Mechanical Ventilation for Very Elderly Patients with Severe Pneumonia

2014 ◽  
Vol 17 (4) ◽  
pp. 383-384 ◽  
Author(s):  
Miyuki Mitamura ◽  
Kosaku Komiya ◽  
Hiromi Watanabe ◽  
Jun-ichi Kadota
Keyword(s):  
Mechanical Ventilation ◽  
Elderly Patients ◽  
Severe Pneumonia ◽  
Very Elderly

Factors influencing weaning from mechanical ventilation in elderly patients with severe pneumonia

2011 ◽  
Vol 12 (2) ◽  
pp. 277-283 ◽  
Author(s):  
Mitsuhiro Fujii ◽  
Shin-ichiro Iwakami ◽  
Haruhi Takagi ◽  
Yukinari Itoigawa ◽  
Masako Ichikawa ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Elderly Patients ◽  
Severe Pneumonia ◽  
Weaning From Mechanical Ventilation ◽  
Factors Influencing

Mortality and Prognostic Prediction in Very Elderly Patients With Severe Pneumonia

2019 ◽  
Vol 35 (12) ◽  
pp. 1405-1410 ◽  
Author(s):  
Moon Seong Baek ◽  
Sojung Park ◽  
Jeong-Hee Choi ◽  
Cheol-Hong Kim ◽  
In Gyu Hyun
Keyword(s):  
Elderly Patients ◽  
Hospital Mortality ◽  
Pneumonia Severity Index ◽  
Nursing Home Residents ◽  
Area Under The Curve ◽  
Severe Pneumonia ◽  
Operating Characteristics ◽  
Very Elderly ◽  
Pneumonia Severity ◽  
Prognostic Prediction

Introduction: Although prognostic prediction scores for pneumonia such as CURB-65 score or pneumonia severity index (PSI) are widely used, there were a few studies in very elderly patients. The aim of the study was to validate prognostic prediction scores for severe pneumonia and investigate risk factors associated with in-hospital mortality of severe pneumonia in very elderly patients. Methods: During the 6-year study period (from October 2012 to May 2018), 160 patients aged 80 or older admitted to medical intensive unit were analyzed retrospectively. Pneumonia severity was evaluated using CURB-65 score, PSI, Sequential Organ Failure Assessment (SOFA) scores, A-DROP, I-ROAD, UBMo index, SOAR score, and lactate. The outcome was in-hospital mortality. Results: The median age was 85 years (interquartile range: 82-88). Nursing home residents accounted for 71 (44.4%) and in-hospital mortality was 40 (25.0%). Logistic regression showed that chronic lung, mechanical ventilation, hemodialysis, and albumin were associated with in-hospital mortality of pneumonia. Using the receiver operating characteristics curve for predicting mortality, the area under the curve in pneumonia was 0.65 for the SOFA score, 0.61 for the CURB-65 score, 0.52 for the PSI, 0.58 for the A-DROP, 0.52 for the I-ROAD, 0.54 for UBMo index, 0.59 for SOAR score, and 0.65 for lactate. Conclusion: The performances of the CURB-65 and PSI are not excellent in very elderly patients with pneumonia. Further studies are needed to improve the performance of prognostic prediction scores in elderly patients.

Outcomes of severe sepsis in very elderly (age >80 years) patients with metastatic cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9558-9558
Author(s):  
Zahra Touqir ◽  
Shagufta Shaheen ◽  
Shivanck Upadhyay ◽  
Creticus Petrov Marak ◽  
Gagan Kumar ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Severe Sepsis ◽  
Elderly Patients ◽  
Metastatic Disease ◽  
Metastatic Cancer ◽  
Invasive Mechanical Ventilation ◽  
Care Providers ◽  
Very Elderly ◽  
Central Venous ◽  
Discharge Disposition

9558 Background: With better treatment and prolonged life expectancy of cancer patients, more elderly patients with metastatic cancer are being treated aggressively for sepsis. There has been philosophical debate about how aggressive the treatment should be for very elderly patients with metastatic disease admitted to intensive care unit with severe sepsis. The data with regards to the outcome of severe sepsis in those above 80 years with metastatic disease is very limited. Methods: Using the Healthcare Cost and Utilization Project - Nationwide Inpatient Sample 2007-2008, patients older than 80 years, discharged with severe sepsis were identified using ICD-9-CM codes. Those with metastatic disease were identified using ICD-9-CM codes 196-199. The outcomes studied were mortality and discharge disposition. We also examined the rates of invasive mechanical ventilation, blood transfusion, use of central venous catheter, tracheostomy and dialysis. The outcomes were compared to those who did not have cancer. Chi square test was used to compare the variables. Significance was defined as p value <0.05. Results: There were 458,443 discharges with severe sepsis in patients aged ≥80 years. Of these 3.3% had metastatic disease. The in-hospital mortality was significantly higher in those with metastatic disease (43.7% vs. 33.3%, p<0.001). The discharge disposition of the very elderly is shown in the Table. The rates of invasive mechanical ventilation, tracheostomy, use of central venous lines and dialysis were similar in both the groups. Blood transfusions were observed to be higher in metastatic group. Conclusions: Resource utilization in elderly with severe sepsis is similar regardless of the presence of metastatic disease. However, the mortality is significantly higher in those with metastatic disease. Of the survivors, only a fraction reaches home with independent functioning. Involvement of palliative care services at an early stage and addressing code status promptly during the beginning of each hospitalization may help relieve resource and financial burden to health care providers. [Table: see text]

Features of diabetes mellitus in very elderly patients

2019 ◽  
Vol 1 (9) ◽  
pp. 13-19
Author(s):  
S. V. Topolyanskaya ◽  
T. M. Kolontai ◽  
O. N. Vaculenko ◽  
L. I. Dvoretski
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Elderly Patients ◽  
Very Elderly ◽  
Younger Patients ◽  
Patients With Diabetes ◽  
Artery Disease

Modern concepts about features of diabetes mellitus in very elderly patients are described in the article. Special attention to the therapeutic methods of management of very elderly patients with diabetes mellitus has been devoted. The results of diabetes mellitus study in patients with coronary artery disease older than 75 years in comparison with younger patients are presented.

CARDIOVASCULAR DISEASE IN VERY ELDERLY PATIENTS HOSPITALIZED IN A DISTRICT HOSPITAL

2018 ◽  
Vol 36 (Supplement 1) ◽  
pp. e249
Author(s):  
M. Mellado-Ferreiro ◽  
V. Jarne-Betrán ◽  
M. Arteaga-Mazuelas ◽  
A. Redondo-Arriazu ◽  
L. Urbina-Soto
Keyword(s):  
Cardiovascular Disease ◽  
Elderly Patients ◽  
District Hospital ◽  
Very Elderly

scholarly journals Oral Candidiasis and COVID-19 in Users of Removable Dentures: Is Special Oral Care Needed?

Gerontology ◽  
2021 ◽  
pp. 1-6
Author(s):  
Laura Silva Jerônimo ◽  
Rafael Paschoal Esteves Lima ◽  
Thaís Yumi Umeda Suzuki ◽  
José Augusto César Discacciati ◽  
Cláudia Lopes Brilhante Bhering
Keyword(s):  
Mechanical Ventilation ◽  
Candida Albicans ◽  
Oral Health ◽  
Early Diagnosis ◽  
Elderly Patients ◽  
Oral Candidiasis ◽  
Oral Care ◽  
Antifungal Treatment ◽  
Immunocompromised Patients ◽  
Appropriate Care

Elderly patients with systemic disorders and immunocompromised patients seem to have a higher risk of developing morbidity from COVID-19. <i>Candida albicans</i> (<i>C. albicans</i>) is a potentially dangerous pathogen for these patients, especially for denture wearers with prosthetic stomatitis who require mechanical ventilation. <i>C. albicans</i> infection, the main candidiasis infection associated with denture wear, can complicate COVID-19 and increase the associated morbidity and mortality. Therefore, early diagnosis of <i>C. albicans</i> infection in COVID-19 patients is important to establish more effective antifungal treatment methods and prophylaxis strategies. Hospitalized COVID-19 patients should undergo an oral examination to assess their oral health, and those with poor oral health should receive the appropriate care and monitoring.

scholarly journals Determinants of In-Hospital Mortality in Elderly Patients Aged 80 Years or above with Acute Heart Failure: A Retrospective Cohort Study at a Single Rural Hospital

2021 ◽  
Vol 10 (7) ◽  
pp. 1468
Author(s):  
Yusuke Watanabe ◽  
Kazuko Tajiri ◽  
Hiroyuki Nagata ◽  
Masayuki Kojima
Keyword(s):  
Heart Failure ◽  
Regression Analysis ◽  
Elderly Patients ◽  
Hospital Mortality ◽  
Acute Heart Failure ◽  
Stepwise Regression ◽  
Stepwise Regression Analysis ◽  
Antibiotic Administration ◽  
Very Elderly ◽  
Survivor Group

Heart failure is one of the leading causes of mortality worldwide. Several predictive risk scores and factors associated with in-hospital mortality have been reported for acute heart failure. However, only a few studies have examined the predictors in elderly patients. This study investigated determinants of in-hospital mortality in elderly patients with acute heart failure, aged 80 years or above, by evaluating the serum sodium, blood urea nitrogen, age and serum albumin, systolic blood pressure and natriuretic peptide levels (SOB-ASAP) score. We reviewed the medical records of 106 consecutive patients retrospectively and classified them into the survivor group (n = 83) and the non-survivor group (n = 23) based on the in-hospital mortality. Patient characteristics at admission and during hospitalization were compared between the two groups. Multivariate stepwise regression analysis was used to evaluate the in-hospital mortality. The SOB-ASAP score was significantly better in the survivor group than in the non-survivor group. Multivariate stepwise regression analysis revealed that a poor SOB-ASAP score, oral phosphodiesterase 3 inhibitor use, and requirement of early intravenous antibiotic administration were associated with in-hospital mortality in very elderly patients with acute heart failure. Severe clinical status might predict outcomes in very elderly patients.

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