Geriatrics Population Research Articles

Prevalence of Non-Communicable disease in Geriatrics population of Kalaburagi District: A Cross-sectional Study in Urban Field Practice Area.

Prevalence of Non-Communicable disease in Geriatrics population of Kalaburagi District: A Cross-sectional Study in Urban Field Practice Area.

A geriatric game to strengthen older adult healthcare delivery and outcomes.

Serious games enhance learner engagement and knowledge, yet few medical education games target older adults' healthcare. Addressing this gap, we developed Geri-POP (Geriatrics Population Health), focusing on the Age-Friendly Health System (AFHS) framework and Geriatric 4Ms. Geri-POP, a healthcare game is aimed at educating health profession learners about the AFHS framework. Geri-POP employs plan-do-study-act cycles of rapid improvement to apply AFHS principles and explore evidence-based geriatric practices within the game environment while garnering points for insight, trust and outcomes. Faculty and medical students were surveyed for feedback on an alpha version of Geri-POP. Players manage patient panels across three age groups (65-74, 75-84, and 85 years and older) while engaging in plan-do-study-act (PDSA) cycles, applying Geriatric 4Ms (What Matters, Medications, Mentation, and Mobility), and refining strategies based on resource utilization, health outcomes, and real-time feedback. Alpha testing of the game received mixed perceptions on graphics, with faculty endorsing the game for training and integration into the curriculum, while students prioritize academic commitments. Suggestions include enhancing graphics and refining dialogue for a more professional tone. Geri-POP demonstrates the potential of gamifying older adult population health and quality improvement around AFHS. Feedback on a prototype game revealed different attitudes between faculty and students, thus emphasizing the importance of game development as an iterative process that accounts for educator and learner-centric needs. A future consideration is whether the game informs user's clinical practices and changes healthcare outcomes for older adults.

IJCM_98A: Prevalence of Non-Communicable disease in Geriatrics population of Kalaburagi District: A Cross-sectional Study in Rural Field Practice Area.

Background: Worldwide total population of geriatric was 703 million (9%) in year 2019 according to United Nation report. The geriatric population is estimated to increase to 198 million by 2030 in India. With advancing years, the incidence of communicable and non-communicable disease (NCD) increases. Most of the available studies on morbidity in India are disease specific and fail to provide comprehensive knowledge about NCD. Objectives :1. To estimate prevalence of non-communicable disease (NCD) in elderly. 2. To assess the risk factor associated with non-communicable disease. Methodology: A community based cross-sectional study was conducted among geriatric people in rural areas of Kalaburagi district, Karnataka. Study participants consisted of age =60 years were comprised in the study and a sample size of 193 was calculated. Pre-designed, pre-tested and semi- structured questionnaire was used to collect information on risk factor and morbidity status of study participants. Data was computed in Microsoft 2013 excel sheets and using SPSS version 25.0 for utilizing appropriate statistical method to calculate frequency and percentage, chi square test fisher extract test were used to find association. Results: Hypertension is the most prevalent morbidity NCD in the rural elderly population found to be 41.45% in Kalaburagi CHC Rajapur. Followed by diabetes 24.35% and other disease 1.62%. Alcohol and Chewing tobacco found to have significant associations in disease causation in the elderly population. Environment like Water Supply, Latrine, Socio-Economic Class found to be having significant association in disease causation in the elderly population. Conclusion: As age advances morbidity increases has been shown in the study. Lifestyle modification also show statistically significant association. Prevalence of NCD like Hypertension, Diabetes, MI, etc can be prevented by reduction of the high-risk factor such as Lifestyle changes, Diet Modification, and Changing Habits of alcohol and tobacco.

USABILITY OF A TABLET-BASED HOME MEMORY TEST IN OLDER ADULTS WITH AND WITHOUT COGNITIVE IMPAIRMENT

Abstract Increasing Alzheimer’s and related disorders prevalence, highlights the need for accurate and reliable cognitive screening and diagnostic tools. We studied usability of LifeBio Brain, a prototype cognitive testing mobile application. We established baseline cognitive performance in volunteers from Brown University’s Geriatric Clinic using the Saint Louis University Mental Status (SLUMS). We asked volunteers to use the LifeBio Brain app at home on an iPad twice daily for 10 times, for about 15 minutes each time, followed by completion of a 10-question System Usability Scale on satisfaction that assesses the app and its ease of use. The LifeBio Brain app contains a mix of adapted cognitive tests such as clock draw and Trails A, and game-like experiences, presented in a randomized order. We analyzed a white non-hispanic sample (n=51) with a balanced distribution of age [79.6 (7.2) years, range 66-95] and sex (58.82% women). The median SLUMS score of 25, indicates cognitive impairment in most participants. Similarly, the median usability score on the 50-point System Usability Scale was 41. We found that 80% of participants had a usability score of 35 or greater, with a 95% CI of 31-38, and 67% had a usability score of 40 or greater. SLUMS score ≤14 correctly predicted study completion in 90% of participants. Most volunteers from an outpatient geriatrics clinic found LifeBio Brain usable. Volunteers leaving the study early tended to have lower SLUMS Scores. The LifeBio Brain app may have utility for measuring memory and thinking abilities in a white outpatient geriatrics population.

Depression and associated risk factors among geriatrics population in field practice areas of tertiary care institution in Unnao district of Uttar Pradesh

Background: Ageing is inevitable for any human being. According to census 2011, the population of over 60 years of age in India accounted 8% of the total population, as of 2016 it is 8.6% which is projected to increase to 20% by 2050. Aim & Objective: To estimate the prevalence of depression among geriatrics age group and to identify factors associated with depression among geriatrics age group. Material & Methods: It was a cross-sectional study conducted between April 2022 and September 2022. Total sample size was 138. Number of subjects to be sampled from each village was calculated by probability proportion to size (PPS). Finally using simple random sampling method, participants were selected from each village. Results: The majority of the participants were in between 60 and 65 years old (63.8% of the total), next 66 to 75 years old (26.8% of the total), and finally over 75 years old (9.4% of the total). The mean age of participants in the study was 65.06+6.60 years. The proportion of male participants in the study was 47.1%, and the proportion of female participants was 52.9%. In present study, it was found that 65.9% had depression among the geriatrics population. Conclusion: This study also portrays significant association with age group, marital status, occupation, type of family and smoking history among depression among geriatrics.

Effectiveness of Choreograph-exercise training versus Multi-modal exercise training on Cognitive function, Psycho-behavioral symptoms in Geriatrics Population: A Pilot Study

Background: Global population ageing is contributing to a growing public health crisis of cognitive impairment (CI), depression, anxiety, and stress. Cognitive dysfunction can affect a variety of cognitive processes, including attention, verbal and nonverbal learning, short-term and working memory, visual and auditory processing, problem-solving, processing speed, and motor functioning. The study aimed to compare the benefits of multi-modal exercise training to choreograph-based exercise training on psycho-behavioural symptoms and cognitive performance in the elderly population. Methods: The populations were distributed using a basic random sampling approach. Eight geriatric groups with cognitive impairment and psycho-behavioural alterations were the subjects of a comparative investigation. Training in choreographed exercises was given to Group A (n = 4), whereas training in multi-modal exercises was given to Group B (n = 4). The study's inclusion requirements required one to be 60 years of age or older. Both genders, MMSE scores 18–30, DASS scores 10–13 for depression, 8–9 for anxiety, and 15–18 for stress. Pre- and post-c Outcome indicators were assessed using MMSE and DASS. Results: A statistically significant (p<0.05) effect was indicated by a within-group examination of all the outcome measures following the intervention. A statistically significant (p<0.05) effect was indicated by a between-group examination of all the outcome measures following the intervention. Exercise training focused on choreography had a greater impact than the other group. Conclusion: The study found that in the senior population, choreograph-based exercise training was superior to multi-modal exercise training in terms of enhancing cognitive function and lowering psycho-behavioural symptoms.

Prevalence of Musculoskeletal Disorders and its Correlation to Physical Activity among Geriatrics Population in Rural Wardha- A Cross-Sectional Study

Objective: Musculoskeletal disorders which leads to the pain in the neck, shoulder, upper back, lower back, knee or other skeletal areas, are instances of musculoskeletal strains. Musculoskeletal problem is the main region of morbodity and the seconldy cause of disability in all world. Any action of the body involving the skeletal muscles that results in a modest to high energy expenditure is referred to as physical activity (PA). This study's aim was to determine the prevalence of musculoskeletal illnesses and how physical activity among senior age groups relates to those disorders. This study aimed to determine the prevalence of musculoskeletal disorders, the level of physical activity using a short-form physical activity questionnaire, and the relationship between the prevalence of these disorders and physical activity. Material and Methods: From October 2021 to August 2022, a cross-sectional study of 152 geriatric patients in a rural Wardha was conducted using pre-structured and pre-designed questionnaires. These included demographic information, a short form of the International Physical Activity Questionnaire to gauge the level of physical activity, and standardized Nordic questionnaires to examine musculoskeletal symptoms. Results: Our survey shows 95.3% of elderly people reported musculoskeletal problems. The age groups 60-70 years of geriatrics had the highest prevalence of MSDs (55.19%), significantly higher than those of 70-80, 80-90, and 90-100 years of geriatrics (p 0.05). There is a substantial correlation between the degree of physical activity and the musculoskeletal disorder; the majority of the participant had a moderate level of physical activity (55.9%), with the knee being the most frequently reported region (61.18%). Conclusions: In this study, there are more musculoskeletal diseases among female individuals from rural Wardha than among male participants. Geriatrics between the ages of 60 and 70 had a higher MSD prevalence than those between the ages of 70- 80 or 80-90. The body component most affected was the knee, followed by the lower back and upper back. The majority of the affected senior population engaged in moderate physical activity

Article Domain Category: Medical Education.

This study measured the effect the experience of house calls might have on third-year medical students. Students were surveyed via an anonymous online survey at the start of their geriatrics clerkship, again at the end of their clerkship, and once more three months later. Empathy was measured using the Jefferson Scale of Empathy - Student version (JSE) and student attitudes towards the geriatrics population was measured using the UCLA Geriatrics Attitudes Scale (GAS). Data were analyzed using SPSS version 27.0. No changes in empathy were found when comparing students who completed house calls versus those who did not. However, students who trained in office settings were noted to have higher JSE scores at the three-month follow-up survey, students who worked in hospital settings had higher JSE scores at the completion of the clerkship, and student who worked in assisted living facilities had higher GAS scores at the completion of the clerkship. Teaching students ways to improve empathy can be challenging. The setting in which a student trains may be an area of focus for improving empathy among trainees and should be researched further.

Gastroparesis in geriatrics population: A United States population study

BackgroundOlder patients with upper gastrointestinal diseases may lack disease-specific symptoms that are required to make the correct diagnosis. This study aimed to compare the gastroparesis demographics, clinical presentation, and surgical management between the older adult and young populations. MethodsThe National Inpatient Sample database was used between the years 2012 and 2014 with the primary diagnosis of gastroparesis. Patients were further divided based on their age into two groups: 70 years or older and younger than 70 years. ResultsThe older adults were more likely to have early satiety and bloating compared to younger population with an odds ratio (OR) = 3.79; 95% Confidence Interval (95%CI) 2.80- 5.11, p < 0.0001 and OR = 2.80, 95%CI 2.07–3.78, p<0.0001 respectively. Older adults had low odds of having nausea with vomiting (OR = 0.86, 95%CI 0.76–0.95, p = 0.003), or abdominal pain (OR = 0.56, 95%CI 0.50–0.63, p<0.0001). ConclusionsOlder adults had more early satiety and bloating, whereas younger patients had more nausea with vomiting and abdominal pain.

METABOLIC SYNDROME &amp; ITS DIETARY MANAGEMENT; A REVIEW

Metabolic Syndrome or MetS is a multifactorial disease consisting of obesity, hypertension, dyslipidemia, and hyperglycemia. It’s common in 25% of the general population in the Northern US and Western Europe. In Pakistan, the statistics of MetS are unknown, however, it is expected to be twice that of the US. The middle age group and the geriatrics population have the highest number of MetS cases with risk factors such as obesity, sedentary lifestyle, alcohol, inadequate, inadequate sleep, and a non-vegetarian diet. The complications of MetS include obesity, diabetes, and cardiovascular events. A Meditteranean diet rich in fruits and vegetables, whole grains, and olive oil as the source of fat is considered to be the only effective dietary management in MetS. Moreover, a high lean protein, low and complex carbohydrate and moderate unsaturated fats have also shown positive progress in MetS, especially with long-term weight reduction. Micronutrients requirements also increase in MetS. Fulfilling these increased requirements has been shown to regulate and improve the metabolism of fats and carbohydrates. Vitamin C and E, flavonoids, vitamin D, conjugated linoleic acid, omega-3 fatty acids, minerals such as magnesium and chromium, α-lipoic acid, phytoestrogens, and dietary fiber all have been studied to support the treatment of MetS along with aloe vera and other herbal products, yoga and aerobic exercises.

Preparing a healthcare workforce for geriatrics care: an Interprofessional team based learning program

BackgroundImproving the care of older adults in our healthcare system involves teams working together. As the geriatrics population rises globally, health science learners need to be prepared to work collaboratively to recognize and treat common conditions in geriatrics. To enable workforce preparation, the Institute of Medicine and the National League for Nursing emphasize the need to implement interprofessional active learning activities for undergraduate healthcare learners at academic medical centers.MethodsThe Geriatrics Champions Program was a team-based learning activity created to meet this task. It was a 24-month program, repeated twice, that impacted 768 learners and 151 faculty from medicine, occupational therapy, physical therapy, nursing, social welfare, psychology, pharmacy and dietetics. Each class was intentionally divided into 20 interprofessional teams that met four times annually. Each session focused on one geriatrics domain. The objectives were centered around the specific geriatrics competencies for each health profession, divided into the eight domains written in the “American Geriatrics Society IM-FM Residency Competencies”. Evaluation consisted of individual and team Readiness Assessment Tests (iRAT and tRAT). Surveys were also used to collect feedback using a Likert scale. Wilcoxon signed rank tests were used to compare iRAT and tRAT scores. Other analyses identified characteristics associated with tRAT performance group (Unpaired t-tests) and tRAT performance on the raw scale (Pearson correlation). Paired t-tests using a 7-level Likert Scale measured pre-post change in learner knowledge.ResultsStudent tRAT scores were 30% higher than iRAT scores (p < 0.001). Teams were more likely to score 100% on the initial tRAT attempt if more team members attended the current session (p < 0.001), more health professions were represented by team members in attendance (p = 0.053), and the team had a better track record of past attendance (p < 0.01). In the post-program evaluation, learners felt this program was helpful for their career preparation in interprofessional geriatrics care.ConclusionsLearners understood that teams performed better than individuals in the care of older adults. Feedback from the learners and faculty was consistently positive and learners felt better prepared for geriatrics care. The program’s benefits may extend beyond individual sessions.

High Circulating Sclerostin Level as Osteoporosis Risk Factor in Male Geriatric Population at Sanglah Hospital Bali

BACKGROUND: Osteoporosis is a disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility. The development of biomolecular world found Wnt/β-catenin signaling pathway may plays an important role in bone mass regulation. Osteoporosis in geriatric population remains one of global health problems and typically thought of as a disease impacting women, but recently increasing attention is being paid to osteoporosis in males. Osteoporosis in male accounts for higher morbidity and mortality compare to woman population. The association between sclerostin serum and risk for osteoporosis in male geriatric will be described as follows. METHODS: This study is a case–control study with a total 54 samples of male geriatrics, divided into 27 non- osteoporosis subjects and 27 osteoporosis subjects (age ≥60 years old). Diagnosis of osteoporosis was defined according to the WHO criteria based on bone mineral density. All participants were scanned on a GE lunar prodigy bone densitometer. Sclerostin serum level was measured using enzyme-linked immunosorbent assay (ELISA). RESULTS: The average age from total 54 samples in case group was 69.81 ± 6.5 years old and control 69.41 ± 5.97 years old. Cutoff value based on receiver operating characteristic curve for sclerostin serum level was 302.5 pg/mL where the sensitivity and specificity for developing osteoporosis in male geriatrics were 59.3% and 81.5%, respectively. Male geriatrics with sclerostin serum ≥302.5 pg/mL is 6.4 times more likely to developed osteoporosis than those with sclerostin serum &lt;302.5 pg/mL (OR = 6.4; p = 0.0020; CI 95% = 1.856–22.068). Multivariate logistic regression analysis after controlling other variables such as bone mass index, age, smoking status, alcohol consumption, physical activity, sun exposure, and type II diabetes mellitus showed that high sclerostin level was an independent susceptibility factors for osteoporosis in male geriatrics population (p = 0.001). CONCLUSIONS: This study showed that high circulating sclerostin serum (≥302.5 pg/mL) was risk factor for developing osteoporosis in male geriatrics.

ASSESSMENT OF CURRENT PRESCRIBING PATTERN AND COST ANALYSIS OF ORAL ANTI-DIABETIC DRUGS IN ELDERLY POPULATION FROM PUNGANUR REGION OF ANDHRA PRADESH

Objective: The main aim of the study is to analyze the prescribing patterns and cost-effective analysis of single therapy and combination therapy oral anti-diabetic drugs, awareness of patients about diabetes, medication and lifestyle modification in the geriatrics population.&#x0D; Methods: A prospective study was carried out over a period of 12 mo in the region of Punganur Andhra Pradesh. Type 2 diabetic patients who were on oral anti-diabetic drugs were enrolled in the study. A suitable data collection form was prepared and used to collect the required data. The demographic data, disease data and the utilization of various oral anti-diabetic agents were analyzed. About 800 patients were enrolled for the study from rural and urban areas in Punganur. Among the study population, 63% (504) were males and 37% (296) were females in the age group of 55 y and above. The majority of patients were from urban areas 70% (560) and 30% (240) were from rural areas. About 78 % of the patients have a history of diabetes more than 10 y and 22% were more than 5 y and less than 10 y.&#x0D; Results: The present study found that type 2diabetes was prevalent in males than females. Results show two anti-diabetic drugs of single drug and fixed dose combination per prescription was more than the single anti-diabetic drug also found new prescription was observed more and cost of treatment was immense when compared to old prescription. Prescription pattern exposed Glibenclamide, Metformin, Glipizide and Glimepiride were the most common drugs used among the various oral antidiabetics. Currently, newer drug DPPi 4 inhibitors like Sitagliptin, Vildagliptin and Teneligliptin are used as single and combination with metformin were increased in prescription. Among the various oral antidiabetics prescribed, the cost of 2 drugs per prescription and newer anti-diabetic drugs like DPPi4 was high but cost analysis study revealed the availability low cost brands in market.&#x0D; Conclusion: The study concluded that Prescription pattern and cost analysis of marketed anti-diabetic drug might be helpful for the professional to prescribe low cost effective medication.

78 A Quality Improvement Project on Oxygen Administration Within the Geriatrics COVID-19 Cohort Ward

IntroductionDue to the COVID-19 pandemic, many medical and surgical wards were reassigned as COVID-19 cohort wards to accommodate the number of patients admitted with the virus. Nurses and healthcare assistants (HCAs) from various departments and backgrounds were redeployed to these areas. Within the geriatrics population, patients with severe COVID-19 often have high oxygen requirements and can rapidly deteriorate. Therefore, we conducted a quality improvement project within the geriatrics COVID-19 ward focused on improving patient safety by improving oxygen administration to patients. We also aimed to enhance the knowledge and confidence levels of nurses and HCAs in regards to oxygen administration.MethodFrom April–July 2020, we compared the oxygen that was administered to COVID-19 patients against the oxygen therapy that was documented on observation charts. This included whether the correct type of device, flow rate and target oxygenation saturations were used. We carried out multiple Plan-Do-Study-Act (PDSA) cycles including a staff education session on oxygen administration, placed an oxygen guidelines poster on each patient’s bedside, administered a short quiz and distributed reminder lanyard cards. We also conducted a staff survey comparing knowledge and confidence on oxygen administration before and after an education session.ResultsOverall there has been an improvement in oxygen charting and administration after 4 PDSA cycles. There is 100% correct use of oxygen device and correct setting of oxygen flow rate after the 2nd and 3rd PDSA cycles. After the teaching session, all staff reported feeling more confident in oxygen management. Based on the audit data and quiz results, there was an improvement in knowledge of oxygen administration.ConclusionsWe have demonstrated that by using simple time-efficient and cost-effective interventions, improvements can be made in oxygen administration and subsequently patient safety. This has the potential to influence prognostic outcomes among the geriatrics population with COVID-19.

The 5-Factor Modified Frailty Index in the Geriatric Surgical Population.

The modified frailty index (mFI-11) is a National Surgical Quality Improvement Program (NSQIP)-based 11-factor index that has been proven to adequately reflect frailty and predict mortality and morbidity. In the past years, certain NSQIP variables have been removed from the database; as of 2015, only 5 out of the original 11 factors remain. While the predictive power and usefulness of this 5-factor index (mFI-5) has been proven in previous work, it has yet to be studied in the geriatrics population. The goal of our study was to compare the mFI-5 to the mFI-11 in terms of value and predictive ability for mortality, postoperative infection, and unplanned 30-day readmission for patients aged 65years and older. Spearman's Rho was calculated to compare the value, and unadjusted and adjusted logistic regressions were created for three outcomes in nine surgical subspecialties. Correlation coefficients were above .86 across all surgical specialties except for cardiac surgery. Adjusted and unadjusted models showed similar C-statistics for mFI-5 and 11. Overall predictive values of geriatric mFI-5 and mFI-11 were lower than those for the general population but still had effective predictive value for mortality and post-operative complications (C-Stat ≥ .7) and weak predictive value for 30-day readmission. The mFI-5 is an equally effective predictor as the mFI-11 in all subspecialties and an effective predictor of mortality and postoperative complication in the geriatric population. This index has credibility for future use to study frailty within NSQIP, within other databases, and for clinical assessment and use.

The Interplay between Immunosenescence and Microbiota in the Efficacy of Vaccines.

Vaccinations are among the most effective medical procedures and have had an incredible impact on almost everyone’s life. One of the populations that can benefit the most from them are elderly people. Unfortunately, in this group, vaccines are less effective than in other groups, due to immunosenescence. The immune system ages like the whole body and becomes less effective in responding to infections and vaccinations. At the same time, immunosenescence also favors an inflammatory microenvironment, which is linked to many conditions typical of the geriatrics population. The microbiota is one of the key actors in modulating the immune response and, in this review, we discuss the current evidence on the role of microbiota in regulating the immune response to vaccines, particularly in elderly people.

A prospective, cross-sectional study on Prescribing Pattern of Drugs and the incidence of potentially inappropriate medications in Geriatrics Population at a Tertiary Care Teaching Hospital in Western India

Background: Polypharmacy and inappropriate prescriptions are the most highlighted health issues among geriatric population, as they have multiple comorbidities. The objective of this study was to assess prescriptions using the World Health Organization (WHO) core indicators and Beers Criteria to discover polypharmacy and inappropriate prescriptions.Methods: This was a prospective, cross-sectional study of geriatric patients (65 years and above) who were attending the medicine outpatients clinic of a tertiary care teaching hospital hospital from May to December, 2016. World Health Organization (WHO) indicators and updated Beers Criteria were used to assess the drug utilization pattern and the prevalence of potentially inappropriatemedications (PIMs), respectively.Results: The prescriptions of 250 geriatrics patients with a distribution of 57.6% male and 42.4% female were assessed for this study. The total numbers of drugs recorded from the prescriptions were 1635 drugs, with an average of 6.54 drugs per person. According tothe Beers Criteria, it was found that nearly 23.05% of the total prescribed drugs were potentially inappropriate.Conclusion: Polypharmacy and use of inappropriate medicines presents a health risk to the geriatric population. Causes could include healthcare practitioner shortage, lack of awareness of PIMs, not understanding drug interaction, and the need for multiple drugs. Prescriber training and retraining is needed.

Prevalence of drug to drug interactions in critical cardiac patients

Abstract Background Pharmacotherapy in the management of cardiovascular disease patients with multiple co-morbidities has been challenging due to polypharmacy (five or more drugs). They have been attributed with potential drug – drug interactions (DDI). Detecting the clinically significant drug interactions allows the opportunity for prevention through clinical drug decision support system (CDDSS) and clinical management. Purpose To identify significant potential DDI in critical cardiac patients Method We prospectively observed patients admitted at CCCU received multiple medications leading to potential DDI from Feb 2018 to July 2018 using two commercially available CDDSS along clinical management and pharmacovigilance algorithm. Results Patients admitted at CCCU co-administered with two or more drugs were analyzed. The mean age was 61.1 years. Total 649 patients were screened, resulting 87.7% (569/649) patients took more than five drugs. Of the 4249 potential DDI 543 were unique interacting drug pairs. On average, CCU patients were prescribed with 12.1 drugs, potentiating 14.1 potential DDI. Older patients (&amp;gt;60 years) received more medications than younger ones (mean 18.7 vs 15.1 drugs). 82.1% patients had one or more potential DDI with major and moderate severity detected by one or both CDDSS. Common potential clinical adverse was bleeding, QTc prolongation and CYP3A4 inhibition. Both CDDSS agreed on the severity ratings in 36.9%. There were significant association of potential DDI with specific risk factors (geriatric, female, Indian and heart failure patients) Conclusions Rate of potential DDI adversely influenced by polypharmacy, antiarrhythmic drugs, comorbidities and LOS. Significant potential DDI occur in the CCU, highlighting the need for CDDSS potentially prevent patient harm. Identified risk factors (geriatrics population, female sex, Indian ethnicity and heart failure patients) can be used in mitigating adverse DDI. Funding Acknowledgement Type of funding source: Private hospital(s). Main funding source(s): NATIONAL HEART INSTITUTE

Frequency of Risk Factors of Pressure Ulcers in Geriatric Population in Lahore, Pakistan

The prevalence of pressure ulcers has turned out to be across the board, particularly in critically ill bedridden patients, especially in the geriatrics population. Along with their condition, poor level of nutrition, increased, moisture, low mobility and constant sheer friction forces acting upon their body lead to the development of pressure ulcers. Lack of proper care from nursing staff, as well as attendants, will contribute more to this. Hence, the aim of this study was to find the prevalence of pressure ulcers in older bedridden patients. Objective: To find out the prevalence of pressure ulcers in the geriatric population in Lahore, Pakistan. Methods: A cross-sectional survey was conducted. The examination was completed between April and July on 180 patients. A cross-sectional survey was done to gather data through a questionnaire to discover the incidence of pressure ulcers in the geriatric population in Lahore. Collected data was statistically entered by SPSS ver.(21.0) software. Results: The study included 180 subjects. Out of 277 subjects, 46(25.6.7%) had severe risk, 17(9.4%) had high risk, 25(13.9%) had moderate risk, 30(16.7) had and finally, 62(34.4) had no risk of developing pressure sores. Conclusions: The study concluded that increased moisture low mobility poor nutrition and continued friction and shear forces lead to the development of pressure ulcers.

Age stratified analysis of pre-operative factors impacting unplanned thirty day readmission in geriatric general surgery

BackgroundThe geriatrics population can no longer be considered as one homogenous group when it comes to patient-centric and value-based care. We aim to determine if there are pre-operative factors which differ between geriatric age strata (65–74, 75–84, 85 + years) that impact unplanned thirty-day readmission. Methods2015 NSQIP general surgery procedure data was utilized. Chi Square and t-tests were utilized to see if certain pre-operative factors impacted readmission. Regressions with age strata as an interaction term were run to determine if age was an effect-modifier. Significant pre-operative factors were included in a multivariate model with step-wise selection for significant age-stratification interaction terms. ResultsGender, inpatient status, wound classification, disseminated cancer, origin status, functional status, and RVU were significantly impacted by age strata in unadjusted models. Gender, inpatient status, emergency, and transfer/origin status were significant in our adjusted model. ConclusionsExogenous variables between age strata significantly impact unplanned thirty-day readmission in comparison to differing co-morbidity and symptomatology.