Aging clinical and experimental research
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The aim of this study was to evaluate the relationships between the serum levels of adiponectin (ADP) and matrix metalloproteinase-9 (MMP-9) and postoperative cognitive dysfunction (POCD) in elderly patients after general anesthesia. ⋯ The increased serum MMP-9 levels and decreased serum ADP levels in elderly patients after general anesthesia might be involved in the POCD pathophysiological process.
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To determine differences in physiological outcome (PO) based on the Geriatric Nutritional Risk Index (GNRI) and cut-off values for PO according to the GNRI in elderly post-cardiac surgery patients complicated by diabetes mellitus (DM). ⋯ Nutritional status might influence PO following cardiac surgery. The cut-off values of PO reported here might be indicative of the need to improve patient nutritional status.
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The mortality of patients with severe sepsis and septic shock is still high, and the prognosis of elderly patients tends to be particularly poor. Therefore, this study sought to conduct a comparative analysis of the abbreviated mortality in emergency department sepsis (abbMEDS) score, sequential organ failure assessment (SOFA) score, infection probability score (IPS), initial procalcitonin (PCT), and cytokine levels to investigate the effectiveness of each index in predicting the prognosis of elderly patients with sepsis in the emergency department (ED). ⋯ In predicting ICU admission and the death of elderly sepsis patients in ED, SOFA and abbMEDS scores were effective. Of the various biomarkers, PCT, IL-10, IL-6, and IL-5 were effective in predicting ICU admission, but were not effective in predicting the death of elderly sepsis patients.
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Randomized Controlled Trial
Dexmedetomidine reduces postoperative delirium after joint replacement in elderly patients with mild cognitive impairment.
Postoperative delirium (POD) is a common and serious surgical complication among the elderly, especially in those with amnestic mild cognitive impairment (aMCI). Dexmedetomidine (DEX) is neuroprotective for delirium. In this study, we determined the effect of intravenously administered DEX during general anesthesia on POD in elderly aMCI patients undergoing elective hip joint or knee joint or shoulder joint replacement surgery. ⋯ These findings suggested that DEX treatment during surgery significantly reduced POD incidence in both normal and aMCI elderly patients, suggesting that it may be an effective option for the prevention of POD.
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Advanced age is associated with increased severity of acute critical illnesses and admission to ICU. Despite advances in the support for older critically ill patients, the short- and long-term mortality rates remain substantial. The purpose of this study is to analyze the factors influencing the outcome of a geriatric population admitted to the ICU. ⋯ Advanced age, needs for vasopressor therapy, and mechanical ventilation are independent predictive factors of adverse outcome. Pre-admission functional status was not independently associated with unfavorable outcome.