Although falls are more prevalent as ageing proceeds, it cannot be assumed that they happen due to ageing alone. The retrospective cohort study of data was targeted to make an analysis of prevalence of falls in anaemic patients in comparison to the non-anaemic elderly admitted to the acute geriatric department and evaluation of pertinent influence of age, gender and immobility on occurrence of falls. During the considered period of four years (2012-2016) the authors treated 9 363 elderly patients aged 79,9±8,6 years (in the majority of them 65+ years). Among them there were 8 809 non-anaemic and subgroup of 551 old anaemic patients (aged 81±7 years) with decreased haemoglobin (<110 g/l). Falls at hospital admission in average was present in 1 766 non-anaemic persons (20%) in comparison to 380 falls among anaemic patients (68,6%). Prevalence in anaemic subgroup is statistically significant higher (p<0,005). Also relation between falls and age, ADL and MMSE test and mobility is highly statistically significant (p<0,001). Meaningfully higher is occurrence of repeated falls in the anaemic subgroup in comparison to the non-anaemic one (41,2 vs 1,7%). The occurrence of falls in female gender in comparison to men is statistically significant higher in non-anaemic patients, not in anaemic group. Authors emphasize that anaemia appears to us as significant risk factor for falls in the elderly.
- MeSH
- anemie komplikace MeSH
- hospitalizace * MeSH
- lidé MeSH
- prevalence MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- úrazy pádem statistika a číselné údaje MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
The aim was to compare an occurrence of acute PE in hospitalized patients 65+ years old with diabetes mellitus (DM) with those without any DM. It was a retrospective analysis of data collected in documentation of patients who were hospitalized at the geriatric department in the years 2007-2015. In this period we had 11 947 patients of an average age of 79,9±8,5 years (min - 65, max - 103 years). Out of this number there were 4 069 diabetics. Acute PE was found in 344 patients of an average age 80,3±7,4 years. 121 of them died (35,3%) and 223 survived (64,7%). From total patients 88 were diabetics with PE. Mortality on PE did not influence the presence of DM. She was the same in both groups of patients (p=NS) - with and without DM. RESULTS: Prevalence PE in the hospitalized 65+ years old was 2,9%. Mortality of PE among all the hospitalized 65+ was 1,0%. Higher prevalence of PE was found in non-diabetics - 3,2%, as compared to the diabetics - 2,3% (p<0,025). The average age of patients with diabetes both with and without PE was lower as compared to the non-diabetics (p<0,01). Among risk factors we found significantly more frequently obesity in the diabetics as compared to the non-diabetics both surviving (p<0,001) and those who died (p<0,05). The most important risk factor of PE was in all the patient's immobility. One risk factor appeared in the set of survivors more frequently in the non-diabetics as compared to the diabetics (p<0,05). Simultaneous occurrence of three risk factors appeared more frequently in the surviving diabetics (p<0,001) as compared to the non-diabetics. Although overall presence of risk factors was higher in the diabetics, PE prevalence in the DM patients was lower as compared to the non-diabetics. The immobility in general was the most important risk factor for PE occurrence, in the diabetics then also obesity.
- MeSH
- akutní nemoc MeSH
- diabetes mellitus epidemiologie mortalita MeSH
- lidé MeSH
- mortalita v nemocnicích MeSH
- obezita epidemiologie MeSH
- pacienti hospitalizovaní * MeSH
- plicní embolie epidemiologie mortalita MeSH
- prevalence MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- sedavý životní styl MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
UNLABELLED: Pulmonary embolism (PE) is after myocardial infarction and cerebrovascular events the third most frequent cardiovascular cause of death. Simultaneously it belongs to at least often correctly diagnosed cardiovascular diseases. The AIM OF THE STUDY: The retrospective analysis of the database of inpatients with the target assess the clinical course of PE according to prevalence, mortality, average duration of stay, risk factors, used diagnostic methods and kinds of therapy. Another aim of the study was a comparison of the data among the survivors and deceased persons. Patient's set and method: between 2005 and 2010 years we had altogether 6,323 elderly patients of an average age 80.7 +/- 6.9 y. (range 65-103 y.) treated at the Department of Geriatrics. Out of this number there were 4,163 women (66%) and 2,160 men (34%). We evaluated the course of PE in 260 cases of mean age 79.8 +/- 7.2 y. (165 women and 95 men). For the verification of the diagnosis of PE we used following usual procedures (anamnesis, clinical examination, ECG, X-ray, labs etc.) also ECHO-cardiography, perfusion scan or helical CT of lungs. Eighty per cent of the deceased had an autopsy. In the set of in-patients with PE 89 died (34.2%) and 171 survived (65.8%) with anticoagulant treatment. RESULTS: Prevalence of PE was 4.1% per year among all the hospitalized elderly in-patients (> or = 65 y.). Mortality among all the admitted patients to our department was 1.4%. Its occurrence was increasing with age to 81 y. and thereafter slightly decreasing. In one third of the deceased PE was an occasional finding in autopsy without any previous clinical signs. Mortality in the non-symptomatic group with PE in autopsy was significantly higher (chi2 = 57,293; p < 0.001). We didn't find any significant gender difference in prevalence of mortality according to gender structure of the set with PE. In 14 cases PE clinically demonstrated as sudden death. We determined the age significant difference between survivors and the deceased--79.1 +/- 7.1 y. vs. 81.3 +/- 7.0 (t = 1.997; p < 0.05). Average duration of hospital stay was significantly different between both groups: the deceased 9.2 +/- 9.6 vs. 12.4 +/- 7.4 in survivors (t = 4.256, p = 0.01). Risk factors were assessed and compared between both groups: the deceased and survivors. We found the most important risk factors in the group of the deceased immobility (p < 0.001) heart failure (p < 0.005) and stroke (p < 0.01). On the contrary in the survivor group there were more frequent risk factors obesity (p < 0.025); deep venous thrombosis (p < 0.025) and tumors (p < 0.05). Previous operations and traumas in the last month did not show any significant difference between both groups. Used treatment methods were evaluated, too. In the group of those who died multi-morbidity, often frailty and geriatric giants predominated even if the anticoagulant therapy was used comparably in both groups (survivors and the deceased). CONCLUSION: We would like to emphasize the need to think permanently in elderly persons with present risk factors of the possibility of PE and also the requirement of correctly assessed diagnosis and starting therapeutic procedures as soon as possible.
- MeSH
- echokardiografie MeSH
- elektrokardiografie MeSH
- geriatrie * MeSH
- lidé MeSH
- plicní embolie diagnóza epidemiologie MeSH
- prevalence MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- Geografické názvy
- Česká republika MeSH
BACKGROUND & OBJECTIVES: Ampullary cancer is one of the periampullary tumours with better prognosis, but relapses occur early in some patients. This study was carried out to assess whether pancreatoduodenectomy (PDE, Whipple operation) could be a safe therapeutic procedure for elderly patients with periampullary tumours. METHODS: Between 2005 and 2007, 19 patients (12 male, 7 female) aged over 65 yr (range 66 and 83 yr) with diagnosis of ampulloma were operated. RESULTS: Of the 19 patients, 6 underwent local surgical ampullectomy with reinsertion of ductus choledochus and Wirsungi's duct for benign or early cancer lesion and 13 underwent PDE (Whipple operation). Of these 13, only one was in T1 stage, one was in T4 stage, two patients were T3 and the rest in T2 stage. Lesion of lymphatic system had 40 per cent of patients in T2 stage and all in T3 and T4 stages. One patient died of pulmonary embolism several days after operation. Post-operative complications occurred in 3 cases: 1 patient with partial dehiscence of gastroenteroanastomosis - treated by conservative approach, 2 patients with dehiscence of pancreatojejunoanastomosis. INTERPRETATION & CONCLUSIONS: Diagnosis and therapy of ampullary tumours is multimodal. With careful patient selection, PDE can be performed in elderly people (>65 yr) safely. The post-operative morbidity in this group is essentially influenced by their multi-morbidity.
- MeSH
- ampulla Vateri patologie chirurgie MeSH
- chirurgie trávicího traktu metody MeSH
- duodenum chirurgie MeSH
- lidé MeSH
- nádory ductus choledochus chirurgie MeSH
- nemoci ductus choledochus diagnóza terapie MeSH
- prognóza MeSH
- riziko MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- absces jater diagnóza mikrobiologie terapie MeSH
- alkoholické nemoci jater komplikace MeSH
- chronická nemoc MeSH
- diferenciální diagnóza MeSH
- lidé MeSH
- pankreatitida MeSH
- prognóza MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- kazuistiky MeSH
