Characteristics Of Geriatric Patients Research Articles

Clinical neurological characteristics of geriatic patients with Coronavirus disease 2019 (COVID-19)

Background and objectives. Coronavirus Disease-2019 (COVID-19) is a respiratory infection caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2). The COVID-19 associates multi clinical symptoms such as neurological manifestations with mild to advanced progression. This study aimed to determine the clinical neurological characteristics of geriatric patients with COVID-19. Methods. The study was an observational and descriptive study on 27 geriatric patients with COVID-19. All patients’ age was over 60 years old who treated in the In-patient Department of Sanglah General Hospital, Denpasar on July 2020 to January 2021. The data had taken from medical records. Outcomes. The mean age of all patients was 70.41 (± 8.902) years which dominated by the male (51.9%). The majority of manifestations in this study were fever in 13 people (48.1%), unconsciousness in 10 people (37%), and hemiparesis in 10 people (37%), and cough in 9 people (33.3%). Conclusion. The clinical neurology characteristics of geriatric patients with COVID-19 vary, which may involve general and neurological manifestations. Promptly accurate diagnosis is necessary for further management.

Clinical characteristics of geriatric patients with non-specific chronic low back pain

A comprehensive analysis of clinical information in patients with chronic low back pain (CLBP) was performed to clarify the clinical characteristics of geriatric LBP from the perspective of body composition, spinal alignment, and blood findings related to senescence. We enrolled 203 patients with an average age of 79.0 years (77 men and 126 women), with non-specific CLBP as a single-center prospective cohort study, the patients were compared with age- and sex-matched controls without CLBP using a propensity score-matching. We performed laboratory analysis, radiographic evaluations for global spinal parameter and lumbar degeneration, and body composition analysis using whole-body dual-energy X-ray absorptiometry. We observed a higher red blood cell distribution width (RDW) (p < 0.001), which is an index of aging, as well as a lower vitamin D level (p = 0.002), skeletal muscle mass index (p = 0.045) and a higher fat mass (p = 0.007) in patients with CLBP. Moreover, patients with geriatric CLBP had significantly lower lumbar lordosis (p = 0.024), and higher sagittal vertical axis (p = 0.006) was correlated with lower extremity and trunk muscle mass (p < 0.001), independent of lumbar degeneration. Geriatric patients with CLBP have sarcopenic fat accumulation and spinal sagittal malalignment with senescent status, such as elevated RDW and hypovitaminosis D.

Clinical neurological characteristics of geriatric patients with COVID-19 in Sanglah General Hospital from 2020 to 2021

Background and objectives. COVID-19 is a respiratory infection caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2). The COVID-19 associates multi-clinical symptoms such as neurological manifestations with mild to advanced progression. This study aimed to determine the clinical neurological characteristics of geriatric patients with COVID-19. Methods. The study was an observational and descriptive study on 27 geriatric patients with COVID-19. All patients’ age was over 60 years old who treated in the in-patient department of Sanglah General Hospital, Denpasar on July 2020 to January 2021. The data were taken from medical records. Outcomes. The mean age of all patients was 70.41 (± 8.902) years, and dominated by the males (51.9%). The majority of manifestations in this study were fever in 13 people (48.1%), unconsciousness in 10 people (37%), hemiparesis in 10 people (37%) and cough in 9 people (33.3%). Conclusions. The clinical neurology characteristics of geriatric patients with COVID-19 vary, which may involve general and neurological manifestations. Promptly accurate diagnosis is necessary for further management.

142 Clinical Characteristics of Geriatric Patients on Denosumab and its Safety Outcome in Geriatric Day-Care, Hospital Kuala Lumpur

Abstract Introduction Denosumab had shown significant effectiveness in managing osteoporosis, but there are insufficient safety data worldwide. This study aimed to identify the baseline clinical characteristics of geriatric patients receiving Denosumab and the safety outcome among this population. Methodology This is a descriptive and retrospective cohort study with universal sampling that reviewed medical records of all geriatric patients of 60 years and above who are on Denosumab in Geriatric Day-care, HKL from 2014 to 2018. Patients who were discharged from Geriatric follow-up and those with untraceable records were excluded. Results and Discussions A total sample of 26 patients were recruited, with the mean age of 81.8 (±5.19) years old and predominantly are female (n=22). All patients were diagnosed osteoporosis based on clinical and imaging. More than three-quarter (n=23) of the subjects had bone mineral densitometry (BMD), and the mean T score is -3.02 (±0.88). Twenty-three patients had history of falls and two-third of them had fracture, predominantly lumbar fracture (n=9). The mean creatinine clearance is 33.23 (±9.78) ml/min, and the mean corrected serum calcium is normal. Six patients had history of infections mainly involving respiratory tract infection (n=4), another six patients had pre-existing dermatological and concomitant respiratory disorder respectively. Twelve patients with the aforementioned pre-existing conditions developed recurrent infections (n=9) and worsening of cutaneous reactions (n=3) post Denosumab initiation, where six of them requires rehospitalization and another three patients required Denosumab discontinuation. Hypocalcemia was not reported since there is an inadequate routine serum calcium monitoring post Denosumab. Conclusion Immunization, infective and electrolyte screenings are warranted to serve as structured baseline monitoring for safety profile of patients receiving Denosumab. The findings of this study are crucial to assist with the development of local Denosumab protocol to guide practitioners for the betterment of patient’s management.

Diagnostic characteristics of geriatric patients admitted to an otorhinolaryngology clinic

Diagnostic characteristics of geriatric patients admitted to an otorhinolaryngology clinic

Infectious Spondylitis: Characteristics of Geriatric Patients and Significance of Surgery

Infectious Spondylitis: Characteristics of Geriatric Patients and Significance of Surgery The goal of this study is to identify the characteristics and common problems of geriatric patients with infectious spondylitis and to explore possible solutions for them.

The prevalence of geriatric problems in the Chilean patient with cancer

Introduction: Chile shows a marked aging of the population and therefore in the future we will be faced with an increasing number of older adults with cancer. Unfortunately in our country is not very currently common the concept of the oncogeriatrics, and only exist two oncology centers in which is usually carried out a comprehensive assessment to the elderly patients. In this scenario to show the high prevalence of vulnerability in the Chilean elderly with cancer and demonstrate the usefulness of the CGA as diagnostic tool, is an essential first step to draw attention to Geriatrics and Oncology societies on a growing problem that involves them directly and eventually lead changes in the public health policies. Objectives: To determine the demographic and clinical characteristics of geriatric patients with cancer through Comprehensive Geriatric Assessment (CGA). Methods: Between July 2011 and May 2013, there was evaluated a random sample of patients of 65 years and older, with recently diagnosed cancer, previous to receive therapy and treated at Cancer Center of the Pontificia Universidad Catolica of Chile. A geriatrician applied the VGA (which included MMSE, MNA, Barthel, Lawton, Charlson, Geriatric depression scale (GDS)), plus Balducci and Rockwood fraiity score, and VES-13. Results: 130 patients patients entered the study. Age average 76 years (66-88).Considered frail 72%, 35% and 58% when assessed by criteria of Balducci, Rockwood and VES-13 respectively. On average, the number of new problems researched was 4 per patient, 52% required assistance with instrumental activities, 22% were dependent in ADL, 52% used inappropriate medications (according to Beers` criteria) 30% had cognitive impairment and 35% met the criteria for depression. 30 % hadmalnutrition. 10 % had an inadequate family support network. 22 % had three or more comorbidities. ECOGwas between 0 and 1 in 85 % of the patients. By comparing these values with a representative sample of Chilean people over 65 years living in the community, it is possible to observe the increased vulnerability of the patient with cancer (Table 1)

Assessing length of stay and associated characteristics of geriatric patients in Northern Ireland

The effective provision of care for the elderly is becoming increasingly more difficult. This is due to the rising proportion of elderly in the population, increasing demands placed on the health services and the financial strain placed on an already stretched economy. The research presented in this paper uses three different models to represent the length of stay distribution of geriatric patients admitted to one of the six key acute hospitals in Northern Ireland and various patient characteristics associated with their respective length of stay. The accurate modelling of bed usage within wards would enable hospital managers to prepare patient discharge packages and rehabilitation services in advance. The models presented within the paper include a Cox proportional hazards model, a Bayesian network with a discrete variable to represent length of stay and a special conditional phase-type model (C-Ph) with a connecting outcome node. This research demonstrates the new efficient fitting algorithm employed for Coxian phase-type distributions while updating C-Ph models for recent elderly patient data.

Drug-Drug Interactions in a Geriatric Outpatient Cohort

The prevalence of drug-drug interactions (DDIs) in a geriatric population may be high because of polypharmacy. However, wide variance in the clinical relevance of these interactions has been shown. To explore whether adverse drug reactions (ADRs) as a result of DDIs can be identified by clinical evaluation, to describe the prevalence of ADRs and diminished drug effectiveness as a result of DDIs and to verify whether the top ten most frequent potential DDIs known to public pharmacies are of primary importance in geriatric outpatients in the Netherlands. All adverse events classified by the Naranjo algorithm as being a possible ADR and drug combinations resulting in diminished drug effectiveness were identified prospectively in 807 geriatric outpatients (mean age 81 years) at their first visit. The setting was a diagnostic day clinic. The Medication Appropriateness Index (MAI) and Beers criteria were used to evaluate drug use and identify possible DDIs. The ten most frequent potential interactions, according to a 1997 national database of public pharmacies ('Top Ten') in the Netherlands, and possible adverse events as a result of other interactions, were described. The effects of changes in medication regimen were recorded by checking the medical records. In 300 patients (44.5% of the 674 patients taking more than one drug), 398 potential DDIs were identified. In 172 (25.5%) of patients taking more than one drug, drug combinations were identified that were responsible for at least one ADR or which possibly resulted in reduced effectiveness of therapy. Eighty-four of the 158 possible ADRs resulting from enhanced action of drugs forming combinations listed in the 'Top Ten' were seen in 73 patients. Only four DDIs resulting in less effective therapy that involved drug combinations in the 'Top Ten' were identified. Changes in drug regimens pertaining to possible interactions were proposed or put into effect in 111 of the 172 (65%) patients with possible DDIs. Sixty-one (55%) of these patients returned for follow-up. Of these, 49 (80%) were shown to have improved after changes were made to their medication regimen. In this study, nearly half of the geriatric outpatients attending a diagnostic day clinic who were taking more than one drug were candidates for DDIs. One-quarter of these patients were found to have possible adverse events or diminished treatment effectiveness that may have been at least partly caused by these DDIs. These potential interactions can be identified through clinical evaluation. In the majority of patients (99 of 172) the potential interactions resulting in possible ADRs or diminished effectiveness were not present in the 'Top Ten' interactions described by a national database of public pharmacies, a finding that emphasizes that the particular characteristics of geriatric patients (e.g. frequent psychiatric co-morbidities) need to be considered when evaluating their drug use. At least 7% of all patients taking more than one drug, and 80% of those with possible drug interactions whose drug regimen was adjusted, benefited from changes made to their drug regimens.

Characteristics of geriatric patients as related to nursing needs.

A series of studies have been conducted at the Health Services Research Centre at the University of Birmingham, England, of nursing needs, nursing workload and staffing levels on geriatric wards in hospitals. The method used to calculate the workload at different levels of skill required takes into account the nursing care needs of individual patients at a defined standard of care, and uses measured event times for necessary items of care, taking account of the patients’ individual characteristics. It also includes an indirect care factor for nursing work which is not directly attributable to the needs of individual patients. A survey of all the geriatric wards in one Region and selected wards in another yielded information on some characteristics of geriatric patients in general, as well as providing data for using a computer package to estimate workload. This paper describes the 7561 patients included in the survey and the rate of occurrence of the recorded dependency characteristics. Previous work has shown that the workload generated by the patients on geriatric wards is strongly dependent upon the care plans in effect for the patients, and hence upon the standard of care upheld (Rhys Hearn, 19794. An earlier study in this series examined the nursing workload generated when care was prescribed at some rather idealised standards of care determined by the ward sisters (Rhys Hearn, 1979b). The present study calculates workload at a less idealistic standard of care based on a Base Line Care Policy (Young and Rhys Hearn, in press) formulated by a Panel including ward sisters, nursing administrators and staff in nursing education. The policy prescribes the frequency with which the main items of nursing care, which account for the bulk of workload, should be carried out. It also provides for the special technical treatments required for individual patients. A survey was conducted in all geriatric wards in the West Midlands Region (Young and Rhys Hearn, 1980) and in one ward in each district of the North West Thames Region. A ‘Patient State Form’ was completed for each patient upon which were recorded characteristics of the patient influencing the method and associated activities (and hence

Some characteristics of geriatric patients.

A group of 255 patients accepted for a geriatric unit in Glasgow was compared with a random sample of old people in the community matched with the patients for age, sex and economic status; and with a group of old people admitted to a general medical unit. The social factors which increased the probability of becoming a geriatric patient were: advanced old age; being a widower, bachelor or spinster; having no children; and living alone. The medical factors were the presence of two or more of the following symptoms: stroke, falls, gait loss, incontinence, and mental abnormality. These symptoms were associated with insufficient community care, heavy burden on relatives, high mortality and low discharge rate from hospital. Geriatric patients are drawn predominantly, although not exclusively, from a ‘hard core’ of socially disadvantaged old people with multiple diseases; they present with symptoms which deprive them of the ability for self-care and frequently they are in the terminal stage of their lives.