Status In Elderly Patients Research Articles

Effectiveness of D-Rd program in the first line therapy of a 75-year-old female patient with multiple myeloma with high-risk cytogenetics. Clinical observation

Multiple myeloma is a B-cell lymphoproliferative disorder. Morphological substrate of the disorder are plasma cells producing monoclonal immunoglobulin, and the disorder is characterized by heterogeneity of clinical manifestations. Due to the understanding of molecular and biological basics of multiple myeloma pathogenesis, significant success was achieved in treatment of the standard and high-risk cytogenetics groups including full remission. However, not all patients show long-term progression-free survival. Necessity of more accurate evaluation of the extent of antitumor response, prognosis of progression-free survival and recurrence development led to minimal residual disease (MRD) testing. The analysis is based on detection of phenotypically aberrant clonal plasma cells in bone marrow aspirate after drug treatment. Currently, MRD-negative status is a significant prognostic factor. In some studies, high effectiveness of daratumumab in achievement of MRD-negative status in elderly patients with newly diagnosed multiple myeloma was demonstrated.

696P Geriatric nutritional risk index as a prognostic factor in elderly patients with locally advanced head and neck cancer receiving definitive chemoradiotherapy with cisplatin

Concurrent chemoradiotherapy (CCRT) is a standard treatment for locally advanced head and neck cancer (LAHNC) in the definitive setting. The Geriatric Nutritional Risk Index (GNRI) is a screening tool to predict the risk of morbidity and mortality in the elderly. Nutritional management is key during CCRT but the association between prognosis and initial nutritional status in elderly patients with LAHNC undergoing CCRT remains unknown.

COVID-19 in Geriatric Patients

Objective: Considering the ongoing pneumonia epidemic associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), aging is a major risk factor alone for serious illness and death. In this study, we aimed to investigate the length of stay, hospital discharge status, and prognostic factors in geriatric patients with COVID-19. Methods: Medical files of 199 patients over the age of 65 years, who were treated as inpatients due to the diagnosis of COVID-19, were reviewed retrospectively. Demographic characteristics, comorbid diseases, laboratory values, the length of stay, and hospital discharge status of eligible patients were evaluated. Results: Of inpatients with COVID-19, the mean age was 75.01±7.86 years and 50.8% were men. In patients, who were transferred to ICU, C-reactive protein (CRP) and ferritin levels were higher compared to patients discharged to home and the monocyte/HDL ratio (MHR) was higher compared to nonsurvivors (p=0.037, p=0.003, p=0.023). Nonsurvivors had significantly higher white blood cell (WBC) counts and erythrocyte sedimentation rates (ESR) compared to patients discharged to home. Nonsurvivors had a significantly shorter length of hospital stay compared to patients, who were transferred to ICU. Conclusion: Geriatric patients are susceptible to adverse clinical outcomes of COVID-19. We think that WBC, ESR, CRP, ferritin, and MHR levels may inform about poor prognosis and the potential discharge status in elderly patients with COVID-19 pneumonia. Gaining insight into poor prognostic factors in elderly patients is essential to control COVID-19 and develop rapid treatment strategies in this age group.

Comparison of Pericapsular Nerve Group Block with Fascia Iliaca Compartment Block in Adult Patients Undergoing Hip Surgeries: A Double-Blinded Randomized Control Study.

Hip fractures are the most common orthopedic condition in elderly patients. In this patient group, efficient preoperative analgesia that reduces the requirement for opioids and their negative side effects is crucial. This study aims for evaluating the efficiency of fascia iliaca compartment block (FICB) and pericapsular nerve group (PENG) in providing the appropriate analgesia before positioning patients for spinal anesthesia (SA). Ninety participants undergoing hip surgeries under SA were selected randomly to receive PENG block (n = 45) using 20 mL 0.25% bupivacaine or FICB using 30 mL of 0.25% bupivacaine. The blinded observer assessed Visual Analog Scale (VAS) scores at rest, with passive leg raise to 15° before and after 30 min of the block. The blinded observer also recorded hemodynamic parameters including noninvasive blood pressure respiratory rate and heart rate. The data were analyzed using SPSS version 19. Using the appropriate statistical methodology, continuous and categorical data were analyzed, and P ≤ 0.05 was considered statistically significant. At rest and with a passive leg raise to 15°, VAS scores in the PENG and FICB groups decreased significantly (P < 0.0001). After 30 minutes of performing the PENG block, the VAS scores at rest and passive leg raise were 2.16±0.67 and 3.29±0.73 respectively, whereas with the fascia iliaca block the VAS scores at rest and passive leg raise were 4.07±0.69 and 5.11±0.71 with the p = 0.001, which is highly significant. PENG block outperforms fascia iliaca block in providing effective analgesia before positioning patients undergoing hip surgery under SA.

Relationship between moral sensitivity and the quality of nursing care for the elderly with Covid-19 in Iranian hospitals

BackgroundThe quality of care has a significant impact on the condition of elderly patients. Many factors affect the quality of care, including ethical considerations. Ethical considerations, such as moral sensitivity, change in times of crisis. The present study was conducted to assess the relationship between moral sensitivity and the quality of nursing care for the elderly with Covid-19 in Iranian hospitals.MethodsThis was a cross-sectional descriptive correlational study. The participants included 445 nurses that were selected by quota sampling method from hospitals admitting COVID-19 patients. The data were collected using the Moral Sensitivity Questionnaire (MSQ) and Quality Patient Care Scale (QUALPAC) as self-reports. We used the SPSS software v.16 for statistical analysis.ResultsThe total score of moral sensitivity and quality of care was 52.29 ± 16.44 and 2.83 ± 0.23, respectively. Moral sensitivity negatively correlates with psychological, social, and physical aspects (P < 0.05). Modifying autonomy, interpersonal orientation, and experiencing moral conflict predicted β = 0.10 of the psychosocial aspect of quality of care. Structural moral meaning and expressing benevolence predicted the changes in the physical dimension of quality of care (β = 0.02).ConclusionThe quality of care had a significant inverse correlation with moral sensitivity. Multiple regression analysis showed that modifying autonomy, interpersonal orientation, and experiencing moral conflict could predict the psychosocial dimensions. Structuring moral meaning could predict the physical dimension. The communication aspects were not related to any of the dimensions of moral sensitivity.

Evaluation of Oxidative Status in Elderly Patients with Multiple Cerebral Infarctions and Multiple Chronic Total Coronary Occlusions.

Background Oxidative stress plays a key role in atherosclerosis. Acting via high level of reactive oxygen species, an increase of oxidative stress is involved in the pathogenesis and progression of atherosclerostic stenosis or occlusion of arteries. Oxidative stress leads to an accumulation of oxidized low-density lipoprotein, which plays important roles in steno-occlusion of cerebral and coronary arteries. However, the exact reasons for multiple cerebral and coronary artery steno-occlusion in elderly patients remain unclear. The aim was to evaluate the effects of imbalance of oxidative/antioxidative status on concomitant multiple brain infarcts and multiple chronic total coronary occlusions in elderly patients. Methods We measured the circulating levels of malondialdehyde (MDA), reactive oxygen species (ROS), thiobarbituric acid reactive substance (TBARS), advanced oxidation protein products (AOPP), superoxide dismutase 1 (SOD 1), superoxide dismutase 2 (SOD 2), superoxide dismutase 3 (SOD 3), and paraoxonase 1 (PON 1) in patients with concomitant multiple cerebral infarcts and multiple chronic total coronary occlusions. Results Circulating levels of oxidative stress markers (MDA, ROS, TBARS, and AOPP) were increased (P < 0.001) and antioxidative stress markers (SOD 1, SOD 2, SOD 3, and PON 1) were decreased (P < 0.001) in elderly patients with concomitant multiple brain infarcts and multiple chronic total coronary occlusions. Conclusions The findings suggested that the imbalance of oxidative/antioxidative status may be associated with multiple cerebral infarcts and multiple chronic total coronary occlusions and may contribute to the development of concomitant multiple brain infarcts and multiple chronic total coronary occlusions in elderly patients.

Parameters of the Blood Oxidant/Antioxidant System in Elderly Patients with Acute Poisoning

The aim of the study was to assess the oxidant/antioxidant status in elderly patients in the early period of acute poisoning by psychotropic drugs or corrosive substances.Material and methods. An open prospective observational study with retrospective control was conducted in 80 patients (age ≥ 60 years) with acute poisoning, of which 49 patients aged 72.1±9.55 years had psychotropic drug poisoning (PDP) and 31 subjects aged 73.0±10.3 years had corrosive substance poisoning (CSP). Patients with mild poisoning were excluded from the study. The control group consisted of 39 volunteers aged 68.3±6.3 years. Total antioxidant status (TAS), blood levels of malondialdehyde (MDA), stable nitric oxide metabolites (nitrite/nitrate, NOx), and oxidative stress index (MDA/TAS) were measured on days 1, 3 and 5 after hospital admission.Results. When analyzing the changes in the parameters of the oxidant/antioxidant system, we observed lower values of the studied parameters in patients with both PDP and CSP compared to the control group. In patients with PDP, several parameters were reduced: MDA by 1.2 times on days 1 and 3 (P=0.002; P=0.008, respectively), NOx by 1.7 times (P&lt;0.001) at all stages of the study, MDA/TAS by 2.4–2.9 times (P&lt;0.001). In patients with CSP, MDA level decreased by 1.1–1.2 times at all study timepoints (P=0.003; P=0.010; P=0.046, respectively), NOx dropped 1.4–1.6-fold (P=0.012; P=0.004; P=0.023, respectively), and MDA/TAS decreased by 2.3–2.4 times (P&lt;0.001). While comparing patients with favorable and fatal outcome, we found that in survived patients an increase of MDA/TAS along with growing NOx level was seen by day 5 with no significant changes of MDA and TAS, while in non-survivors MDA/TAS dropped continuously due to progressive fall of NOx level, reaching values 2.8–2.9 times (P&lt;0.001) lower than those of the controls.Conclusion. In elderly patients with acute poisonings due to psychotropic drugs or corrosive substances, an inadequate response of the oxidant/antioxidant system occurs manifesting as a reduced blood level of peroxidation products with simultaneous normal or slightly decreased concentration of antioxidant protection system components. Thus, the oxidative stress develops, which contributes to the death of the patients.

Features of geriatric status in elderly patients with osteoarthritis combined with neuropathic pain: data from the Russian epidemiological study EVKALIPT

The main symptoms of osteoarthritis (OA) are pain and dysfunction of the joints. Neuropathic pain (NP) occurs in more than half of patients with OA, it is refractory in nature and is the cause for seeking medical advice more frequently, poor quality of life and disability.Objective: to evaluate the frequency of NP and its relationship with geriatric syndromes (GS) in patients with OA aged 65 years and older. Patients and methods. The subanalysis of the study EVKALIPT included 2286 patients with OA and chronic pain syndrome. All patients underwent a comprehensive geriatric assessment (CGA) and diagnostics of NP using the DN4 questionnaire.Results and discussion. The prevalence of NP in patients with OA was 22.7%. Patients with OA and NP more often experienced pain of any localization with a large number of tender points, they had a higher frequency and intensity of pain syndrome, they more often took analgesics and noted limitations in daily life. When conducting a correlation analysis, correlations of medium strength were found between the sum of scores according to DN4 questionnaire and the pain intensity assessment on a numerical rating scale at the time of examination (r=0.26; p&lt;0.001) and in the previous 7 days (r=0.29; p&lt;0.001). CGA data in patients with OA and NP demonstrated worse geriatric status and a higher incidence of GS. The most common GSs were basic (81%) and instrumental (64%) dependence in everyday life, senile asthenia (70%), urinary incontinence (69%), depression (69%) and cognitive impairment (67%). Multivariate analysis showed that, in addition to age, the presence of NP was independently associated with sensory deficits, depression, falls, urinary incontinence, and bedsores (odds ratio 1.77–2.49). Patients with NP were more likely to use mobility aids, absorbent underwear, and orthotics.Conclusion. NP was diagnosed in 22.7% of OA patients aged 65 years and older. Such patients have worse functional status, they are more often diagnosed with a number of GSs.

A novel support vector machine to predict sentinel lymph node status in elderly patients with breast cancer.

1560 Background: Routine sentinel lymph node biopsy in older breast cancer patients with favorable tumor biology is not recommended. However, cases must be evaluated on an individual basis to avoid under or over-treatment. Many nomograms have been developed to calculate the risk of nodal positivity, but machine learning (ML) is a novel tool that may improve the accuracy of nodal prediction. In this study, we developed a support vector machine (SVM) model to delineate factors indicative of sentinel lymph node positivity and refine individualized nodal risk assessment for this heterogeneous patient population. Methods: We conducted a single-institution comprehensive retrospective review of patients 70 years or older diagnosed with unilateral stage I–III primary breast cancer from January 2005 to January 2016. Patient data was partitioned into training and testing sets. A SVM model was developed to predict lymph node status using patients’ demographics, tumor stage, genetic profile, and imaging data. Primary outcome was model performance determined by area under the curve (AUC). Secondary outcomes were accuracy, sensitivity and specificity. Permutation feature importance (PFI) analysis and accumulated local effect (ALE) plots were used to evaluate significant predictors identified by the SVM. Results: We identified 1706 consecutive patients who met the study criteria with a mean age of 76±4.5 years. The plurality of patients were Caucasian (82%), had ER+ (86%), PR+ (70%), HER2- (87%) stage I (72%) breast cancer. Sixteen percent of patients (n = 271) had a positive sentinel lymph node biopsy. The SVM model demonstrated good discriminatory performance for predicting sentinel lymph node positivity with mean AUC of 0.70 (95%CI, 0.62-0.77), mean accuracy of 84% (95%CI, 80-88%), mean sensitivity of 61% (95%CI, 57-66%), and mean specificity of 62% (95%CI, 52-73%). PFI and ALE identified higher disease stage, younger age, family history of breast cancer, margin status, estrogen and progesterone receptor positivity as independently associated with high risk of sentinel lymph node positivity. Conclusions: The proposed ML model accurately identified sentinel lymph node status in older patients with breast cancer. This model holds promise for counselling patients as to the potential risk for node positive disease which may impact surgical and adjuvant therapy recommendations.

Machine learning model prediction of 6-month functional outcome in elderly patients with intracerebral hemorrhage

Spontaneous intracerebral hemorrhage (ICH) has an increasing incidence and a worse outcome in elderly patients. The ability to predict the functional outcome in these patients can be helpful in supporting treatment decisions and establishing prognostic expectations. We evaluated the performance of a machine learning (ML) model to predict the 6-month functional status in elderly patients with ICH leveraging the predictive value of the clinical characteristics at hospital admission. Data were extracted by a retrospective multicentric database of patients ≥ 70 years of age consecutively admitted for the management of spontaneous ICH between January 1, 2014 and December 31, 2019. Relevant demographic, clinical, and radiological variables were selected by a feature selection algorithm (Boruta) and used to build a ML model. Outcome was determined according to the Glasgow Outcome Scale (GOS) at 6 months from ICH: dead (GOS 1), poor outcome (GOS 2–3: vegetative status/severe disability), and good outcome (GOS 4–5: moderate disability/good recovery). Ten features were selected by Boruta with the following relative importance order in the ML model: Glasgow Coma Scale, Charlson Comorbidity Index, ICH score, ICH volume, pupillary status, brainstem location, age, anticoagulant/antiplatelet agents, intraventricular hemorrhage, and cerebellar location. Random forest prediction model, evaluated on the hold-out test set, achieved an AUC of 0.96 (0.94–0.98), 0.89 (0.86–0.93), and 0.93 (0.90–0.95) for dead, poor, and good outcome classes, respectively, demonstrating high discriminative ability. A random forest classifier was successfully trained and internally validated to stratify elderly patients with spontaneous ICH into prognostic subclasses. The predictive value is enhanced by the ability of ML model to identify synergy among variables.

Association between Sarcopenia and Insulin-Like Growth Factor-1, Myostatin, and Insulin Resistance in Elderly Patients Undergoing Hemodialysis.

Sarcopenia is common in hemodialysis patients, especially in the elderly patients undergoing hemodialysis. Various factors may contribute to the occurrence of sarcopenia, such as anabolic and catabolic imbalance. This study aims to investigate the correlation of insulin-like growth factor-1 (IGF-1) levels as an anabolic factor, myostatin levels, and insulin resistance as catabolic factors with sarcopenia in the pathogenesis of sarcopenia in elderly patients undergoing hemodialysis. A total of 40 subjects aged 60 years or more who undergoing hemodialysis in Dr. Soetomo Hospital Surabaya were included in this cross-sectional study. Sarcopenia was diagnosed according to Asian Working Group Sarcopenia 2019 criteria. IGF-1, myostatin, and insulin resistance levels were measured once before hemodialysis. Subjects with sarcopenia diagnosis were 33 (82.5%), that is, 19 (47.5%) men and 14 (35%) women. There were 28 (70%) of the subjects diagnosed with severe sarcopenia. Furthermore, there were significant differences in the characteristics and geriatric parameters between the sarcopenia and nonsarcopenia groups. There were differences between the two groups in hemoglobin levels, IGF-1 levels, myostatin levels, homeostasis model assessment-insulin resistance (HOMA-IR) levels, muscle mass, handgrip strength, body mass index status, mini nutritional assessment status, and physical activity scale for elderly status (all p < 0.05). Correlation analyses showed that IGF-1 levels negatively correlated with sarcopenia status in elderly patients undergoing hemodialysis (p < 0.05). On the contrary, myostatin and HOMA-IR levels were positively correlated with sarcopenia status in elderly patients undergoing hemodialysis (all p < 0.05). Based on this recent study, IGF-1, myostatin, and insulin resistance were significantly correlated with sarcopenia in elderly patients undergoing hemodialysis.

Can vena cava ultrasound-guided volume repletion prevent general induced hypotension in elderly patients? A mini-fluid challenge

BackgroundHypotension is often occurring after induction of general anesthesia (IGA) and can cause organ hypoperfusion and ischemia which associated with adverse outcomes in patients having both cardiac and non-cardiac surgery. Elderly patients are particularly more vulnerable and at increased risk to the depressant effect of anesthetic drugs. So, recognition and prevention of such event are of clinical importance. This study recruited patients aged above 60 years, with ASA physical status classification I-II-III who were scheduled for surgery under general anesthesia with the aim to assess the effectiveness of preoperative IVC ultrasonography in predicting hypotension which develops following IGA and its association with the volume status in elderly patients receiving general anesthesia, through measurements of the maximum inferior vena cava diameter (dIVCmax), minimum inferior vena cava diameter (dIVCmin), inferior vena cava collapsibility index (IVC-CI), and basal and post-induction mean arterial pressure (MAP).ResultsThirty-nine (44.3%) of the 88 patients developed hypotension after IGA, and it was significantly more in patients who did not receive preoperative fluid (p = 0.045). The cut-off for dIVCmax was found as 16.250 mm with the ROC analysis. Specificity and sensitivity for the cut-off value of 16.250 mm were calculated as 61.2% and 76.9%, respectively. The cut-off for IVC-CI was found as 33.600% with the ROC analysis. Specificity and sensitivity for the cut-off value of 33.600% were calculated as 68.7% and 87.2%, respectively.ConclusionsIVC ultrasonography may be helpful in the prediction of preoperative hypovolemia in elderly patients in the form of high IVC-CI and low dIVCmax. The incidence of hypotension was lower in patients who received fluid infusion before IGA.

The Effect of Combination Use of Hemodialysis and Hemoperfusion on Microinflammation in Elderly Patients with Maintenance Hemodialysis

Background: Patients with maintenance hemodialysis (MHD) generally have a microinflammatory state. The aim of this study was to investigate the effects of hemodialysis (HD) combined with hemoperfusion (HP) on microinflammatory state in elderly patients with MHD. Methods: One hundred and fifty elderly patients with MHD were randomly divided into the control group and the observation group. The control group received simple HD treatment, and the observation group received combined HD + HP treatment on the basis of the control group. After 6 months of continuous treatment, the patients were evaluated to compare the quality of life, inflammation, adverse reactions, and nutritional indicators in the 2 groups before and after treatment. Results: There was no significant difference in the quality of life between the 2 groups before treatment. After treatment, the scores of psychological aspects, physiological aspects, social aspects, environmental aspects, and independent ability in the observation group were higher than those in the control group, with statistical significance (p < 0.05). There was no statistical significance in the level of inflammation between 2 groups before treatment. After treatment, the levels of hs-CRP, Hcy, IL-6, and TNF-α in the observation group were significantly lower than those in the control group, with statistical significance (p < 0.05). The incidence of dry mouth, skin reaction, neuritis, and subcutaneous tissue fibrosis in the observation group was lower than that in the control group, with statistical significance (p < 0.05). There was no statistical significance in nutritional level indexes between 2 groups before treatment (p₁ > 0.05). After treatment, the levels of hemoglobin, total protein, albumin, and transferrin in the observation group were significantly higher than those in the control group, with statistical significance (p < 0.05). Conclusion: The clinical effect of HD combined with HP in elderly MHD patients is significant, which can effectively reduce the incidence of adverse reactions and inflammation in the patients and improve the quality of life and nutritional indicators of the patients.

Clinical features of chronic obstructive pulmonary disease in the elderly

Analysis of randomized, retrospective and prospective clinical, case-control, and observational studies revealed the following main features of COPD in the elderly: (1) COPD is a complex and common condition in elderly patients, characterized by high rates of disturbing symptoms, significant risk of cognitive and functional decline, disease progression, frequent use of health care, extremely difficult treatment and increased mortality. (2) The elderly have an increased prevalence of COPD: in subjects aged 65 years and over, it represents 14,2% (from 11,0% to 18,0%), compared to 9,9% (from 8.2% to 11.8%) in those aged 40 and over. (3) Simultaneously with the 2-4 times higher prevalence of COPD, the elderly patients, especially those aged 75 years or older, also have a higher burden of the disease: frequency, severity and impact of symptoms significantly higher. higher, tolerance to effort and lower daily activities, higher incidence of severe acute exacerbations and higher prevalence of systemic comorbidities. (4) COPD acute exacerbations and comorbidities have poorer results in elderly patients, fact manifested by an increased rate and duration of the hospitalization, an increased rate of repeted hospitalizations and a higher mortality rate. (5) COPD is a multifaceted condition that involves more than just obstruction of the airflow. Systemic inflammation contributes to the development of systemic effects (loss and dysfunction of skeletal muscle, osteoporosis, anemia, cachexia, neurocognitive dysfunction). (6) Multidimensional assessment and multidisciplinary intervention, well recognized in the geriatric population, should be extended to patients with COPD

The effect of perioperative nutritional therapy on the cognitive functions and nutritional status in elderly patients with femoral neck fracture

The effect of perioperative nutritional therapy on the cognitive functions and nutritional status in elderly patients with femoral neck fracture

Analysis of neuropathological comorbid conditions in elderly patients with mild cognitive impairment in a tertiary care center in South India.

Introduction:Mild cognitive impairment (MCI) is a transitional stage in the continuum of cognitive decline. Multiple risk factors may be involved apart from neuropathological states such as Alzheimer’s disease, Parkinson’s disease, and vascular dementia. There is scant data in the literature pertaining to our study population in Kerala, South India that provide associations between suggested risk factors and MCI. Most of the elderly present to family and primary care physicians with complaints of some form of memory impairment.Objectives:To find out the significant neuropathological comorbid conditions present in elderly patients with MCI. To assess for other risk factors in the same population- including laboratory parameters, comorbidities, and psychosocial parameters.Methods:This retrospective record-based study included a sample of 93 patients with MCI as quantified by the Mini-Mental Status Examination (MMSE). These subjects were compared with controls (n = 97) without MCI, with respect to neuropathological diagnoses, laboratory parameters and psychosocial parameters.Results:The findings of our study were that female gender, higher depression scores, a greater number of medications taken, benzodiazepine use, higher alkaline phosphatase levels, positive fall history, loss of a spouse, and lower levels of education were associated with MCI. MCI is negatively associated with positive alcohol history. The most commonly seen proven neuropathological diagnosis was Parkinson’s disease.Conclusion:The risk factors that were found in our study should be highlighted in the elderly and preventive measures should be taken to prevent the downward progression through the cognitive continuum. Prospective studies looking into mild cognitive impairment with better screening tools and proper assessment of neuropathological comorbid conditions can further elucidate the findings related to this study.

Effects of Total Intravenous Anesthesia and Static Aspiration Combined General Anesthesia on Postoperative Cognitive Function and Psychological State of Elderly Patients with Esophageal Cancer

Effects of Total Intravenous Anesthesia and Static Aspiration Combined General Anesthesia on Postoperative Cognitive Function and Psychological State of Elderly Patients with Esophageal Cancer

Kalça kırıklarının epidemiyolojisine Covid-19 pandemisinin etkisi

Aim: This study aimed to compare the epidemiology of hip fractures in an elderly population in 6 months of the COVID-19 pandemic and the same 6-month period in the previous year to be able to reveal how the decrease in community activity beyond normal seasonal habits because of the pandemic had affected the incidence of fractures in the elderly patient population.Methods: A comparison was made of the data of patients who presented at our hospital with a hip fracture between 1 April 2020 and 30 September 2020, and those who presented in the same 6-month period in 2019 before the pandemic. Comparisons were made in respect of epidemiology, treatments applied, complication rates and mortality. The demographic data of the patients were examined, and those presenting during the pandemic were evaluated in respect of the presence of COVID-19 infection. Results: A total of 78 patients were treated in the defined study period in 2020 and 71 in the equivalent period in 2019 before the pandemic. No statistically significant change was found in the number of hip fractures in 2020 (p&amp;gt;0.05). No statistically significant difference was observed between the demographic data of the patients, the ASA scores, the treatment methods, or the mortality rates in the two periods (p&amp;gt;0.05 for all).Conclusion: The most significant finding of this study was that there was no decrease in the number of patients with hip fracture during the pandemic in 2020, compared to the equivalent period in 2019. The increase in pulmonary complications during the pandemic period demonstrates the need for special care conditions in elderly patients with hip fractures, which are still seen at a high rate despite the pandemic

Evaluation of the effect of chronic pain on the functional and physical status of patients in older age groups

Objective: to assess the structure and influence of chronic pain (CP) on the functional status of patients with geriatric syndromes.Patients and methods. The study included 370 geriatric patients who were divided into two groups. Group A included 300 patients (mean age 75.1±8.25 years) with CP, and group B – 70 subjects of comparable age (75.1±7.75 years) without CP. All study participants were found to have polymorbidity: the Charlson index was 5.55±1.59 points in group A and 5.56±1.64 points in group B (p=0.963). All patients underwent a comprehensive geriatric assessment (CGE) to determine the functional status and diagnose geriatric syndromes.Results and discussion. According to the CGE data, senile asthenia syndrome was detected in 127 (42.3%) patients with CP and in 20 (28.6%) patients without CP (p=0.035). The average number of geriatric syndromes in group A was 7.06±2.68, in group B – 5.2±1.8 (p&lt;0.001).Group A patients differed from those without CP in a significantly higher degree of dependence in daily life (Bartel index) and a lower score on the Physical Performance Battery.Conclusion. Patients with CP have poorer physical functioning and a greater degree of dependence on others in their daily life. When planning the most effective complex strategies for the treatment and prevention of CP exacerbations, it is necessary to take into account the functional status of elderly patients.

Analysis of Self-care Status of Elderly Patients with Cerebral Infarction in Ji'nan Community

Analysis of Self-care Status of Elderly Patients with Cerebral Infarction in Ji'nan Community