RISK FACTORS OF ADVERSE CLINICAL OUTCOMES IN THE ELDERLY AND SENILE PATIENTS WITH STROKE-ASSOCIATED PNEUMONIA

2021 ◽  
pp. 586-591
Author(s):  
В.А. Белобородов ◽  
И.А. Степанов ◽  
А.В. Щербатых ◽  
И.И. Томашов ◽  
З.С. Саакян ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Outcomes ◽  
Nosocomial Pneumonia ◽  
Binary Logistic Regression ◽  
The Elderly ◽  
Older Age ◽  
Binary Logistic Regression Model ◽  
Protein Levels ◽  
Reactive Protein ◽  
Degree Of Disability

В отечественной и зарубежной специализированной литературе отсутствуют исследования, посвященные изучению факторов риска развития неблагоприятного исхода у пациентов старшей возрастной группы с инсультассоциированной нозокомиальной пневмонией. Цель исследования - изучение факторов риска развития неблагоприятного клинического исхода у пациентов пожилого и старческого возраста с нозокомиальной пневмонией на фоне ОНМК. В исследование были включены 247 пациентов пожилого и старческого возраста (139 мужчин, 108 женщин, средний возраст - 74,1±6,3 года), госпитализированных с признаками ОНМК по ишемическому или геморрагическому типу. Согласно модели бинарной логистической регрессии, статистически значимо ассоциированы с развитием неблагоприятного исхода у изучаемой группы респондентов следующие параметры: возраст свыше 75 лет (p=0,011), степень инвалидизации по шкале mRS 3 (р=0,009), а также уровень С-РБ >100 мг/л (р=0,023) и мочевины >7 ммоль/л (р=0,044). Для снижения частоты встречаемости неблагоприятного клинического исхода у пациентов старшей возрастной группы с инсульт-ассоциированной нозокомиальной пневмонией необходимо верифицировать перечисленные выше клинико-лабораторные параметры на ранних этапах госпитализации. In the domestic and foreign specialized literature, there are no studies devoted to the study of risk factors of mortality in the older age patients with stroke-associated nosocomial pneumonia. The purpose of the study was to study the risk factors of adverse clinical outcomes in elderly and senile patients with stroke-associated nosocomial pneumonia. The study included 247 elderly and senile patients (139 men, 108 women, mean age - 74,1±6,3 years) who were hospitalized with signs of ischemic or hemorrhagic stroke. According to the binary logistic regression model, the following parameters are statistically significantly associated with adverse clinical outcomes in the studied group of respondents: age over 75 years (p=0.011), degree of disability according to mRS ≥3 (p=0,009), and C-reactive protein levels over 100 mg/l (p=0,023) and urea more than 7 mmol/l (p=0,044). In order to reduce the incidence of adverse clinical outcomes in patients of the older age group with stroke-associated nosocomial pneumonia, it is necessary to verify the above clinical and laboratory parameters at the early stages of hospitalization.

Association between diet, lifestyle, metabolic cardiovascular risk factors, and plasma C-reactive protein levels

Metabolism ◽  
2004 ◽  
Vol 53 (11) ◽  
pp. 1436-1442 ◽  
Author(s):  
Gunilla Nordin Fredrikson ◽  
Bo Hedblad ◽  
Jan-Åke Nilsson ◽  
Ragnar Alm ◽  
Göran Berglund ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein

Acute Myelogenous Leukemia in the Elderly. Intensive Induction Chemotherapy Improves Survival

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4002-4002
Author(s):  
Anant Sharma ◽  
Runhua Shi ◽  
Francesco Turturro
Keyword(s):  
Clinical Outcomes ◽  
Induction Chemotherapy ◽  
Median Survival ◽  
The Elderly ◽  
Older Age ◽  
Myelogenous Leukemia ◽  
Risk Of Death ◽  
Elderly Aml ◽  
History Of ◽  
Wbc Count

Abstract Acute Myeloid Leukemia (AML) in the elderly has poor prognoses and carries inferior results with therapy. The purpose of this study was to determine the incidence of elderly AML, examine clinical outcomes with treatment and investigate the impact of intensive induction chemotherapy and other variables such as such as age, leucocytoses, cytogenetics and presence of antecedent hematologic disorder (AHD) on survival, in a cohort of elderly patients with AML treated at our institution. Patients and Methods: The retrospective review included all patients (age>59) treated between January 1999 and February 2008. Patients diagnosed with acute promyelocytic leukemia were excluded. Records were reviewed from time of diagnoses till death or last follow-up. Statistical analyses: Median survival was calculated using Kaplan Meier method and differences in survival between patients treated with intensive chemotherapy and those receiving supportive care were compared using the logrank test which was also used to determine the association between survival and variables such as older age (<69 vs. ≥ 69), leucocytoses (WBC >10k), cytogenetics and history of AHD. Results: Study cohort included 51 patients with age>59. This represented 29% of all AML cases (n=176) treated at our institution. 31(60.78%) were males. Mean age was 68.42 years, range (60–82) with 23 (45.10%) being >69 years of age. History of AHD was observed in 15 (29.41%). Results of cytogenetic studies were available for 29(56.86%) patients of which 11(37.93%) had poor risk cytogenetics with the remainder falling in the intermediate risk group. Elevated WBC count was seen in 25(49.02%). Intensive induction chemotherapy was administered with an anthracycline and cytarabine regimen to 42(82.35%) patients with an induction mortality of 26%. Total of 23 (54.76%) patients achieved first complete remission (CR1). Of those who achieved CR1, 19(82.60%) underwent consolidation. Median survival was 120 days, range (1–2035). By univariate analyses, survival was not affected by older age (p=0.98), poor cytogenetics (p=0.23) or history of AHD (p=0.59), but was affected by induction chemotherapy (p=0.0001), ability to achieve CR1 (p=0.0001) and elevated WBC (p=0.05). In multivariate analyses after adjusting for other variables risk of death was influenced by ability to achieve CR1 (HR 0.146), AHD (HR=2.66) and elevated WBC count (HR=2.48). Conclusion: Elderly AML has poor clinical outcomes. Risk of death is reduced by intensive induction chemotherapy and achievement of CR1. It is increased by history of AHD and elevated WBC at presentation.

scholarly journals Leprosy Reaction in Thai Population: A 20-Year Retrospective Study

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Poonkiat Suchonwanit ◽  
Siripich Triamchaisri ◽  
Sanchawan Wittayakornrerk ◽  
Ploysyne Rattanakaemakorn
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Treatment Regimen ◽  
Descriptive Analysis ◽  
Binary Logistic Regression ◽  
Binary Logistic Regression Model ◽  
Thai Population ◽  
Leprosy Reactions ◽  
Appropriate Treatment ◽  
Leprosy Patients

Background. Leprosy is a chronic infectious disease that presents with varying dermatological and neurological symptoms. The leprosy reactions occur over the chronic course of the disease and lead to extensive disability and morbidity.Objective. To analyze and identify the risk factors which contribute to leprosy reactions.Methods. In a retrospective study, we reviewed the medical records of leprosy patients registered at the leprosy clinic, Ramathibodi Hospital, Thailand, between March 1995 and April 2015. One hundred and eight patients were included; descriptive analysis was used for baseline characteristics and a binary logistic regression model was applied for identifying risk factors correlated with leprosy reactions.Results. Of the 108 cases analyzed, 51 were male and 57 were female. The mean age of presentation was 45 years. The borderline tuberculoid type was the most common clinical form. Leprosy reactions were documented in 61 cases (56.5%). The average time to reaction was 8.9 months. From multivariate analysis, risk factors for leprosy reactions were being female, positive bacillary index status, and MB treatment regimen.Conclusions. Leprosy reactions are common complications in leprosy patients. Being female, positive bacillary index status, and multibacillary treatment regimen are significantly associated with the reactions. Early detection in cases with risk factors followed by appropriate treatment could prevent the morbidity of leprosy patients.

scholarly journals Joint evaluation of serum C-Reactive Protein levels and polygenic risk scores as risk factors for schizophrenia

2018 ◽  
Vol 261 ◽  
pp. 148-153 ◽  
Author(s):  
Vishwajit L. Nimgaonkar ◽  
Faith Dickerson ◽  
Jennie G. Pouget ◽  
Kodavali Chowdari ◽  
Colm O’Dushlaine ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Scores ◽  
C Reactive Protein ◽  
Polygenic Risk ◽  
Protein Levels ◽  
Reactive Protein ◽  
Joint Evaluation

scholarly journals Comparison of C-reactive protein levels, neutrophil count, and clinical outcomes between low-dose ketamine given at the end of surgery and at induction in laparotomy

2021 ◽  
Vol 5 (2) ◽  
pp. 98
Author(s):  
MadeSeptyana Parama Adi ◽  
IMade Gede Widnyana ◽  
IPutu Pramana Suarjaya ◽  
TjokordaGde Agung Senapathi ◽  
Christopher Ryalino
Keyword(s):  
Clinical Outcomes ◽  
Neutrophil Count ◽  
Low Dose ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein

scholarly journals SERUM ZINC AND C-REACTIVE PROTEIN LEVELS AS RISK FACTORS FOR MORTALITY IN SYSTEMIC INFLAMMATORY RESPONSE SYNDROME

2018 ◽  
Vol 24 (1) ◽  
pp. 1
Author(s):  
Dwi Retnoningrum ◽  
Banundari Rachmawati ◽  
Dian Widyaningrum
Keyword(s):  
Risk Factors ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Serum Zinc ◽  
Latex Agglutination ◽  
Systemic Inflammatory Response ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein

Kondisi Systemic Inflammatory Response Syndrome (SIRS) berkebahyaan terjadinya sepsis dan kegagalan multi organ. Inflamasidapat menyebabkan terjadinya redistribusi zinc ke jaringan sehingga terjadi penurunan kadar zinc plasma. Kadar CRP pada SIRSmeningkat sebagai respons peningkatan protein tahap akut. Tujuan penelitian ini untuk mengetahui apakah kadar zinc dan CRP serummerupakan faktor kebahayaan kematian di pasien SIRS. Penelitian observasional analitik dengan pendekatan kohort prospektif di 30pasien SIRS berusia 27–64 tahun. Kadar zinc serum diperiksa dengan metode atomic absorbance spectrophotometer (AAS) dan CRPserum dengan metode latex agglutination immunoassay menggunakan alat autoanaliser. Kejadian kematian subjek dinilai setelah 28hari perawatan. Data dilakukan uji statistik Chi-Kwadrat, bila tidak memenuhi maka dilakukan uji alternatif Fisher. Besarnya nilaifaktor kebahyaan dilakukan perhitungan kebahayaan relatif. Rerata kadar zinc dan CRP berturut-turut 81,24 ± 8,72 μg/dL, dan 8,13± 8,12 mg/dL. Kematian dalam 28 hari adalah 33,3%. Penelitian ini menunjukkan bahwa kadar zinc plasma < 80 μg/dL bukanmerupakan faktor kebahayaan terjadinya kematian (p=0,114), sedangkan kadar CRP ≥ 10 mg/dL merupakan faktor kebahayaanterjadinya kematian di pasien SIRS (RR=3,28, 95% CI 1,33-8,13, p=0,015). Kadar zinc plasma bukan merupakan faktor kebahayaanterjadinya kematian pada SIRS, sedangkan kadar CRP merupakan faktor kebahayaan terjadinya kematian di pasien SIRS.

scholarly journals Risk factors for fear of falling in the elderly in Serbia

2018 ◽  
Vol 75 (8) ◽  
pp. 764-772
Author(s):  
Suncica Ivanovic ◽  
Sanja Trgovcevic
Keyword(s):  
Risk Factors ◽  
Fear Of Falling ◽  
Binary Logistic Regression ◽  
Female Gender ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Everyday Functioning ◽  
Cross Sectional ◽  
Demographic Questionnaire ◽  
Study Results

Background/Aim. After a fall, the elderly can develop a fear of falling which can be more frequent and more serious problem than the fall itself because it represents the main factor limiting an older person in his/her everyday functioning. The aim of this study was to identify and examine, in a more detailed way, risk factors for developing fear of falling triggered by the history of their falls over the previous year in the elderly in Serbia who live in houses or apartments. Methods. The cross-sectional study was conducted on 400 people, mean age 75.04 years (min. 65, max. 94), randomly selected from the register of patients in the Primary Health Center of Nis (164 men and 236 women), in the period January- June 2014. Socio-demographic questionnaire ? Elderly Fall Screening Test (EFST), Multi-Factor Questionnaire Falls (MFQ) and Falls Efficacy Scale International (FESI) were used in this study. Results. After applying the multivariate binary logistic regression, it was found that significant predictors for developing fear of falling were as follows: female gender (OR = 2.599; p = 0.009), age 75?79 years (OR = 4.637; p = 0.009) and over 80 years (OR = 3.830; p = 0.001), increase in household members (OR = 1.206; p = 0.033), people who estimate their health as average (OR = 0.268; p < 0.001) and good (OR = 0.059; p < 0.001), number of falls higher than 2 (OR = 2.761; p = 0.003), presence of injuries during the fall (OR = 2.483; p = 0.028), periodical and repeating situations of ?near-fall? (OR = 3.830; p = 0.001), limited activity (OR = 2.124; p = 0.007) problems with sight (OR = 3.006; p < 0.001), cognitive problems (OR = 2.296; p = 0.005) and problems with balance (OR = 3.809; p < 0.001). Conclusion. The results of this study can be used for planning promotional programs for falls and a fear of falling prevention, as well as prevention of their consequences.

scholarly journals Analysis of Characteristics, Methods of Suicide, and Clinical Outcomes in Elderly Suicide Attempters in South Korea by Age Subgroup

2020 ◽  
Keyword(s):  
Risk Factors ◽  
South Korea ◽  
Clinical Outcomes ◽  
Age Groups ◽  
The Elderly ◽  
Substance Exposure ◽  
South Korean ◽  
The Third ◽  
Elderly Suicide ◽  
Methods Of Suicide

Introduction: As the elderly comprise 14.3% of the South Korean population, suicide among the elderly has become a significant public concern. Methods: This study retrospectively analyzed data from the Emergency Department-Based Injury In-depth Surveillance nationwide of South Korea. Patients aged ≥ 65years old who intentionally caused self-injury were included. These elderly patients were subdivided into age groups, and their associated characteristics and correlation between suicide attempt methods and the clinical outcomes were analyzed. Results: A total of 5,333 cases were analyzed. The mean age of the subjects was 75.1 years old, comprising 3,039 males (57.0%) and 2,294 females (43.0%). Substance exposure was the most frequent method across all age groups. In terms of risk factors of admission, drowning, hanging, and asphyxia showed the following results: OR 2.372 for the first group; OR 2.224 for the second group; and OR 5.606 for the third group. Fall/slip was identified as a risk factor of admission in the first and second groups (OR 5.016 for the first group; OR 5.101 for the second group). In terms of risk factors of mortality, drowning, hanging, and asphyxia showed the following results: OR 9.066 for the first group; OR 7.320 for the second group; and OR 7.135 for the third group. With regard to fall/slip, the results were OR 14.596 for the first group; OR 10.096 for the second group; and OR 24.167 for the third group. Conclusions: This study showed that clinical outcomes were different according to the suicide-related characteristics and chosen suicide method. Based on these results, it is necessary to prepare measures to prevent suicide of the elderly in the future.

scholarly journals Risk factors for onset of delirium after neck of femur fracture surgery: a prospective observational study

SICOT-J ◽  
2018 ◽  
Vol 4 ◽  
pp. 27 ◽  
Author(s):  
Muaaz Tahir ◽  
Shahbaz S Malik ◽  
Usman Ahmed ◽  
Jakub Kozdryk ◽  
Syeda Huma Naqvi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Length Of Stay ◽  
Binary Logistic Regression ◽  
The Elderly ◽  
Cognitive Status ◽  
Adverse Outcomes ◽  
Electrolyte Imbalance ◽  
Chronic Obstructive ◽  
Neck Of Femur ◽  
Obstructive Pulmonary Disease

Background: Delirium is a common complication after surgery in the elderly that leads to increased length of stay and other adverse outcomes. The aim of this study was to better understand the exact causes of post-operative delirium in patients undergoing surgery for neck of femur (NOF) fractures. Methods: We performed a prospective cohort study of 381 consecutive patients undergoing surgery for NOF fractures at a single institution. Baseline cognitive status and risk factors were recorded on admission. Post-operative cognitive status was assessed at regular intervals until discharge. Binary logistic regression was performed to identify independent predictors of delirium. Results: Patients who developed post-operative delirium (n = 70) were significantly older (average age 83 vs. 78, p = 0.019) and more likely to be female (79% vs. 67%, p = 0.062) than non-affected patients. The presence of delirium was associated with increased length of stay (13 vs. 10 days, p = 0.001) and 1-year mortality (25.7% vs. 15% p = 0.03). Independent predictors of delirium included age ≥65 years (Odds Ratio = 5.8), presence of anaemia (OR = 2.9), hypoxia (OR = 2.86), cardiac disease (OR = 2.8), Chronic Obstructive Pulmonary Disease (OR = 2.5), new onset electrolyte imbalance (OR = 2.2) and renal failure (OR = 1.9). Conclusion: Overall analysis demonstrated an increased incidence of delirium in older females with greater comorbid conditions. It was also found to be associated with increased morbidity and mortality. We recommend clinicians put greater effort into recognising risk factors of delirium and diagnosing it in a timely manner to mitigate its effects.

scholarly journals Gender Differences in Healthcare-Seeking Behaviors in China’s Ageing Population: An Empirical Study of Shanghai

2020 ◽  
Author(s):  
Luxue Liu ◽  
Chunlan Wang ◽  
Shangguang Yang ◽  
Kevin Lo ◽  
Xi Yang
Keyword(s):  
Gender Differences ◽  
Elderly Population ◽  
Binary Logistic Regression ◽  
The Elderly ◽  
Influential Factors ◽  
Ageing Population ◽  
Binary Logistic Regression Model ◽  
Healthcare Seeking ◽  
Factors Influencing ◽  
Tertiary Hospitals

Abstract Background: Given the growing healthcare demands of the elderly, an improved understanding of the factors influencing their healthcare-seeking behaviors is necessary to enhance the effectiveness of the current healthcare system. This study empirically investigates the factors influencing the elderly population’s healthcare-seeking behaviors in Shanghai, China, from a gender differences perspective.Methods: We combine both quantitative and qualitative analyses by constructing a binary logistic regression model and identifying the relevant influential factors based on the following types of dimensions: individual, family, and cultural.Results: The results indicate that gender differences exist in the elderly population with common diseases but not in those with severe diseases, and that the female elderly are more likely to choose non-tertiary hospitals than males. In addition, age, marital status, employment status, income, health conditions, medical insurance, family support, and social capital are found to be critical influencing factors.Conclusions: The findings provide a better understanding of the elderly population’s healthcare demands and can be used to promote healthcare equality.

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