High-risk Elderly Patients Research Articles

The effect of telehealth, telephone support or usual care on quality of life, mortality and healthcare utilization in elderly high-risk patients with multiple chronic conditions. A prospective study

Background and objectiveTo assess the effect of home based telehealth or structured telephone support interventions with respect to usual care on quality of life, mortality and healthcare utilization in elderly high-risk multiple chronic condition patients. Patients and methods472 elderly high-risk patients with plurimorbidity in the region of Valencia (Spain) were recruited between June 2012 and May 2013, and followed for 12 months from recruitment. Patients were allocated to either: (a) a structured telephone intervention, a nurse-led case management program with telephone follow up every 15 days; (b) telehealth, which adds technology for remote self-management and the exchange of clinical data; or (c) usual care. Main outcome measures was quality of life measured by the EuroQol (EQ-5D) instrument, cognitive impairment, functional status, mortality and healthcare resource use. Inadequate randomization process led us to used propensity scores for adjusted analyses to control for imbalances between groups at baseline. ResultsEQ-5D score was significantly higher in the telehealth group compared to usual care (diff: 0.19, 0.08–0.30), but was not different to telephone support (diff: 0.04, −0.05 to 0.14). In adjusted analyses, inclusion in the telehealth group was associated with an additional 0.18 points in the EQ-5D score compared to usual care at 12 months (p<0.001), and with a gain of 0.13 points for the telephone support group (p<0.001). No differences in mortality or utilization were found, except for a borderline significant increase in General Practitioner visits. ConclusionsTelehealth was associated with better quality of life. Important limitations of the study and similarity of effects to telephone intervention call for careful endorsement of telemedicine. Clinicaltrials.gov (identifier: NCT02447562).

PP-549 - Simultaneous Coronary and Peripheral Arterial Interventions in Patients Undergoing Transcatheter Aortic Valve Replacement

Introduction: Today, the frequency of Transcatheter aortic valve replacement (tavr) is increasing. The increase in the number of procedures causes us to encounter more complications. In addition, patients who undergo TAVR are high-risk elderly patients and the incidence of coronary artery disease is high. In this case, we offered the manegement of patient with NONST elevated myocardial infarction (MI), who also had advanced aortic stenosis that undergoing TAVR in the same session, after right common femoral dissection developed.

Outcome after azacitidine treatment in patients with high-risk myelodysplastic syndrome and acute myeloid leukemia in the Clinic of Hematology at St. Marina University Hospital, Varna

Introduction: Hypomethylating agents have become a standard therapy for high-risk myelodysplastic syndromes (MDS) and elderly patients with acute myeloid leukemia (AML). Aim: The aim of the study was to assess the efficacy of azacitidine treatment in patients with MDS and AML followed for 18 months. Materials and Methods: Twenty-seven patients with MDS and AML treated in the Clinic of Hematology at St. Marina University Hospital, Varna were included in the study. Azacitidine was administered subcutaneously in at a dose of 75 mg/m 2 for 7 days. Disease assessment was performed on the 3 rd month, 6 th month, and at progression. Results: Twenty-seven patients were analyzed. Their median age was 71.5 years. Nine had refractory anemia with excess of blasts II (RAEB II), 5 had chronic myelomonocytic leukemia II (CMML II), 1 was with unclassifiable MDS (MDS-U), and 12 with AML. The median number of administered cycles was 6 (1-19). Eleven patients completed 6 cycles of azacitidine. Partial response was achieved in 9 patients (33%) (7 MDS and 2 AML), stable disease in 8 (29%) (5 MDS and 3 AML). Progressive disease was observed in 10 patients (37%). The response correlated with the type of the disease (p=0.03), cytogenetic risk (p=0.01), and survival (p=0.000). At 18 months, 60% of MDS patients were alive compared to 41.7% in the AML group. The median time to death in the AML patient group was 2.5 months. The mean overall survival was 10.4 months (12.6 months for MDS patients and 5.4 months for AML patients). Conclusion: The therapy with azacitidine is an option for elderly patients with high-risk MDS. In patients with AML a rapid progression is observed during the first two cycles with mortality rate of 58.3%.

An Overview of Risk Stratification in the Elderly Orthopaedic Population

Orthopaedic surgeries are occurring at an increasing frequency in the elderly patient. The goal of this review was to provide exposure to risk stratification scores to help identify high-risk elderly orthopaedic patients. New guidelines have been developed to assess the risk of cardiopulmonary and other perioperative complications. Older scoring systems, such as the American Society of Anesthesiologists (ASA) score and revised cardiac index, are still of importance as they have strong correlation with risks of cardiac and other complications. Other scoring systems, such as the Estimation of Physiologic Ability and Surgical Stress (E-PASS) score and Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) score, have recently been shown to stratify high-risk elderly patients undergoing hip fracture surgery and other orthopaedic surgeries. The elderly orthopaedic patient has higher risks of perioperative complications than the younger patient. Scoring systems have been developed to help identify those patients at higher risk. Familiarity with these scoring systems will help the practitioner to appropriately select patients for surgery and guide patient counseling on risks on complications and protocols to optimize preoperative care.

EQ-5D studies in cardiovascular diseases in eight Central and Eastern European countries: a systematic review of the literature.

The measurement of health-related quality of life (HRQoL) by validated generic instruments, such as EQ-5D, has become an increasingly important tool for the assessment of health care in a wide range of diagnoses. We aimed to systematically review EQ-5D literature on cardiovascular diseases in eight Central and Eastern European (CEE) countries. A structured literature search was conducted in MEDLINE, EMBASE, Web of Science, CINAHL, PsycINFO, Cochrane Library, and the EuroQol website up to November 2016. Original cardiovascular-related studies that reported EQ-5D results were included. Of the 36 papers, 17 reported EQ-5D index scores. Most studies were performed in Poland (n = 24, 67%). The most common diagnosis regarding the number of publications and population size was ischaemic heart disease (n = 13, N = 6394), followed by atrial fibrillation (n = 4, N = 1052). The average EQ-5D index scores ranged from 0.61 to 0.88 and from 0.66 to 0.95 for patients before and after cardiac procedure/surgery, respectively (including angioplasty, coronary artery bypass grafting, ablation, surgical correction of septal defects, transcatheter aortic valve implantation [TAVI]). In all studies baseline scores were lower than the repeated assessments after the procedure, with the most substantial improvement of 0.24 in high-risk elderly patients after TAVI. Studies which did not assess invasive treatment reported mean EQ-5D index scores ranging from 0.18 to 0.80. The number of cardiovascular-related studies reporting HRQoL using EQ-5D has consistently increased in CEE countries over the past decade and is outstanding compared with other clinical fields. The EQ-5D index and EQ VAS scores varied based on the disease severity, patient characteristics, and treatment protocol.

Adding dexmedetomidine to bupivacaine–fentanyl mixture in high-risk elderly patients undergoing orthopedic surgery: a randomized, double-blind, controlled study

Objectives The increased demand for spinal anesthesia in high risk elderly patients with comorbidity dictates the continual search for drug combinations to improve perioperative analgesia while limiting side effects. This study was designed to compare block characteristics, postoperative analgesia and hemodynamic effects associated with intrathecal dexmedetomidine when added to bupivacaine–fentanyl mixture in high risk elderly patients undergoing orthopedic surgery. Methods This prospective, double blind, randomized controlled study included fifty patients ≥60 years old, of either sex, ASA III and IV undergoing elective orthopedic hip surgery in one lower limb under unilateral spinal anesthesia. The patients were randomized in two groups to receive; Group F: 12.5 mg of 0.5% hyperbaric bupivacaine + 20 μg fentanyl. Group FD: 12.5 mg of 0.5% hyperbaric bupivacaine + 20 μg of fentanyl + 6 μg dexmedetomidine. Block characteristics, hemodynamic changes, postoperative analgesia and adverse effects were studied. Results The addition of dexmedetomidine (DEX) had no significant impact on the onset or highest level of sensory or motor blockade. DEX, however, significantly increased the duration of sensory and motor block and postoperative analgesia. Average times to first request for analgesia were longer in FD group (522.79±59.0 min) compared to (207.37±20.19 min) in F group (P=0.000). Blood pressure and heart rate changes were not significantly different among both groups. Pruritis was observed in 12% in F Group, whereas sedation was significantly more frequent in Group FD. Conclusion Addition of 6 μg dexmedetomidine to 12.5 mg bupivacaine + 20 µg fentanyl intrathecally greatly enhanced the duration of postoperative analgesia and was not associated with hemodynamic instability or other complications in high risk elderly patients undergoing orthopedic surgery under unilateral spinal anesthesia.

Pharmacological and Non-pharmacological Means for Prevention of Fractures among Elderly.

Fractures are major cause of morbidity, mortality, and healthcare and social services expenditure in elderly. Fractures often have multifactorial etiologies and the condition emerges due to the interaction between the different predisposing and precipitating factors. One of the most common causes leading to fractures after minimal trauma in older people is osteoporosis. The objective of this article is to describe the clinical concept and summarize the evidence and to explain the future directions for research, focusing on specific issues related to prevent fracture in the elderly. This study reviewed the scientific literature addressing strategies for primary and secondaryprevention of fractures among elderly in the context of pharmacological and non-pharmacological means. A growing body of scientific evidence supports the use of both non-pharmacological and pharmacological interventions for the prevention of fracture. Research on these interventions has yielded positive outcomes in fracture rates. The bisphosphonates and vitamin D and calcium suppliments are the preferred therapy for prevention of osteoporotic fractures. Weight-bearing exercise and reducing home hazards have beneficial effects in reducing the incidence of falls and consequently reduce fractures. Prevention of fractures in elderly consists of therapy and prevention of osteoporosis, fall prevention, and using injury-site protection by high-risk elderly patients. Special consideration needs to be taken to reduce home hazard, and falls prevention education can be recommended to the elderly with history of fall or mobility limitations. Future research to prevent fractures in elderly population should not only concentrate on improving bone density and strength but also need to be focused on falls reduction strategies.

Rapid Deployment Valves: Therapy of Choice in Elderly Patients?

Objective: Over the past few years the number of aortic valve replacements (AVR) has increased with outcomes that have been improved despite increasing age of patients and increasing burden of comorbidities. Rapid deployment (RD) AVR is an emerging alternative to standard AVR in elderly high-risk surgical patients. It has been even shown that for patients with severe aortic stenosis, RD-AVR may achieve better perioperative survival than TAVI.

Outcomes and Predictors of Mortality After Mitral Valve Surgery in High-Risk Elderly Patients: The Heidelberg Experience.

BackgroundOverall, life expectancy at the age of 80 has significantly increased in the industrialized world and the proportion of this age class undergoing cardiac surgery has also grown. In this context, we have analyzed a contemporary series of octogenarians undergoing mitral valve surgery at our institution.Material/MethodsWe performed a retrospective analysis of 138 consecutive octogenarians receiving mitral valve surgery between January 2006 and April 2017. Preoperative comorbidities, early mortality, postoperative clinical course, and predictors of mortality were examined.ResultsThe mean age was 82.4±2.0 years and 50% (n=69) were male. Preoperative comorbidities included history of heart infarction (24.6%, n=34), chronic renal failure (37.7%, n=52), and COPD (27.5%, n=38). A total of 52.9% (n=73) had a history of previous cardiac decompensation, while 20 (14.5%) presented with cardiogenic shock or cardiac arrest. In all, 33 patients (23.9%) underwent emergency surgery. There were only 39 isolated mitral valve procedures, while 99 patients (71.7%) underwent various concomitant procedures. The intensive care unit average length of stay was 5.3±7.5 days. Respiratory complications and sepsis were the most frequent postoperative complications. Emergency surgery and concomitant coronary artery bypass grafting were the most important predictors of early mortality. The overall 30-day mortality was 18.1% (n=25). The mean follow-up time was 1.7±2.3 years.ConclusionsOctogenarians are increasingly represented in cardiac surgery and combined procedures. Prudent patient selection is necessary for optimizing postoperative outcomes among the elderly. In our seriously ill octogenarian cohort, mitral valve surgery was associated with moderate but acceptable mid-term survival.

Embolic protection devices for transcatheter aortic valve replacement.

Transcatheter aortic valve replacement (TAVR) is a major advancement in the treatment of severe aortic valve stenosis in elderly high-risk patients. Implementing TAVR also in younger intermediate- or low-risk patients increases interest in the possibility of further lowering the risk of perioperative cerebrovascular events. To this aim, some embolic protection devices (EPDs) have been developed, some of which have already been approved for clinical use. Nevertheless, the cause of cerebrovascular events after TAVR is multifactorial, and selection of patients who would benefit from EPD is crucial to further improve outcomes, survival rate and quality of life. We reviewed the available literature in order to assess the incidence of and the mechanisms responsible for neurological events that can occur during TAVR, and we analysed clinical results and imaging findings following EPD use. Clinical trials for Embrella, TriGuard, Sentinel and Embol-X devices were designed to test their safety and their ability to prevent neurological complications in patients having TAVR. So far, published results showed that EPD may help in reducing the volume and size of periprocedural silent ischaemic brain lesions identified on magnetic resonance images but not in reducing the incidence of new lesions and new neurological events. The clinical impact of EPD in lowering the number of transient ischaemic attacks/strokes during TAVR needs to be further investigated in randomized trials.

Continuous Spinal Anaesthesia (CSA) for Emergency Laparotomy in High-Risk Elderly patients: Technique and Outcomes of a Prospective Service Evaluation

Continuous Spinal Anaesthesia is a recognized technique for providing anaesthesia for various surgical procedures. It may be an alternative to general anaesthesia in high-risk elderly patients requiring emergency laparotomy. The objective was to evaluate the benefits of continuous spinal anaesthesia in providing effective anaesthesia for emergency laparotomy, in enhancing recovery after major abdominal surgery and in reducing length of stay in the intensive care unit in high-risk elderly patients. Prospective service evaluation was performed at a tertiary care university hospital. High-risk elderly patients were offered both general anaesthesia and continuous spinal anaesthesia. An 18-gauge macro catheter was inserted into the intrathecal space through a 16-gauge Tuohy needle. Sedation was maintained with remifentanil. Prophylactic anti-emetics were administered. Blood pressure was maintained with an infusion of metaraminol. Over a 27-month period, 25 high risk elderly patients were offered continuous spinal anaesthesia and general anaesthesia for emergency laparotomy. Twenty-one patients opted for continuous spinal anaesthesia. Three patients required conversion to general anaesthesia. In the remaining 18 patients, continuous spinal anaesthesia provided adequate anaesthesia for major bowel surgery. Mean length of stay in level 2 care was 1.6 days. 30-day mortality was 14%. None of the patients reported post dural puncture headache. There were no neurological complications. Emergency laparotomy carries well-recognised intra and postoperative risks and in the elderly cohort, these risks are significant and probably life threatening. Continuous spinal anaesthesia is a well-established technique that may offer some reduction of both intra and postoperative risks with an improved immediate recovery from major emergency surgery.

Prognostic significance of immune-nutritional parameters for surgically resected elderly lung cancer patients: a multicentre retrospective study.

The world's population is rapidly ageing, and the age of patients with lung cancer will increase as well. The prognostic nutritional index, controlling nutritional status and the geriatric nutritional risk index (GNRI) are useful parameters for evaluating immune-nutritional status. We aimed to perform a multicentre retrospective study to investigate the correlations of these immune-nutritional parameters with postoperative comorbidities or surgical outcomes of elderly patients with non-small-cell lung cancer (NSCLC). We selected 272 consecutive patients with NSCLC aged >75 years treated from January 2005 to December 2012 and evaluated 3 preoperative immune-nutritional parameters as potential predictive factors of postoperative comorbidities or as prognostic factors for surgically resected elderly patients with NSCLC. Prognostic nutritional index, GNRI, sex and preoperative respiratory comorbidities were significantly associated with postoperative comorbidities. Multivariate analyses revealed that preoperative GNRI, sex, preoperative serum carcinoembryonic antigen levels, preoperative serum cytokeratin 19 fragment levels, pathological N factor and pleural invasion were significantly associated with overall survival (OS). Abnormal GNRI was significantly associated with histology and outcomes. The Kaplan-Meier analysis of OS as a function of preoperative GNRI revealed that patients with an abnormal GNRI experienced significantly shorter OS compared with those with normal GNRI (5-year OS, 45.15% vs 64.10%, respectively; P = 0.0007, log-rank test). The controlling nutritional status score was not significantly associated with postoperative comorbidities or surgical outcomes. Preoperative GNRI is a novel preoperative predictor of postoperative comorbidities and a prognostic factor that may identify high-risk elderly patients with NSCLC.

Validation and Assessment of Three Methods to Estimate 24-h Urinary Sodium Excretion from Spot Urine Samples in High-Risk Elder Patients of Stroke from the Rural Areas of Shaanxi Province.

Background: 24-h urine collection is regarded as the “gold standard” for monitoring sodium intake at the population level, but ensuring high quality urine samples is difficult to achieve. The Kawasaki, International Study of Sodium, Potassium, and Blood Pressure (INTERSALT) and Tanaka methods have been used to estimate 24-h urinary sodium excretion from spot urine samples in some countries, but few studies have been performed to compare and validate these methods in the Chinese population. Objective: To compare and validate the Kawasaki, INTERSALT and Tanaka formulas in predicting 24-h urinary sodium excretion using spot urine samples in 365 high-risk elder patients of strokefrom the rural areas of Shaanxi province. Methods: Data were collected from a sub-sample of theSalt Substitute and Stroke Study. 365 high-risk elder patients of stroke from the rural areas of Shaanxi province participated and their spot and 24-h urine specimens were collected. The concentrations of sodium, potassium and creatinine in spot and 24-h urine samples wereanalysed. Estimated 24-h sodium excretion was predicted from spot urine concentration using the Kawasaki, INTERSALT, and Tanaka formulas. Pearson correlation coefficients and agreement by Bland-Altman method were computed for estimated and measured 24-h urinary sodium excretion. Results: The average 24-h urinary sodium excretion was 162.0 mmol/day, which representing a salt intake of 9.5 g/day. Three predictive equations had low correlation with the measured 24-h sodium excretion (r = 0.38, p < 0.01; ICC = 0.38, p < 0.01 for the Kawasaki; r = 0.35, p < 0.01; ICC = 0.31, p < 0.01 for the INTERSALT; r = 0.37, p < 0.01; ICC = 0.34, p < 0.01 for the Tanaka). Significant biases between estimated and measured 24-h sodium excretion were observed (all p < 0.01 for three methods). Among the three methods, the Kawasaki method was the least biased compared with the other two methods (mean bias: 31.90, 95% Cl: 23.84, 39.97). Overestimation occurred when the Kawasaki and Tanaka methods were used while the INTERSALT method underestimated 24-h sodium excretion. Conclusion: The Kawasaki, INTERSALT and Tanaka methods for estimation of 24-h urinary sodium excretion from spot urine specimens were inadequate for the assessment of sodium intake at the population level in high-risk elder patients of stroke from the rural areas of Shaanxi province, although the Kawasaki method was the least biased compared with the other two methods.

P4012Antiplatelet therapy and adverse outcomes in high cardiovascular risk elderly patients: a sex and gender focused analysis from REPOSI study

P4012Antiplatelet therapy and adverse outcomes in high cardiovascular risk elderly patients: a sex and gender focused analysis from REPOSI study

Hip Fractures in Elderly People: Surgery or No Surgery? A Systematic Review and Meta-Analysis.

Introduction:Increasing numbers of patients with hip fractures also have advanced comorbidities. A majority are treated surgically. However, a significantly increasing percentage of medically unfit patients with unacceptably high risk of perioperative death are treated nonoperatively. Important questions about patients’ prefracture quality of life (QOL) and future perspectives should be asked before considering different treatment options to assess what kind of treatment is advisable in frail elderly high-risk patients with a hip fracture.Objective:The aim of this review was to provide an overview of differences in mortality, health-related QOL [(HR)QOL], functional outcome, and costs between nonoperative management (NOM) and operative management (OM) of hip fractures in patients above 65 years.Methods:A systematic literature search was performed in EMBASE, OvidSP, PubMed, Cochrane Central, and Web of Science for observational studies and trials. Observational studies and randomized controlled trials comparing NOM with OM in hip fracture patients were selected. The methodological quality of the selected studies was assessed according to the Methodological Index for Nonrandomized Studies (MINORS) or Furlan checklist.Results:Seven observational studies were included with a total of 1189 patients, of whom 242 (20.3%) were treated conservatively. The methodological quality of the studies was moderate (mean: 14.7, standard deviation [SD]: 1.5). The 30-day and 1-year mortalities were higher in the nonoperative group (odds ratio [OR]: 3.95, 95% confidence interval [CI]: 1.43-10.96; OR: 3.84, 95% CI: 1.57-9.41). None of the included studies compared QOL, functional outcome, or health-care costs between the 2 groups.Conclusion:This systematic review and meta-analysis demonstrated that only a few studies with small number of patients comparing NOM with OM were published. A significantly higher 30-day and 1-year mortality was revealed in nonoperatively treated hip fracture patients. No data were found examining (HR)QOL and costs. Further work is needed to enable shared decision-making and to initiate NOM in frail elderly patients with advanced comorbidity and limited life expectancy.

64 Older (higher risk) patients with non-st-elevation acute coronary syndrome (nsteacs) have the most to gain from invasive therapy: a population study in south wales 2004–2014

Background and aimCardiovascular disease is the biggest killer in Wales, with non-ST-elevation acute coronary syndrome (NSTEACS) forming the commonest diagnosis. NSTEACS patients are at risk of death, reinfarction and ischaemia,...

Efficacy of US-guided transversus abdominis plane block and rectus sheath block with ropivacaine and dexmedetomidine in elderly high-risk patients.

This study was designed to evaluate the effectiveness and safety of ultrasound-guided transversus abdominis plane (TAP) and rectus sheath (RS) blocks with ropivacaine and dexmedetomidine in elderly, high-risk patients undergoing emergency abdominal surgery. Sixty elderly patients undergoing emergency abdominal surgery receiving both bilateral ultrasound-guided TAP and RS blocks were randomly divided into two groups: R+D (10 mL of 0.25% ropivacaine+0.5μg/kg dexmedetomidine) and R (10 mL of 0.25% ropivacaine). Pain scores (at rest and with movement) and overall analgesia satisfaction were assessed. The total amount of sufentanil administered postoperatively during the first 24 h, duration of sensory blockade, first time and total number of patient-controlled intravenous analgesia (PCIA) pump activations on the first postoperative day were recorded. The duration of sensory blockade and the first time to PCIA pump activation in the R+D group were longer than that of the R group (P<0.05). The total number of PCIA pump activations on the first postoperative day as well as the total amount of sufentanil administered during the first 24 h in R+D group were less than in the R group (P<0.05). VAS scores at rest and during activity in the R+D group were lower than those in the R group at 2, 6, and 12 h after surgery (P<0.05). Ultrasound-guided TAP and RS blocks with ropivacaine and dexmedetomidine are more effective in promoting block effect, prolonging the duration of analgesia, reducing postoperative pain in elderly high-risk patients undergoing emergency abdominal surgery.

EP-1201: SLR versus SBRT for high-risk elderly patients with stage I NSCLC

EP-1201: SLR versus SBRT for high-risk elderly patients with stage I NSCLC

Tu1414 Long-Term Prognosis After Biliary Stenting for Common Bile Duct Stones in Elderly High-Risk Patients

Tu1414 Long-Term Prognosis After Biliary Stenting for Common Bile Duct Stones in Elderly High-Risk Patients

Abstract P5-14-08: Adjuvant and neoadjuvant chemotherapy for elderly patients (≥70 years) with early high-risk breast cancer: A retrospective analysis of 116 patients

Abstract Background: adjuvant or neoadjuvant chemotherapy in elderly patients (pts) is currently considered as a toxic treatment and reserved for fit women and high-risk breast cancer; few guidelines are available in this age group. The aim of this study was to evaluate the tolerability of chemotherapy in this patient population. Patients and Methods: We performed a retrospective analysis of the use of adjuvant and neo adjuvant chemotherapy in our Cancer Center in two groups of patients (≥70y-75y and &amp;gt;75 y) with early high-risk breast cancer. Between 2009 and 2014, 116 consecutive breast cancer patients (90pts:70-75y and 26pts:75&amp;gt;y: range70-84) received adjuvant or neoadjuvant chemotherapy; all patients had optimal surgery. The chemotherapy regimens were 3 FEC100 (epirubicine 100mg/m2 + 5-fluorouracil and cyclophosphamide 500mg/m2) + 3 docetaxel100mg/m2 or 4 TC( docetaxel 75mg/m2 + cyclophosphamide 600mg/m2). In case of HER2 positive breast cancer (IHC3+ or Sish+), the patients received trastuzumab for one year. The treatment is considered non optimal when there was a decrease in the number of courses or a dose reduction. However Docetaxel75mg/m2 after 3 FEC100 was considered acceptable as well as weekly administration. A yearly follow-up was performed after the end of the chemotherapy. The association between clinical data and age group (70-75) or (&amp;gt;75) was analyzed with Khi-2 test or Fisher test. Results Pts &amp;gt; 75y had more ≥ 3 co-morbidities: (38.5% vs 18.9% (p= 0.04), had more frequently triple negative breast (TN) breast cancer (53.8% vs 20% (p=0.001), inflammatory breast cancer (19.2% vs 3.3%) (p=0.014). Pts&amp;gt;75y had less frequently RH+ breast cancer (23.1% vs 61.1% (p=0.001); there was no significant differences for N+ between the two groups. The &amp;gt;75y pts received more frequently growth factors: 57.7% vs 35.6% (p=0.043); they had more often comprehensive geriatric assessment: 42.3% vs 11.1% (p&amp;lt;0.001) and were more often hospitalized (38.5% vs12.2% (p=0.002). There was no differences between the two age groups for Her2 status, SBR histoprognostic grading, grade ≥3 toxicity, 1year and persistent toxicity. One patient died in the group 70y-75y because of sepsis. There was no differences between the age groups in the rate of decrease of chemotherapy dosing. There was a statistical association between co-morbidities and grade ≥3 toxicity (p=0.004), grade≥3 toxicity and hospitalization rate (p&amp;lt;0.001), grade ≥3 toxicity and chemotherapy dosing (p&amp;lt;0.001). Conversely no association was found between chemotherapy dosing and 1 year health status. One year Trastuzumab was well tolerated in both groups. Conclusions: Adjuvant or neo adjuvant chemotherapy for elderly high-risk breast cancer patients is feasible. The &amp;gt;75 years old patients, those with ≥3 co morbidities are especially frail, at risk of toxicity, hospitalization, inadequate chemotherapy. These results questioned about the best tools for survey and the value of geriatric intervention along the treatment. Citation Format: Servent V, Tresch E, Vuagnat P, Bonneterre J. Adjuvant and neoadjuvant chemotherapy for elderly patients (≥70 years) with early high-risk breast cancer: A retrospective analysis of 116 patients [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-14-08.