Clinical Factors Related to Frailty Estimated by the Korean Frailty Index

BACKGROUND: On the point of entering into the aged society, frailty will be recognized as a new geriatric problem in Korea. This study was conducted to identify clinical factors related to frailty in the community dwelling elderly. METHODS: This was a cross-sectional study comprised of 515 participants among 834 potential subjects who were residents of three towns in Gyeong-ju and had health check-ups at a university hospital in the same region. Using the Korean Frailty Index, those with a total score of 5 or more were considered frail and those with scores 3 to 4 as prefrail. Socio-demographics, anthropometry and laboratory data were the selected clinical factors. Those younger than 65 years or with incomplete data were excluded. Finally, 447 participants were analyzed. RESULTS: Among the participants, those identified as frail were 20 (4.5%), prefrail 72 (16.1%) and robust 355 (79.4%). By gender, the percentage of frail, prefrail and robust individuals were 3.2%, 17.4% and 79.5%, respectively, in men and 5.4, 15.2% and 79.4% in women (p=0.447). On ordinal logistic regression analysis, factors related to frailty were increased age (odds ratio [OR], 1.08; 95% confidence interval [CI], 1.01 to 1.17), functional disability (OR, 8.88; 95% CI, 4.46 to 17.68), chronic disease such as pulmonary disease (OR, 4.69; 95% CI, 1.47 to 14.99) or hypertension (OR, 2.23; 95% CI, 1.15 to 4.32), increased waist circumference (OR, 1.06; 95% CI, 1.01 to 1.11), decreased serum cholesterol (OR, 0.98; 95% CI, 0.97 to 0.99) and elevated blood urea nitrogen (OR, 1.07; 95% CI, 1.01 to 1.14). CONCLUSION: Clinical factors related to frailty were age, functional disability, chronic disease, waist circumference, serum cholesterol and blood urea nitrogen. Primary physicians should assess frailty when seeing elderly patients who have these factors.

Plasma Exchange in a Patient with Post-abortion Hemolytic Uremic Syndrome / 대한수혈학회지

Hemolytic uremic syndrome is characterized by microangiopathic hemolytic anemia, thrombocytopenia and severe renal failure. Microangiopathic thrombosis, thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS) seem to occur under the condition of certain stresses, including pregnancy. Therapeutic plasma exchange (TPE) has proven to be an effective treatment for HUS and it has decreased the mortality of this illness. We experienced a case of a 34-year-old woman who was admitted for renal failure to our hospital immediately after an abortion. She presented with anuria, hemolytic anemia and thrombocytopenia. Plasma exchange was started and substitution was performed with fresh frozen plasma and four consecutive plasmapheresis sessions were administered. After about five days from the beginning of her illness, the signs of active hemolysis disappeared and her renal function partially recovered.