Geriatric Age Group Research Articles

Oral Leiomyoma – A Rare Presentation in a Child

Leiomyoma is a benign smooth muscle tumour most commonly found in the myometrium of the uterus GI tract skin and lower extremity of the body with abundant smooth muscle. These tumours have been reported to occur at any age and reported in literature as firm slow growing locally circumcised mass which may present as a submucosal nodule. The highest incidence occurs between the 4th to 5th decades of life. Occurrence is unusual and uncommon in paediatric and geriatric age groups. Its occurrence in oral cavity is a rare phenomenon due to the paucity of smooth muscle tissue in the oralperioral region. Most of the cases reported were in adults and very few cases were reported in children. Frequent intra-oral sites of occurrence include tongue lips palatal tissue buccal mucosa and retromolar trigone. The tumours are commonly asymptomatic although some tumours maybe symptomatic and painful. The diagnosis is confirmed by histological studies with the use of specific stains. Surgical excision of the lesion is reported to be the treatment of choice as recurrence is rare and patient responds well to the treatment. This report discusses about a case of rare occurrence of leiyomyoma in a 9-year-old girl who presented with a growth in the oral cavity on the right lower jaw extending to the retromolar region with associated difficulty in speech and chewing for past two months.

Evaluation of the Potentially Inappropriate Cardiovascular Medication Prescription in Elderly: A Nationwide Study in Turkey.

Elderly comprises a specific group due to possible alterations in the effects of drugs and comorbidities. We aimed to identify for the first time the characteristics and rates regarding the inappropriate prescriptions of cardiovascular system medications in the geriatric age group in Turkey. Cardiovascular system medications prescribed electronically by family physicians to patients aged 65 and over, in the years 2015 and 2016, were obtained through Prescription Information System administered by the Ministry of Health. Evaluation of potentially inappropriate prescriptions was done according to the 'Beers Criteria 2015 update.' Prescription rates for each group were evaluated under sub-breakdowns for the specialty of family physicians, gender, age groups, and 'Nomenclature of Territorial Units for Statistics' regions. Approximately 65 million prescriptions were evaluated. The rate of potentially inappropriate cardiovascular medication prescribing was 0.33%. This raised to 11.56% when 'drugs to be used with caution' were included. It was observed that potentially inappropriate drugs have been prescribed more by specialist family physicians. The most frequently prescribed potentially inappropriate drugs were doxazosin in the diagnosis of hypertension and methyldopa regardless of indication. Diclofenac-warfarin was the most commonly prescribed concomitant drug use in the potentially clinically important drug-drug interactions group. The rate of potentially inappropriate drug prescribing was higher in males and in aged 80 years and older. This pharmacoepidemiological study draws attention to potentially inappropriate cardiovascular system drugs prescribed in primary care settings to the elderly. The rate of potentially inappropriate cardiovascular system drug prescribed was found to be very low in Turkey.

Unmet Need for Screening for Diabetes Mellitus, Hypertension, and Dyslipidemia in a Population That Is at Risk for NCDs; A Study Among Older Adults in Kottayam District, Kerala

Background: More than half of the people in the geriatric age group have a history of at least one chronic illness, the majority of which are associated with the cardiovascular system. Hypertension, dyslipidemia, and diabetes mellitus are recognized risk factors for cardiovascular disease morbidity and mortality. The early detection of noncommunicable diseases (NCDs) has been found to reduce the disease burden and the associated complications. The study aims to assess the unmet need for screening of NCDs among older adults in the Kottayam district. Methods: A cross-sectional study was conducted among 420 older adults (60 years and above) in all 11 blocks of the Kottayam district using a structured interview schedule. Statistical analysis using proportions with appropriate stratification was undertaken using SPSS Version 26. Results: The unmet need for dyslipidemia screening (45.5%) was the highest among the screening. Employment status, socioeconomic status, and education were associated with the unmet need for dyslipidemia screening. Education, employment status, current means of sustenance, and socioeconomic status were associated with the unmet need for screening of diabetes mellitus. The unmet need for screening of only dyslipidemia was 22.4%. Among the participants with hypertension and diabetes mellitus, more than three-fourths (77.0%) had an unmet need for dyslipidemia screening. Conclusions: Unmet need for screening of dyslipidemia was the highest among all the 3 diseases. About one-eight of those aged 60 and above have not been screened appropriately for all the 3 diseases. Any programmatic effort needs to address this to reduce the burden of NCD morbidity among the elderly.

Carbapenem-resistant biofilm-producing multidrug resistant Klebsiella pneumoniae induced hospital-acquired infections and analysis of resistant genes

In recent years, drug resistance has caused a significant number of fatalities. This review focuses on the emergence of medication resistance in Klebsiella pneumoniae strains associated with biofilm development, neonatal sepsis, aging, and secondary K. pneumoniae infection in COVID-19 cases. This review is an exclusive survey of >200 research articles and >100 review articles indexed in the Web of Science list with the keywords “K. pneumoniae,” “drug resistance,” “sepsis,” “neonatal sepsis,” “sepsis in older age,” “secondary infection,” “biofilm production,” “secondary infection in COVID-19,” “drug resistance genes,” and “whole genome sequencing”. In order to protect antibiotic susceptibility and to provide an overview of the biofilm forming mechanisms among gram-negative bacteria, the review discusses the function of multidrug-resistant K. pneumoniae in the production of biofilms. Additionally, K. pneumoniae’s role in contemporary cases of sepsis, spread of medication resistance in hospitals, and sepsis caused by K. pneumoniae in the geriatric age group are discussed. A summary of current approaches and the identification of drug resistance genes utilizing a whole genome sequencing technique are also reviewed in this article.

Hemiarthroplasty in geriatric population with neck femur fracture: A retrospective study of 43 cases

Abstract Introduction: Hip fractures in the elderly have represented a major public health concern. Studies have shown that over 90% of the patients having these fractures are people of more than 50 years. These fractures have been classified according to their anatomical location into the neck of femur fracture, intertrochanteric fracture, and subtrochanteric fracture. The neck of femur fractures is associated with high mortality in the elderly compared to young adults. Surgical treatment is an established gold standard, with the option being osteosynthesis and hip replacement. Hemiarthroplasty is one of the gold-standard treatments chosen for the geriatric age group and has yielded universally acceptable results. Materials and Methods: The study evaluates the clinical, radiological, and functional outcomes of hip hemiarthroplasty in elderly with fracture neck of the femur Data of patients above 60 years who were operated on for fracture neck of the femur by bipolar hemiarthroplasty from May 2018 till December 2021were retrieved from the Medical Records Department of SCL Municipal General Hospital, affiliated to NHL Municipal medical college. The patients fitting the inclusion criteria were selected for the study. The sample size was calculated to be 43. Data were collected from the inpatient files, and then patients were asked to complete the questionnaire form during the final follow-up. All the patients were evaluated clinically and radiologically during the follow-up, and the functional outcome was assessed using the Harris Hip Score. Thirty-five patients had a domestic fall as the mode of injury. The lateral decubitus position of all patients was used during the operation that was performed using the Southern Moore approach. Forty patients received cemented femoral stems; the remaining three received press-fit ones. Results: The average age was calculated to be 71.86 years with the male-to-female ratio of 1: 1.15 with an average follow-up of 12.7 months. Eight patients had acetabular erosion at the end of 1 year. There was no femoral stem malalignment or aseptic loosening at the final follow-up. Nine patients had excellent Harris Hip scores, and five had fair scores. The remaining 29 patients had good Harris hip scores. Bipolar hemiarthroplasty has served us well in the study. Forty-one patients were able to get back to their preinjury functional level. Only one patient reported major pain in the hip at the final follow-up. In this study, there was no incidence of dislocation or revision surgeries. Conclusion: The present study modular bipolar hemiarthroplasty provides better pain relief with early mobilization and a good level of return to daily routine activities with minimal complications.

Geriatric Health Status in a Rural Area of North Karnataka – A Cross-sectional Study

Abstract Context: Today, older people are starting to form a higher proportion of the entire population in the whole community due to an increase in life expectancy. In the future, the challenge for our health care is to ensure proper quality of life, especially for the rural elderly who are devoid of basic amenities. This study attempts to assess the health status of the elderly in a rural area of Vijayapura district, which can help to plan health-care facilities for the old in this part of northern Karnataka. Aims: The aims of this study included the study of the sociodemographic profile and finding out the morbidity pattern among the rural geriatric age group. Settings and Design: The current study was done as cross-sectional research undertaken in Ukkali, the rural field practice areas of a tertiary care hospital. Materials and Methods: One hundred and seventy-five elderly selected by the systematic random sampling method were included in this study. The participants were interviewed using pretested and semi-structured questionnaires through house-to-house visits and data were collected. Statistical Analysis: The statistical analysis was done using Chi-square test and proportions. Results: The most commonly prevalent morbidities found were joint pain (47.1%) and hypertension (34.3%). Association was found between various morbidities and habits in the rural elderly. Conclusion: The present study concludes that health demand in the elderly is of high importance in the Indian scenario, especially in rural areas. Efforts are needed to educate and make these elderly aware of healthy aging.

The Effect of the COVID-19 Pandemic on Vaccination Behaviour of Individuals over the Age of 65 Years in Turkey: Single-Centre Experience

The aim of this study is to evaluate the awareness of individuals over 65 years of age who have had the COVID-19 vaccine at the Samsun Research and Training Hospital and to evaluate whether the COVID-19 pandemic affected the vaccination behaviour in the geriatric age group. A total of 290 people who were vaccinated against COVID-19 at the Samsun Training and Research Hospital between 16 April 2021 and 16 April 2022 and volunteered to participate in the study were included. The questionnaire form was created by the researchers. According to the national and global guidelines, the seasonal influenza vaccine, Td or Tdap vaccines (tetanus, diphtheria, and pertussis), shingles vaccine, and pneumococcal conjugate vaccine (PCV15 or PCV20), have been recommended to all adults over the age of 65. It was questioned whether the participants had the vaccines recommended for them before and after the pandemic, if they were not vaccinated, what were the reasons, and whether the COVID-19 pandemic affected the general view on vaccination in this age group. Demographic data and comorbidities were also recorded. After each response that showed that the participant was not vaccinated, reasons were investigated with new questions to find out the causes of vaccine refusal or vaccine hesitancy. Finally, all participants were asked whether they would have the relevant vaccinations when offered. It was shown that 282 (94.3%) of the 299 people who participated in the study were considering getting a regular COVID-19 vaccine from now on, while 84.3% of the participants mentioned that the COVID-19 pandemic had a positive effect on their general vaccination behaviour. While 39 (13%) people stated that their view on vaccination was not affected by the pandemic, 8 (2.7%) people stated that it was negatively affected. The most common reason about low vaccination rates before the pandemic was a lack of enough knowledge about the recommended vaccines. The pandemic increased the vaccination awareness among the adult population. We think that vaccination rates may be improved by education of the geriatric population on this subject.

USE RWE TO IMPROVE DRUG INFORMATION FOR GERIATRIC PATIENTS

Abstract Older adults are the main users of medications. However, they are usually excluded from clinical trials due to comorbidity and polypharmacy. Older adults, especially those 75 years and older, are underrepresented in clinical trials. This creates a unique opportunity to use RWE to improve the quantity and quality of drug information for geriatric patients. The quality of RWD is critical to have information on patient population, comparator, measurement, and endpoints. Data linkage is encouraged if key variables are not included in one data source. In addition, external controls based on RWE can be used when clinical trials are unethical or impractical. They can be applied for older adults, rare diseases, and under-represented minorities. For conditions common in older adults (e.g. Alzheimer's disease, lung cancer, and osteoporosis), RWE is greatly needed for all geriatric age groups. The entire spectrum of geriatric populations could identify age differences in efficacy and safety outcomes.

Study of Corelation of Obesity with Comorbidities in Respect of Geriatric Age Groups

Study of Corelation of Obesity with Comorbidities in Respect of Geriatric Age Groups

Abstract 11771: Impact of Overweight/Obesity/Higher Body Mass Index on Long-Term Major Adverse Cardiac Outcomes Following Chronic Total Occlusion-Percutaneous Coronary Interventions- A Systematic Review and Meta-Analysis

Background: Obesity is usually associated with worse cardiovascular outcomes. However, fewer studies have evaluated its impact on long-term major adverse cardiovascular events (MACE) following CTO PCI. We conducted a meta-analysis to assess the same. Methods: PUBMED, Scopus, and EMBASE were systematically searched for studies reporting long-term (at least >1 year) outcomes with obesity vs no obesity in patients with CTO PCI. MACE events [all-cause mortality, cardiac mortality, revascularization, restenosis/reocclusion, recurrent angina pectoris (RAP), target-vessel myocardial infarction (MI), heart failure, cardiac death, or ischemia-driven target-vessel revascularization (TVR) were the primary endpoint. Pooled odds ratios (OR) and heterogeneity were assessed with random-effects models and I2 statistics respectively. Subgroup analysis was performed to assess the risk by age group and follow-up duration. The leave-one-study-out method was used for sensitivity analysis. Results: After an initial electronic search of thirty-two studies, five studies were selected, and between 2016 to 2021 selected were included in the final analysis. The sample size consisted of 5022 patients with a median age of 63. No significant impact of higher BMI/obesity was seen overall on a median duration of 2.6 yrs [OR(95% CI)= 0.95 (0.82-1.11), p=0.53, I 2 = 90.86%)] (Fig 1). However, on a subgroup analysis, the geriatric age group (≥65 yrs) demonstrated an "Obesity Paradox" effect on MACE after CTO PCI, [OR (95%CI)=0.64 (0.47-0.88), I 2= 42.13, p<0.01]. There was no difference in a subgroup analysis based on follow-up duration (≥3 years [OR (95%CI)=0.73 (0.42-1.27)] vs <3 years OR (95%CI)=1.04 (0.84-1.27)]. Conclusions: Although higher BMI/obesity was not associated with overall long-term MACE in CTO PCI, the subgroup analysis demonstrated the "Obesity Paradox" (protective) effect in studies with a predominantly geriatric population.

A Glimpse into the Resistant Pattern of Uropathogens: An Overview

Urinary tract infection (UTI) poses a serious health issue for all age groups from neonates to geriatric age groups. Majority of the women experience urinary tract infections once in their lifetime. Escherichia coli (E.coli) is the most common uropathogen causing UTI which is followed by Klebsiella and Enterococci. Amoxicillin is the most resistant antibiotic against both E.coli and Klebsiella pneumonia whereas Gentamycin and Nitrofurantoin have been sensitive to both E.coli and Klebsiella pneumonia. Gram-negative bacteria such as E. coli, Klebsiella species, Proteus species, Acinetobacter species, Enterobacter species, Pseudomonas aeruginosa, and Citrobacter species are the most common causes of UTI. Enterococcus species, Staphylococcus saprophyticus, and Coagulase-negative bacteria are among Gram-positive bacteria. Staphylococcus aureus is a coagulase-positive gram-positive bacteria that cause urinary tract infections (UTIs). Hence, we come to the serious conclusion that Uropathogens are becoming increasingly resistant to a different group of antibiotics. The misuse and indiscriminate use of antimicrobials have led to the emergence of antibiotic resistance in bacteria all over the world, posing a threat to the public. Estimating the local etiology and sensitivity pattern could help in successful treatment. Inquiring into UTI epidemiology, such as risk factors, bacterial strains, and antimicrobial susceptibility, could help healthcare planners determine the best course of action.

Prevalence and Outcomes of Geriatric Traumatic Brain Injury in Developing Countries: A Retrospective Study

Abstract Introduction The world populace is aging and it is anticipated that 2 billion people will be older than 60 years by 2050. Traumatic brain injury (TBI) is a major cause of death and disability worldwide. In the United States, 2.8 million people pursue medical attention yearly. TBI exemplifies a leading cause of mortality and morbidity among the geriatric age group worldwide. Methods A retrospective study of geriatric cases who were admitted to the Neurosurgery Department in Khoula Hospital from January 1, 2016, to December 31, 2019, was conducted. Patients' demographics, risk factors, neuro-vital sign, diagnosis, Glasgow coma scale (GCS) on arrival, treatment types, and length of stay (LOS) were recorded. Results Two hundred and thirty-four patients were admitted due to TBI in four years period. Seventy-five percent of the study cohort were more than 75 years old. Male to female ratio was 2.4:1. Subdural hematoma (SDH) was the most common TBI diagnosis based on computed tomography (77.4%). Most of the patients were having GCS scores of 14 to 15 (67.9%). Sixteen percent of the patients received antiepileptic medications. The majority of the patients underwent surgical intervention (70.5%). Eighty percent of the patients stayed in the hospital for less than 15 days. There was a significant difference between the LOS and type of surgery. Subarachnoid hemorrhage was found to have the highest mean age (79.7 years). Intracerebral hemorrhage patients had the longest LOS in the hospital with a mean of 44.2 days. There was no significant difference between the age of patients and type of surgery. Conclusion The number of TBI in the elderly population is increasing annually. The most common type of TBI in our cohort was SDH and most of the patients were treated with burr hole surgery.

Evaluation of polypharmacy and its effects in geriatric age group patients applying to the internal diseases outpatient clinic

Evaluation of polypharmacy and its effects in geriatric age group patients applying to the internal diseases outpatient clinic

Non-Thyroidal Illness Syndrome: A Pattern of Thyroid Dysfunction Seen in Intensive Care Unit Patients of a Tertiary Care Centre

Introduction: The response to the endocrine mechanism including thyroid gland hormones to critical illness is a complex phenomenon.1 There is a marked and distinct changes in the levels of thyroid hormones in critical illness.2 The magnitude of the decrease in circulating tri-iodothyronine (fT3) levels (also known as non-thyroidal illness) during the first 24 hour after the onset of acute illness reflects the severity of illness and correlates with mortality. The study aims to evaluate the thyroid function test (TFT) of critically ill patients. The results of the study will be helpful in determining the thyroid picture of the critically ill patients in our setting and definitely help in assessing the outcome of the patient admitted in ICU or ward.
 Materials and Methods: This is a hospital based cross sectional study. A total of 150 cases with the critical illness assessed as per Acute Physiology and Chronic Health Evaluation II (APACHE II) score were enrolled in the study from 12th December 2021 to 15th June, 2022. Informed written consent and ethical approval were taken.
 Results: The majority of the cases (52%) were of geriatric age group with the mean age of 57 years. Majority of the study participants (42%) in APACHE II were from 20–24 across all participants, and both sexes. Fifty‑one percent of the patients had reduced fT3 levels. There was an increase in percentage of patients with decreased fT3 levels with increasing APACHE II score, compared to normal fT3 levels at similar APACHE II score and the distribution was found to be statistically significant (p = 0.0233). Of the 68 patients expired, 52 of them had low fT3 levels whereas only 16 cases expired were with the normal fT3 level, making it a strong predictor of severity and outcome.
 Conclusion: Decrease in the levels of fT3, a condition of non-thyroidal illness, is a crucial prognostic indicator in critically ill patients which in coordination APACHE Score II can be helpful in clinical settings to predict the severity and outcome of such patients.

429 Clinical Audit Ankle Fractures

Abstract Aim Ankle fractures are common among adult age group with an incidence of 174 per 100000 per year and they pose serious problems in management of geriatric age group because of osteoporotic bone. Our aim of current clinical audit was to introduce changes in current clinical practice by recommendations according to Standard BOAST guidelines of management of Ankle Fractures. Method Clinical Audit was carried out in Department of Orthopedics Benazir Bhutto Hospital in Outdoor and Emergency in March 2021 in patients of age group 20–70 years taking 50 patients for pre- and post-audit assessment. Emergency, Outdoor Slips were evaluated according to Standards of Practice formulated. Then a presentation was given to medical staff on Guidelines of Ankle fractures management, and they were informed about the deficiencies in their documentation and management. Panaflexes of Guidelines were displayed in ER, ward and then re-evaluation was done after 4 weeks in April 2021 using proformas in which clinical notes, discharge certificates and emergency slips were used for data analysis and observing improvement. Results The results of asymmetric data were calculated by Fischer Exact Test and with a p-value of <0.05 considered as significant. Results were very pleasing as they showed great improvements in documentation as well as management of patients in accordance with the set guidelines and protocols. Conclusion Clinical Audits should be carried out on regular basis in hospital settings as they help to improve the standards of care as well as proper documentation which has medico-legal importance.

A clinical study spectrum of various cutaneous manifestation in geriatric age group in rural patient

To study the demographic profile of the geriatric age group patients among the rural population in kanchipuram district who are presenting to the Dermatology department.

SLEEP PATTERN AS A RISK FACTOR FOR DIABETES MELLITUS AND HYPERTENSION IN GERIATRIC POPULATION

Introduction: Due to changes in circadian rhythm geriatric population struggles to get enough sleep. Also there is increase in risk of diabetes and hypertension with increasing age. To nd out correlation between 'durationObjectives: and quality' of sleep and incidence of 'diabetes mellitus (DM) and hypertension' in geriatric population staying at old age home and home. To compare geriatric population staying at old age home with geriatric population staying at home. It was an analyticalMaterials And Methods: observational study done in 50 subjects of geriatric age group of 65-75years, 25 subjects staying at old age home (Group A) and 25 subjects staying at home (Group B) were examined by using sleep questionnaire. DM was reported in 76% with short duration and 84% withResults: disturbed sleep in total geriatric population. For Group A DM was reported in 75% with short duration and 82% with disturbed sleep. For Group B DM was reported in 77% with short duration and 85% with disturbed sleep. Hypertension was reported in 75% with short duration and 81% with disturbed sleep in total geriatric population. For Group A hypertension was reported in 71% with short duration and 79% with disturbed sleep. For Group B hypertension was reported in 79% with short duration and 85% with disturbed sleep. Due to sympathovagal imbalanceDiscussion: there is insulin resistance, impaired glucose metabolism and obesity which manifests into DM in short duration disturbed sleep. Also insufcient sleep causes increased sympathetic activity, increased stress hormones and lack of nocturnal dipping in blood pressure which is responsible for prevalence of hypertension. Prevalence of DM and Hypertension is more in geriatric population with short disturbed sleep. There isConclusion: no signicant difference in prevalence of DM and hypertension in Group A and Group B

Long Term Outcomes of Single Staged Sequential Bilateral Total Knee Replacement in Patients aged 60 years or above

Objective: To determine the long-term outcomes of single staged bilateral total knee arthroplasty in patients of geriatric age group.Methods: This single-center retrospective study was carried out at Liaquat National Hospital Karachi, Pakistan. Data of 2001 to 2010 were retrieved from the medical records. All geriatric age group patients above 60 years irrespective of comorbidity status, underwent single-stage bilateral total knee arthroplasty were consecutively included. Pre-operative diagnoses such as primary osteoarthritis, post-traumatic arthritis and rheumatoid arthritis were noted. The minimum follow-up time period was 10 years. Long term outcome such as knee society score, adverse event, and need of revision surgery were noted.Results: Of 96 patients, the median age was 69.0 (65.0-76.0) years. There were 44 (45.8%) males and 52 (54.2%) females. Primary osteoarthritis was the most common primary diagnosis, i.e., 66 (68.8%) followed by rheumatoid arthritis in 24 (25.0%), and post-traumatic arthritis in 6 (6.3%) patients. Most of the patients had moderate Charlson Comorbidity Index score, i.e., 70 (72.9%) while Knee Society Score showed that 41 (40%) reported excellent outcome. Need of revision surgery was reported by 6 (6.3%) patients. Adverse events were reported by 11 (11.5%) patients. A significant median difference of Knee Society Score was found among patients with diabetes mellitus (p-value <0.001) and pre-operative diagnosis (p-value <0.001).Conclusion: The long-term outcome of patients underwent bilateral total knee arthroplasty was found satisfactory. It is likely that total knee arthroplasty is widely regarded as the best option for treating end-stage knee osteoarthritis.

Outcomes of ultra-old vs old patients after hip fracture surgery: a matched cohort analysis of 1524 patients.

Surgical management of geriatric hip fractures yields improved functional outcomes with decreased morbidity and mortality. Cohort studies have suggested that the older patients within the geriatric age group have worse outcomes with surgery, However, these studies inherently report inflated risks due to poor handling of confounders and have inadequately age-stratified their geriatric population. This study aims to investigate the effect of age alone on the 1-year mortality and functional status of geriatric patients after hip fracture surgery. This is a retrospective single institution cohort study based on the prospectively-maintained registry of hip fracture patients. 2603 patients aged 60years and above were treated surgically under a geriatric-orthopaedic hip fracture pathway from January 2014 to December 2018. Patients were split into two age groups: ultra-old (≥ 85years) vs old (< 85years). Baseline demographics and the ASA (American Society of Anaesthesiologists) status and the Modified Barthel's Index (MBI) were obtained at admission and 1year after the fracture. Adverse outcomes from the fracture and surgery were recorded during a follow-up period of minimally 2years. A 2:1 matching process based on the gender, fracture type, ASA status, CCI and MBI categories was conducted. There were 1009 and 515 patients in the old and ultra-old age groups, respectively. 1-year mortality was similar for both age groups (4.0% ultra-old vs 3.6% old, p = 0.703). 30-day morbidity was similar except for higher rates of postoperative pneumonia in the ultra-old (14.0 vs 6.3%, p < 0.001). MBI scores at 1-year were lower in the ultra-old (severe dependence: 16.4 vs 10.0%; p = 0.001). Ultra-old patients were less likely to be community ambulant at 12months (21.2 vs 36.0%) with the deterioration in ambulatory status significant after correction for baseline status (p < 0.001). The 1-year mortality of surgically-managed geriatric hip fracture patients older than 85years of age is not determined by age alone. Patients aged 85years and above are at higher risk for pneumonia postoperatively. Ultra-old hip fracture patients with an intertrochanteric fracture are more likely to have poorer function at 1year after hip fracture surgery.

Prognostic factors of elderly patients with hepatocellular carcinoma: should we be more courageous in treatment?

Hepatocellular carcinoma (HCC) is a cancer with a poor prognosis, its incidence increases with age. The risk of developing HCC is highest in the seventh decade. In this study, we aimed to determine the clinicopathological differences, treatment choices, survival times, and effective prognostic factors of HCC in the elderly and young populations. All patients aged ≥18 years who were diagnosed histologically between 2016 and 2020 were included in the study. Patients were divided into two groups: <70 years and ≥70 years. The clinicopathological differences, treatment choices, survival times, and effective prognostic factors of HCC were compared in the elderly and young populations. A total of 407 patients were evaluated. There were 164 patients (40.3%) in the geriatric age group. There was no significant difference in the female/male ratio, the laboratory values, survival time between the two groups. There was no significant difference between the two groups in terms of tumor focality and portal vein invasion ( P > 0.05). The presence of NAFLD, maximal tumor diameter (MTD), and portal invasion were found to be significant for survival according to the univariate analysis in elderly group ( P < 0.05). In the multivariate analysis, presence of NAFLD etiologically, and MTD independent risk factors were observed in elderly group ( P < 0.05). If the clinicomorphological features of the tumor and prognostic risk factors can be determined by examining the patients in detail, all treatments can be easily applied in the geriatric group.