Elderly Ones Research Articles

CLINICAL FEATURES, DIAGNOSTIC SIGNIFICANCE, AND PROGNOSIS OF VITREORETINAL LYMPHOMA IN YOUNG PATIENTS.

To investigate the clinical features, diagnostic approaches, and outcomes of young patients with vitreoretinal lymphoma. Fifty-one vitreoretinal lymphoma patients (97 eyes) referred to the Eye and ENT Hospital of the Fudan University from 2011 to 2020 were grouped based on their onset age (age ≤50 years and age >50 years). Complete eye examinations, evaluation of systemic conditions, and biological analysis of intraocular fluids were performed. Young patients accounted for 31.4% (n = 16) of the cohort. More eyes had retinal/subretinal pigment epithelial infiltration (20 [64.5%] vs. 23 [34.8%]; P = 0.018) in young patients than in elderly ones. The mutation rate of Myeloid Differentiation Factor 88 gene (MYD88) was significantly lower in young patients than in elderly ones (5 [50%] vs. 21 [91.3%]; P = 0.016). The median time to new onset of central nervous system lymphoma was significantly shorter in young patients (11.7 vs. 36.2 months; P = 0.012). However, mean overall survival did not differ between the 2 groups (64.9 vs. 57.5 months; P = 0.871). Early diagnosis and central nervous system evaluation are crucial for young vitreoretinal lymphoma patients with rapid central nervous system involvement. Meanwhile, young vitreoretinal lymphoma patients have some unique features, including more retinal/subretinal pigment epithelial infiltrations and lower MYD88 mutation rates.

Factors Affecting Hospitalization and Length of Hospitalization of the Patients with Covid-19

Factors Affecting Hospitalization and Length of Hospitalization of the Patients with Covid-19

Concept development and prototypes for robotic systems in active assisted living

Active and Assistive Living, AAL, is a concept that attention have been focused on in the last decades. There are many young people with disabilities, such as visually impairment, missing limbs, AVC stroke problems. There are also many old people who have locomotion, eyesight and many other health problems that make their lives so very difficult. The authors of this paper present aspects of their research regarding new concepts, models and prototypes (virtual and 3D printed) of robotic systems intended to assist people with disabilities for an active and normal life. An innovative open source system for guidance of young people (but, also elderly ones) with eyesight problems has been developed. It is intended to be used indoors also outdoors, to provide audio guidance, haptic guidance, or both. Research aspects on a bionic prosthesis for the upper limb are evidenced. The focus is on a two fingers model that should be considered as the proof of concept. Innovative mechatronic system designed to help people, who can no longer stand and / or walk is further presented. A virtual platform concept aimed at the integration of all these devices, and similar others, to communicate by IoT is shown.

Exploring opioid addictions and responsibilities: almost lost in the midst of the Covid-19 pandemic

PurposeThe purpose of this study is to highlight the overshadowing of the opioid crisis due to Covid-19 pandemic. Opioids are affecting increasing numbers as the current opioid overdose death rate is increasing to 209 per day. While there appears light shining on the end of the Covid-19 pandemic with the advent of a fourth vaccine, there is no such light for the opioid epidemic. Based on a sample of 603 relatively educated adults in NE Ohio, the health harm caused by both crises, prescribing physician blaming, high levels of income loss and physical and emotional burdens shared by the respondents were obvious and striking.Design/methodology/approachUsing Bertram et al. (2014) theory of the blame model, the number of results concerning gender and personally involvement of friends and family members, including men empathy increased with greater knowledge of numbers of addicted opioid users in their personal contracts.FindingsUnfortunately, many women had to remain home taking care of children and elderly loved ones at greater percentages than their male counterparts may account for less empathy as such addicted users have become a burden to economically impaired families. This tendency for placing blame for circumstances with twin crises appears to follow a relatively predictable path as modeled by Bertram et al. (2014) (i.e. denial, justification and excuse).Originality/valueThese are few studies that are studying the amplification effects of the Covid-19 pandemic context on the current opioid crisis.

Hypoglycemia following the use of glucagon-like peptide-1 receptor agonists: a real-world analysis of post-marketing surveillance data.

BackgroundRecent evidence has emerged concerning hypoglycemia following the application of glucagon-like peptide-1 receptor agonists (GLP-1RAs). Nevertheless, few real-world investigations have been performed to determine the clinical characteristics, onset, and outcomes of hypoglycemia associated with different GLP-1RAs. This study aimed to compare and assess the relationship between various GLP-1RAs and hypoglycemia in a large population based on updated data from the Food and Drug Administration Adverse Event Reporting System (FAERS).MethodsBayesian and disproportionality analyses were applied to data mining in order to investigate suspected cases of hypoglycemia following various GLP-1RAs using the FAERS data between January 2004 and September 2020. We also evaluated the onset time, fatality risks, and hospitalization proportions of GLP-1RA-related hypoglycemia.ResultsWe identified 1,164 GLP-1RA-associated hypoglycemia cases, which seemed to affect more middle-aged patients than elderly ones. Also, females were more affected than males. Lixisenatide demonstrated a stronger association with hypoglycemia compared to other GLP-1RAs, according to the highest reporting odds ratio (ROR) (28.03, 95% confidence interval =15.92, 49.32), empirical Bayes geometric mean [26.00, 95% confidence interval (CI): 16.20], and proportional reporting ratio (PRR) (26.01, χ2=313.37). The median time to hypoglycemia onset was 5 days (interquartile range, 0–67.75 days) following GLP-1RA treatment. In general, GLP-1RA-associated hypoglycemia resulted in fatality and hospitalization proportions of 3.53% and 56.08%, respectively.ConclusionsBy analyzing the FAERS data, we outlined the association between hypoglycemia and different GLP-1RAs in greater detail in terms of clinical features, onset, and outcomes. Among all six GLP-1RAs, lixisenatide demonstrated the strongest association with hypoglycemia while no relationship between albiglutide and hypoglycemia was observed. Attention should be given to GLP-1RAs when used in patients with high risks of hypoglycemia.

Evaluation of central venous catheter and other risk factors for mortality in chronic hemodialysis patients with COVID-19 in Brazil.

PurposeHemodialysis patients with COVID-19 are at increased risk of death. We aimed to describe the characteristics of a cohort of Brazilian hemodialysis patients with COVID-19 and assess their mortality rate and risk factors for death.MethodsRetrospective cohort study of 741 Brazilian hemodialysis patients with confirmed COVID-19 from Feb–Dec/2020, of 52 dialysis centers of the country. We analyzed comorbid conditions, sociodemographic factors, and dialysis-related parameters. To detect risk factors for mortality in hemodialysis patients, we performed multivariable Cox proportional hazard regression analysis. Survival was analyzed by Kaplan–Meier.ResultsFrom 9877 hemodialysis patients, 741 were diagnosed with COVID-19. Mean age was 57 ± 16 years, 61% were male, and 51% white. The most frequent symptoms were fever (54.1%), cough (50.9%), and dyspnea (37.2%); 14.2% were asymptomatic. There were 139 deaths (18.8%), with 66% within the disease’s first 15 days. 333 patients (44.9%) required hospitalization, and 211 (28.5%) were admitted to an intensive care unit. The cumulative probability of survival at 90 days of diagnosis was 79% (95% CI 76–82%). In the fully adjusted multivariate model, the risk factors significantly associated with death were diabetes mellitus (HR 1.52, 95% CI 1.05–2.19, P = 0.026), use of a central venous catheter (CVC) (HR 1.79, 95% CI 1.22–2.64, P = 0.003), age (HR 1.03, 95% CI 1.01–1.04, P < 0.001), and origin from the North vs. Southeast region (HR 2.60, 95% CI 1.01–6.68, P = 0.047).ConclusionsHemodialysis patients using a CVC as the vascular access, aside from diabetic and elderly ones, should be closely monitored due to their high risk of death in the course of the COVID-19.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11255-021-02920-9.

Preparation and optimization of fast disintegrating tablets of isosorbide dinitrate using lyophilization method for oral drug delivery.

Background: Orally disintegrating tabletsrapidly disintegrate in saliva and then swallowed without the need for water. Materials & methods: The orally disintegrating tablets were prepared by freeze-drying of an aqueous dispersion of isosorbide dinitrate containing a matrix former (gelatin), a cryoprotectant (mannitol), a plasticizer (glycerin) and a dissolution enhancer (Tween/polyethylene glycol). Results: Results demonstrated that the selected formulation, Ft9, disintegrated within 1 min and showed faster dissolution rate compared with the commercial tablet. Conclusion: Having a fast disintegration time, the developed lyophilized tablet does notneed to be swallowed as a whole. So, it is a convenient solid oral dosage form for the patients who have difficulty with swallowing such as the pediatric and elderly ones.

Prognosis and follow-up of young patients admitted to a critical coronary care unit with acute coronary syndrome

Abstract Funding Acknowledgements Type of funding sources: None. Introduction The presence of young patients admitted to a Critical Coronary Care Unit (CCCU) with the diagnosis of Acute Coronary Syndrome (ACS) is very common nowadays. The prognosis of these patients seems to be better than the elderly ones, although there are few records that endorse this statement. Objective Our aim is to carry out a follow-up of this population and study their prognosis during the index hospitalization and the follo-up. Methods Retrospective, descriptive, unicentric and observational registry of young patients (&amp;lt;45 years old) admitted to one CCCU with the diagnosis of ACS between January 2.010 and November 2.020. The follow-up of these patients was performed using the electronic platform of Andalusian Health Security System. Results A total number of 252 patients were included in the registry, with a mean age of 40 years old, being male 206 (81,7%). The main reason of the admission was ACS with persistent ST segment elevation (STEMI) (177 patients – 70,2%). The most prevalent risk factor in this population was active smoking (198 patients – 78,6%). The main underlying mechanism of the ACS was the rupture of an atherosclerotic plaque (194 patients – 77%) and in most cases, there was only 1 coronary artery affected (153 patients – 60,7%). Intra-hospital mortality was low (2 patients died of cardiovascular cause – 0,8%, and 1 died of non-cardiovascular cause – 0,4%). Left ventricle ejection fraction (LVEF) at the discharge was preserved in 166 patients (65,9% - mean 58%), and reduced (&amp;lt;40%) in 37 patients (14,7%). The median of the follow-up was 77 months (minimum 1 month and maximum 132 months). A total number of 5 patients died during this follow-up (2%, 3 during the first year), 3 of them of cardiovascular cause; these 3 patients had reduced LVEF at the discharge. During this follow-up, 64 (25,4%) patients were re-admitted to the hospital due to cardiovascular causes, most of them (30 – 11,9%) with the diagnosis of chest pain and 20 of them (7,9%) with the diagnosis of a new ACS. Conclusions Young patients admitted to our CCCU with the diagnosis of ACS presented most frequently with STEMI, affecting predominantly one coronary artery. Most of them had preserved LVEF at the discharge. The prognosis of this group of patients is good, with a low intra-hospital mortality and during the follow-up, with clear relation with the presence of reduced LVEF at the discharge. Re-admission was relatively frequent, mostly due to chest pain.

Increased oxidative stress in elderly leprosy patients is related to age but not to bacillary load.

Leprosy continues to be a public health problem in Brazil. Furthermore, detection rates in elderly people have increased, particularly those of multibacillary (L-Lep) patients, who are responsible for transmitting M. leprae. Part of the decline in physiological function during aging is due to increased oxidative damage and change in T cell subpopulations, which are critical in defense against the disease. It is not still clear how age-related changes like those related to oxidation affect elderly people with leprosy. The aim of this work was to verify whether the elderly leprosy patients have higher ROS production and how it can impact the evolution of leprosy. 87 leprosy patients, grouped according to age range and clinical form of leprosy, and 25 healthy volunteers were analyzed. Gene expression analysis of antioxidant and oxidative burst enzymes were performed in whole blood using Biomark's microfluidic-based qPCR. The same genes were evaluated in skin lesion samples by RT-qPCR. The presence of oxidative damage markers (carbonylated proteins and 4-hydroxynonenal) was analyzed by a DNPH colorimetric assay and immunofluorescence. Carbonylated protein content was significantly higher in elderly compared to young patients. One year after multidrug therapy (MDT) discharge and M. leprae clearance, oxidative damage increased in young L-Lep patients but not in elderly ones. Both elderly T and L-Lep patients present higher 4-HNE in cutaneous lesions than the young, mainly surrounding memory CD8+ T cells. Furthermore, young L-Lep demonstrated greater ability to neutralize ROS compared to elderly L-Lep patients, who presented lower gene expression of antioxidant enzymes, mainly glutathione peroxidase. We conclude that elderly patients present exacerbated oxidative damage both in blood and in skin lesions and that age-related changes can be an important factor in leprosy immunopathogenesis. Ultimately, elderly patients could benefit from co-supplementation of antioxidants concomitant to MDT, to avoid worsening of the disease.

Correlation Constraints for Regression Models: Controlling Bias in Brain Age Prediction

In neuroimaging, the difference between chronological age and predicted brain age, also known as brain age delta, has been proposed as a pathology marker linked to a range of phenotypes. Brain age delta is estimated using regression, which involves a frequently observed bias due to a negative correlation between chronological age and brain age delta. In brain age prediction models, this correlation can manifest as an overprediction of the age of young brains and an underprediction for elderly ones. We show that this bias can be controlled for by adding correlation constraints to the model training procedure. We develop an analytical solution to this constrained optimization problem for Linear, Ridge, and Kernel Ridge regression. The solution is optimal in the least-squares sense i.e., there is no other model that satisfies the correlation constraints and has a better fit. Analyses on the PAC2019 competition data demonstrate that this approach produces optimal unbiased predictive models with a number of advantages over existing approaches. Finally, we introduce regression toolboxes for Python and MATLAB that implement our algorithm.

Clinicopathological characteristics and prognosis of young patients with upper tract urethelial carcinoma

Objective: To investigate the clinicopathological characteristics and prognosis of the young patients with upper tract urothelial carcinoma (UTUC). Methods: The clinical data of 839 UTUC patients receiving radical nephroureterectomy at Peking University Third Hospital, Beijing, China from September 1999 to September 2019 were retrospectively analyzed. The patients were divided into the young (<55 years old, 107 cases) and elderly groups (≥55 years old, 732 cases). After the variables were balanced using propensity score matching, the patients were paired at a 1∶1 ratio. The clinicopathological characteristics and survival rates were compared between the two groups. Results: Compared with the elderly group, the young group had more males (P=0.047), a higher rate of smoking history (P=0.042), a higher rate of renal transplantation history (P<0.01), and fewer symptoms of hematuria (P=0.048). The 1-, 3-, and 5-year cancer specific survival (CSS) rates after surgery were 77.9%, 62.2%, 60.2% and 85.7%, 70.3%, 65.0% in the young and the elderly groups, respectively. The CSS and disease free survival (DFS) of young patients were shorter than those of elderly patients, but the difference was not significant either by subgroup analysis or propensity matching analysis (P>0.05). Young female patients had shorter CSS (P=0.034) and DFS (P=0.046) than elderly females. Perineural invasion (CSS, P=0.002; DFS, P<0.01) and extensive necrosis (CSS, P=0.041; DFS, P=0.001) were the independent risk factors of survival in young patients. Conclusions: Young UTUC patients are different from elderly ones in the frequencies of gender, smoking history, renal transplantation history, and first symptoms. Young female patients have a worse prognosis than elderly female ones. Perineural invasion and extensive necrosis could help clinicians to evaluate the prognosis of young UTUC patients.

근감소증 기준에 따른 악력수준과 남녀 노인의 체력차이

Purpose: The purpose of this study is to compare and analyze the difference in physical fitness according to grip strength in elderly men and women (based on the European Society of Sarcopenia: male 30kg, female:20kg more and less).<BR> Method: The data were obtained from the 2015 National Physical Fitness Survey. The subjects, total of 880 adults (369 men and 511 women) aged 65 years or older were measured muscular strength, muscular endurance, flexibility, balance and cardiovascular endurance. All measurements were presented with a mean (M) and standard deviation (SD), and an independent t-test was used to compare differences in physical fitness level according to grip strength. The statistical significant level was set to α＝.05.<BR> Results: The results of this study were as follows. 1) The normal group of male Koreans had relatively superior muscular strength, muscular endurance, balance, and cardiovascular endurance compared to those of the sarcopenia group (p<.05). 2) On the other hand, the normal group of Korean women was relatively superior in all measurement factors (muscular strength, muscular endurance, flexibility, balance, cardiovascular endurance) compared to those of the sarcopenia group (p<.05).<BR> Conclusion: Although there are some dependent variables in differences between genders, we could see that grip strength is an important factor in predicting physical fitness level for elderly men and women. Therefore, in order to sustain and improve the physical fitness level of the elderly ones, efforts to strengthen grip strength should be given priority.

Did the elderly suffer more from housing deprivation? Evidence from Poland

PurposeThe elderly seem to be more subject to housing problems due to lower income, older age of the housing stock and lower mobility. Nonetheless, housing deprivation (HD) is commonly analysed amongst the general population. Less is known about the differences between age clusters, which seems to be a crucial issue in countries like Poland due to population ageing. What is more, the current literature usually analyses only the occurrence of HD, while also an accumulation of its indicators seems to be substantial. The aim of this article is to identify the differences in HD (its occurrence and accumulation) amongst elderly and non-elderly households and to diagnose the risk factors behind those phenomena.Design/methodology/approachThe HD index was calculated and compared. Next, the multinomial logit models were used to assess risk factors of HD.FindingsThe study showed that, surprisingly, HD in Poland occurs more frequently amongst non-elderly households. The elderly ones suffered more from housing cost overburden, while non-elderly from the overpopulation. In large part, analysed risk factors had a stronger influence on housing conditions of the elderly than non-elderly households.Social implicationsSocial policy tools should focus on the situation of single elderly households, especially living in houses, often in villages. This group is particularly affected by problems with the quality of the dwelling and housing cost overburden.Originality/valueIn the paper, the occurrence and accumulation of HD indicators were analysed. The authors applied a methodological framework that is applicable to other European Union (EU) member states based on the EU Survey on Income and Living Conditions (EU-SILC) data. It is possible to continue the research study and compare different economies.

An Android Based Home Electrical Appliance Control System

Electric bulbs, television sets, fans and other home appliances are usually controlled largely with human effort using mechanical switches. However, over the past decade, there has been drastic improvement and advancement in consumer electronics and embedded systems. This has ensured a home environment where appliances can be connected and controlled using wireless technology and an Android smart phone. This study demonstrates the design of an automated system to assist and provide support in order to fulfill the needs of the physically disabled and elderly ones in controlling electrical appliances in homes. The heart of the control system is the wireless Bluetooth technology which provide remote access from a smart phone to a Bluetooth module and then to a control and switching unit. Bluetooth wireless connection enables the system to communicate with a Java application on an Android smart phone without cable. The user can easily touch on the phone screen to control the home appliances linked to the system. This method which requires minimal human effort is able to assist the disabled, sick and elderly people who have difficulties with locomotion. Thus, a control system has been designed which offer a low design, installation ease, quick response time and a user friendly interface in controlling home electrical appliances.Keywords - Android Phone, Bluetooth, Microcontroller, Relay and Switching

Patient with polymyalgia rheumatica — how to prevent gastrointestinal damage?

Basis. The problem of multimorbidity and related polypragmasia is highly relevant for health practitioners. Providing treatment a doctor should keep in mind itsall possible negative consequences that might exacerbate other diseases. One of the most current problems of modern pharmacotherapy is the development of gastropatia and other gastrointestinal lesions because of drug intake. It is extremely important for rheumatologic patients, especially elderly ones, due to side effects of nonsteroidal anti-inflammatory drugs and glucocorticoids. Reasonable approach to the prescription of this therapy and side effects prevention is a significant factor of the preventive work of the therapist and the general practitioner of the outpatient service. In patients with rheumatic polymyalgia we showed an approach to long-term treatment of corticosteroids in elderly patients, the aim of which is to achieve a stable remission of the disease and to minimize the undesirable effect of the medication on the gastrointestinal tract.Aim. Provide an algorithm for the approach to identifying the risk factors of medicinal gastrointestinal lesions and methods for their prevention.Material and methods. We analyzed literature sources, including Russian guidelines over the last 10 years.Results. In the article we present an algorithm for detecting the risk of developing gastrointestinal tract lesions against the background of corticosteroid therapy in elderly patients and ways of preventing it.Conclusion. The prevention of unwanted drug reactions is an important aspect of a doctor’s work, especially in the treatment of elderly patients. The presented algorithm for identification of risk groups and prevention of side effects is intended to help the practical doctor in working with this category of patients.

Global Elderly Migrations and Their Impact on Health Care Systems.

Demographic transitions that occur in decreased dynamics of natality and rising number of elderly in population structures constitute a challenge for all national economies. Another global phenomena are large-scale migration processes driven by intensification of globalization process, development of technologies, and telecommunications. Although both these phenomena were vastly addressed in many ways in scientific literature, a notifiable fact is that there are only few researches that would investigate them in connection and consider migration of older people and its consequences, especially for health systems. Despite the fact that generally the likelihood of migrations reduces along with age, in some countries a higher share of migrants older than 65 years in reference to the entire group of migrants are being observed. It is the more essential that groups of seniors represent an increasing percentage of people. There are also differences in between standard reasons for migrations in young people and the factors affecting migrations in elderly ones. Many variables can influence migration decisions among older people, and they can be affected by seniors' health conditions, levels of health care within the target countries they migrate to, and the living standards. Such factors as population aging, reduced fertility, and international migration have affected the changes in demographic profiles of many countries. The consequence of migration decisions in the group of seniors is, among others, the impact on health care systems of single nation states, which are more and more important elements of economic, social, and financial systems.

Conducting Other People’s Affairs Without a Power of Attorney in a Pandemic: Poland and Ukraine

The Covid-19 coronavirus pandemic has caused changes in all areas of human life. The field of law is no exception to this list. In particular, the issues of conducting other people’s affairs without a power of attorney have become especially relevant, as social distancing and restrictions on social activity have led to a significant increase in the practical need for the application of this legal institution. The significance of this study is also important in connection with the comparative analysis of the normative aspect and the practical measurement of the application of the institute of conducting other people’s affairs without a power of attorney in Ukraine and Poland. These two countries are comparable in territory, number of citizens, legal tradition, but Poland has become member of the European Union, while Ukraine has remained on the sidelines of European civilization. The dialectical method, the method of comparative analysis and system analysis were chosen as the methodological basis of the research. The authors of the article concluded that institute of conducting other people’s affairs without a power of attorney is characterized by an increased level of social utility. In such cases, the one who protects the interests of others without a power of attorney, as a rule, acts not only in the interests of the individual but also in the interests of the society. Thus, it helps to protect single people, the elderly ones, disabled individuals and other groups which are socially unprotected and thus prevent the pandemic spread.

Geragogy as a pedagogical subdyscipline

The text presents geragogy ( first of all from from polish research perspective) that is frequently described as pedagogy of old age, but here presented as a pedagogical subdiscipline dealing with education aimed at old age. It points to the beginnings of geragogy and its position in the system of scientific research concerning old age and ageing that are, on the one hand pedagogical and on the other remaining in the realm of gerontology. It presents the subject matter of geragogy highlighting the key research context that education plays here, including its various functions. The work outlines the sections and contemporary fields of geragogical research and also reveals the character of geragogy as science as well as its methodology. Additionally, it presents the model of a geragogue as a specialist dealing with educational support for people (not only the elderly ones) as far as experiencing old age and the processes of ageing are concerned.

Diabetic neuropathy in the elderly

The increase in the diabetes mellitus (DM) prevalence and incidence has taken on the features of the epidemic. Particularly often, DM occurs in the elderly and senile patients, while at least half of the cases of diabetes in this population remain undiagnosed. DM contributes to the deterioration of the quality of life, causes formation of dependence and progression of various geriatric syndromes leading to increased mortality. Elderly age is an independent risk factor for diabetic neuropathy. The main clinical forms of which are represented by chronic sensorimotor and autonomic impairments, complicated by impaired cardiovascular, gastrointestinal and urogenital functions, as well as chronic neuropathic pain syndrome. Progression of diabetic neuropathy aggravates walking and balance disorders, increases the risk of falls and loss of mobility, and significantly increases the risk of adverse diabetes outcomes. The article discusses in detail risk factors, pathogenesis, differential diagnosis and the possibilities of clinical and non-clinical evaluation of patients with suspected diabetic neuropathy. Possibilities for pain assessment in elderly people with communicative disorders or concomitant cognitive impairment are demonstrated. The article presents an algorithm for management of diabetic neuropathy in elderly ones, ways for optimization of risk and benefit balance, as well as the possibility of etiopathogenetic and symptomatic treatment of pain, autonomic disorders and prevention of late complications of diabetes with use of alpha-lipouc acid, taking into account key characteristics of discussed population.

Acute kidney injury following the use of different proton pump inhibitor regimens: A real-world analysis of post-marketing surveillance data.

Recent evidence has concerned acute kidney injury (AKI) after the proton pump inhibitor (PPI) application. There are few real-world studies to compare the occurrences, clinical features, and prognosis of AKI related to various PPI regimens. We aimed to evaluate and compare the links between different PPIs and AKI in a large population by investigating the Food and Drug Administration Adverse Event Reporting System (FAERS) until recently. Disproportionality analysis and Bayesian analysis were used in data mining to screen the suspected AKI after different PPIs based on the FAERS from January 2004 to December 2019. The times to onset, fatality, and hospitalization rates of PPI-associated AKI were also investigated. We identified 19522 PPI-associated AKIs, which appeared to influence more middle-aged patients than elderly ones (53.04% vs 33.94%). Women were more affected than men (55.42% vs 44.58%). Lansoprazole appeared a stronger AKI association than other PPIs, based on the highest reporting odds ratio (reporting odds ratio=20.8, 95% confidence interval=20.16, 21.46), proportional reporting ratio (proportional reporting ratio=15.55, χ2 =73899.68), and empirical Bayes geometric mean (empirical Bayes geometric mean=15.15, 95% confidence interval=14.76). The median time to AKI onset was 446 (interquartile range [IQR] 16-2176) days after PPI administration. PPIs showed a significant difference in average time to AKI onset (P<0.001), with the shortest of 9 (IQR 3-25) days for rabeprazole and the longest of 1221 (IQR 96.5-2620) days for esomeprazole. PPI-associated AKI generally led to a 5.69% fatality rate and an 8.94% hospitalization rate. The highest death rate occurred in rabeprazole (15.35%). Based on the FAERS database, we profiled AKI related to various PPIs with more details in occurrences, clinical characteristics, and prognosis. Concern should be paid for PPIs when applied to patients with a tendency for AKI.