Clinical interventions in aging
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Multicenter Study Observational Study
Association between a frailty index based on common laboratory tests and QTc prolongation in older adults: the Rugao Longevity and Ageing Study.
Risk factors for heart rate-corrected QT interval (QTc) proglongation should be explored to stratify high-risk individuals to aid the prevention of incident cardiovascular events and mortality. The diversity of risk factors for QTc prolongation suggests that use of the frailty index (FI), indicating general health deficits, may be an effective approach, especially in the elderly, to identify the risk of QTc prolongation. ⋯ An FI based on routine laboratory data can identify older adults at increased risk for QTc prolongation. The FI approach may therefore be useful for the risk stratification of QTc prolongation.
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Several authors have reported the degree of total blood loss (TBL) following hemiarthroplasty for displaced femoral neck fracture; however, the research specifically investigating on hidden blood loss (HBL) after hip hemiarthroplasty is still lacking. The purpose of this study is to evaluate the HBL in patients who underwent hip hemiarthroplasty for displaced femoral neck fractures and to analyze its risk factors. ⋯ HBL should not be ignored in patients who underwent hip hemiarthroplasty for displaced femoral neck fractures in the perioperative period, because it is a significant portion of TBL. Female patients, patients with higher ASA classification and perioperative gastrointestinal bleeding/ulcer, patients who were administered general anesthesia, or patients who underwent transfusion had a greater amount of HBL after hip hemiarthroplasty was performed. Having a correct understanding of HBL may help surgeons improve clinical assessment capabilities and ensure patients' safety.
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Postoperative delirium is a common complication of cardiac surgery associated with increased mortality, morbidity, and long-term cognitive dysfunction. The aim of this study was to identify incidence and risk factors of delirium in elderly (≥65 years) and very elderly (≥80 years) patients undergoing major cardiac surgery. ⋯ Patients above 65 years of age with postoperative delirium have poorer outcome and are more likely to have prolonged hospitalization and ICU stay, and longer intubation times, but 30-day mortality is not increased. In our study, eight independent risk factors for development of post-cardiac surgery delirium were age, low ejection fraction, diabetes, extracardiac arteriopathy, postoperative atrial fibrillation, pneumonia, elevated creatinine, and prolonged hospitalization time.
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Randomized Controlled Trial
Relationship between enteral nutrition and serum levels of inflammatory factors and cardiac function in elderly patients with heart failure.
To investigate enteral nutrition's effect on serum inflammatory factors and the cardiac function of malnourished elderly patients with heart failure. ⋯ The use of enteral nutrition in conventional treatment of elderly patients with heart failure could improve not only patients' nutritional status and cardiac function, but also their immune function, thus reducing the levels of inflammatory factors. The longer the treatment period is, the more obvious the improvement in patients' cardiac function and inflammatory factors will be observed.
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The purpose of this pilot study was to determine the effectiveness and costs of the occupation-based practice for community dwelling frail elderly. ⋯ The results of this study showed that occupation-based practice has a potential to improve IADL in frail elderly, with low frequency of intervention, within a short-term, and direct cost reduction. We believe that this pilot study will contribute to future clinical studies for frail elderly, and the findings can be easily applied to daily clinical intervention. A well-designed prospective randomized-controlled trial is necessary to verify these results.