scholarly journals The Clinical Analysis on the postoperative complications of the Elderly Patients with the Oral and Maxillofacial Tumours

2015 ◽  
Author(s):  
Guangping Sun ◽  
Jingchun Huang ◽  
Zhongyan Li
Keyword(s):  
Postoperative Complications ◽  
Elderly Patients ◽  
The Elderly ◽  
Clinical Analysis

scholarly journals Displaced olecranon fractures in the elderly: outcomes after non-operative treatment – a narrative review

2020 ◽  
Vol 5 (7) ◽  
pp. 391-397
Author(s):  
Olga D. Savvidou ◽  
Panagiotis Koutsouradis ◽  
Angelos Kaspiris ◽  
Leon Naar ◽  
George D. Chloros ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Elderly Patients ◽  
Operative Treatment ◽  
Treatment Option ◽  
Gold Standard ◽  
Elderly Population ◽  
Standard Of Care ◽  
The Elderly ◽  
Small Series ◽  
Olecranon Fractures

Operative treatment with tension band wiring or plate is the gold standard of care for displaced olecranon fractures. In elderly patients, multiple comorbidities combine with increased intraoperative risks, and postoperative complications may yield poor results. There are small series in the literature that show promising results with non-operative treatment. Non-operative treatment may provide reasonable function and satisfaction in the elderly population and could be considered as a treatment option in this group, especially for those with comorbidities, to avoid postoperative complications and the need for re-operation. Cite this article: EFORT Open Rev 2020;5:391-397. DOI: 10.1302/2058-5241.5.190041

Effects of age on perioperative complications of extensive multilevel thoracolumbar spinal fusion surgery

2010 ◽  
Vol 12 (4) ◽  
pp. 402-408 ◽  
Author(s):  
Jordan M. Cloyd ◽  
Frank L. Acosta ◽  
Colleen Cloyd ◽  
Christopher P. Ames
Keyword(s):  
Postoperative Complications ◽  
Elderly Patients ◽  
Spinal Fusion ◽  
Perioperative Complications ◽  
Intraoperative Complications ◽  
The Elderly ◽  
Complication Rates ◽  
Fusion Surgery ◽  
Spinal Fusion Surgery

Object The elderly compose a substantial proportion of patients presenting with complex spinal pathology. Several recent studies have suggested that fusion of 4 or more levels increases the risk of perioperative complications in elderly patients. Therefore, the purpose of this study was to analyze the effects of age in persons undergoing multilevel (≥ 5 levels) thoracolumbar fusion surgery. Methods A retrospective review of all hospital records, operative reports, and clinic notes was conducted for 124 consecutive patients who underwent surgery between 2000 and 2007 with an average follow-up of 3.5 years and a minimum follow-up of 1.2 years. The most frequent preoperative diagnoses included scoliosis, tumor, osteomyelitis, vertebral fracture, and degenerative disc disease with stenosis. Complications were classified as intraoperative and major and minor postoperative as well as the need for revision surgery. Multivariate logistic regression analysis was used to determine the effects of age and other potentially prognostic factors. Results After controlling for other factors, increasing age was associated with an elevated risk for major postoperative complications (OR 1.04, 95% CI 1.00–1.10) as were increasing levels of fusion (OR 1.5, 95% CI 1.1–2.1) and male sex (OR 4.6, 95% CI 1.3–16.2). In patients 65 years of age or older, rates of intraoperative complications, major and minor postoperative complications, and reoperation were 14.1, 23.4, 29.7, and 26.6%, respectively. The number of comorbidities was associated with a greater risk for perioperative complications in elderly patients (OR 1.8, 95% CI 1.1–2.8). Conclusions Age is a positive risk factor for major postoperative complications in extensive thoracolumbar spinal fusion surgery. Complication rates in the elderly are high, and good clinical judgment and careful patient selection are needed before performing extensive thoracolumbar reconstruction in older persons.

Validation of hepatectomy for elderly patients with hepatocellular carcinoma.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 380-380
Author(s):  
Norihiro Kishida ◽  
Taizo Hibi ◽  
Osamu Itano ◽  
Masahiro Shinoda ◽  
Minoru Kitago ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Postoperative Complications ◽  
Elderly Patients ◽  
Tumor Size ◽  
The Elderly ◽  
Alpha Fetoprotein ◽  
Long Term Results ◽  
Elderly Cohort ◽  
Disease Free

380 Background: Hepatectomy for hepatocellular carcinoma (HCC) and its outcomes in the elderly population have yet to be defined. We aimed to validate our current strategy to determine surgical indication regardless of age. Methods: A single-center, retrospective cohort study was conducted for 104 patients who underwent hepatectomy for HCC from 2005 to 2010. The patients were divided into 2 groups according to age; i.e. <75 years (non-elderly cohort; n=82) and ≥75 years (elderly cohort; n=22), and short-/long-term results were compared. Results: In the elderly cohort, the prevalence of ECOG performance status 1 preoperatively (p<0.001) and HCV or non-HBV/non-HCV were higher than in the non-elderly cohort (p=0.04). Otherwise, patient/tumor characteristics were comparable between the 2 groups. The elderly cohort suffered postoperative complications more frequently (42% vs. non-elderly, 16%, p=0.01) but the length of hospital stay was equivalent. Ninety-day mortality occurred in 1 case each (elderly, respiratory failure; non-elderly, liver failure; p=0.38). During a median follow-up period of 47 months, unadjusted 5-year disease-free and overall survivals were comparable per log-rank comparison (elderly, 25% and 80% vs. non-elderly, 33% and 79%, p=0.96 and 1.00, respectively). Cox univariate analyses on recurrent HCC showed hypertension, Child-Pugh grade B, tumor size, recurrent/multiple tumors, preoperative alpha-fetoprotein level, moderate/poor differentiation, portal invasion, intrahepatic metastases, and positive margins to have p values <0.20. After adjustment, the hazard ratio of recurrent HCC at 5 years in the elderly cohort was 0.87 (95% CI, 0.40-1.91; p=0.74). Tumor size, alpha-fetoprotein level, and intrahepatic metastases emerged as independent predictors of diminished 5-year disease-free survival in the entire cohort. Conclusions: Although postoperative complications develop more frequently, hepatectomy in the elderly patients affords comparable short- and long-term prognoses to the non-elderly patients. Surgical strategy for HCC should be based on tumor factors and hepatic reserve and not by age alone. Perioperative management needs to be individualized according to coexisting disorders.

scholarly journals Proximal femoral nail anti-rotation versus cementless bipolar hemiarthroplasty for unstable femoral intertrochanteric fracture in the elderly: a retrospective study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Shenghu Zhou ◽  
Jun Liu ◽  
Ping Zhen ◽  
Weiwei Shen ◽  
Yanfeng Chang ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Elderly Patients ◽  
Intertrochanteric Fracture ◽  
Operation Time ◽  
The Elderly ◽  
Proximal Femoral Nail ◽  
Bipolar Hemiarthroplasty ◽  
Intertrochanteric Fractures ◽  
Intraoperative Bleeding ◽  
Femoral Intertrochanteric Fracture

Abstract Background The treatment for unstable intertrochanteric fractures in the elderly has always been a controversial issue. The aim in this study was to compare the curative effects of proximal femoral nail anti-rotation (PFNA) and cementless bipolar hemiarthroplasty (CPH) on femoral intertrochanteric fracture in the elderly. Methods From March 2008 to December 2012, 108 elderly patients with femoral intertrochanteric fractures were treated by PFNA or CPH. There were 63 males and 45 females, aged 75.3–99.1 years [(83.7 ± 5.6) years]. The patients’ bone mineral density was routinely measured, and the fractures were classified according to Evans-Jensen. The patients were divided into CPH group and PFNA group. The differences in operation time, intraoperative bleeding, immobilization duration, hospitalization time, Harris scores and postoperative complications including deep venous thrombosis, lung and urinary infection were analyzed. Results All patients were followed for 12.5–36.2 months [(28.0 ± 6.3) months)]. The operation time was (53.7 ± 15.2) min and (77.5 ± 16.8) min in PFNA group and CPH group, respectively (P < 0.05); intraoperative bleeding was (132.5 ± 33.2) mL and (286.3 ± 43.2) mL, respectively (P < 0.05); immobilization duration was (28.2 ± 3.7) days and (3.1 ± 1.2) days, respectively (P < 0.05); hospitalization time was (7.6 ± 1.8) days and (6.9 ± 2.2) days, respectively (P > 0.05); and the Harris scores after 1 year were (87.7 ± 7.9) points and (88.3 ± 9.2) points, respectively (P > 0.05). There was no significant difference in postoperative complications between the two groups (P > 0.05). Conclusion Both PFNA and CPH are safe and effective treatments for femoral intertrochanteric fracture in elderly patients. Nonetheless, CPH allows faster mobilization and recovery. Trial registration Registration Number: ChiCTR1900022846. Reg Date:2019-04-26 00:27:33 Retrospective registration

scholarly journals Comparative Quality of Laparoscopic and Open Cholecystectomy in the Elderly Using Propensity Score Matching Analysis

2010 ◽  
Vol 2010 ◽  
pp. 1-10 ◽  
Author(s):  
Kazuaki Kuwabara ◽  
Shinya Matsuda ◽  
Koichi Benjamin Ishikawa ◽  
Hiromasa Horiguchi ◽  
Kenji Fujimori
Keyword(s):  
Postoperative Complications ◽  
Propensity Score ◽  
Elderly Patients ◽  
Propensity Score Matching ◽  
Open Cholecystectomy ◽  
Severe Disease ◽  
The Elderly ◽  
Propensity Score Matching Analysis ◽  
Safe Technique

The safety of laparoscopic cholecystectomy (LC) in patients ≥65 years of age requires further investigation of postoperative outcomes before it becomes more widely accepted as a safe technique. The advantages of using LC versus open cholecystectomy (OC) in elderly patients were analyzed using propensity score matching. The demographics, cholecystitis severity, comorbidities, complications, and admission and discharge Barthel Index (BI) scores of patients with benign gallbladder diseases were analyzed. Outcomes were analyzed by age, length of stay (LOS), total charges (TCs), BI improvement, and postoperative complications. OC, which was indicated in severe disease cases, increased hospital resource use and caused more complications than LC, but did not improve BI. Advanced age and OC resulted in greater LOS and TCs and was the best indicator of BI deterioration. Whenever possible, surgeons should use LC in elderly patients to minimize postoperative complications and allow them to regain a good quality of life.

Clinical Analysis of Lumbar Herniation in the Elderly Patients

2004 ◽  
Vol 11 (3) ◽  
pp. 147
Author(s):  
Dae Moo Shim ◽  
Byung Chang Lee ◽  
Tae Kyun Kim ◽  
Dae Ho Ha ◽  
Young Jin Kim ◽  
...  
Keyword(s):  
Elderly Patients ◽  
The Elderly ◽  
Clinical Analysis

scholarly journals Comparative analysis of the immediate results of the off-pump versus on-pump myocardial revascularization in the elderly patients

2019 ◽  
Vol 47 (4) ◽  
pp. 334-341
Author(s):  
A. I. Yusupov ◽  
V. V. Vitsukaev ◽  
A. I. Sushkov ◽  
P. D. Makalskiy ◽  
V. N. Zavgorodniy
Keyword(s):  
Mechanical Ventilation ◽  
Renal Failure ◽  
Cardiopulmonary Bypass ◽  
Postoperative Complications ◽  
Elderly Patients ◽  
Comparison Group ◽  
Myocardial Revascularization ◽  
The Elderly ◽  
Study Group ◽  
Working Heart

Aim: To evaluate efficacy and safety of surgical myocardial revascularization with two internal thoracic arteries in the elderly patients and to identify special aspects and immediate results of the interventions on a working heart and with the use of cardiopulmonary bypass and on a working heart.Materials and methods: This retrospective single center study included patients over 65 years of age with multivessel coronary artery disease who underwent coronary artery bypass grafting with two internal thoracic arteries in a  working heart without cardiopulmonary bypass at the Federal Clinical Center of High Medical Technologies of FMBA of Russia from 2015 to 2017  (the study group, n=50) and with cardiopulmonary bypass and cardioplegia (the comparison group, n=51). We analyzed demographic characteristics, preoperative state severity, and special aspects of myocardial damage, operational parameters, rates, and structure of postoperative complications.Results: None of the patients died. Median intraoperative parameters in the study group were better than those in the comparison group: blood loss, 300  vs. 800  mL (p<0.001), duration of the surgery, 190  and 240  min (p<0.001), duration of mechanical ventilation, 3  and 5  hours (p<0.001), respectively. Early postoperative acute renal failure was less frequent in the patients who had undergone surgery without cardiopulmonary bypass (median serum creatinine levels 90  vs. 125  µmol/L (p<0.001)). Postoperative complications were observed in the group of patients operated with cardiopulmonary bypass: three cases of acute cerebrovascular accidents (stroke) and one deep wound infection of the sternum. Mean duration of the hospital stay in the patients operated on a working heart without the use of cardiopulmonary bypass was 7  days versus 9  in the comparison group.Conclusion: Myocardial revascularization without cardiopulmonary bypass is associated with lower rates of postoperative complications, decreased duration of the procedure, decreased blood loss, time on mechanical ventilation and acute renal failure rate, which all results in decreased duration of hospital stay. Bimammary myocardial revascularization without cardiopulmonary bypass could be the method of choice in the elderly patients. 

scholarly journals Total Laryngectomy with Horizontal Mechanical Closure of the Pharyngoesophagectomy: Evaluation of the Effectiveness in Elderly Patients

2019 ◽  
Vol 23 (03) ◽  
pp. e338-e342
Author(s):  
Eugenia Allegra ◽  
Ignazio La Mantia ◽  
Alfio Azzolina ◽  
Massimo De Natale ◽  
Serena Trapasso ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Elderly Patients ◽  
Total Laryngectomy ◽  
The Elderly ◽  
Linear Stapler ◽  
Pharyngocutaneous Fistula ◽  
Transoral Laser Microsurgery ◽  
Surgical Time ◽  
Number Of Patients

Introduction The main modalities of surgical treatment for laryngeal cancer include transoral laser microsurgery (TLM), open preservation surgery, and total laryngectomy (TL). In the elderly, for the presence of comorbidities, the surgical approach more appropriate in many cases remains TL. The use of a stapler for the closure of the esophagus has been introduced to reduce surgical time and postoperative complications such as pharyngocutaneous fistula (PCF). Objective In the present study, we have evaluated the effectiveness of the use of the horizontal mechanical pharyngoesophageal closure in patients who underwent TL. Methods This nonrandomized study was performed on consecutive patients with histopathologically proven squamous cell endolaryngeal carcinoma. The TL was performed using a linear stapler to mechanically suture the pharyngotomy using the semiclosed technique. Results A total of 33 patients underwent TL, and 13 of them underwent neck dissection. A total of 15 patients (45.4%) were ≤70 years old, and 18 were > 70 years old. Analyzing the results in relation to age, patients > 70 years old showed tumors at an earlier stage than those aged ≤70 years old. Furthermore, in this group there was a greater number of patients who had comorbidities (p = 0.014). In total, we had 2 (6%) cases of PCF in 6.6% in the group ≤70 years old, and in 5.5% of the group > 70 years old (p = 1.00). Conclusions The use of the stapler for the horizontal closure of the pharyngoesophagectomy in the patients subjected to TL is proven to be useful and safe even when used in elderly patients.

Laparoscopic Common Bile Duct Exploration Is a Safe and Effective Strategy for Elderly Patients

2018 ◽  
Vol 25 (5) ◽  
pp. 465-469 ◽  
Author(s):  
Wen-song Liu ◽  
Yong Jiang ◽  
Dong Zhang ◽  
Long-Qing Shi ◽  
Dong-Lin Sun
Keyword(s):  
Bile Duct ◽  
Postoperative Complications ◽  
Common Bile Duct ◽  
Elderly Patients ◽  
Chronic Diseases ◽  
Heart Diseases ◽  
The Elderly ◽  
Common Bile Duct Exploration ◽  
Cbd Stones ◽  
Recurrent Stone

Purpose. Laparoscopic common bile duct exploration (LCBDE) has been widely used to remove common bile duct (CBD) stones. However, surgery is not considered as the first treatment choice for elderly patients with CBD stones because of the potential risk of postoperative complications. This study aims to evaluate the safety and efficiency of LCBDE for elderly patients. Methods. From April 2011 to October 2016, 265 consecutive patients underwent LCBDE. We performed a retrospective study and divided these patients into 2 groups. The younger group was younger than 70 years old (n = 179), and the elderly group was 70 years old or older (n = 86). We compared patient demographics, clinical characteristics, intraoperative parameters, postoperative complications, and incidence of recurrent stone between the 2 groups. Results. The elderly patients had higher preoperative morbidity of chronic diseases, such as pulmonary diseases, heart diseases, arterial hypertension, and abdominal operation history ( P < .05). There were no significant differences between the 2 groups in terms of operation time, intraoperative blood loss, conversion rate to open surgery, total cost, overall complications, and incidence of recurrent stone ( P > .05). Conclusion. LCBDE can also be carried out as a safe and effective approach to remove CBD stones in elderly patients, although they have higher risk of chronic diseases.

106 Precipitating factors in the elderly patients admitted with the diagnosis of heart failure. Are easy to find?

2006 ◽  
Vol 5 (1) ◽  
pp. 25-26
Author(s):  
R VIDALPEREZ ◽  
E ABUASSI ◽  
M PARAMODEVEGA ◽  
P VELOSO ◽  
A VARELAROMAN ◽  
...  
Keyword(s):  
Heart Failure ◽  
Elderly Patients ◽  
The Elderly ◽  
Precipitating Factors
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