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1.
Artículo en Inglés | MEDLINE | ID: mdl-39161131

RESUMEN

BACKGROUND: Transvenous lead extraction (TLE) for cardiovascular implantable electronic device (CIED)-related infections has increased. The incidence of TLE in nonagenarians is low, with limited reports outlining the outcomes of this procedure. Therefore, in this study, we aimed to clarify the outcomes of TLE in nonagenarians. METHODS: Patients with TLE treated at our hospital between 2014 and 2023 were retrospectively examined; patient characteristics, device type, indications, procedures, complications, and clinical data of nonagenarians were analyzed. RESULTS: Of 12 patients with 24 leads (active fixation lead, n = 11; passive fixation lead, n = 13) who underwent TLE, the indication for TLE was infection (pocket infection, n = 8; sepsis, n = 4). Methicillin-resistant Staphylococcus epidermidis was the most frequently identified causative agent (n = 4). The median patient age was 91 years; five patients were female. The median lead dwell time was 9 years. Excimer laser sheath (16 leads), mechanical sheath (five leads), Evolution RL (one lead), and manual traction (two leads) were employed in TLE. The procedure was successful in all patients, and only one had a minor complication. Six patients required CIED re-implantation, and leadless pacemakers were selected for five patients. The 30-day mortality after TLE was 0%. CONCLUSION: TLE can be safely performed in nonagenarians. The decision to perform TLE should not be based on old age alone; the suitability of removing infected CIEDs should be determined based on each patient's condition.

2.
J Stroke Cerebrovasc Dis ; 33(7): 107722, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38616014

RESUMEN

BACKGROUND: Our aim was to compare the outcomes of treatment with endovascular thrombectomy for pre-stroke dependent versus pre-stroke independent among the very elderly ≥90 years. METHODS: A retrospective cohort study was performed on 106 patients ≥90 years who underwent endovascular thrombectomy for ischaemic stroke in Western Australia between June 2016 and September 2021. Patient, stroke and procedural details along with inpatient progress and outcome at 90 days were recorded. Patients were divided into Group A (pre-stroke modified Rankin Scale 0-2) and Group B (pre-stroke modified Rankin Scale >2). Primary outcome measure was functional status at 90 days post-stroke, with favourable clinical outcome defined as a 90-day mRS category equal to the patients' respective pre-stroke mRS category. Secondary outcome measures include successful reperfusion, symptomatic intracranial haemorrhage, hospital length-of-stay, change in accommodation to an aged care facility, and mortality during admission, at 90 days and one year. RESULTS: 61 patients were allocated to Group A and 45 to Group B. There was none with pre-stroke mRS 5. Group B had more pre-existing cognitive impairment, aged care facility residents, higher median age and lower Alberta Stroke Program Early CT Score. For primary outcome measure, 38 % of patients in Group A and 49 % in Group B achieved a favourable clinical outcome. The difference was not significant (p=0.3408). For secondary outcome measures, Group B had a significantly higher 90-day mortality rate at 47 % versus 24 % in Group A (p=0.03). All other secondary outcome measures were similar between the two groups. These include the rate of successful reperfusion and symptomatic intracranial haemorrhage, hospital length-of-stay, new transition into an aged care facility, inpatient mortality rate and 1-year mortality rate. CONCLUSION: When treated with endovascular thrombectomy for ischaemic stroke, nonagenarians with pre-existing dependency achieved a rate of favourable functional outcome comparable with their independent peers, although they also had higher 90-day mortality rate.


Asunto(s)
Evaluación de la Discapacidad , Procedimientos Endovasculares , Estado Funcional , Accidente Cerebrovascular Isquémico , Recuperación de la Función , Trombectomía , Humanos , Masculino , Femenino , Trombectomía/efectos adversos , Trombectomía/mortalidad , Anciano de 80 o más Años , Procedimientos Endovasculares/efectos adversos , Procedimientos Endovasculares/mortalidad , Estudios Retrospectivos , Resultado del Tratamiento , Accidente Cerebrovascular Isquémico/mortalidad , Accidente Cerebrovascular Isquémico/diagnóstico , Accidente Cerebrovascular Isquémico/terapia , Accidente Cerebrovascular Isquémico/fisiopatología , Accidente Cerebrovascular Isquémico/cirugía , Factores de Tiempo , Factores de Riesgo , Factores de Edad , Australia Occidental , Tiempo de Internación , Medición de Riesgo
3.
Laryngoscope ; 134(9): 3989-3996, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38587164

RESUMEN

OBJECTIVE: To describe types and outcomes of elective otolaryngological surgeries undergone by patients ≥90 years of age and to assess whether very old age is an independent risk factor for postsurgical complications and death. METHODS: The National Surgical Quality Improvement Program, a validated national prospective surgical outcomes database, was used to identify all patients aged 65 years and older who underwent elective otolaryngological procedures from 2011 to 2020. Study outcomes included minor complications, major life-threatening complications, and 30-day mortality. Predictors of outcomes, including frailty, were identified using univariable analyses and age was added into the final logistic regression models with stepwise selection. RESULTS: A total of 40,723 patients met inclusion criteria; 629 (1.5%) patients were ≥90 years of age. Of the 63,389 procedures, head and neck (67.6%) and facial plastics and reconstructive (15.0%) procedures were most common. The overall incidence of major life-threatening complications, minor complications, and death was 2.0%, 3.5%, and 0.4%, respectively. Age ≥90 was significantly associated with an increased risk for 30-day mortality, but not with major or minor postoperative complications. A high modified frailty index was significantly associated with an increased risk for major postoperative complications and death amongst patients ≥90 years. CONCLUSIONS: Elective otolaryngological surgery can be safe in relatively healthy nonagenarians and centenarians, though there is a small increased risk of 30-day mortality. Although older age can predispose patients to other comorbidities, age alone should not deter surgeons and patients from considering elective otolaryngological procedures. Frailty may be a better predictor for surgical outcomes. LEVEL OF EVIDENCE: IV Laryngoscope, 134:3989-3996, 2024.


Asunto(s)
Procedimientos Quirúrgicos Electivos , Procedimientos Quirúrgicos Otorrinolaringológicos , Complicaciones Posoperatorias , Humanos , Anciano de 80 o más Años , Procedimientos Quirúrgicos Electivos/estadística & datos numéricos , Femenino , Masculino , Complicaciones Posoperatorias/epidemiología , Procedimientos Quirúrgicos Otorrinolaringológicos/estadística & datos numéricos , Factores de Riesgo , Anciano , Estados Unidos/epidemiología , Mejoramiento de la Calidad , Factores de Edad , Estudios Prospectivos , Bases de Datos Factuales , Fragilidad/epidemiología
4.
Colorectal Dis ; 26(5): 871-885, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38527938

RESUMEN

AIM: The aim of this work was to evaluate the safety and feasibility of performing colonoscopy in patients aged 90 years or over. METHOD: In compliance with PRISMA statement standards, a systematic review of studies reporting the outcomes of colonoscopy in patients aged ≥90 years was conducted. A proportional meta-analysis model was constructed to quantify the risk of outcomes and a direct comparison meta-analysis model was constructed to compare outcomes between nonagenarians and patients aged between 50 and 89 years via random-effects models. RESULTS: Seven studies enrolling 1304 patients (1342 colonoscopies) were included. Analyses showed that complications related to bowel preparation occurred in 0.7% (95% CI 0.1%-1.6%), procedural complications in 0.6% (0.00%-1.7%), 30-day complications in 1.5% (0.6%-2.7%), procedural mortality in 0.3% (0.0%-1.1%) and 30-day mortality in 1.1% (0.3%-2.2%). Adequate bowel preparation and colonoscopy completion were achieved in 81.3% (73.8%-87.9%) and 92.1% (86.7%-96.3%), respectively. No difference was found in bowel preparation-related complications [risk difference (RD) 0.00, p = 0.78], procedural complications (RD 0.00, p = 0.60), 30-day complications (RD 0.01, p = 0.20), procedural mortality (RD 0.00, p = 1.00) or 30-day mortality (RD 0.01, p = 0.34) between nonagenarians and patients aged between 50 and 89 years. The colorectal cancer detection rate was 14.3% (9.8%-19.5%), resulting in therapeutic intervention in 65.9% (54.5%-76.6%). CONCLUSIONS: Although the evidence is limited to a selected group of nonagenarians, it may be fair to conclude that if a colonoscopy is indicated in a nonagenarian with good performance status (based on initial less-invasive investigations), the level 2 evidence supports its safety and feasibility. Age on its own should not be a reason for failing to offer colonoscopy to a nonagenarian.


Asunto(s)
Colonoscopía , Estudios de Factibilidad , Humanos , Colonoscopía/efectos adversos , Colonoscopía/métodos , Colonoscopía/estadística & datos numéricos , Anciano de 80 o más Años , Factores de Edad , Femenino , Masculino , Persona de Mediana Edad , Análisis de Regresión
5.
JSES Int ; 8(1): 176-184, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38312289

RESUMEN

Background: Increased age is a well-known risk factor for development of osteoarthritis. Total shoulder arthroplasty (TSA) is a common treatment option for patients with severe glenohumeral osteoarthritis. The purpose of this study was to investigate the association between the septuagenarian, octogenarian, and nonagenarian populations and postoperative outcomes following TSA. Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried for all patients who underwent TSA between 2015 and 2020. Patients were divided into cohorts based on age: sexagenarians (60-69), septuagenarians (70-79), octogenarians (80-89), and nonagenarians (90+). Multivariate logistic regression was used to identify associations between age and postoperative complications. Results: On bivariate analysis, compared to sexagenarians, septuagenarians were significantly associated with higher rates of myocardial infarction (P = .038), blood transfusion (P < .001), organ/space surgical site infection (P = .048), readmission (P = .005), and nonhome discharge (P < .001. Compared to septuagenarians, octogenarians were significantly associated with higher rates of urinary tract infection (P < .001), blood transfusion (P < .001), readmission (P = .002), non-home discharge (P < .001), and mortality (P = .027). Compared to octogenarians, nonagenarians were significantly associated with higher rates of sepsis (P = .013), pneumonia (P = .003), reintubation (P = .009), myocardial infarction (P < .001), blood transfusion (P < .001), readmission (P = .026), nonhome discharge (P < .001), and mortality (P < .001). Conclusion: From age 60, each decade of age was identified to be an increasingly significant predictor for blood transfusion, readmission, and nonhome discharge following TSA. From age 70, each decade of age was additionally identified to be an increasingly significant predictor for mortality.

6.
Heliyon ; 10(3): e25151, 2024 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-38322977

RESUMEN

Background: Hip fracture is a common disease in the elderly. Among these patients, surgical intervention for hip fracture should be carefully considered because of old age and multiple comorbidities. There are still insufficient comparisons between nonagenarian patients treated with surgery and those treated non-surgically. We studied hip fracture nonagenarian patients to compare the different outcomes between surgical and non-surgical treatments. Materials and methods: Nonagenarian patients visiting the emergency department with hip fractures between March 2010 and December 2020 were identified. Overall survival was estimated using multivariate Cox proportional hazards models. The mortality rates, the length of hospital stay, complication and readmission rates were also recorded. Results: A total of 173 patients who underwent surgery and 32 who received conservative treatments were included. The median survival time was 58.47 months in the OP group, which was significantly higher than the 24.28 months in the non-OP group. After adjusting for covariates, including age, sex, Charlson Comorbidity Index (CCI), injury severity score, and fracture type, the risk of death was reduced by surgery (hazard ratio [HR] = 0.427; 95 % confidence interval [CI]: 0.207-0.882; p = 0.021). CCI was also an independent risk factor for poor survival rate (HR = 1.3; 95 % CI: 1.115-1.515; p = 0.001). After adjusting for several factors, surgery within 48 h improved overall survival (HR: 2.518; 95 % CI: 1.299-4.879; p = 0.006) in operative group. Conclusion: Our study suggests that surgical treatment may provide better survival for nonagenarian patients with hip fractures than non-operation, especially patients with less concurrent comorbidities.

7.
Artículo en Inglés | MEDLINE | ID: mdl-38243638

RESUMEN

AIMS: The recent rise in the number of nonagenarians (age ≥ 90 years) undergoing percutaneous coronary intervention (PCI) has revealed gaps in research, in particular on patients' experiences. Therefore, the aim of the study was to explore and describe nonagenarians' internal resources and their experiences of the in-hospital pathway. METHODS AND RESULTS: Nineteen nonagenarian patients (women n = 9), mean age 91 years, 9 acutely, and 10 electively treated, were consecutively enrolled from a tertiary university hospital from June 2021 to February 2023. In-depth interviews were conducted during hospitalization, audiotaped and transcribed. The interviews were analysed using qualitative content analysis. Three sub-themes emerged from the nonagenarians' experiences with the PCI treatment trajectory: (i) Taking lifelong responsibility for own physical and mental health describes a population striving to live a healthy life and to stay independent. Physical and mental activities including healthy food choices had been an integral aspect of their lives from early childhood. (ii) Individual internal resources influenced the PCI pathway describes how their internal resources were used, from actively engaging in the decision-making process to withstanding discomfort during the PCI procedure. (iii) The post-PCI pathway was multifaceted describes a short stay at the cardiac ward with individual post-procedural experiences, close monitoring, and preparation for discharge including cardiac rehabilitation. CONCLUSION: Nonagenarians undergoing PCI demonstrated a personal incentive to stay healthy and independent. Their internal resources of independence, stoicism, and resilience were used during their in-hospital stay contributing to a successful PCI procedure. Individual cardiac rehabilitation strategies were highlighted after discharge from hospital.

8.
Rev. clín. esp. (Ed. impr.) ; 223(9): 569-577, nov. 2023. tab, graf
Artículo en Español | IBECS | ID: ibc-226823

RESUMEN

Introducción La enfermedad vascular es la causa más frecuente de morbimortalidad, y su prevalencia incrementa con la edad. Los pacientes muy añosos no se encuentran incluidos en los estudios sobre enfermedad vascular, desconociéndose sus características y tratamientos. Objetivo Conocer las características clínicas de los pacientes nonagenarios hospitalizados en servicios de medicina interna con diagnóstico de EV establecida y la adecuación de su manejo farmacológico. Material y métodos El Registro NONAVASC-2 es un estudio observacional, prospectivo y multicéntrico. Se incluyeron pacientes hospitalizados por cualquier causa. La recogida de datos se realizó a través de una base anonimizada online con parámetros sociodemográficos, clínicos, analíticos, terapéuticos y evolutivos. Resultados Se incluyeron 1.049 pacientes con una edad media de 93,14 años (57,8% mujeres). La prevalencia de los factores de riesgo fue muy elevada: hipertensión (84,9%), dislipemia (50,9%) y diabetes mellitus (29,4%). El 33,4% presentaba dependencia grave/total. El 82,9% recibía tratamiento antitrombótico (53,7% antiagregantes, 25,4% anticoagulación y 3,8% doble terapia). Solo el 38,2% recibía estatinas. El porcentaje de dependencia (39,2 vs. 24,1%; p=0,00) y deterioro cognitivo grave (30,8 vs. 13,8%; p=0,00) era significativamente mayor entre los pacientes que no las recibían. El 19% falleció durante el ingreso. Conclusión Los pacientes nonagenarios con EV presentan una elevada comorbilidad, dependencia y mortalidad. A pesar de estar en prevención secundaria, el 17% de ellos no recibía antitrombóticos y solo el 38% estatinas. Esta infraprescripción está condicionada por la situación funcional, entre otros factores, por lo que es necesario realizar más estudios para conocer el impacto sobre su pronóstico (AU)


Introduction Vascular disease is the most frequent cause of morbidity and mortality and its prevalence increases with age. Old patients are not included in studies on vascular disease, their characteristics and treatments being unknown. Objective Know the clinical characteristics of nonagenarian patients hospitalized in Internal Medicine services with a diagnosis of established VD and the adequacy of their pharmacological management. Material and methods The NONAVASC-2 registry is an observational, prospective, multicentre study. Hospitalized patients for any cause were included. Data collection was carried out through an anonymous online database with sociodemographic, clinical, analytical, therapeutic and evolutionary parameters. Results One thousand forty-nine patients with a mean age of 93.14 years (57.8% women) were included. The prevalence of risk factors and VD was high: hypertension (84.9%), dyslipidemia (50.9%) and diabetes mellitus (29.4%). 33.4% presented severe-total dependency. 82.9% received antithrombotic treatment (53.7% antiplatelets, 25.4% anticoagulation and 3.8% double therapy). Only 38.2% received statins. The percentage of severe dependence (39.2% vs 24.1%; p=0.00) and severe cognitive impairment (30.8% vs 13.8%; p=0.00) was significantly higher among patients who did not receive them. 19% died during admission. Conclusions Nonagenarian patients with VD present high comorbidity, dependence and mortality. Despite being in secondary prevention, 17% did not receive antithrombotics and only 38% received statins. The underprescription is conditioned, among other factors, by the functional status. More studies are necessary to determine the impact of this issue on their prognosis (AU)


Asunto(s)
Humanos , Masculino , Femenino , Anciano de 80 o más Años , Anciano de 80 o más Años , Enfermedades Vasculares/etiología , Estudios Prospectivos , Factores de Riesgo , Prevalencia
10.
Sci. med. (Porto Alegre, Online) ; 29(1): ID32831, 2019.
Artículo en Portugués | LILACS | ID: biblio-1009913

RESUMEN

OBJETIVOS: Verificar o impacto da autopercepção de saúde sobre a chance de desenvolver incontinência urinária em longevos. MÉTODOS: Trata-se de um estudo transversal e analítico com idosos de 90 anos ou mais. Foi realizada análise estatística analítica e descritiva (frequências, média e desvio padrão, análise de regressão logística univariada e ajustada pela autopercepção de saúde) das variáveis sociodemográficas e clínicas (sexo, estado conjugal, continência, idade, sintomas depressivos, cognição, comorbidades e facilidade de realizar atividades básicas e funcionais). RESULTADOS: Participaram 182 longevos, 71% mulheres. O diagnóstico prévio de depressão, o escore de sintomas depressivos e o percentual de facilidade para atividades funcionais e básicas foram relacionados com a autopercepção de saúde (p<0,05). A perda de urina, contudo, não foi relacionada à autopercepção de saúde. A autopercepção de saúde influenciou o efeito das variáveis diagnóstico prévio de depressão, número de sintomas depressivos, pontuação do Mini Exame do Estado Mental e número de comorbidades sobre a chance de incontinência urinária na presença das mesmas. O sexo masculino, a viuvez e a facilidade no desempenho de atividades básicas e funcionais foram variáveis significativamente relacionadas com a incontinência urinária independentemente do ajuste da autopercepção de saúde. CONCLUSÕES: Não houve relação entre incontinência urinária e autopercepção de saúde, contudo, a autopercepção de saúde influenciou no efeito das variáveis sociodemográficas e clínicas sobre a chance de ter incontinência urinária.


AIMS: To verify the impact of self-perceived health on the chance of developing urinary incontinence in very-old. METHODS: This is a cross-sectional and analytical study with elderly individuals aged 90 years and over. The statistical and analytical variables (sex, marital status, continence, age, depressive symptoms, cognition, comorbidities and ability to perform activities) were analyzed analytical and descriptive statistics (frequencies, mean and standard deviation, univariate and health self-perception adjusted logistic regression analysis). RESULTS: There were 182 participants, 71% women. The previous diagnosis of depression, the score of depressive symptoms and the percentage of ease for functional and basic activities were related to self-perception of health (p<0.05). The loss of urine, however, was not related to self-perceived health. The self-perception of health influenced the effect of the variables previous diagnosis of depression, number of depressive symptoms, Mini-Mental State Examination score and number of comorbidities on the chance of urinary incontinence in the presence of these variables. Males, widowhood and ease of performance of basic and functional activities were significantly related to urinary incontinence regardless of the adjustment of health self-perception. CONCLUSIONS: There was no relationship between urinary incontinence and health self-perception. However, health self-perception influenced the effect of sociodemographic and clinical variables on the chance of having urinary incontinence.


Asunto(s)
Incontinencia Urinaria , Urología , Anciano , Medicina
11.
J. coloproctol. (Rio J., Impr.) ; 37(4): 285-289, Oct.-Dec. 2017. tab
Artículo en Inglés | LILACS | ID: biblio-894004

RESUMEN

ABSTRACT Purpose: The objective of the present study was to compare the results of surgical treatment of nonagenarian patients having colorectal cancer with patients younger than 90 years. Methods: A total of 622 patients who underwent curative surgery were included in the present study. The database of the surgical service, in the period from 2007 to 2013, was used to obtain the sample. This is a descriptive, retrospective study that compared the profiles of 17 nonagenarian patients (Group I) with 605 patients younger than 90 years (Group II). The groups were compared regarding surgical complications, length of hospital stay, type of surgery performed and ASA classification. Results: The mean age between the groups was 92.2 years and 61.2 years. The mean length of hospital stay in Groups I and II was 17.3 days and 8.75 days, respectively. The surgery performed most frequently was the right colectomy, in both groups. The most common postoperative complication was sepsis (11.8%) among the nonagenarians, and paralytic ileus (4.5%) among those younger than 90 years. Laparoscopic surgery was performed on 5 out of a total of 17 patients evaluated in Group I. Among the three mortalities registered in this latter group, two were classified as ASA III and only one as ASA I. Conclusion: The results indicate that colorectal surgery may be performed in this group, with acceptable morbidity and mortality rates, in patients with low preoperative risk (ASA I/II).


RESUMO Finalidade: O objetivo do presente estudo foi comparar os resultados do tratamento cirúrgico de pacientes nonagenários portadores de câncer colorretal versus pacientes com menos de 90 anos. Métodos: O estudo envolveu 622 pacientes que foram submetidos à cirurgia curativa. Para obtenção da amostra, utilizamos o banco de dados do serviço de cirurgia, abrangendo o período de 2007-2013. Este é um estudo retrospectivo descritivo que comparou os perfis de 17 pacientes nonagenários (Grupo I) versus 605 pacientes com menos de 90 anos (Grupo II). Os grupos foram comparados para complicações cirúrgicas, duração da permanência no hospital, tipo de cirurgia realizada e classificação ASA. Resultados: A média de idade para os Grupos I e II foi, respectivamente, 92,2 e 61,2 anos. A duração média de permanência no hospital nos Grupos I e II foi, respectivamente, 17,3 dias e 8,75 dias. A cirurgia mais frequentemente realizada foi colectomia direita, nos dois grupos. A complicação pós-operatória mais comum foi sepse (11,8%) entre os nonagenários, e íleo paralítico (4.5%) entre os pacientes com menos de 90 anos. Cirurgia laparoscópica foi realizada em 5 pacientes, em um total de 17 pacientes avaliados no Grupo I. Considerando as três mortalidades registradas nesse último grupo, duas foram classificadas como ASA III e apenas uma como ASA I. Conclusão: Os resultados obtidos indicam que, nesse grupo, a cirurgia colorretal é opção válida, com percentuais aceitáveis de morbidade e mortalidade, em pacientes com baixo risco pré-operatório (ASA I/II).


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Neoplasias Colorrectales/cirugía , Morbilidad , Mortalidad , Neoplasias Colorrectales/complicaciones
12.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-192640

RESUMEN

BACKGROUND: As the life expectancy increases, extreme old age is not a contraindication to surgery. Limited information is available regarding preoperative evaluation for very old patients in Korea. We hypothesized that the American Society of Anesthesiologists physical status (ASA PS) score would differ between nonagenarian and septuagenarian patients in Korea. METHODS: The medical records of 100 nonagenarian (90s group) and septuagenarian (70s group) patients who had received elective surgery under general or regional anesthesia were reviewed to investigate their nutritional status, coexisting diseases, surgical procedure related cardiac risk, and ASA PS before surgery. RESULTS: The body mass index, hemoglobin, arterial oxygen partial pressure and albumin levels were significantly lower in the 90s group than in the 70s group. The age-adjusted Charlson Comorbidity Index was significantly higher in the 90s group than in the 70s group. The intermediate cardiac risk associated with surgical procedures was significantly higher in the 90s group than in the 70s group. There was no significant difference in the ASA PS class between the 90s group and the 70s group. CONCLUSIONS: The nonagenarian patients did not present a significant difference from the septuagenarian patients in ASA PS classification. However, the comorbidity index scores and cardiac risk related to surgical procedures were higher in the 90s group than in the 70s group. Thus, in the preoperative evaluation of very old patients, a category assessing their physiologic reserve should be added.


Asunto(s)
Anciano de 80 o más Años , Humanos , Anestesia de Conducción , Índice de Masa Corporal , Clasificación , Comorbilidad , Corea (Geográfico) , Esperanza de Vida , Registros Médicos , Estado Nutricional , Oxígeno , Presión Parcial
13.
Journal of Geriatric Cardiology ; (12): 148-152, 2012.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-471869

RESUMEN

Objective To explore the treatment, procedure related risks, and outcomes of patients older than 90 years of age undergoing cardiac catheterization. Methods We retrospectively studied 32 patients ≥ 90 years (93.0 ± 1.2 years) who underwent cardiac catheterisation in a tertiary specialist hospital (0.2% of 14,892 procedures during three years). The results were compared to a patient cohort younger than 90 years of age. Results Baseline characteristics revealed a higher prevalence of diabetes (P < 0.001), chronic obstructive pulmonary disease (P < 0.04), previous myocardial infarction (P < 0.02), and complex coronary anatomy (SYNTAX score 33 vs. 19) in nonagenarians. Patients < 90 years of age showed more hyperlipidemia (P < 0.01) and previous percutaneous coronary interventions (P < 0.015). Nonagenarians underwent coronary angiography more often for acute coronary syndrome (ACS) (P < 0.003), were presented more often in cardiogenic shock (P < 0.003), and were transferred faster to coronary angiography in cases of ACS (P < 0.0001). The observed in-hospital mortality rate (13% study group vs. 1% control group; P < 0.003) in nonagenarians was lower than the calculated rate of thrombolysis in myocardial infarction (TIMI) and global registry of acute cardiac events (GRACE) mortality and strongly influenced by the severity of clinical presentation and the presence of co-morbidities. Conclusion Despite the common scepticism that cardiac catheterisation exposes patients ≥ 90 years to an unwarranted risk, our data demonstrate an acceptable incidence of complications and mortality in this group of patients.

14.
Artículo en Coreano | WPRIM (Pacífico Occidental) | ID: wpr-115397

RESUMEN

BACKGROUND: As the elderly population is fast growing, the incidence of stroke is also increasing. We studied the clinical characteristics of nonagenarian stroke compared to a population of patients under the age of ninety. METHODS: Subjects included 44 nonagenarian stroke patients and 22,227 control patients aged under ninety. Clinical characteristics including age, sex, risk factors, stroke subtype, and outcome (one-year prognosis, evaluated by a modified Rankin scale) were analyzed. RESULTS: The proportion of nonagenarian stroke accounted for 0.2% of all cases of stroke. Ischemic stroke was more common than hemorrhagic stroke in the nonagenarian group. In addition, the female gender was more frequent (p<0.01). As the patients were older, their admission period was shorter, the discharge against medical advice was increased, and the mortality was higher. Hypertension and atrial fibrillation were significantly higher (p<0.05, p<0.001, respectively) in the nonagenarian ischemic stroke patients. CONCLUSIONS: Nonagenarian stroke patients have unique clinical characteristics compared with stroke patients under the age of ninety.


Asunto(s)
Anciano , Anciano de 80 o más Años , Femenino , Humanos , Fibrilación Atrial , Hipertensión , Incidencia , Mortalidad , Pronóstico , Factores de Riesgo , Accidente Cerebrovascular
15.
Artículo en Coreano | WPRIM (Pacífico Occidental) | ID: wpr-61505

RESUMEN

The dietary habits and eating behaviors of nonagenarian subjects over 90 years old in Korean representative longevity belts of Damyang, Gokseong, Kurye, Sunchang were evaluated. The subjects of the study were 91 elderly people (26 males and 65 females) over 90 years old and their dietary habits, food preferences and meal patterns were collected by individual interview. The percentage of subjects, who answered "very good" or "good" for their health status, was 65.9%. In this study, 55% of subjects were without chronic diseases, and there was no significance difference in gender. Many subjects had performed regular exercise and outdoor activity. The rate of eating together with their family was 79.1%. Most of subjects (91.2%) had a regular mealtime consuming three meals a day, and they had good appetite and pleasure of eating. The higher preference of food group was fruits (95.6%), legumes (94.5%), mushrooms (93.4%) and vegetables (92.3%), but the amount of intakes is higher in vegetables than the others. Eating with family, regular exercise and self-rated good health are improved their nutrient intakes. Most frequently consumed meal pattern was rice plus soup and side dishes. The side dish consumed frequently was Namul (blanch and seasoned vegetables). From this study, the nonagenarian populations in longevity belt in Korea have good dietary habits such as regular mealtime, constant amount of meal and eat with pleasure. They are taking Korean traditional meal pattern, providing enriched antioxidant vegetable foods. Also, it can be concluded that the amount and quality of diet in the long-lived elderly are responsible for the Korean traditional family system.


Asunto(s)
Anciano , Anciano de 80 o más Años , Humanos , Masculino , Agaricales , Apetito , Enfermedad Crónica , Dieta , Ingestión de Alimentos , Fabaceae , Conducta Alimentaria , Conducta Alimentaria , Preferencias Alimentarias , Frutas , Corea (Geográfico) , Longevidad , Comidas , Placer , Estaciones del Año , Verduras
16.
Artículo en Coreano | WPRIM (Pacífico Occidental) | ID: wpr-143879

RESUMEN

The nutrients intake and health-related habits of nonagenarian subjects in Korean representative longevity belts of Damyang, Gokseong, Kurye, Sunchang were evaluated for the purpose of providing the information on the desirable food selection and dietary pattern of elderly population. A survey was conducted with 91 subjects (26 males and 65 females) and their food intakes were measured by the combination of one meal weighing and 24-hr recall, and their general background information was collected by visit. The mean age of the subjects was 93.6 +/- 2.2 (male) and 97.6+/- 4.6 (female). The average smoking rate was 20.9%; the rate of regular drinking was 26.4%. The average energy intake was 1,284.9 kcal comprising 77.1% of RDA for elder people over 75. The energy ratio of carbohydrate, protein and fat were 66.5 :18.2 :15.3. The average intake of protein, calcium, iron and zinc were 107.4%, 59.9%, 106.3% and 60% of RDA respectively. The lower intake of vitamins as low as 70% was found except vitamin B6 and niacin. The majority of the subjects consumed rice as staple diet and mostly consumed white plain rice rather than mixed grain rice. The animal and plant food intakes were 88.4 :11.6 in males and those of females were 83.0 :17.0 showing a tendency of plant-based meals. Nutrients that showed NAR over 0.7 were protein, iron, vitamin B6, niacin and phosphate, but those with INQ over 1. Nutrient with INQ below 0.7 was only vitamin E. Even though their nutritional quantity did not appear to be enough, but their nutritional quality was relatively high. The adding dairy products, nuts and fruits for the purpose of proving sufficient vitamin and minerals can achieve the optimal nutritional intake patterns. Further research on RDA of this age population should be followed.


Asunto(s)
Anciano , Anciano de 80 o más Años , Animales , Femenino , Humanos , Masculino , Calcio , Grano Comestible , Productos Lácteos , Dieta , Ingestión de Líquidos , Ingestión de Alimentos , Ingestión de Energía , Preferencias Alimentarias , Frutas , Hierro , Corea (Geográfico) , Longevidad , Comidas , Minerales , Niacina , Estado Nutricional , Valor Nutritivo , Nueces , Plantas , Humo , Fumar , Vitamina B 6 , Vitamina E , Vitaminas , Zinc
17.
Artículo en Coreano | WPRIM (Pacífico Occidental) | ID: wpr-143886

RESUMEN

The nutrients intake and health-related habits of nonagenarian subjects in Korean representative longevity belts of Damyang, Gokseong, Kurye, Sunchang were evaluated for the purpose of providing the information on the desirable food selection and dietary pattern of elderly population. A survey was conducted with 91 subjects (26 males and 65 females) and their food intakes were measured by the combination of one meal weighing and 24-hr recall, and their general background information was collected by visit. The mean age of the subjects was 93.6 +/- 2.2 (male) and 97.6+/- 4.6 (female). The average smoking rate was 20.9%; the rate of regular drinking was 26.4%. The average energy intake was 1,284.9 kcal comprising 77.1% of RDA for elder people over 75. The energy ratio of carbohydrate, protein and fat were 66.5 :18.2 :15.3. The average intake of protein, calcium, iron and zinc were 107.4%, 59.9%, 106.3% and 60% of RDA respectively. The lower intake of vitamins as low as 70% was found except vitamin B6 and niacin. The majority of the subjects consumed rice as staple diet and mostly consumed white plain rice rather than mixed grain rice. The animal and plant food intakes were 88.4 :11.6 in males and those of females were 83.0 :17.0 showing a tendency of plant-based meals. Nutrients that showed NAR over 0.7 were protein, iron, vitamin B6, niacin and phosphate, but those with INQ over 1. Nutrient with INQ below 0.7 was only vitamin E. Even though their nutritional quantity did not appear to be enough, but their nutritional quality was relatively high. The adding dairy products, nuts and fruits for the purpose of proving sufficient vitamin and minerals can achieve the optimal nutritional intake patterns. Further research on RDA of this age population should be followed.


Asunto(s)
Anciano , Anciano de 80 o más Años , Animales , Femenino , Humanos , Masculino , Calcio , Grano Comestible , Productos Lácteos , Dieta , Ingestión de Líquidos , Ingestión de Alimentos , Ingestión de Energía , Preferencias Alimentarias , Frutas , Hierro , Corea (Geográfico) , Longevidad , Comidas , Minerales , Niacina , Estado Nutricional , Valor Nutritivo , Nueces , Plantas , Humo , Fumar , Vitamina B 6 , Vitamina E , Vitaminas , Zinc
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