Levels In Elderly Patients Research Articles

Clinical Outcomes of Bipolar Hemiarthroplasty versus Total Hip Arthroplasty: Assessing the Potential Impact of Cement Use and Pre-Injury Activity Levels in Elderly Patients with Femoral Neck Fractures.

PurposeThis study was performed to analyze the potential impact of cement use and favorable pre-injury activity on clinical outcomes of bipolar hemiarthroplasty (BHA) compared with total hip arthroplasty (THA) in elderly patients with femoral neck fractures.Materials and MethodsSystematic review and meta-analysis of 12 clinical studies (5 randomized controlled trials and 7 comparative studies). Subgroup analysis was performed based on type of fixation method (cemented vs. cementless) and in the patient with independent ambulation, respectively.ResultsA significantly higher dislocation rate was observed in patients treated with THA compared with those treated with BHA in individuals capable of independent ambulation before injury (odds ratio [OR], 0.17; 95% confidence interval [CI], 0.05–0.62; P=0.05, Z=1.98). Also, the dislocation rate was significantly higher in patients treated with cemented THA compared with those treated with cemented BHA (OR, 0.18; 95% CI, 0.05–0.62; P=0.006, Z=2.73). EQ-5D was significantly higher in those treated with cemented THA compared with patients treated with cemented BHA. Lastly, HHS was significantly higher in patients treated with cementless THA compared with those treated with cementless BHA.ConclusionAn increase in the dislocation rate was observed when THA was performed in elderly patients with femoral neck fracture and who were pre-injury independent walkers. In addition, cemented THA was associated with a higher dislocation rate compared with cemented BHA. However, the dislocation rate in those treated with cementless THA were similar to patients treated with cementless BHA. With regards to functional score, THA was superior to BHA in both cementless and cemented fixation.

Effect of three kinds of anaesthetic drugs on postoperative recovery, regulatory T cells and T lymphoid cells in elderly patients

Purpose: To investigate the effect of three anaesthetic drugs on postoperative recovery, regulatory T cells and T cell subset levels in elderly patients. Methods: The patients were randomly divided into groups A, B and C (42 patients per group). Group A received intravenous remifentanil, dexamethasone, dexmedetomidine and propofol, followed by continuous intraoperative inhalation of sevoflurane and continuous intravenous pumping of remifentanil. Group B was given intravenous propofol and midazolam, followed by continuous intraoperative inhalation of sevoflurane, while Group C received intravenous etomidate and rocuronium, with continuous intraoperative inhalation of sevoflurane. The preoperative or 24-h postoperative T regulatory cells (CD4 + CD25 + ) and T cell subsets (CD4 + and CD8 + ) were determined for each group. Results: MMSE scores in the three groups were lower than their pre-operation scores ( p < 0.05). There were significant reductions in 24-h postoperative serum CD4 + CD25 + and CD4 + levels, with higher reductions in group B ( p < 0.05). In contrast, CD8 + increased in all groups, but was lower in group B than in the other two groups ( p < 0.05). Conclusion: These findings strongly suggest that propofol, midazolam and sevoflurane have rapid onset of action and recovery, which improves the comfort of patients while decreasing negative impact on the function of the immune system. Furthermore, these anaesthetic agents enhance the recovery of elderly patients. Keywords: Anaesthesia, Cognitive function, Regulatory T cells, T cell subsets

Correlation between hypocalcemia and acute exacerbation of chronic obstructive pulmonary disease in the elderly

ABSTRACTIntroduction: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is an important disease of hospitalized elderly patients, who often have electrolyte imbalances. This study was performed to analyze total serum calcium levels in elderly patients with AECOPD and identify the correlation between hypocalcemia and AECOPD.Methods: 153 elderly patients with AECOPD served as the observation group, and 115 healthy elderly people undergoing physical examinations served as the control group. Differences in the corrected serum calcium, albumin (ALB), and neutrophil/lymphocyte ratio (NLR) were analyzed between the observation and control groups before and after treatment. The incidence of hypocalcemia was compared among patients at different ages and with different pulmonary function classifications before treatment. The relationship between hypocalcemia and respiratory infection was analyzed. Differences in the pretreatment NLR, ALB, logarithm of the serum C-reactive protein level (LogCRP), and hospital stay were compared between patients with and without hypocalcemia.Results: The corrected serum calcium level (P < 0.001), NLR (P = 0.001) and albumin level (P < 0.001) were significantly different among the pretreatment group, post-treatment group, and control group. The serum calcium level, LogCRP, and NLR were significantly lower after than before treatment (P < 0.05). Significant differences in the incidence of hypocalcemia were found among patients of different ages (P = 0.002). The respiratory infection rate (P < 0.001), hospital stay (P < 0.001), NLR (P = 0.007), and LogCRP (P < 0.001) was higher in patients with than without hypocalcemia. However, the albumin level was lower in patients with than without hypocalcemia (P < 0.001).Conclusions: In elderly patients with AECOPD, hypocalcemia may be related to the disease progression, respiratory infection rate, and hospital stay of patients with AECOPD.

Increased level of high-sensitivity cardiac Troponin T in a geriatric population is determined by comorbidities compared to age

High level of cardiac Troponin T (hs-cTnT) in geriatric population has been considered as an age-related phenomenon, which may question the interpretation of the increase of hs-cTnT in this population. The challenge is what is the primary cause of the increased hs-cTnT levels in elderly patients without AMI. ObjectiveThe aim of the current study was to determine the impact of aging on hs-cTnT levels in elderly patients without acute cardiac events but in the presence of comorbidities. MethodsSociodemographic and clinical data were collected from 6977 medical records of patients aged ≥65 years without acute coronary events but for whom hs-cTnT measurements were available. The patients were stratified based on age, troponin levels and the number of comorbidities. ResultsThe results suggested that the likelihood of increased hs-cTnT was related to the presence of comorbidities independently of their number (p < 0.05). The adjusted odds ratio (AOR) for both advanced age and having comorbidity was statistically significant, however for the old group (74 ≥ age ≥ 84 years) the chance of having elevated troponin regarding age compared to the presence of comorbidity was 1.070 vs. 1.216, whereas for the old-old group (≥85 years) it was found to be 1.071 vs. 1.311. Besides statistical significance for age, from a clinical standpoint, the AOR of 1.070 may not be considered clinically relevant. ConclusionIncreased hs-cTnT levels were associated with the presence of pre-existing comorbidities independently of age. Increased hs-cTnT levels in the elderly should always be considered as pathological, and a specific etiology should be searched.

Repetitive transcranial magnetic stimulation increases serum brain-derived neurotrophic factor and decreases interleukin-1β and tumor necrosis factor-α in elderly patients with refractory depression.

ObjectiveTo investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on serum levels of brain-derived neurotrophic factor (BDNF), interleukin (IL)-1β, and tumor necrosis factor (TNF)-α in elderly patients with refractory depression.MethodsA total of 58 elderly patients diagnosed with refractory depression between January 2015 and December 2016 were divided randomly into two groups: 29 patients who received rTMS and 29 controls without rTMS. Thirty healthy individuals were also enrolled and all received rTMS. Serum levels of BDNF, IL-1β, and TNF-α were measured before the study (0 days), and at 48 hours and 1, 2, 3, and 4 weeks after the first TMS treatment.ResultsBDNF levels gradually increased with treatment duration in the rTMS group and were significantly higher compared with the control group. In contrast, IL-1β and TNF-α levels gradually decreased and were significantly lower than in the control group. None of the serum factors were affected by rTMS in the healthy individuals. BDNF levels were negatively correlated and IL-1β and TNF-α levels were positively correlated with Hamilton Depression Rating Scale-24 scores.ConclusionThese results suggest that rTMS may increase BDNF and decrease IL-1β and TNF-α serum levels in elderly patients with refractory depression.

Insulin Glargine and Acarbose in the treatment of elderly patients with diabetes.

Objective:To investigate the clinical efficacy of insulin glargine combined with acarbose in the treatment of elderly patients with diabetes.Methods:One hundred and forty-four elderly patients with diabetes who received treatment between December 2016 and December 2017 in Binzhou People’s Hospital, China, were selected and divided into a control group and an observation group, 72 each, using random number table. The control group was treated with insulin glargine, while the observation group was treated with insulin glargine combined with acarbose. The therapeutic effect, improvement of quality of life and adverse reactions were compared between the two groups.Results:After treatment, fasting blood glucose (FBG), 2h postprandial blood glucose (PBG) and glycosylated hemoglobin (Hb Alc) of the two groups were lower than those before treatment, and the decrease degree of the observation group was significantly larger than that of the control group (P<0.05). The time needed for blood glucose reaching the standard level and daily insulin dosage of the observation group were significantly lower than that of the control group, and the differences were statistically significant (P<0.05). SF-36 scale score of the observation group was significantly better than the control group, and the difference was statistically significant (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).Conclusion:The combination of insulin Glargine and Acarbose can significantly control the blood glucose level of elderly patients with diabetes, improve the biochemical indicators, and enhance the quality of life. It is worth promotion in clinical practice.

EVALUATION OF THE RESULTS OF PELVIC FIXATION IN LONG LUMBOSACRAL INSTRUMENTATIONS IN ELDERLY PATIENTS

ABSTRACT Objective: Evaluate the initial results and the possible complications of the combination of pelvic fixation using iliac screws in long instrumentations of the lumbar spine in elderly patients. Methods: An analysis of 38 patients who underwent lumbar spine arthrodesis instrumentation with more than 3 levels, in which we included level L5-S1 and extended the fixation to the iliac crest. Radiological assessment of instrumentation through X-ray of the lumbar spine and pelvis, and computed tomography, to investigate the presence of radiological fusion. Clinical evaluation through a questionnaire of buttock pain including the visual analogue pain score (VAS). Complications related to pelvic instrumentation were investigated. Results: All patients had radiological fusion in the lumbosacral transition. A halo was found around the iliac screw on imaging studies in 31% of patients, but without related symptoms. The questionnaire of buttock pain found that 15% of patients had some low intensity buttock pain (VAS 1-2) and no need to or interest in removing the screws. There was infection at the surgical site in 2% of cases, hematoma in the buttocks in 5%, and vertebral body fracture in the cranial level instrumented in 7% of cases. Conclusions: Pelvic fixation through the iliac screws proved to be effective in protecting the S1 screws in long instrumentations including the L5-S1 level in elderly patients, allowing the radiological bone fusion. The overall results for pain were satisfactory, based on a questionnaire of buttock pain. There are no signs of overload or degeneration of the sacroiliac joints in the early years after surgery. Level of Evidence IV; Case series - therapeutic study.

A8380 Investigation of serum uric acid levels in elderly patients with persistent atrial fibrillation

A8380 Investigation of serum uric acid levels in elderly patients with persistent atrial fibrillation

Correlation Between Walking Ability and Monthly Care Costs in Elderly Patients After Surgical Treatments for Hip Fractures.

ObjectiveTo validate the relationship between residual walking ability and monthly care cost as well as long-term care insurance (LTCI) certification level in elderly patients after surgical treatment for hip fractures in Japan.MethodsElderly patients aged >75 years who underwent surgical treatment for hip fractures in our hospital were included. The preand post-surgical (6-month) walking ability and LTCI certification and the presence or absence of dementia was determined from medical records and questionnaires. Walking ability was classified into 6 levels used in our daily medical practice. Based on these data, we correlated the relationship between walking ability and the LTCI certification level. Further, based on the official statistics pertaining to the average monthly costs per person at each LTCI certification level, we evaluated the relationship between walking ability and monthly care cost.ResultsA total of 105 cases (mean age, 80.2 years; 16 men; 39 patients with dementia) were included. The correlation between walking ability and average monthly cost per person as well as LTCI certification level at 6 months postoperatively (r=0.58) was demonstrated. The correlation was found in both groups with and without dementia.ConclusionThe ability to walk reduced the cost of care in elderly patients who experienced hip fracture, regardless of the presence of dementia.

Leptin concentration and oxidative stress in diabetic ketoacidosis.

Diabetes is a common metabolic state during ageing, and one in five elderly individuals suffers from diabetes. However, few studies have been performed in elderly diabetic patients, and large randomized clinical trials in this population are rare. The purpose of this study was to investigate changes in serum leptin levels in elderly patients with diabetic ketoacidosis (DKA) before and after treatment and assess its relationship with oxidative stress parameters. Serum leptin levels, plasma superoxide dismutase (SOD) activity, plasma malondialdehyde (MDA) levels, plasma total antioxidant capacity (TAC) and plasma 8-iso-prostaglandin F2α (8-iso-PGF2α ) levels were measured in elderly patients aged 81.76 ± 9.42 years with DKA before and after treatment. Plasma SOD activity, TAC and serum leptins before treatment were significantly lower in elderly patients with DKA compared with the control group (P < 0.05), whereas plasma MDA and 8-iso-PGF2α levels before treatment were significantly higher in elderly patients with DKA (P < 0.05). Plasma SOD activity, TAC and serum leptin levels in elderly patients with DKA were significantly elevated after treatment, whereas their plasma MDA and 8-iso-PGF2α levels were significantly reduced (P < 0.05). Leptin levels negatively correlated with plasma 8-iso-PGF2α after treatment in elderly DKA patients (r = -0.36, P < 0.05). Stepwise multiple regression analysis showed that 8-iso-PGF2α was a significant factor affecting serum leptin levels. Serum leptin levels in the elderly patients with DKA were significantly reduced after treatment, which was associated with oxidative stress.

Dabigatran Levels in Elderly Patients with Atrial Fibrillation: First Post-Marketing Experiences.

The number of elderly individuals with non-valvular atrial fibrillation (NV-AF) requiring long-term anticoagulation is rising. The pharmacokinetics of oral anticoagulants in elderly individuals may differ from that for younger patients. The aim of this study was to assess the dabigatran levels in elderly patients with NV-AF. A pilot prospective post-marketing study in patients with NV-AF on dabigatran therapy was performed; we enrolled 21 consecutive elderly patients (aged ≥ 75years) on a reduced dabigatran regimen (110mg twice daily) and compared them with 13 younger (≤ 70years) individuals on reduced dabigatran therapy due to renal impairment and with 16 younger patients on standard dabigatran therapy (150mg twice daily). Blood samples were taken for the assessment of dabigatran trough and peak levels. Dabigatran levels were measured with the Hemoclot® Thrombin Inhibitor Assay. There were significant differences in dabigatran trough levels when comparing elderly patients on reduced dabigatran with non-elderly patients on reduced dabigatran (99.3 ± 73.6 vs 51.6 ± 25.6ng/mL; p < 0.01). Similarly, the detected dabigatran peak levels were significantly higher in elderly patients on reduced dabigatran compared with non-elderly patients on reduced dabigatran (173.4 ± 116.2 vs 116.1 ± 19.1ng/mL; p < 0.01). No significant differences in dabigatran trough and peak levels were found when comparing elderly patients on reduced dabigatran with non-elderly patients on standard dabigatran therapy. This pilot study demonstrated that elderly patients on reduced dabigatran exhibit significantly higher dabigatran levels than younger individuals on a reduced regimen, and similar levels compared with younger individuals on standard dabigatran.

Outcome of elderly emergency department patients hospitalised on weekends - a retrospective cohort study

BackgroundStudies investigating different medical conditions and settings have demonstrated mixed results regarding the weekend effect. However, data on the outcome of elderly patients hospitalised on weekends is scarce. The objective was to compare in-hospital and two-day mortality rates between elderly emergency department (ED) patients (≥65 years) admitted on weekends versus weekdays.MethodsA retrospective cohort study of emergency department visits of internal medicine patients ≥65 years presenting to the emergency department between 01 and 09-2010 and 31–08-2012 was conducted. The weekend was defined as the period from midnight on Friday to midnight on Sunday.ResultsData on 3697 emergency department visits by elderly internal medicine patients (mean age 78.6 years old) were included. In total, 2743 emergency department visits (74.2%) resulted in hospitalisation, of which 22.9% occurred on weekends. Comorbidity and urgency levels were higher in patients admitted on weekends. In-hospital mortality was 11.4% for patients admitted on weekends compared with 8.9% on weekdays (OR 1.3, 95%CI 0.99–1.8). Two-day mortality was 3.2% in patients hospitalised on weekends versus 1.9% on weekdays (OR 1.7, 95%CI 0.99–2.9). Multivariable adjustment for age, comorbidity and triage level demonstrated comparable in-hospital and two-day mortality for weekend and week admission (ORadj 1.2, 95%CI 0.9–1.7 and ORadj 1.5, 95%CI 0.8–2.6, resp.).ConclusionA small weekend effect was observed in elderly internal medicine patients, which was not statistically significant. This effect was partly explained by a higher comorbidity and urgency level in elderly patients hospitalised on weekends than during weekdays. Emergency care for the elderly is not compromised by adjusted logistics during the weekend.

Protein intake, serum lipids and muscle strenght in the elderly

The daily protein recommendation for adults is 0.8 g/kg/day; however, several studies argue that an intake of 1.0-1.5 g protein/kg/day could benefit the health of the elderly. We evaluated the protein intake and serum lipid levels in elderly patients with hip fracture, determining their correlation with the grip strength in both hands. The study included 47 adult patients aged 65-85 years hospitalized for recent hip fracture. Weight, height, lipid profile and muscle strength of both hands were measured, and MNA was also used to evaluate the nutritional status. The elderly, predominantly women and with a homogeneous age of 80 years on average, were malnourished or at risk of malnutrition in 93% of cases according to the MNA. Men consumed significantly more protein than women. Muscle strength negatively associated with triglyceride levels; 36% of the elderly had triglyceride levels above 150 mg/dl. TG levels associated inversely with muscle strength in elderly patients with hip fracture. According to these results, which should be validated in other populations, elevated TG levels are a factor of metabolic syndrome and are associated with low muscle strength in the elderly. This is relevant because obesity prevention and metabolic syndrome are one priority through the promotion of healthier lifestyles and nutrition policies that could be widely implemented.

Relationship of Apathy with Depressive Symptom Severity and Cognitive Functions in Geriatric Depression.

Apathy which is known as loss of primary motivation is observed more frequently in elderly depression in comparison with younger adults. It is put forth that apathy is related with depressive symptom severity and cognitive functions, that the existence of apathy may be a predictor of neurocognitive impairment. The objective of this study was to examine the apathy levels in elderly patients with major depression as well as the relationship between depressive symptom severity and cognitive functions. The study was carried out with 40 major depressive disorder patients (MDD) aged 60 and above, 40 healthy controls aged 60 and above. Sociodemographic data form, structured psychiatric interview (SCID-I), Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Montgomery-Asberg Depression Rating Scale (MADRS), Standardized Mini Mental State Examination (SMMSE), Montreal Cognitive Assessment Scale (MoCA), Apathy Evaluation Scale (AES) and Sheehan Disability Scale (SDS) were applied to the participants. In our study, HAM-D, HAM-A and MADRS scale scores of MDD group was determined to be higher in comparison with those of the healthy control group. A positive correlation was determined in the MDD groups between the AES scores and depressive symptom severity, whereas a negative correlation was determined between the AES scores and cognitive functions. The SMMSE and MoCA scores of the geriatric MDD group were determined to be lower in comparison with healthy control group. Low performance was observed in the geriatric MDD group especially in the fields of orientation, visual/spatial functions, memory and language. Functionality was found to be lower in MDB group than in the control group, and functionality decreased as the level of apathy increased. Our results indicate that the apathy levels in geriatric depression are higher in comparison with the control group. Cognitive functions are affected adversely in geriatric patients in major depressive disorder, depressive symptom severity, impairment in cognitive functions and functionality are observed to be related with apathy level.

Relationship Between the Kihon Checklist as an Index of Frailty and Plasma Fatty Acid Levels in Elderly Patients Undergoing Cardiac Rehabilitation

Relationship Between the Kihon Checklist as an Index of Frailty and Plasma Fatty Acid Levels in Elderly Patients Undergoing Cardiac Rehabilitation

Glycemic control of elderly patients with type 2 diabetes mellitus in Spain (2015) and its relationship with functional capacity and comorbidity. The Escadiane study

ObjectivesTo understand the state of glycemic control of elderly patients with type 2 diabetes mellitus in Spain and its relationship with functional capacity and comorbidity. MethodsCross-sectional, observational, multicentre national study on patients with diabetes mellitus aged 65 years or older. The study analyzed demographic and anthropometric variables, cardiovascular risk factors, clinical and laboratory data, associated comorbidity and treatments.We analyzed the functional capacity using the Barthel index and the comorbidity with Charlson index. ResultsThe study included 939 patients with a mean age of 76.4±6.7 years. The mean glycated hemoglobin (HbA1c) level was 7.0%±1.2%, and the mean basal blood glucose level was 137±39.6mg/dL. The HbA1c level showed statistically significant differences depending on the degree of disability. In the patients who were totally, severely, moderately or slightly dependent or who were independent, the mean HbA1c levels were 7.0%, 7.9%, 7.4% and 7.0%, respectively (p<.028). HbA1c levels were 7.3%, 7.1% and 6.9% in the patients with very high, high and medium comorbidity, respectively (p<.001). ConclusionsMean HbA1c levels in elderly patients with type 2 diabetes analyzed in Spain are below those recommended by the main clinical practice guidelines. The levels are higher in patients who have more functional disability and a higher level of comorbidity.

Control glucémico de los pacientes ancianos con diabetes mellitus tipo 2 en España (2015) y su relación con la capacidad funcional y la comorbilidad. Estudio Escadiane

ObjectivesTo understand the state of glycaemic control of elderly patients with type 2 diabetes mellitus in Spain and its relationship with functional capacity and comorbidity. MethodsCross-sectional, observational, multicentre national study on patients with diabetes mellitus aged 65 years or older. The study analysed demographic and anthropometric variables, cardiovascular risk factors, clinical and laboratory data, associated comorbidity and treatments.We analysed the functional capacity using the Barthel index and the comorbidity with Charlson index. ResultsThe study included 939 patients with a mean age of 76.4±6.7 years. The mean glycated haemoglobin (HbA1c) level was 7.0%±1.2%, and the mean basal blood glucose level was 137±39.6mg/dL. The HbA1c level showed statistically significant differences depending on the degree of disability. In the patients who were totally, severely, moderately or slightly dependent or who were independent, the mean HbA1c levels were 7.0%, 7.9%, 7.4% and 7.0%, respectively (P<.028). HbA1c levels were 7.3%, 7.1% and 6.9% in the patients with very high, high and medium comorbidity, respectively (P<.001). ConclusionsMean HbA1c levels in elderly patients with type 2 diabetes analysed in Spain are below those recommended by the main clinical practice guidelines. The levels are higher in patients who have more functional disability and a higher level of comorbidity.

The Effect of Tempe Dietary Intake on Plasma Glucose Level in Elderly Patients with Type 2 Diabetes Mellitus

The aim of the study was to investigate the effect of daily intake of 100 grams tempe for four weeks on plasma glucose level in elderly patients with type 2 diabetes mellitus. This study was a parallel randomized clinical trial. Subjects were 30 diabetic elderly living in four nursing homes in Jakarta. In the study subjects were assigned to two groups using block randomization. All subjects had to take diabetic regiment with calorie and macronutrient following diabetic recommendation diet. The treatment group (n=16) received tempe, while control group (n=14) received legumes other than tempe. Fasting plasma glucose level (FPG) was assessed before and after intervention. Unpaired t test and Mann Whitney were used to analyzed data with the 5% significance level. There were 27 subjects completed the study: 15 of treatment group and 12 of control group. Both group were comparable in age, gender, BMI, calorie and macronutrient intake before treatment. Fat, fiber, and isoflavone intake were significantly higher in treatment group compare to control group. Decrease in FPG after intervention were observed but were statisticaly insignificant. In conclusion daily intake of 100 grams tempe for four weeks did not decrease FPG. Keywords: elderly, plasma glucose level, tempe, type 2 diabetes

Frailty syndrome and rehospitalizations in elderly heart failure patients

BackgroundHeart failure (HF) patients with frailty syndrome (FS) are at higher risk of falling, decreased mobility, ability to perform the basic activities of daily living, frequent hospitalizations, and death.AimsThe purpose of this study was to evaluate the correlations between FS and hospital readmissions, and to assess which factors are associated with rehospitalizations.MethodsThe study included 330 patients with a mean age of 72.1 ± 7.9 years, diagnosed with HF. Frailty was measured using the Polish version of the Tilburg Frailty Indicator (TFI). Demographic, sociodemographic, and clinical data, such as the New York Heart Association (NYHA) functional class, ejection fraction (EF), number of rehospitalizations, and the medications taken, were obtained.ResultsPositive correlation was observed between the number of hospitalizations and FS. In the single-factor correlation analysis, treatment with diuretics, a higher NYHA class, and a lower left ventricular EF were predictors of a higher number of hospitalizations. Additionally, the physical and psychological components of the TFI, as well as the total TFI score, predisposed HF patients to more frequent hospitalizations.DiscussionIt seems that a deterioration of functional capabilities and an increase in symptom severity naturally lead to increased hospitalization frequency in HF. In the own study, regression analysis indicates that high NYHA classes and TFI social component scores are significant predictors of the number of hospitalizations in the studied group.ConclusionsFS is highly prevalent among elderly HF patients. Higher frailty levels in elderly patients are a determinant of more frequent rehospitalizations in HF.

Expression of intercellular adhesion molecule-1 and myeloperoxidase in peripheral blood and its significance in elderly patients with OSAHS

Objective:To investigate the detection and significance of serum intercellular adhesion molecule-1 (ICAM-1) and myeloperoxidase (MPO) in elderly patients with OSAHS in adults.Method:Ninety-three cases of elderly OSAHS patients who confirmed by PSG were observed. According to the range of AHI, they were divided into 3 groups (severe, moderate and mild). 31 cases of healthy person were observed as control group. The serum ICAM-1 and MPO were determined by ELISA method; ICAM-1 and MPO were measured after comprehensive treatment in patients with elderly severe OSAHS, and the correlation between ICAM-1, MPO and PSG were analyzed.Result:①With the severity of snoring increased, the serum levels of ICAM-1 and MPO increased gradually (F=29.937,18.946; P< 0.01); The concentration of ICAM-1 and MPO in each group showed that there was no significant difference between the mild group and the control group (P> 0.05), there were significant differences between the rest each two groups (P< 0.05). ②There was no correlation between serum levels of ICAM-1, MPO, BMI, age in OSAHS patients (P> 0.05). There was a positively relationship between ICAM-1 and MPO . Both of them were negatively correlated with AHI, and positively correlated with LSaO2 (P< 0.01). ③The concentration of ICAM-1, MPO and AHI in 31 elderly patients with severe OSAHS decreased and LSaO₂ increased significantly after 3 months of comprehensive treatment (P< 0.01).Conclusion:The increase of ICAM-1 and MPO concentration in peripheral blood is one of the mechanisms of cardiovascular damage in elderly patients with OSAHS. Determination of peripheral blood ICAM-1, MPO levels in elderly patients with OSAHS to help determine the severity of disease, the evaluation of treatment,which may have a certain reference value for the prediction of cardiovascular disease risk in patients with severe OSAHS.