our primary aim was to describe migration of the Exeter stem with a 32 mm head on highly crosslinked polyethylene and whether this is influenced by age. Our secondary aims were to assess functional outcome, satisfaction, activity, and bone mineral density (BMD) according to age. Patients and Methods A prospective cohort study was conducted. Patients were recruited into three age groups: less than 65 years (n = 65), 65 to 74 years (n = 68), and 75 years and older (n = 67). There were 200 patients enrolled in the study, of whom 115 were female and 85 were male, with a mean age of 69.9 years (sd 9.5, 42 to 92). They were assessed preoperatively, and at three, 12 and, 24 months postoperatively. Stem migration was assessed using Einzel-Bild-Röntgen-Analyse (EBRA). Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Harris Hip Score (HHS), Hip Disability and Osteoarthritis Outcome Score (HOOS), EuroQol-5 domains questionnaire (EQ-5D), short form-36 questionnaire (SF-36,) and patient satisfaction were used to assess outcome. The Lower Extremity Activity Scale (LEAS), Timed Up and Go (TUG) test, and activPAL monitor (energy expelled, time lying/standing/walking and step count) were used to assess activity. The BMD was assessed in Gruen and Charnley zones. Results Mean varus/valgus tilt was -0.77⁰ and axial subsidence was -1.20 mm. No significant difference was observed between age groups (p ⩾ 0.07). There was no difference according to age group for postoperative WOMAC (p ⩾ 0.11), HHS (p ⩾ 0.06), HOOS (p ⩾ 0.46), EQ-5D (p ⩾ 0.38), patient satisfaction (p ⩾ 0.05), or activPAL (p ⩾ 0.06). Patients 75 years and older had a worse SF-36 physical function (p = 0.01) and physical role (p = 0.03), LEAS score (p < 0.001), a shorter TUG (p = 0.01), and a lower BMD in Charnley zone 1 (p = 0.02). Conclusion Exeter stem migration is within normal limits and is not influenced by age group. Functional outcome, patient satisfaction, activity level, and periprosthetic BMD are similar across all age groups. Cite this article: N. D. Clement, M. Bardgett, K. Merrie, S. Furtado, R. Bowman, D. J. Langton, D. J. Deehan, J. Holland. Cemented Exeter total hip arthroplasty with a 32 mm head on highly crosslinked polyethylene: Does age influence functional outcome, satisfaction, activity, stem migration, and periprosthetic bone mineral density? Bone Joint Res 2019;8:275–287. DOI: 10.1302/2046-3758.86.BJR-2018-0300.R1.


Sign in / Sign up

Export Citation Format

Share Document