Medical Care For Elderly Patients Research Articles

Development of New Minimally Invasive Treatments That Contribute to Medical Care for Elderly Patients

Development of New Minimally Invasive Treatments That Contribute to Medical Care for Elderly Patients

Maintaining health-system functionality in response to the surge of COVID-19 cases due to the Omicron variant, Japan.

The Omicron variant of severe acute respiratory syndrome coronavirus 2 caused the largest surge of coronavirus disease (COVID-19) cases in Japan starting in the summer of 2022. We describe the mechanisms introduced to provide appropriate health care to all Omicron cases, provide appropriate health care to all non-COVID-19 patients, and protect health-care workers (HCWs) while providing necessary health services. Optimization of care for elderly patients was particularly important. Japan is home to 125 million people, of whom 28.6% are 65 years or older. Between January and June 2022, the country experienced 4.3 times more COVID-19 cases than in the previous 2years (7.3 million vs 1.7 million). To adjust care pathways, inpatient treatment capacity was increased, a home-based care system was established, and an on-site treatment scheme at long-term care facilities was started. Among essential health services, disruption of emergency care became most noticeable. Administrative and financial support was provided to hospitals with emergency departments to maintain emergency medical services. To protect HCWs while maintaining hospital services, flexible exemptions were introduced to enable those who became close contacts to return to work, and broadly targeted contact tracing and testing in case of nosocomial outbreaks were all helpful. As a result of the adjustments made to inpatient capacity and patient flow, bed occupancy for COVID-19 patients decreased, mostly because many patients were cared for at home or in temporary-care facilities. From this study, we extracted two essential lessons to aid in current and future health emergencies: how to balance the provision of acute medical care for elderly patients and maintain their well-being; and how to maintain essential health services.

Features of Hemodynamics in Elderly Patients Undergoing CABG Surgery at the Stage of Induction Anesthesia

Due to the global trend of the population ageing, an important task of modern medicine is to improve the provision of medical care for elderly patients. These people have reduced compensatory reserves of the body and numerous chronic pathologies, necessitating a more meticulous approach to anesthesia induction and maintenance by anesthesiologists. According to the authors, the use of propofol and fentanyl leads to decreased myocardial contractility and reduction in overall peripheral vascular resistance. However, the resulting decrease in perfusion pressure in vital organs and tissues, as a consequence of the aforementioned effects, is unacceptable in elderly patients with coronary heart disease (CHD).
 The aim
 . To analyze changes in hemodynamics in elderly patients undergoing coronary artery bypass grafting (CABG) during the induction of anesthesia.
 
 Materials and methods. A prospective study was conducted which included the results of examination of 20 patients with CHD over 60 years old who underwent CABG without the use of cardiopulmonary bypass at the National Amosov Institute of Cardiovascular Surgery (Kyiv, Ukraine). The mean age of the patients was 67.5±6.8 years. There were 16 (80%) men and 4 (20%) women. Typical manifestations of heart failure were noted (there were 1 [5%], 10 [50%] and 9 [45%] NYHA functional class I, II and III patients, respectively). Also, the patients were classified according to the Canadian classification of angina: 1 (5%), 9 (45%) and 10 (50%) patients fell within class I, II and III, respectively. Stage 2-3 hypertension was reported in 18 patients (90%).
 For induction of anesthesia, the following medications were used: propofol 1.5 mg/kg, fentanyl 2.0 μg/kg, and rocuronium bromide 0.1 mg/kg. Anesthesia maintenance included: propofol 4 mg/kg/hour, fentanyl 2.0 μg/kg/hour. Hemodynamic parameters saturation indices (SpO2), and transthoracic echocardiography parameters were recorded at the following stages: 1) upon the patient’s arrival in the operating room; 2) prior to tracheal intubation; 3) immediately after tracheal intubation; 4) 25 minutes after intubation.
 Results. Upon arrival in the operating room, the hemodynamic parameters reflected stable general condition of the examined patients. After administration of induction agents according to the study design, it was recorded that mean blood pressure (BP) was 72.7±4.76% (p<0.001), heart rate was 89.8±5.95% (p=0.0004), cardiac index was 81.47±6.6% (p<0.001), and systemic vascular resistance index (SVRI) was 89.9±7.02% of the baseline values (p=0.063). After intubation, an increase in most hemodynamic indicators was observed, although only mean BP, which constituted 86.7±8.8% of the baseline data (p<0.001), and SVRI (89.8±11.04% of the baseline data, p=0.0315), significantly differed from the baseline values. Within 25 minutes after the intubation, the parameters decreased again: with mean BP 74.9±7.9% (p<0.001), heart rate 91.3±9.5% (p=0.008), cardiac index 79.6±10.1% (p<0.001), and SVRI 91.1±9.34% (p=0.062) of the baseline values.
 Conclusions. The main changes in hemodynamics were reported during induction of anesthesia, where a significant decrease in most indicators compared to the baseline state was recorded. After intubation, the parameters slightly increased but did not return to the baseline values. During further anesthesia maintenance, a significant decrease in most indicators relative to the baseline data were observed. The instability of hemodynamic parameters during the induction stage of anesthesia in elderly patients with CHD can be an obstacle to the normal course of the perioperative period, necessitating the search for methods to stabilize them.

A Meta-Analysis of Pension Models for Patients with Mental Disorders

Objective: To analyze the pension models available for patients with mental disorders and design a more suitable one. Methods: A total of 135 pieces of literature in the database of China National Knowledge Infrastructure (CNKI) published from August 11, 1970, to November 17, 2022, were classified and analyzed. A knowledge map was drawn and the research context was sorted out from the aspects of temporal distribution, spatial distribution, research hotspots, and evolutionary trend, so as to reveal the research status and development trend in the field of pension for patients with mental disorders. Results: The temporal distribution of the literature in this review involved 20 disciplines, 41 papers, 2 information articles, 40 authors, 13 research levels, and 20 research institutions. In terms of research hotspots and evolutionary trends, the keywords “disability pension,” “pension institutions,” and “patients with mental disorders” play a fundamental role in the dynamic evolution and diversification of research topics in the field of the mental disorder pension model. Conclusion: There has been not much research on elderly care for patients with mental disorders, and it is still in the exploratory stage without a sustainable and stable research theme. In recent years, keywords such as “the combination of medical care,”“community care for the elderly,” and “intelligent care” for the elderly have become prominent and the number of related studies has increased, and the research quality in this field has also improved. Intelligent medical care for elderly patients with mental disorders will become the trend of future research.

Generation-Dependent Retention Rates and Reasons for Discontinuation of Molecular Targeted Therapies in Patients with Rheumatoid Arthritis: From FIRST Registry.

The study aimed to optimize medical care for elderly patients with rheumatoid arthritis (RA) by examining the 3-year continuation rate of different molecular targeted therapies across age groups in Japan, which has a significant elderly population. The study included patients with RA who started molecular targeted therapies between 2013 and 2019 and divided them into three age groups. The primary outcome was to assess the 3-year continuation rate of each drug and analyze reasons for treatment discontinuation using inverse probability of treatment weighting. Among 2292 patients analyzed, tumor necrosis factor (TNF) inhibitors were most commonly used in those younger than 65years of age (43.5%), while Janus kinase (JAK) inhibitors were also utilized (17.1%). In contrast, JAK inhibitors were less frequently used in patients aged 75years and older (7.8%), with cytotoxic Tlymphocyte antigen4 immunoglobulin fusion proteins (CTLA4-Ig) being the most common (39.2%). JAK inhibitors and anti-interleukin-6 receptor (IL-6R) antibodies had higher continuation rates than other drugs in patients under 65years (p < 0.001). For those aged 65-74years, JAK inhibitors and CTLA4-Ig had higher continuation rates (p < 0.001), while among those aged 75years and older, CTLA4-Ig and IL-6R antibodies had higher continuation rates (p < 0.001). Inadequate efficacy was the main reason for discontinuation in all age groups, while infection leading to discontinuation increased with age. The study highlights the need to consider different age groups separately in elderly RA care. Among patients aged 75years and older, abatacept and anti-IL-6R antibodies showed the highest continuation rates, suggesting their potential suitability and efficacy for this specific age cohort.

Age-dependent association of discharge heart-failure medications with clinical outcomes in a super-aged society

AimsReal-world evidence about heart failure (HF) medical care for elderly patients is limited. The aim of this study was to clarify the age-dependent associations of HF medications at discharge with clinical outcomes in a super-aged society using a real-world big database. Methods and resultsPatients hospitalized with a first episode of acute HF in 2013–2019 were identified in a nationwide claims database in Japan and were analyzed based on the HF medications at discharge. Hazard ratios (HRs) and 95 % confidence intervals (95 % CIs) for clinical outcomes were calculated after adjustment. Among 325,468 patients from 4351 hospitals, 130,230 (40.0 %) were aged ≥ 85 years. All-cause mortality and HF readmission rate within 1 year were 14 % and 23 %, respectively. β-Blockers and angiotensin-converting-enzyme inhibitors or angiotensin II receptor blockers (ACEI/ARB) uses were associated with lower mortality (HR [95 %CI]: 0.84 [0.83,0.86] and 0.73 [0.71,0.74], respectively) and HF readmission (0.98 [0.97,0.99] and 0.89 [0.88,0.90], respectively). The associations were attenuated as the age increased and, in β-blockers use, the favorable associations with mortality and HF readmission were not observed in patients with ≥ 95 years and ≥ 80 years, respectively. In contrast, mineralocorticoid receptor antagonists (MRA) use was associated only with lower HF readmission (0.83 [0.82,0.84]), which was not attenuated with increased age. ConclusionsThe favorable associations of β-blockers and ACEI/ARB uses with mortality and HF readmission were age-dependently attenuated in patients across a broad spectrum of HF in a super-aged society. In contrast, positive impact of MRA use on HF readmission was not attenuated with aging.

Clinical and anamnestic features and the nature of medical care for patients of older age groups as factors of unfavorable prognosis of myocardial infarction

Objective: to study the features of the anamnestic background, clinical course, as well as the nature of medical care for elderly patients with acute myocardial infarction (MI) and to assess their impact on the prognosis of the disease. Material and methods: the study included patients 60 years and older who survived acute MI and registered in the «Register of Acute Myocardial Infarction»(Tomsk) (n=410). The study conducted a 5-year prospective follow-up of patients with an assessment of their vital status. The Statistica V10.0 application software package («StatSoft Inc.») was used for statistical processing of the data obtained. Results: the analysis showed that 90% of patients had a history of comorbid pathology. In almost 20% of patients, the onset of the disease was characterized by an atypical clinical picture, which in more than a third of cases was represented by a low-symptomatic form. The presence of atypical MI manifestation lengthened the prehospital stage of medical care due to the late treatment of patients for medical help (120 [49; 311.5] minutes), as well as longer time before the first medical contact (26.5 [20;40] minutes (p=0.005)). A fifth of patients were treated for acute MI in non-core hospitals, where the hospital mortality rate among elderly patients reached 65.7%, which was 3 times higher than the same indicator in specialized cardiology departments (19.7%, p&lt;0.001). Conclusion: the main factors affecting the long-term postinfarction period in elderly patients were: isolated systolic arterial hypertension, diabetes mellitus, impaired renal function, a history of myocardial infarction and acute cerebrovascular accident.

Relationship between pre-hospitalization home-based medical care of elderly patients who died from pneumonia and inpatient aggressive therapy in Japan

The number of elderly people aged 65 and over is increasing in Japan. Elderly, terminal patients in acute care hospitals receive aggressive therapy treatments, leading to higher national medical costs; however, reports indicate that patient discussions regarding end-of-life medical care can reduce unnecessary aggressive therapies. This study investigated whether the presence of home-based medical care impacted the use of aggressive therapies in terminal, elderly patients who had died of pneumonia during hospitalization. Japanese Diagnosis Procedure Combination (DPC) patient data were obtained for the period April 2014 to March 2017. We conducted a multicenter, cohort study of inpatients aged 65 years or older who were hospitalized for pneumonia and subsequently died. We analyzed the relationship between pre-hospitalization, home-based medical care, and aggressive therapies during the terminal stages of pneumonia using the chi-square test, t-tests, and logistic regression analyses. Data extracted included 13,582 cases of patients with pneumonia over the age of 65 years. The mean patient age was 83.1 (±7.02) years, 64.7% were male, 47.8% underwent ambulance transport, and 17.2% had home-based medical care. Aggressive therapy was administered in 33.3% of the cases. Effects of the independent variables on incidence of aggressive therapy were observed in 2,332 cases (17.2%; OR: 0.879; 95% CI: 0.791-0.977). Odds ratios were higher for patients undergoing ambulance transport, a higher Barthel index, and a higher A-DROP. We found that incidences of aggressive therapy during terminal stages of pneumonia were significantly lower for elderly patients who received home-based medical care prior to hospitalization.

Medical Care of Elderly Patients with Crohn’s Disease:

Medical Care of Elderly Patients with Crohn’s Disease:

The effectiveness of the organization of medical care for elderly patients with acute coronary syndrome in the regional vascular center

The article provides a retrospective analysis of the activities of the regional vascular center (RCC) of the Moscow City Clinical Hospital named after M.P. Konchalovsky, working in the framework of the Regional program of specialized medical care for acute coronary syndrome (ACS). A multidisciplinary team of doctors based on the RIC has been created at the hospital. Organizational measures allowed to reduce the time interval from the moment a patient with ACS arrives at the hospital admission department until the mechanical recanalization and stenting of the infarct-related artery begins, increase operative activity and reduce the average hospital bed-day of the patient's hospital stay.

Practice of Social and Medical Care for Elderly Patients with Cardiovascular Diseases in Volgograd Region

Currently, the first place among the causes of mortality and disability of the adult population of the Russian Federation is occupied by cardiovascular diseases. According to the reporting documentation of the Health Committee of the Volgograd region for three quarters of 2019, at the expense of the federal budget in the conditions of federal specialized medical institutions, high-tech medical care was provided to 2615 residents of the Volgograd region. Over three quarters of 2019, high-tech medical care was provided to 868 patients in budget health-care institutions of the Volgograd region. The following medical care profiles are in the leading positions: cardiovascular surgery (904 patients treated), traumatology and orthopedics (820 patients treated), oncology (498 patients treated).The development of cardiovascular diseases is based on physiological factors (especially the human body, etc.) and social factors (lifestyle, alcoholism, etc.). A statement of the influence of both physiological and social factors on the health of the cardiovascular system actualizes the need to study the experience of preventive work and the provision of social and medical assistance in a unified system of social protection of the population of the Volgograd region. The main elements of this system are institutions and organizations with different functions – prevention, treatment and rehabilitation. Because the fact that the profiles of institutions providing services to people with cardiovascular diseases are different, the task of comprehensive support cannot be solved without a well-functioning mechanism for the interaction of all elements of assistance aimed at reducing the incidence and mortality rate from cardiovascular diseases. The work explores the activities of the Committee for Social Protection of the Volgograd Region as an organization that coordinates the work on building a system of prevention, treatment, and rehabilitation of older people, including those with cardiovascular diseases. Problems are systematized on the basis of a comprehensive review of theoretical approaches, the regulatory framework, and the results of an analysis of the work of medical and social institutions in the Volgograd Region, that impede the establishment of integrated work with patients who have cardiovascular pathology and do not allow building effective work.

A case of autoimmune hepatitis with tuberculosis caused by prednisolone from undeterminable enzyme-linked immunospot assay

An 88-year-old woman was referred to our hospital for autoimmune hepatitis in 2016. She was treated with prednisolone. In 2018, she was rehospitalized owing to hepatitis relapse. Steroid pulse therapy was performed. She exhibited good recovery of hepatitis, but was transferred to a convalescent ward in a general hospital because of decreased activity of daily life. After a month later, she had high fever and cough. She was diagnosed as having tuberculosis because of positive Mycobacterium tuberculosis polymerase chain reaction. At our first medical examination in 2016, we performed enzyme-linked immunospot and the result was undeterminable. There is an increase in the opportunities to use immunosuppressant and biologic agents for elderly patients. Our case report should contribute to future medical care for elderly patients who are at risk of latent tuberculosis infection.

The modern characteristics of quality of ambulatory polyclinic medical care of patients of elderly age

The organization of out-patient care of elderly people has its own clinical and organizational characteristics. The study was carried out to establish quality factors of ambulatory polyclinic medical care of elderly people from the position of attending physician. The sampling consisted of 80 physicians interviewed. Out of them 70 were females (87.5%), 50 local therapists and general practitioners and 30 physicians of various specialties. The genuinely elaborated questionnaire was applied. Results and discussion. It is established that most physicians are aware of the need of improving quality of medical care of elderly patients and developing geriatric care. The percentage of elderly patients in ambulatory polyclinic network makes up to 50%, and in particular cases up to 60-70%. The majority of elderly patients visit their physician 1-2 times per month. More than 50% of physicians consider elderly patients have to be observed by physicians of geriatric profile that confirms actual need in this medical specialty. The social and organizational factors of quality of medical care are identified: insufficient duration of physician admission, low level of preferential medications support, lacking of cash resources in patients to purchase prescribed medications, difficulties in making an appointment to medical specialist and district physician, difficult access of medical organization. The orientation of doctors in provision of care to elderly patients only to medication therapy is established. Conclusion. The specific characteristics of identified factors of quality of medical care of elderly patients are to be considered in developing directions of optimizing medical care for this contingent.

Raising enthusiasm for the medical care of elderly patients: a concept mapping study to find elements for an elderly friendly medical curriculum

BackgroundTo deliver high quality of care for the growing population of older patients more geriatricians are needed. However, the interest of medical students for a career in geriatrics is lagging behind due to a lack of exposure, the nature of the work, and the low status and financial rewards.So far, only isolated interventions aimed at enhancing interest and/or attitudes with regard to geriatrics have been studied, pointing to the need for a broader-based strategy. The goal of this research is to find elements for a curriculum framework that can raise medical students’ enthusiasm for the medical care of elderly patients.MethodsWe used the concept mapping method developed by Trochim. This computer-assisted procedure consists of five steps: brainstorming, prioritizing and clustering with several experts, followed by processing by the computer and analysis.ResultsThe views that were generated were grouped into the following clusters: a patient-centered medical curriculum, a curriculum representative of patient population, geriatrics presented as intellectually challenging and emotionally appealing, senior-friendly role models, a clear professional perspective.The results are presented in the form of a graphic chart.ConclusionsAn agenda to discuss the necessary actions for drastic curricular reforms in medical schools is set. This may give some guidance to this urgent, but highly complicated issue how to make medical student enthusiastic for the medical care for elderly patients.

The optimization of treatment of patients with community-acquired pneumonia with high cardiovascular risk (case from practice).

Pneumonia occupies a significant part in the structure of morbidity and mortality of the population of Ukraine and the whole world. The incidence of this disease is several times higher among elderly patients. At the same time the prognosis for patients of this category can be fairly unfavorable, being connected with a number of age features. This fact, in its turn, points out the necessity of more precise criteria and new methods of assessing changes in the condition of a patient with pneumonia, and it also became a valid criterion to use in determining the severity and prognosis of the disease course. In this article the specific example of the application of the algorithm, named “Integral geriatric evaluation adapted for emergency care”, in the treatment of an elderly patient with pneumonia was considered. The role of statins in the complex treatment of patients with inflammatory diseases and their link with the level of C-reactive protein as a risk indicator of the unfavourable course of the disease in the form of the thrombotic complications was specifieced. So, medical care for elderly patients with pneumonia should be comprehensive in terms of diagnosis (improving the fairness through the application of the new and more precise methodology of assessing the functional state of a human organism) and treatment. The high degree of comorbidity among patients of the category “frail elderly” with pneumonia requires the application of approaches, which enable to reduce the cardiovascular risks and otherones. Such approaches include the administering of statins at high doses, in light of its impact on the level of C-reactive protein as a predictor of the thrombotic complications.

Factors associated with unexpected admissions and mortality among low-functioning older patients receiving home medical care.

The need for and availability of home medical care for elderly patients with limitations in terms of access to medical facilities has been increasing. We investigated the association between low function, malnutrition, dementia and multicomorbidity with patient prognosis, focusing on unexpected hospital admissions and mortality in elderly non-cancer patients receiving home care. The study included 124 Japanese patients receiving home medical care in the form of regular visits from doctors and nurses for physical and/or mental disability. Of the patients studied, 36.2% experienced hospital admission. Student's t-test showed that admitted patients had significantly higher Charlson Comorbidity Index scores. Meanwhile, 19.6% of patients died during the course of the study. Student's t-test showed that older patients had a higher risk of mortality, and significantly lower activities of daily living and Mini-Nutritional Assessment Short-Form scores. Cox hazard analysis showed that multicomorbidity was a risk for unexpected hospital admission, and malnutrition was a risk for mortality in frail older adults receiving home medical care. We found that multicomorbidity was a risk for unexpected hospital admission, and malnutrition was a risk for mortality in frail older adults receiving home medical care. Geriatr Gerontol Int 2017; 17: 1623-1627.

都市部二次救急1病院における高齢者救急医療の現状と今後の展望(Present status and prospects of emergency medical care for elderly patients in an urban secondary emergency hospital)

要旨【背景】65歳以上の高齢者人口は2,958万人で，総人口に占める割合は23.1%となり，2011年度の全国平均では高齢者救急搬送率は49.3%を占めた。今後，高齢者数の増加に伴い，さらに救急医療の需要が増大することが予想される。高齢者救急は倫理的，社会的，医学的に重症と軽症の選別が難しく，地域医療の重要な課題である。【目的】都市部で二次救急を担当する当院の高齢者救急医療の現状を明らかにすること。【対象と方法】2013年4月～2014年3月迄の救急搬送患者を対象とし，合計救急搬送数等の各項目について65歳以上及び65歳未満両群で比較検討した。【結果】65歳以上群の救急搬送数は合計2,330件（年間総搬送数4,148件の56%に相当）。年齢は78±8歳，男性1,121例，女性1,209例であった。搬送元は病院（施設含む）163例，診療所319例，自宅または外出先1,848例であった。高齢者救急搬送のうち，入院症例は合計1,301例（56%）であり，65歳未満の入院合計821例（45%）に比し有意に多かった（p=0.02）。65歳以上群では循環器疾患で搬送される症例は同群全搬送数の32%であり，65歳未満群の18%に比し有意に高値であった。また循環器科に分類される救急搬送例の中で，緊急処置を要する頻度，ならびに冠動脈造影やペースメーカー植込みを要する頻度はいずれも65歳以上群の方が有意に高値であった。65歳以上群における平均入院期間は17±22日，入院後死亡は57例で，いずれも65歳以上群が65歳未満群に比べて有意に高値であった。【結語】65歳以上群において処置を有する重篤な循環器疾患が多く，様々な合併症を有するため，高齢者は入院率が高く，入院日数が延長していた。入院率も高い傾向にある高齢者救急は，都市部救急病院における診療の要である。今後も継続して適切な高齢者救急医療サービスの提供が望まれる。

Why medical students do not choose a career in geriatrics: a systematic review.

BackgroundWhile the demand for doctors specialised in the medical care of elderly patients is increasing, the interest among medical students for a career in geriatrics is lagging behind.MethodsTo get an overview of the different factors reported in the literature that affect the (low) interest among medical students for a career in geriatrics, a systematic literature search was conducted using PubMed, Embase, PsycINFO, and ERIC. Quality assessment criteria were applied.ResultsTwenty studies met the criteria and were included in the review.In relation to the nature of the work, the preference of medical students is young patients, and acute somatic diseases that can be cured. The complexity of the geriatric patient deters students from choosing this specialty. Exposure by means of pre-clinical and particularly clinical education increases interest. The lack of status and the financial aspects have a negative influence on interest.ConclusionExposure to geriatrics by means of education is necessary. The challenge in geriatric education is to show the rewarding aspects of the specialty.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-015-0384-4) contains supplementary material, which is available to authorized users.

The Hidden Curriculum of the Medical Care for Elderly Patients in Medical Education: A Qualitative Study

Despite more attention being given to geriatrics in medical curricula, few new physicians are seeking training in this field. So far, there has been no exploration of factors in the hidden curriculum that could potentially influence the persisting lack of interest in this field of medicine. To study this hidden curriculum in medical education in relation to medical care of elderly patients, the authors used a qualitative research design including participant observations on two internal medicine wards in a teaching hospital and semistructured interviews. The results showed that elderly patients with multiple problems are seen as frustrating and not interesting. Medical students were not stimulated to go into the totality of medical problems of elderly patients. They picked up a lot of disparaging remarks about these patients. The mainly negative attitudes demonstrated by role models, in particular the residents, may potentially influence the development of future doctors and their choice of career.

Condition of Need for Long-term Care and High BNP Level are Risk Factors of Long-term Hospitalization for Elderly Patient

BackgroundBecause of Japanese society is aging gradually, the medical care for elderly patients with cardiovascular disease are becoming important. Generally, the elderly patient would have potential renal dysfunction, anemia, dementia, and low activity of daily living.PurposeTo clarify the risks of long-term hospitalization for elderly patient.MethodsOne hundred seventy patients older than 80 with cardiovascular disease had been admitted to our hospital, classified into Long-term hospitalization (LTH) group (N=28) and Short-term hospitalization (STH) group (N=142) according to whether the patients needed hospitalization for longer than 20 days or not. Patient characteristics, clinical outcome, blood examination, echocardiographic parameters, and Certification of Needed Long-Term Care or Support Condition were compared between the two groups.ResultsPatient characteristics were not significant difference between the two groups. The left ventricle diastolic dimension, ejection fraction, serum creatinine, and hemoglobin level were not significant difference too. But the serum BNP level was significantly higher in LTH group (P<0.05). The ratio of the patient was issued a certification of Needed Long-Term Care or Support Condition was significantly higher in LTH group (P<0.05). In hospital death by any reason was significantly higher in LTH group (p<0.05).ConclusionsHigh BNP level and certification of Needed Long-Term Care or Support Condition was correlated with long-term hospitalization, and showed the possibility of early intervention. BackgroundBecause of Japanese society is aging gradually, the medical care for elderly patients with cardiovascular disease are becoming important. Generally, the elderly patient would have potential renal dysfunction, anemia, dementia, and low activity of daily living. Because of Japanese society is aging gradually, the medical care for elderly patients with cardiovascular disease are becoming important. Generally, the elderly patient would have potential renal dysfunction, anemia, dementia, and low activity of daily living. PurposeTo clarify the risks of long-term hospitalization for elderly patient. To clarify the risks of long-term hospitalization for elderly patient. MethodsOne hundred seventy patients older than 80 with cardiovascular disease had been admitted to our hospital, classified into Long-term hospitalization (LTH) group (N=28) and Short-term hospitalization (STH) group (N=142) according to whether the patients needed hospitalization for longer than 20 days or not. Patient characteristics, clinical outcome, blood examination, echocardiographic parameters, and Certification of Needed Long-Term Care or Support Condition were compared between the two groups. One hundred seventy patients older than 80 with cardiovascular disease had been admitted to our hospital, classified into Long-term hospitalization (LTH) group (N=28) and Short-term hospitalization (STH) group (N=142) according to whether the patients needed hospitalization for longer than 20 days or not. Patient characteristics, clinical outcome, blood examination, echocardiographic parameters, and Certification of Needed Long-Term Care or Support Condition were compared between the two groups. ResultsPatient characteristics were not significant difference between the two groups. The left ventricle diastolic dimension, ejection fraction, serum creatinine, and hemoglobin level were not significant difference too. But the serum BNP level was significantly higher in LTH group (P<0.05). The ratio of the patient was issued a certification of Needed Long-Term Care or Support Condition was significantly higher in LTH group (P<0.05). In hospital death by any reason was significantly higher in LTH group (p<0.05). Patient characteristics were not significant difference between the two groups. The left ventricle diastolic dimension, ejection fraction, serum creatinine, and hemoglobin level were not significant difference too. But the serum BNP level was significantly higher in LTH group (P<0.05). The ratio of the patient was issued a certification of Needed Long-Term Care or Support Condition was significantly higher in LTH group (P<0.05). In hospital death by any reason was significantly higher in LTH group (p<0.05). ConclusionsHigh BNP level and certification of Needed Long-Term Care or Support Condition was correlated with long-term hospitalization, and showed the possibility of early intervention. High BNP level and certification of Needed Long-Term Care or Support Condition was correlated with long-term hospitalization, and showed the possibility of early intervention.