scholarly journals Long-Term Relative Survival after Stroke: The Dijon Stroke Registry

2019 ◽  
Vol 54 (6) ◽  
pp. 498-505
Author(s):  
Gaëlle Romain ◽  
Anne-Sophie Mariet ◽  
Valérie Jooste ◽  
Gauthier Duloquin ◽  
Quentin Thomas ◽  
...  
Keyword(s):  
Sex Differences ◽  
Age Groups ◽  
Relative Survival ◽  
Older Age ◽  
Term Survival ◽  
Old Patients ◽  
Stroke Registry ◽  
Stroke Subtypes ◽  
Age And Sex

<b><i>Objective:</i></b> The aim of this study was to assess long-term survival after stroke and to compare survival profiles of patients according to stroke subtypes, age, and sex, using relative survival (RS) method. <b><i>Methods:</i></b> All patients with a first-ever stroke were prospectively recorded in the population-based Dijon Stroke Registry from 1987 to 2016. RS is the survival that would be observed if stroke was the only cause of death. Ten-year RS was estimated using a flexible parametric model of the cumulative excess mortality rate, which was obtained by matching the observed all-cause mortality in the stroke cohort to the expected mortality in the general population. A separate model was fitted for each stroke subtypes, first fitted for each age and sex separately, and then adjusted for age and sex. <b><i>Results:</i></b> In total, 5,259 patients (mean age 74.9 ± 14.3 years, 53% women) were recorded including 4,469 ischemic strokes (IS), 655 intracerebral hemorrhages (ICH), and 135 undetermined strokes. In IS patients, unadjusted RS was 82% at 1 year and decreased to 62% at 10 years. Adjusted RS showed a lower survival in older age groups (<i>p</i> &#x3c; 0.001), but no difference between men and women (<i>p</i> = 0.119). In ICH patients, unadjusted RS was 56 and 42% at 1 and 10 years, respectively, with a lower adjusted survival in older age groups (<i>p</i> &#x3c; 0.001), but no sex differences (<i>p</i> = 0.184). <b><i>Conclusion:</i></b> This study showed that RS after stroke is lower in older than in younger patients but without significant sex differences, and survival profiles differ according to stroke subtypes. Since RS allows a better estimation of stroke-related death than observed survival does, especially in old patients, such a method is adapted to provide reliable information when considering long-term outcome.

Octogenarian Patients with Colon Cancer – Postoperative Morbidity and Mortality are the Major Challenges

2021 ◽  
Author(s):  
Øystein Høydahl ◽  
Tom-Harald Edna ◽  
Athanasios Xanthoulis ◽  
Stian Lydersen ◽  
Birger Henning Endreseth
Keyword(s):  
Colon Cancer ◽  
Survival Rate ◽  
Emergency Surgery ◽  
Relative Survival ◽  
Curative Intent ◽  
Term Survival ◽  
Younger Patients ◽  
Long Term Survival ◽  
Over Time

Abstract Background Few studies have addressed colon cancer surgery outcomes in an unselected cohort of octogenarian patients. The present study aimed to evaluate the relative survival of octogenarian patients after a major resection of colon cancer with a curative intent. Methods All patients diagnosed with colon cancer at Levanger Hospital between 1980 and 2016 were included. We performed logistic regression to test for associations between 100-day mortality and explanatory variables. We performed a relative survival analysis to identify factors associated with short- and long-term survival.Results Among 239 octogenarian patients treated with major resections with curative intent, the 100-day mortality was 10.1%. Among 215 patients that survived the first 100 days, the five-year relative survival rate was 99.7%. The 100-day mortality of octogenarian patients was significantly shorter than that of younger patients, but the long-term survival converged with that of younger patients. Among octogenarian patients, the incidence of colon cancer more than doubled during our 37-year observation period. The relative increase in patients undergoing surgery exceeded the increase in incidence; hence, more patients were selected for surgery over time. A high 100-day mortality was associated with older age, a high American Society of Anaesthesiologists (ASA) score, and emergency surgery. Moreover, worse long-term survival was associated with a high Charlson Comorbidity Index, a high ASA score, a worse TNM stage, emergency surgery and residual tumours. Both the 100‑day and long-term survival rates improved over time. Conclusion Among octogenarian patients with colon cancer that underwent major resections with curative intent, the 100-day mortality was high, but after surviving 100 days, the relative long-term survival rate was comparable to that of younger patients. Further improvements in survival will primarily require measures to reduce the 100-day mortality risk.

PREVALENCE AND FEATURES OF GERIATRIC SYNDROMES TREATMENT IN OLD PATIENTS (CLINICAL AND EPIDEMIOLOGICAL STUDY)

2020 ◽  
pp. 331-338
Author(s):  
Е. Д. Голованова ◽  
Н. Е. Титова ◽  
Т. Е. Афанасенкова ◽  
И. А. Аргунова ◽  
Т. Н. Янковая ◽  
...  
Keyword(s):  
Geriatric Patients ◽  
Age Groups ◽  
Older Age ◽  
Age Dependence ◽  
Old Patients ◽  
Increased Risk ◽  
Planning Treatment ◽  
Risk Of Falls ◽  
Gender Characteristics ◽  
Outpatient Practice

Изучали распространенность хронических неинфекционных заболеваний (ХНИЗ) у пациентов пожилого и старческого возраста во взаимосвязи с синдромом старческой астении, распространенность саркопении в зависимости от гендерных особенностей и частоту встречаемости синдрома падений у пациентов старших возрастных групп с саркопенией. Анализировали особенности медикаментозной терапии в амбулаторной практике. Использовали метод комплексной гериатрической оценки у 528 пациентов, разделенных на три возрастные группы (65-74 года, 75-84 года, 85 лет и старше). Оказалось, что в структуре ХНИЗ у пациентов гериатрического профиля преобладают артериальная гипертензия, ИБС, а также их осложнения - ХСН и фибрилляция предсердий, частота встречаемости которых имеет выраженную возрастную зависимость и увеличивается у больных со старческой астенией. Для пациентов старших возрастных групп обоего пола характерно увеличение частоты встречаемости саркопении и связанного с ней повышенного риска синдрома падений, что необходимо учитывать при планировании лечебно-реабилитационных мер как в стационаре, так и при оказании первичной медикосоциальной помощи. We studied the prevalence of chronic non-communicable diseases (CND) in elderly and senile patients in conjunction with the syndrome of senile asthenia, the prevalence of sarcopenia depending on gender characteristics and the frequency of occurrence of the falls syndrome in patients with sarcopenia of older age groups. The features of drug therapy in outpatient practice were analyzed. The method of complex geriatric assessment was used in 528 patients divided into 3 age groups (65-74 years, 75-84 years, 85 years or more). It turned out that in the structure of CND in geriatric patients dominated: arterial hypertension, coronary heart disease, and their complications - chronic heart failure and atrial fi brillation their incidence has a pronounced age dependence and increases in patients with senile asthenia. Patients of older age groups of both sexes are characterized by an increase in the incidence of sarcopenia and the associated increased risk of falls syndrome, which must be taken into account when planning treatment and rehabilitation measures both in the hospital and when providing primary medical and social care.

Impact of age on early outcomes and long-term survival of patients undergoing aortic repair with Stanford A dissection

Perfusion ◽  
2018 ◽  
Vol 33 (8) ◽  
pp. 687-695 ◽  
Author(s):  
Julia Merkle ◽  
Anton Sabashnikov ◽  
Carolyn Weber ◽  
Georg Schlachtenberger ◽  
Johanna Maier ◽  
...  
Keyword(s):  
Surgical Repair ◽  
Age Groups ◽  
Term Outcome ◽  
Term Survival ◽  
Long Term Outcome ◽  
Long Term Survival ◽  
Cerebrovascular Events ◽  
Short And Long Term ◽  
Male Patients

Objectives: Stanford A acute aortic dissection (AAD) is a life-threatening emergency, typically occurring in older patients and requiring immediate surgical repair. The aim of this study was to evaluate early outcome and short- and long-term survival of patients under and above 65 years of age. Methods: Two hundred and forty patients with Stanford A AAD underwent aortic surgical repair from January 2006 to April 2015 in our center. After statistical analysis and logistic regression analysis, Kaplan-Meier survival estimation was performed, with up to 9-year follow-up, comprising patients under and above 65 years of age. Results: The proportion of patients above 65 years of age suffering from Stanford A AAD was 50% (n=120). The group of patients above 65 years of age compared to the group under 65 years of age showed statistically significant differences in terms of higher odds ratios (OR) for hypertension (p=0.012), peripheral vascular disease (p=0.026) and tachyarrhythmia absoluta (p=0.004). Patients over 65 years of age also showed significantly poorer short- and long-term survival. Our subgroup analysis revealed that male patients (Breslow p=0.001, Log-Rank p=0.001) and patients suffering with hypertension (Breslow p=0.003, Log-Rank p=0.001) were reasonable for these results whereas younger and older female patients showed similar short- and long-term outcome (Breslow p=0.926, Log-Rank p=0.724). After stratifying all patients into 4 age groups (<45; 55-65; 65-75; >75years), short-term survival of the patients appeared to be significantly poorer with increasing age (Breslow p=0.026, Log-Rank p=0.008) whereas long-term survival of patients free from cerebrovascular events (Breslow p=0.0494, Log-Rank p=0.489) remained similar. Conclusions: All patients referred to our hospital for repair of Stanford A AAD with higher age had poorer short- and long-term survival, caused by male patients and patients suffering from hypertension, whereas survival of women and survival free from cerebrovascular events of the entire patient cohort was similar, irrespective of age.

Age groups changes in self-rated health: A prospective longitudinal study over a 20-year period using Health Survey of North Trøndelag data

2020 ◽  
pp. 140349482090462
Author(s):  
Frode Lysberg ◽  
Siw Tone Innstrand ◽  
Milada Cvancarova Småstuen ◽  
Cathrine Lysberg ◽  
Magnhild Mjåvatn Høie ◽  
...  
Keyword(s):  
Sex Differences ◽  
Health Survey ◽  
Age Groups ◽  
Older Age ◽  
Age Group ◽  
Middle Aged ◽  
Prospective Longitudinal Study ◽  
Future Studies ◽  
Self Rated Health ◽  
Prospective Longitudinal

Background: The aim of the study was to investigate changes in self-rated health (SRH) between different age groups and sexes over a 20-year period. Methods: Data were retrieved from the large longitudinal Health Survey of North Trøndelag, Norway, which includes data collected from more than 190,000 participants aged 20–70+ years between the years 1984 and 2008. Data were analysed using logistic regression and adjusted for sex. Results: From 1984 to 2008, the odds of scoring higher on SRH decreased by 46% in the youngest age group (20–29 years) and increased by approximately 35% in the middle-aged and older age groups (40–70+ years). When considering sex differences, women in most age groups scored lower than the men on their SRH. Conclusions: Our finding suggest a trending shift in SRH, with a reduction in the youngest age group (20–29 years) and an increase in the middle-aged and older age groups (40–70+ years). Despite the sex differences being small, our data indicate that in most age groups, women tend to score lower than men on their SRH. Future studies should focus on these trends to understand better the mechanisms underlying these changes in SRH and to follow future trends to see if the trend is reinforced or diminished.

Progress in Hodgkin lymphoma: a population-based study on patients diagnosed in Sweden from 1973-2009

Blood ◽  
2012 ◽  
Vol 119 (4) ◽  
pp. 990-996 ◽  
Author(s):  
Jan Sjöberg ◽  
Cat Halthur ◽  
Sigurdur Y. Kristinsson ◽  
Ola Landgren ◽  
Ulla Axdorph Nygell ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Treatment Options ◽  
Age Groups ◽  
Relative Survival ◽  
Population Based ◽  
Term Treatment ◽  
Cure Rate ◽  
Population Based Study ◽  
Long Term Treatment

Abstract In recent decades, attention has focused on reducing long-term, treatment-related morbidity and mortality in Hodgkin lymphoma (HL). In the present study, we looked for trends in relative survival for all patients diagnosed with HL in Sweden from 1973-2009 (N = 6949; 3985 men and 2964 women; median age, 45 years) and followed up for death until the end of 2010. Patients were categorized into 6 age groups and 5 calendar periods (1973-1979, 1980-1986, 1987-1994, 1994-2000, and 2001-2009). Relative survival improved in all age groups, with the greatest improvement in patients 51-65 years of age (P < .0005). A plateau in relative survival was observed in patients below 65 years of age during the last calendar period, suggesting a reduced long-term, treatment-related mortality. The 10-year relative survival for patients diagnosed in 2000-2009 was 0.95, 0.96, 0.93, 0.80, and 0.44 for the age groups 0-18, 19-35, 36-50, 51-65, and 66-80, respectively. Therefore, despite progress, age at diagnosis remains an important prognostic factor (P < .0005). Advances in therapy for patients with limited and advanced-stage HL have contributed to an increasing cure rate. In addition, our findings support that long-term mortality of HL therapy has decreased. Elderly HL patients still do poorly, and targeted treatment options associated with fewer side effects will advance the clinical HL field.

scholarly journals Prevalence of Stroke Risk Factors and Their Distribution Based on Stroke Subtypes in Gorgan: A Retrospective Hospital-Based Study—2015-2016

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Mahdi Habibi-koolaee ◽  
Leila Shahmoradi ◽  
Sharareh R. Niakan Kalhori ◽  
Hossein Ghannadan ◽  
Erfan Younesi
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Ischemic Stroke ◽  
Stroke Risk ◽  
Healthcare Providers ◽  
Age Groups ◽  
University Hospital ◽  
Stroke Registry ◽  
Stroke Risk Factors ◽  
Stroke Subtypes

Background. Stroke is a leading cause of death and disability worldwide. According to the Iranian Ministry of Medical Health and Education, out of 100,000 stroke incidents in the country, 25,000 lead to death. Thus, identifying risk factors of stroke can help healthcare providers to establish prevention strategies. This study was conducted to investigate the prevalence of stroke risk factors and their distribution based on stroke subtypes in Sayad Shirazi Hospital, Gorgan, Northeastern Iran. Material and Methods. A retrospective hospital-based study was conducted at Sayad Shirazi Hospital in Gorgan, the only referral university hospital for stroke patients in Gorgan city. All medical records with a diagnosis of stroke were identified based on the International Classification of Diseases, Revision 10, from August 23, 2015, to August 22, 2016. A valid and reliable data gathering form was used to capture data about demographics, diagnostics, lifestyle, risk factors, and medical history. Results. Out of 375 cases, two-thirds were marked with ischemic stroke with mean ages (standard deviation) of 66.4 (14.2) for men and 64.6 (14.2) for women. The relationship between stroke subtypes and age groups (P=0.008) and hospital outcome (P=0.0001) was significant. Multiple regression analysis showed that hypertension (Exp. (B) =1.755, P=0.037), diabetes mellitus (Exp. (B) =0.532, P=0.021), and dyslipidemia (Exp. (B) =2.325, P=0.004) significantly increased the risk of ischemic stroke. Conclusion. Overall, hypertension, diabetes mellitus, and dyslipidemia were the major risk factors of stroke in Gorgan. Establishment of stroke registry (population- or hospital-based) for the province is recommended.

Imatinib in the Treatment of CML Patients ≥ 65 Years Old in Late Chronic Phase: Results of a Phase II Study of the GIMEMA CML Working Party.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2935-2935
Author(s):  
Simona Bassi ◽  
Fausto Castagnetti ◽  
Marilina Amabile ◽  
Barbara Giannini ◽  
Daniela Cilloni ◽  
...  
Keyword(s):  
Adverse Events ◽  
Older Patients ◽  
Age Groups ◽  
Chronic Phase ◽  
Working Party ◽  
Cytogenetic Response ◽  
Term Survival ◽  
Grade Iii ◽  
Two Age Groups

Abstract Older age constitutes a poor prognostic variable in CML patients: the negative effect of age on long-term survival has been consistently observed with most effective therapeutic modalities, both drug therapies (busulfan, hydroxyurea and interferon) and allogeneic transplant. In particular, older patients treated with interferon experienced much more adverse events than younger ones. In part their poorer prognosis was probably due to poor treatment compliance and few older patients have been included in prospective studies of interferon. Actually, imatinib is the first-line treatment for CML: its efficacy is very high and it seems to be well tolerated across age groups. We performed a sub-analysis of the effects of age on response and tolerance within the phase II trial of the italian GIMEMA CML Working Party (serial n.CML/002/STI571), which included 284 late chronic phase patients, treated with imatinib (400 mg daily) after interferon failure. Following the WHO, who defines “old” a patient ≥ 65 years, we analyzed the safety and efficacy of imatinib by age group: 226/284 patients (80%) were &lt; 65 years (extr. 17–64) and 58/284 (20%) were ≥ 65 years (extr. 65–85 yrs) old. No significant differences between the two age groups were present at enrollment. Table 1 shows the responses and incidence of hematologic and non-hematologic adverse events (AEs). As expected, older patients experienced more AEs, both hematologic and non-hematologic. In part this significantly poorer tolerance probably justifies the lower response rates, both hematologic and cytogenetic. However, the overall survival was not different between the two age groups: with a median observation time of 33 months, the overall survival curves were superimposed (91%). Moreover, the rate of progression to accelerated/blastic phase was the same (10%). This study demonstrates that imatinib is greatly effective in older CML patients in late chronic phase (53% of MCR and 36% of CCR) and allows a good long-term survival. It is conceivable that treating old CML patients at the onset of the disease, as already shown by Jorge Cortes et al (Cancer2003;98:1105), could translate into response rates as the ones of younger patients. Responses and adverse events ≥ 65 (n. 58) ≤ 65 (n226) p value Complete Hematologic response 91% 99% 0,001 Major Cytogenetic Response 53% 74% 0,003 Complete Cytogenetic Response 36% 57% 0,001 Grade III Hematologic AEs 72% 50% 0,002 Grade III+IV Hematologic AEs 86% 60% 0,0001 Grade II non Hematologic AEs 83% 68% 0,0001 Grade III + IV non Hematologic AEs 29% 10% 0,0001

Long-term follow-up of the GELA LNH 03-7B study: A prospective phase II study of 150 patients over 80 years with diffuse large B-cell lymphoma (DLBCL) treated with RminiCHOP.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 8536-8536 ◽  
Author(s):  
Frederic Peyrade ◽  
Olivier Fain ◽  
Bettina Fabiani ◽  
Frederic Bauduer ◽  
Eric Van Den Neste ◽  
...  
Keyword(s):  
Phase Ii ◽  
Phase Ii Study ◽  
B Cell Lymphoma ◽  
Response To Treatment ◽  
Disease Stage ◽  
Term Survival ◽  
Old Patients ◽  
Prospective Phase

8536 Background: We report the outcome of patients included in the LNH 03-7B prospective phase II study of the GELA group which evaluated the tolerance and efficacy of a reduced dosage chemotherapy regimen (miniCHOP) associated with full dose rituximab in patients aged over 80 years with DLBCL. Methods: Patients were between 80 and 95 years (median 83 years), had disease stage I Bulky to IV and 65% had poor risk lymphoma according to IPI. Perfomance status was 0-2 in all cases. The majority of deaths and grade III/IV toxicity occurred during cycle 1 and 2. Response to treatment and early survival analyses were previously presented with 20 months median follow-up (Lancet oncol 2011;12:460-468). Results: At the time of this analysis, The median follow-up time was 41 months and 75 (50%) patients were alive. The 4-year estimated overall survival (OS) was 49.3% [95% CI: 40.8-57.3%] and the median OS was 38 months. The 4-year estimated PFS, EFS and DFS were 41.4% [95% CI: 33.1-49.5%], 39.4% [95% CI : 31.2-47.5%] and 57.9% [95% CI : 47.3-67.2%] respectively.]. During the additional follow-up, 8 patients relapsed (10% of CR patients) and 17 died. No long term toxicity was recorded. In a multivariate analysis an albumin level >35 g/l remained significantly associated with a longer survival. Conclusions: These results show that very old patients with DLBCL treated with RminiCHOP could express long-term survival and probably be cured. Regarding the DFS and despite the early toxicity, it seems crucial to obtain the best possible response. This long term analysis confirm that in patient aged over 80y with DLBCL and with PS from 0 to 2, RminiCHOP is the treatment cornerstone. Clinical trial information: NCT01087424.

Social Security

2012 ◽  
Author(s):  
Larry DeWitt ◽  
Edward D. Berkowitz
Keyword(s):  
United States ◽  
Social Security ◽  
Older People ◽  
Age Groups ◽  
The United States ◽  
Critical Question ◽  
Term Survival ◽  
History Of ◽  
Government Benefits

This chapter considers the history of Social Security, arguing that the 1950 amendments represented the fundamental adjustment that allowed the program’s long-term survival. It analyzes current issues in Social Security related to gender, race, and the program’s long-term solvency. It concludes that Social Security has legitimized the receipt of government benefits among many Americans and changed the nature of old age in the United States by providing older people with a guaranteed means of support. A large and costly program, Social Security has evolved into the United States’ major antipoverty program. Nonetheless it faces the criticism of those who argue that it favors older people over other age groups and that it represents an inefficient form of government coercion. Whether the program will be sustained in the future or modified in a significant way remains a critical question.

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