Pancreaticoduodenectomy in the Elderly Patient: Age-Adapted Risk Assessment

2016 ◽  
Vol 34 (1) ◽  
pp. 43-51 ◽  
Author(s):  
Georg Wiltberger ◽  
Babett Muhl ◽  
Christian Benzing ◽  
Hans-Michael Hau ◽  
Michael Bartels ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Elderly Patient ◽  
The Elderly ◽  
Patient Age ◽  
Patient Âgé

Considerations in Cardiac Revascularization for the Elderly Patient: Age Isn't Everything

2016 ◽  
Vol 32 (9) ◽  
pp. 1132-1139 ◽  
Author(s):  
Deirdre E. O'Neill ◽  
Merril L. Knudtson ◽  
Teresa M. Kieser ◽  
Michelle M. Graham
Keyword(s):  
Elderly Patient ◽  
The Elderly ◽  
Patient Age ◽  
Patient Âgé ◽  
Cardiac Revascularization

The Portrayal of the Elderly in Drug Advertisements: A Factor in Inappropriate Prescribing?

1990 ◽  
Vol 9 (3) ◽  
pp. 296-303 ◽  
Author(s):  
Joel Lexchin
Keyword(s):  
Inappropriate Prescribing ◽  
The Elderly ◽  
Personnes Âgées ◽  
Patient Age ◽  
Patient Âgé ◽  
Pour Cent

RÉSUMÉLe problème concernant les ordonnances contre-indiquées continue de prendre de l'ampleur et devient un des facteurs contribuant aux réactions néfastes que subissent les personnes âgées. De toute évidence, le médecin qui s'appuie sur les documents promotionnels pour rédiger une ordonnance sera porté à commettre plus d'erreurs. La présente étude se concentre sur deux revues médicales canadiennes importantes et elle examine les réclames publicitaires qui s'adressent aux personnes semblant avoir dépassé les 65 ans. Les gens âgés étaient représentés dans seulement 7 pour cent des annonces. Celles-ci ne semblaient pas tenir compte des besoins particuliers aux personnes âgées en ce qui a trait aux médicaments. Les textes et les illustrations contenus à l'intérieur de ces annonces pourraient être une des causes à l'origine des ordonnances contre-indiquées. Des études de recherche plus approfondies devraient être mises au point dans le but d'examiner plus attentivementles facteurs qui influencent le médecin lorsqu'il décide de rédiger une ordonnance pour un patient âgé. Entretemps, par égard à ce segment de leur pratique, les médecins devraient analyser prudemment les messages publicitaires et demeurer conscients des risques encourus lorsqu'ils s'en servent à titre d'information thérapeutique.

Dental Students’ Knowledge, Attitudes, and Intended Behaviors Regarding Caries Risk Assessment: Impact of Years of Education and Patient Age

2007 ◽  
Vol 71 (11) ◽  
pp. 1420-1427 ◽  
Author(s):  
Sophia H. Calderón ◽  
Paul Gilbert ◽  
Rasika N. Zeff ◽  
Stuart A. Gansky ◽  
John D.B. Featherstone ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Dental Students ◽  
Caries Risk ◽  
Caries Risk Assessment ◽  
Patient Age ◽  
Patient Âgé

scholarly journals Renal transplantation in the elderly: does patient age determine the results?

2005 ◽  
Vol 34 (6) ◽  
pp. 583-587 ◽  
Author(s):  
Fernando Otero-Raviña ◽  
Mónica Rodríguez-Martínez ◽  
Francisco Gude ◽  
José Ramón González-Juanatey ◽  
Francisco Valdés ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
The Elderly ◽  
Patient Age ◽  
Patient Âgé

scholarly journals Preoperative preparation of geriatric patients

2011 ◽  
Vol 58 (2) ◽  
pp. 169-175 ◽  
Author(s):  
Radmilo Jankovic ◽  
Angelina Bogicevic ◽  
Biljana Stosic ◽  
Anica Pavlovic ◽  
Anita Petrovic ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Elderly Patient ◽  
Geriatric Patients ◽  
Elderly Care ◽  
Postoperative Cognitive Dysfunction ◽  
The Elderly ◽  
Surgical Patient ◽  
Preoperative Preparation ◽  
Continuous Increase ◽  
Preoperative Optimization

There is a continuous increase in the proportion of elderly patients undergoing surgical procedures. This review will concentrate on selected topics related to elderly care that represent current unresolved and relevant issues for the care of the elderly surgical patient including: aging related organ dysfunction, perioperative risk assessment of geriatrics patient, preoperative optimization and pharmacological support of elderly patient. Additionally, age as a clear risk factor for postoperative cognitive dysfunction is also discussed.

Impact of age on the likelihood of reaching a minimum clinically important difference in 374 three-column spinal osteotomies

2014 ◽  
Vol 20 (3) ◽  
pp. 306-312 ◽  
Author(s):  
Justin K. Scheer ◽  
Virginie Lafage ◽  
Justin S. Smith ◽  
Vedat Deviren ◽  
Richard Hostin ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Deformity Correction ◽  
Minimum Clinically Important Difference ◽  
The Elderly ◽  
Young Group ◽  
Elderly Group ◽  
Patient Age ◽  
Patient Âgé ◽  
Health Related

Object Spinal osteotomies for adult spinal deformity correction may include resection of all 3 spinal columns (pedicle subtraction osteotomy [PSO] and vertebral column resection [VCR]). The relationship between patient age and health-related quality of life (HRQOL) outcomes for patients undergoing major spinal deformity correction via PSO or VCR has not been well characterized. The goal of this study was to characterize that relationship. Methods This study was a retrospective review of 374 patients who had undergone a 3-column osteotomy (299 PSOs and 75 VCRs) and were part of a prospectively collected, multicenter adult spinal deformity database. The consecutively enrolled patients were drawn from 11 sites across the United States. Health-related QOL outcomes, according to the visual analog scale (VAS), Oswestry Disability Index (ODI), 36-Item Short-Form Health Survey (SF-36, physical component score [PCS] and mental component score), and Scoliosis Research Society-22 questionnaire (SRS), were evaluated preoperatively and 1 and 2 years postoperatively. Differences and correlations between patient age and HRQOL outcomes were investigated. Age groupings included young (age ≤ 45 years), middle aged (age 46–64 years), and elderly (age ≥ 65 years). Results In patients who had undergone PSO, age significantly correlated (Spearman's correlation coefficient) with the 2-year ODI (ρ = 0.24, p = 0.0450), 2-year SRS function score (ρ = 0.30, p = 0.0123), and 2-year SRS total score (ρ = 0.30, p = 0.0133). Among all patients (PSO+VCR), the preoperative PCS and ODI in the young group were significantly higher and lower, respectively, than those in the elderly. Among the PSO patients, the elderly group had much greater improvement than the young group in the 1- and 2-year PCS, 2-year ODI, and 2-year SRS function and total scores. Among the VCR patients, the young age group had much greater improvement than the elderly in the 1-year SRS pain score, 1-year PCS, 2-year PCS, and 2-year ODI. There was no significant difference among all the age groups as regards the likelihood of reaching a minimum clinically important difference (MCID) within each of the HRQOL outcomes (p > 0.05 for all). Among the PSO patients, the elderly group was significantly more likely than the young to reach an MCID for the 1-year PCS (61% vs 21%, p = 0.0077) and the 2-year PCS (67% vs 17%, p = 0.0054), SRS pain score (57% vs 20%, p = 0.0457), and SRS function score (62% vs 20%, p = 0.0250). Among the VCR patients, the young group was significantly more likely than the elderly patients to reach an MCID for the 1-year (100% vs 20%, p = 0.0036) and 2-year (100% vs 0%, p = 0.0027) PCS scores and 1-year (60% vs 0%, p = 0.0173) and 2-year (70% vs 0%, p = 0.0433) SRS pain scores. Conclusions The PSO and VCR are not equivalent surgeries in terms of HRQOL outcomes and patient age. Among patients who underwent PSO, the elderly group started with more preoperative disability than the younger patients but had greater improvements in HRQOL outcomes and was more likely to reach an MCID at 1 and 2 years after treatment. Among those who underwent VCR, all had similar preoperative disabilities, but the younger patients had greater improvements in HRQOL outcomes and were more likely to reach an MCID at 1 and 2 years after treatment.

Community use of anthracyclines for adjuvant HER2-positive breast cancer (BC).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e11609-e11609
Author(s):  
Akhil Kumar ◽  
Marc L. Fishman ◽  
William S. Shimp ◽  
Laura Rose Bobolts ◽  
James Edward Krook ◽  
...  
Keyword(s):  
The Elderly ◽  
Cardiac Events ◽  
Her2 Positive ◽  
Chi Square ◽  
Adjuvant Trastuzumab ◽  
Patient Age ◽  
Patient Âgé ◽  
Chi Square Analysis ◽  
Improvement In Survival ◽  
Relationship Of

e11609 Background: Anthracyclines remain among the most active agents for the treatment of BC. NSABP B-31, NCCTG N9831 and HERA, each employing anthracyclines followed by trastuzumab in adjuvant HER2+ BC, demonstrated significant reduction in the risk of recurrence and improvement in survival. A fourth study, BCIRG-006, compared a non-anthracycline containing regimen, TCH, to an anthracycline based regimen, AC-TH. Both arms had similar overall survival, but there was a higher incidence of cardiac events in patients who received anthracycline. HER2-analyses in randomized adjuvant trials, in the pre-trastuzumab era, comparing anthracycline with non-anthracycline chemotherapy regimens, show that HER2+ BC derives greater benefit from anthracycline use. TOP2A coamplification, which occurs in 35% of HER2-positive patients, has shown a direct association with anthracycline benefit in several studies. We investigate and report, herein, the ways in which community oncologists are currently treating these patients. Methods: All treatment requests for adjuvant trastuzumab were examined, from 2009 through 2012. Chi-square analysis at 0.05α was used to test for interaction of age group to type of treatment. Results: During this span, oncologists requested adjuvant trastuzumab for 121 patients. In 10% (12/121) of patients, adjuvant trastuzumab alone, without chemotherapy and with or without hormonal therapy, was requested. Among patients who also received adjuvant chemotherapy (109), 35% (38/109), received anthracyclines. There was no relationship of anthracycline-usage with BC stage (data not shown) or patient age (Chi Sq p = 0.73). Adjuvant trastuzumab, without chemotherapy, was requested more often for the elderly (20% versus 4%; Chi Sq p = 0.003). Conclusions: Anthracyclines are utilized in adjuvant HER2+ BC in only about a third of patients, regardless of BC stage or patient age. The availability of a reliable, inexpensive, and convenient test to predict which patients are most likely to benefit from anthracyclines, over other options, would be useful. [Table: see text]

Principles of surgical risk assessment of the elderly patient

1990 ◽  
Vol 48 (9) ◽  
pp. 972-979 ◽  
Author(s):  
Gregg H. Gilbert ◽  
Kenneth L. Minaker
Keyword(s):  
Risk Assessment ◽  
Elderly Patient ◽  
The Elderly ◽  
Surgical Risk
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