Pub Date : 2023-03-01DOI: 10.29400/tjgeri.2023.330
Elif Büyükerkmen, Ahmet Yüksek, Elif DOĞAN BAKI, S. Yılmaz
Introduction: Endoscopic retrograde cholangiopancreatography is extremely painful and uncomfortable when performed without anesthesia. However, the type of anesthesia to be applied remains a matter of debate. In this study, general anesthesia and sedation procedures were compared in endoscopic retrograde cholangiopancreatography performed by the same anesthesia and surgical team over a 5-year period. Materials and Method: Patients aged over 65 years were divided into two groups, general anesthesia and sedation, and their data were analyzed retrospectively. Anesthesia complications, surgical complications, duration of the procedure, need for intensive care, and length of hospital stay and intensive care needs were compared between groups in 2812 patients. Results: Data from 1885 patients were analyzed. The procedure time and hospital stay were shorter, and anesthesia-related complication rate was lower in the general anesthesia group. Although not statistically significant, mortality was higher, and the need for intensive care was similar to the sedation group. The complication rate significantly increased in patients aged over 75 years Conclusion: Endoscopic retrograde cholangiopancreatography can be performed under deep sedation or general anesthesia. The experience of the anesthetist is an important factor for this choice. The use of sedation in geriatric patients is associated with more complications that require airway interventions. In addition, anesthesia complications due to prolonged procedures were more common in the sedation group. Conclusion: In our study, it was observed that general anesthesia was safer for endoscopic retrograde cholangiopancreatography procedures performed in geriatric patients by an experienced anesthesia and surgical team. Keywords: Geriatrics; Cholangiopancreatography; Anesthesia, General; Deep Sedation.
{"title":"Comparison of the effects of general anesthesia and deep sedation on anesthesia complications and mortality in endoscopic retrograde cholangiopancreatography procedures","authors":"Elif Büyükerkmen, Ahmet Yüksek, Elif DOĞAN BAKI, S. Yılmaz","doi":"10.29400/tjgeri.2023.330","DOIUrl":"https://doi.org/10.29400/tjgeri.2023.330","url":null,"abstract":"Introduction: Endoscopic retrograde cholangiopancreatography is extremely painful and uncomfortable when performed without anesthesia. However, the type of anesthesia to be applied remains a matter of debate. In this study, general anesthesia and sedation procedures were compared in endoscopic retrograde cholangiopancreatography performed by the same anesthesia and surgical team over a 5-year period. Materials and Method: Patients aged over 65 years were divided into two groups, general anesthesia and sedation, and their data were analyzed retrospectively. Anesthesia complications, surgical complications, duration of the procedure, need for intensive care, and length of hospital stay and intensive care needs were compared between groups in 2812 patients. Results: Data from 1885 patients were analyzed. The procedure time and hospital stay were shorter, and anesthesia-related complication rate was lower in the general anesthesia group. Although not statistically significant, mortality was higher, and the need for intensive care was similar to the sedation group. The complication rate significantly increased in patients aged over 75 years Conclusion: Endoscopic retrograde cholangiopancreatography can be performed under deep sedation or general anesthesia. The experience of the anesthetist is an important factor for this choice. The use of sedation in geriatric patients is associated with more complications that require airway interventions. In addition, anesthesia complications due to prolonged procedures were more common in the sedation group. Conclusion: In our study, it was observed that general anesthesia was safer for endoscopic retrograde cholangiopancreatography procedures performed in geriatric patients by an experienced anesthesia and surgical team. Keywords: Geriatrics; Cholangiopancreatography; Anesthesia, General; Deep Sedation.","PeriodicalId":51196,"journal":{"name":"Turkish Journal of Geriatrics-Turk Geriatri Dergisi","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43929167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.29400/tjgeri.2023.331
M. Kanar, N. Cam
Introduction: This study aimed to evaluate the effectiveness of a computer-assisted circular external fixator used to achieve arthrodesis in elderly patients with failed infected total knee arthroplasty. Materials and Methods: Retrospectively 11 patients who treated with arthrodesis between 2015 and 2020 were included in the study. The average age was 73.5 ±4.73 years (65–81). All patients had recurrent infections after total knee arthroplasty. Radiologic evaluations, the time for fusion, shortening of extremities, visual analog scale scores, Oxford knee scoring system, lower extremity functional scale of all patients were compared pre-and post-operatively. complications of the technique were noted. Results: The mean follow-up was 33.7 ±12.85 (12–52) months. Fusion was achieved in all patients. The average limb length discrepancy after removal of the fixator was 46±0.78 (36–61) mm. The mean visual analog scale score measured pre-op was 6.91±0.94 (5–8), and after fixator removal they were measured as 2.36±0.92 (1–4). The mean Oxford knee score was 10.27±2.68 (4–14) pre-operatively and 28.64±2.69 (23–32) postoperatively. The mean, lower extremity functional scale was 17.06±9.38 (7.5–33.8) pre-operatively and 38.54±12.22 (21.3–56.3) postoperatively. No joint infection recurrence was seen post-operatively. Conclusion: Arthrodesis is a suitable option for elderly patients with limited mobilization who are tired of repeated revision surgeries. Due to its high fusion and low complication rate, computer-assisted circular external fixator is an effective method in the treatment of difficult knee arthrodesis required after infected total knee arthroplasty. Key Words: Arthroplasty, Replacement, Knee; Reoperation; Infection; Arthrodesis; External Fixators.
{"title":"KNEE ARTHRODESIS WITH COMPUTER-ASSISTED EXTERNAL FIXATOR SYSTEM AFTER PROSTHETIC JOINT INFECTION FOR ELDERLY POPULATION","authors":"M. Kanar, N. Cam","doi":"10.29400/tjgeri.2023.331","DOIUrl":"https://doi.org/10.29400/tjgeri.2023.331","url":null,"abstract":"Introduction: This study aimed to evaluate the effectiveness of a computer-assisted circular external fixator used to achieve arthrodesis in elderly patients with failed infected total knee arthroplasty. Materials and Methods: Retrospectively 11 patients who treated with arthrodesis between 2015 and 2020 were included in the study. The average age was 73.5 ±4.73 years (65–81). All patients had recurrent infections after total knee arthroplasty. Radiologic evaluations, the time for fusion, shortening of extremities, visual analog scale scores, Oxford knee scoring system, lower extremity functional scale of all patients were compared pre-and post-operatively. complications of the technique were noted. Results: The mean follow-up was 33.7 ±12.85 (12–52) months. Fusion was achieved in all patients. The average limb length discrepancy after removal of the fixator was 46±0.78 (36–61) mm. The mean visual analog scale score measured pre-op was 6.91±0.94 (5–8), and after fixator removal they were measured as 2.36±0.92 (1–4). The mean Oxford knee score was 10.27±2.68 (4–14) pre-operatively and 28.64±2.69 (23–32) postoperatively. The mean, lower extremity functional scale was 17.06±9.38 (7.5–33.8) pre-operatively and 38.54±12.22 (21.3–56.3) postoperatively. No joint infection recurrence was seen post-operatively. Conclusion: Arthrodesis is a suitable option for elderly patients with limited mobilization who are tired of repeated revision surgeries. Due to its high fusion and low complication rate, computer-assisted circular external fixator is an effective method in the treatment of difficult knee arthrodesis required after infected total knee arthroplasty. Key Words: Arthroplasty, Replacement, Knee; Reoperation; Infection; Arthrodesis; External Fixators.","PeriodicalId":51196,"journal":{"name":"Turkish Journal of Geriatrics-Turk Geriatri Dergisi","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47686064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.29400/tjgeri.2023.335
Pelin Koçdor, Zeynep Kayaarası Öztürker, O. Çam
Introduction: This study aims to evaluate the balance and vestibular system of patients with pseudoexfoliation syndrome. Materials and Method: A prospective case–control study was performed in a university hospital. The study population consisted of 37 patients (16 patient group, 21 control group). The Modified Clinical Test of Sensory Interaction Balance was performed in four conditions: 1) eyes open, firm surface; 2) eyes closed, firm surface; 3) eyes closed, foam surface; and 4) eyes open, foam surface. The Equilibrium Score, Anteroposterior Stability Index, Mediolateral Stability Index were employed for all conditions in both groups. Scores were compared between and within groups. Additionally, the physical activity of the patients with pseudoexfoliation syndrome was assessed using questionnaires based on the Turkish versions of the Modified Falls Efficacy Scale and the Physical Activity Scale for the Elderly. Results: There were no significant differences in terms of stability index and equilibrium scores with eyes open or closed conditions between the two groups; the only difference was in the mean mediolateral stability index score in the eyes open, firm surface condition with low scores in the pseudoexfoliation group (p=0.01). In the group analysis, patients with pseudoexfoliation had a significant increase in the equilibrium scores when their eyes were closed in the firm and foam surface conditions (p=0.001 for both). Conclusion: The central nervous system redistributes its dependence on sensory information when vision is compromised in patients with pseudoexfoliation syndrome. Their somatosensory input might deteriorate in some way but not the vestibular system. Keywords: Dizziness; Glaucoma; Aged.
{"title":"Assessment of Vestibular System and Balance Function in Patients with Pseudoexfoliation Syndrome","authors":"Pelin Koçdor, Zeynep Kayaarası Öztürker, O. Çam","doi":"10.29400/tjgeri.2023.335","DOIUrl":"https://doi.org/10.29400/tjgeri.2023.335","url":null,"abstract":"Introduction: This study aims to evaluate the balance and vestibular system of patients with pseudoexfoliation syndrome. Materials and Method: A prospective case–control study was performed in a university hospital. The study population consisted of 37 patients (16 patient group, 21 control group). The Modified Clinical Test of Sensory Interaction Balance was performed in four conditions: 1) eyes open, firm surface; 2) eyes closed, firm surface; 3) eyes closed, foam surface; and 4) eyes open, foam surface. The Equilibrium Score, Anteroposterior Stability Index, Mediolateral Stability Index were employed for all conditions in both groups. Scores were compared between and within groups. Additionally, the physical activity of the patients with pseudoexfoliation syndrome was assessed using questionnaires based on the Turkish versions of the Modified Falls Efficacy Scale and the Physical Activity Scale for the Elderly. Results: There were no significant differences in terms of stability index and equilibrium scores with eyes open or closed conditions between the two groups; the only difference was in the mean mediolateral stability index score in the eyes open, firm surface condition with low scores in the pseudoexfoliation group (p=0.01). In the group analysis, patients with pseudoexfoliation had a significant increase in the equilibrium scores when their eyes were closed in the firm and foam surface conditions (p=0.001 for both). Conclusion: The central nervous system redistributes its dependence on sensory information when vision is compromised in patients with pseudoexfoliation syndrome. Their somatosensory input might deteriorate in some way but not the vestibular system. Keywords: Dizziness; Glaucoma; Aged.","PeriodicalId":51196,"journal":{"name":"Turkish Journal of Geriatrics-Turk Geriatri Dergisi","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48614927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.29400/tjgeri.2023.326
Oğuz Kılıç, Fatma Özpamuk Karadeniz, F. Kahraman
Introduction: Acute myocardial infarction is the most common cardiovascular disease and the cause of significant mortality worldwide. The C-reactive protein/albumin ratio, which measures inflammatory conditions, can be used to predict mortality. In this study, we aimed to investigate the relationship between in-hospital mortality and the C-reactive protein/albumin ratio in patients diagnosed with non-ST-elevation myocardial infarction who underwent interventional treatment at our hospital. Materials and Method: Two hundred and ninety-seven elderly patients were included in the study. The information of the patients was obtained from the hospital database. The C-reactive protein/albumin ratio was calculated for each patient. We used regression analysis to investigate the relationship between the C-reactive protein/albumin ratio and in-hospital mortality. Results: A univariate analysis showed that gender, ejection fraction, white blood cell, glucose, creatinine, systolic and diastolic blood pressure, heart rate, GRACE risk score, and CAR ratio were significant predictors of mortality (Table 2). All parameters were added to a multivariable logistic regression, and multivariable logistic regression analysis showed that the GRACE risk score (OR: 0.956, 95% CI: 0.941–0.971; p<0.001) and the C-reactive protein/albumin ratio (OR: 0.812, 95% CI: 0.661–0.998; p=0.048) were the only significant predictors of mortality. Furthermore, bivariate correlation analysis showed a weak but statistically significant correlation between GRACE risk score and C-reactive protein/albumin ratio (r=0.180, p<0.001). Conclusion: We found a significant relationship between C-reactive protein/albumin and in-hospital mortality. C-reactive protein/albumin ratio can be used in clinical practice because it is inexpensive and easy to apply and has a strong prognostic value for elderly non-ST-elevation myocardial infarction patients. Keywords: Myocardial Infarction; Albumin; Inflammation; Mortality.
{"title":"THE RELATIONSHIP OF THE C-REACTIVE PROTEIN /ALBUMIN RATIO TO IN-HOSPITAL MORTALITY IN ELDERLY PATIENTS WITH NON-ST-ELEVATION MYOCARDIAL INFARCTION WHO HAVE UNDERGONE PERCUTANEOUS CORONARY INTERVENTION","authors":"Oğuz Kılıç, Fatma Özpamuk Karadeniz, F. Kahraman","doi":"10.29400/tjgeri.2023.326","DOIUrl":"https://doi.org/10.29400/tjgeri.2023.326","url":null,"abstract":"Introduction: Acute myocardial infarction is the most common cardiovascular disease and the cause of significant mortality worldwide. The C-reactive protein/albumin ratio, which measures inflammatory conditions, can be used to predict mortality. In this study, we aimed to investigate the relationship between in-hospital mortality and the C-reactive protein/albumin ratio in patients diagnosed with non-ST-elevation myocardial infarction who underwent interventional treatment at our hospital. Materials and Method: Two hundred and ninety-seven elderly patients were included in the study. The information of the patients was obtained from the hospital database. The C-reactive protein/albumin ratio was calculated for each patient. We used regression analysis to investigate the relationship between the C-reactive protein/albumin ratio and in-hospital mortality. Results: A univariate analysis showed that gender, ejection fraction, white blood cell, glucose, creatinine, systolic and diastolic blood pressure, heart rate, GRACE risk score, and CAR ratio were significant predictors of mortality (Table 2). All parameters were added to a multivariable logistic regression, and multivariable logistic regression analysis showed that the GRACE risk score (OR: 0.956, 95% CI: 0.941–0.971; p<0.001) and the C-reactive protein/albumin ratio (OR: 0.812, 95% CI: 0.661–0.998; p=0.048) were the only significant predictors of mortality. Furthermore, bivariate correlation analysis showed a weak but statistically significant correlation between GRACE risk score and C-reactive protein/albumin ratio (r=0.180, p<0.001). Conclusion: We found a significant relationship between C-reactive protein/albumin and in-hospital mortality. C-reactive protein/albumin ratio can be used in clinical practice because it is inexpensive and easy to apply and has a strong prognostic value for elderly non-ST-elevation myocardial infarction patients. Keywords: Myocardial Infarction; Albumin; Inflammation; Mortality.","PeriodicalId":51196,"journal":{"name":"Turkish Journal of Geriatrics-Turk Geriatri Dergisi","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45739852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.29400/tjgeri.2023.350
Ali KUTSAL
With the prolongation of life expectancy, the increase in the number of elderly individuals in societies and the high rates of disability, frailty and morbidity associated with this situation have led to the acceptance of old age as a prior social problem. And since the 2000s, many studies have been carried out in this field. Inflammation is a very important physiological function and a complex biological process that is initiated by the immune system in response to infection, injury or tissue damage. In connection with this process, inflammaging refers to the chronic, low-grade inflammation that occurs with aging. As one ages, the immune system undergoes changes including a descent in the production of new immune cells and a decrease in the ability of existing immune cells to function properly that can contribute to a state of chronic inflammation. Clinical trials suggest that modulating inflammation prevents many of the chronic diseases, frailty, and disability that increases at older age. In the light of existing information, one can predict that a possible reason for long life today is the capability of reaching an optimal balance between pro- inflammatory (C-Reactive Protein, Interleukin 6, Tumor necrosis factor-alpha) and anti-inflammatory (Interleukin-1 receptor antagonist protein, Cortisol, Interleukin-10) molecules. Keywords: Aging; Cellular Senescence; Inflammation; Immunosenescence.
{"title":"A PILLAR OF CARDIOVASCULAR DISEASES: INFLAMMAGING","authors":"Ali KUTSAL","doi":"10.29400/tjgeri.2023.350","DOIUrl":"https://doi.org/10.29400/tjgeri.2023.350","url":null,"abstract":"With the prolongation of life expectancy, the increase in the number of elderly individuals in societies and the high rates of disability, frailty and morbidity associated with this situation have led to the acceptance of old age as a prior social problem. And since the 2000s, many studies have been carried out in this field. Inflammation is a very important physiological function and a complex biological process that is initiated by the immune system in response to infection, injury or tissue damage. In connection with this process, inflammaging refers to the chronic, low-grade inflammation that occurs with aging. As one ages, the immune system undergoes changes including a descent in the production of new immune cells and a decrease in the ability of existing immune cells to function properly that can contribute to a state of chronic inflammation. Clinical trials suggest that modulating inflammation prevents many of the chronic diseases, frailty, and disability that increases at older age. In the light of existing information, one can predict that a possible reason for long life today is the capability of reaching an optimal balance between pro- inflammatory (C-Reactive Protein, Interleukin 6, Tumor necrosis factor-alpha) and anti-inflammatory (Interleukin-1 receptor antagonist protein, Cortisol, Interleukin-10) molecules. Keywords: Aging; Cellular Senescence; Inflammation; Immunosenescence.","PeriodicalId":51196,"journal":{"name":"Turkish Journal of Geriatrics-Turk Geriatri Dergisi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135595989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.29400/tjgeri.2023.352
Ali GÜLER, Yiğit CAN ŞENOL, Afşin Emre AKPINAR, Halis Emre ÇİFTÇİ, Mert YİĞİT, Zeynep GENCE ÖZ, Elif ORHUN, Ali DALGIÇ
Introduction: Treatment of lumbar spinal pain in geriatric patients is challenging. This study retrospectively investigated the effects of an ultrasonography-guided caudal epidural steroid injection on pain and functional recovery in geriatric patients (age ≥65 years). Materials and Methods: Fifty-eight patients who received ultrasonography-guided caudal epidural steroid injection between December 2019 and March 2023 were retrospectively evaluated. Pain levels were evaluated using the Visual Analog Scale, and functional recovery was assessed using Oswestry Disability Index. The time points for evaluation were preoperative, immediately post-procedure, and at three weeks and three months post-procedure. Results: The main underlying conditions in this cohort were lumbar spondylosis, lumbar disc herniation, and lumbar spondylolisthesis. Thirty patients had multiple-level lumbar canal narrowing, 13 had L4-5 and L5-S1 disc herniation, and five had lumbar spondylolisthesis. Ten patients had a history of lumbar spinal surgery. Fourteen patients had at least three comorbid conditions (cardiovascular disease, morbid obesity, renal disease, etc.), and six had four comorbid conditions. Pain Visual Analog Scale scores in the immediate postoperative period and at three weeks and three months were significantly lower than the preoperative score (p < 0.001). Oswestry Disability Index scores at three weeks and three months postoperatively were significantly better than the pre-procedure scores (p < 0.001). Conclusions: Ultrasonography-guided caudal epidural steroid injection is an excellent pain management modality in the treatment of spinal pain, especially in the geriatric age group. Keywords: Pain; Steroid; Ultrasonography; Comorbidity.
{"title":"Effectiveness of ultrasonography-guided caudal epidural steroid injection in improving pain and functional status of geriatric patients with spinal pain","authors":"Ali GÜLER, Yiğit CAN ŞENOL, Afşin Emre AKPINAR, Halis Emre ÇİFTÇİ, Mert YİĞİT, Zeynep GENCE ÖZ, Elif ORHUN, Ali DALGIÇ","doi":"10.29400/tjgeri.2023.352","DOIUrl":"https://doi.org/10.29400/tjgeri.2023.352","url":null,"abstract":"Introduction: Treatment of lumbar spinal pain in geriatric patients is challenging. This study retrospectively investigated the effects of an ultrasonography-guided caudal epidural steroid injection on pain and functional recovery in geriatric patients (age ≥65 years). Materials and Methods: Fifty-eight patients who received ultrasonography-guided caudal epidural steroid injection between December 2019 and March 2023 were retrospectively evaluated. Pain levels were evaluated using the Visual Analog Scale, and functional recovery was assessed using Oswestry Disability Index. The time points for evaluation were preoperative, immediately post-procedure, and at three weeks and three months post-procedure. Results: The main underlying conditions in this cohort were lumbar spondylosis, lumbar disc herniation, and lumbar spondylolisthesis. Thirty patients had multiple-level lumbar canal narrowing, 13 had L4-5 and L5-S1 disc herniation, and five had lumbar spondylolisthesis. Ten patients had a history of lumbar spinal surgery. Fourteen patients had at least three comorbid conditions (cardiovascular disease, morbid obesity, renal disease, etc.), and six had four comorbid conditions. Pain Visual Analog Scale scores in the immediate postoperative period and at three weeks and three months were significantly lower than the preoperative score (p < 0.001). Oswestry Disability Index scores at three weeks and three months postoperatively were significantly better than the pre-procedure scores (p < 0.001). Conclusions: Ultrasonography-guided caudal epidural steroid injection is an excellent pain management modality in the treatment of spinal pain, especially in the geriatric age group. Keywords: Pain; Steroid; Ultrasonography; Comorbidity.","PeriodicalId":51196,"journal":{"name":"Turkish Journal of Geriatrics-Turk Geriatri Dergisi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135594260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.29400/tjgeri.2023.360
Ümit Murat PARPUCU, Onur KÜÇÜK, Fatih SAĞ, Nurgül BALCI, Cihan DÖGER, Şuayip BİRİNCİ, Semih AYDEMİR, Kadriye KAHVECİ
Introduction: We aimed to define the characteristics of patients hospitalised in a palliative care unit and evaluate the role of palliative care services in the geriatric age group. The priorities and treatment approaches needed according to age groups were also evaluated. Materials and Methods: The records of patients aged 18 years and older who followed up with palliative care between 01/2020-12/2021 were reviewed retrospectively. Patients aged 18-64 were defined as “group-1”, patients aged 65-75 as “group-2”, patients aged 76-90 as “group-3”, and patients aged 91 and over as “group-4”. The patient’s age, sex, diagnosis, comorbidities, length of stay in the clinic, prognosis, pressure ulcers and immobilisation status were recorded and compared according to age groups. Results: A total of 560 patients were included. The mean age was 73.14±14.22 years, and 53.2% were women. 48.2% of patients were transferred to the palliative care unit from the intensive care unit. Groups-1, 2, 3, and 4 consisted of 139 (24.8%), 129 (23%), 254 (45.4%), and 38 (6.8%) patients, respectively. When patients were examined according to age group, there was a statistically significant difference between the groups in terms of sex, pressure ulcers, immobilisation, mean hospital stay in the palliative care, and prognosis (p=0.026, p≤.001, p=0.006, p≤.001, p≤.001). While 72% of patients were discharged from the palliative care unit, 28% died during admission. The prognosis was better in group-1 compared to other groups. Conclusion: Geriatric age and presence of chronic disease were the primary groups receiving palliative care. Access and integration of these patients to palliative care must be expanded. Keywords: Palliative Care; Geriatrics; Critical Care; Chronic Diseases; Health Services Accessibility.
{"title":"Pre-Assessment Criteria for the Needs of Patients in Palliative Care: The Role of Palliative Care by Age Groups","authors":"Ümit Murat PARPUCU, Onur KÜÇÜK, Fatih SAĞ, Nurgül BALCI, Cihan DÖGER, Şuayip BİRİNCİ, Semih AYDEMİR, Kadriye KAHVECİ","doi":"10.29400/tjgeri.2023.360","DOIUrl":"https://doi.org/10.29400/tjgeri.2023.360","url":null,"abstract":"Introduction: We aimed to define the characteristics of patients hospitalised in a palliative care unit and evaluate the role of palliative care services in the geriatric age group. The priorities and treatment approaches needed according to age groups were also evaluated. Materials and Methods: The records of patients aged 18 years and older who followed up with palliative care between 01/2020-12/2021 were reviewed retrospectively. Patients aged 18-64 were defined as “group-1”, patients aged 65-75 as “group-2”, patients aged 76-90 as “group-3”, and patients aged 91 and over as “group-4”. The patient’s age, sex, diagnosis, comorbidities, length of stay in the clinic, prognosis, pressure ulcers and immobilisation status were recorded and compared according to age groups. Results: A total of 560 patients were included. The mean age was 73.14±14.22 years, and 53.2% were women. 48.2% of patients were transferred to the palliative care unit from the intensive care unit. Groups-1, 2, 3, and 4 consisted of 139 (24.8%), 129 (23%), 254 (45.4%), and 38 (6.8%) patients, respectively. When patients were examined according to age group, there was a statistically significant difference between the groups in terms of sex, pressure ulcers, immobilisation, mean hospital stay in the palliative care, and prognosis (p=0.026, p≤.001, p=0.006, p≤.001, p≤.001). While 72% of patients were discharged from the palliative care unit, 28% died during admission. The prognosis was better in group-1 compared to other groups. Conclusion: Geriatric age and presence of chronic disease were the primary groups receiving palliative care. Access and integration of these patients to palliative care must be expanded. Keywords: Palliative Care; Geriatrics; Critical Care; Chronic Diseases; Health Services Accessibility.","PeriodicalId":51196,"journal":{"name":"Turkish Journal of Geriatrics-Turk Geriatri Dergisi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135594704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.29400/tjgeri.2023.355
Özlem ERGİN BETON, Mustafa Harun ŞAHİN, Hasan DOĞAN, Şule BİLEN, Hesna BEKTAŞ
Introduction: We aimed to compare the demographic characteristics, stroke localizations, stroke risk factors, and prognoses of geriatric stroke patients in different age groups. Materials and Methods: Geriatric patients who had a neurological consultation following an acute ischemic stroke were evaluated in the study. Patients were divided into age groups of 65–69, 70–79, 80–89, and 90 years and older. The demographic findings, the diseases of the patients, pre-stroke antiaggregant or anticoagulant treatment, previous history of cerebrovascular disease, presence of atrial fibrillation, laboratory data, imaging reports from initial presentation, Echocardiography and Carotid-Vertebral Doppler Ultrasonography results were recorded. Neurological deficits were evaluated using the National Institutes of Health Stroke Scale and the Modified Rankin Score. Results: The study evaluated 298 patients (161 females, 137 males). Significant differences were found in all four age groups in terms of the presence of diabetes mellitus. In relation to infarct localization, there were no significant differences between the four age groups. Previous antiaggregant or anticoagulant treatments were similar in all age groups. There were significant differences between the groups in terms of the presence of atrial fibrillation at presentation. In the 90 years and over age group, the values for the National Institutes of Health Stroke Scale and Modified Rankin Score were significantly higher. Conclusion: The incidence of stroke can be reduced by the regular evaluation of elderly individuals for modifiable risk factors and their management. In elderly individuals who had ischemic strokes, we recommend to comprehensive cardiac assessment, including procedures like a 24-hour Holter monitor and transesophageal echocardiography for cardioembolic origins. Keywords: Stroke; Geriatric; Risk factors; Prognosis.
{"title":"PROGNOSIS AND RISK FACTORS FOR GERIATRIC STROKE PATIENTS IN EACH DECADE","authors":"Özlem ERGİN BETON, Mustafa Harun ŞAHİN, Hasan DOĞAN, Şule BİLEN, Hesna BEKTAŞ","doi":"10.29400/tjgeri.2023.355","DOIUrl":"https://doi.org/10.29400/tjgeri.2023.355","url":null,"abstract":"Introduction: We aimed to compare the demographic characteristics, stroke localizations, stroke risk factors, and prognoses of geriatric stroke patients in different age groups. Materials and Methods: Geriatric patients who had a neurological consultation following an acute ischemic stroke were evaluated in the study. Patients were divided into age groups of 65–69, 70–79, 80–89, and 90 years and older. The demographic findings, the diseases of the patients, pre-stroke antiaggregant or anticoagulant treatment, previous history of cerebrovascular disease, presence of atrial fibrillation, laboratory data, imaging reports from initial presentation, Echocardiography and Carotid-Vertebral Doppler Ultrasonography results were recorded. Neurological deficits were evaluated using the National Institutes of Health Stroke Scale and the Modified Rankin Score. Results: The study evaluated 298 patients (161 females, 137 males). Significant differences were found in all four age groups in terms of the presence of diabetes mellitus. In relation to infarct localization, there were no significant differences between the four age groups. Previous antiaggregant or anticoagulant treatments were similar in all age groups. There were significant differences between the groups in terms of the presence of atrial fibrillation at presentation. In the 90 years and over age group, the values for the National Institutes of Health Stroke Scale and Modified Rankin Score were significantly higher. Conclusion: The incidence of stroke can be reduced by the regular evaluation of elderly individuals for modifiable risk factors and their management. In elderly individuals who had ischemic strokes, we recommend to comprehensive cardiac assessment, including procedures like a 24-hour Holter monitor and transesophageal echocardiography for cardioembolic origins. Keywords: Stroke; Geriatric; Risk factors; Prognosis.","PeriodicalId":51196,"journal":{"name":"Turkish Journal of Geriatrics-Turk Geriatri Dergisi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135595507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.29400/tjgeri.2023.354
Hasret ERDEN, Burcu AKPINAR SÖYLEMEZ
Introduction: The study was conducted to examine the effect of fear of falling on self-efficacy and quality of life in older stroke survivors. Methods: A descriptive cross-sectional study design was used. One hundred and twenty-one older adults who had had a stroke and admitted to hospital between March and December 2021 were included. Data were collected using the Sociodemographic Characteristics Form, Stroke Specific Quality of Life Scale, Tinetti Falls Efficacy Scale, Stroke Self-Efficacy Questionnaire, Barthel Activities of Daily Living Index, and Standardized Mini Mental Test. Descriptive statistics, numbers, percentages, means, Pearson correlation analysis, and simple linear regression analysis were used. Results: The mean age of participants was 74.19±6.66 years, Tinetti Falls Efficacy score was 47.67±17.38, Stroke Self Efficacy Questionnaire score was 22.49±7.64, and Stroke Specific Quality of Life Scale score was 3.13 ± 0.68. A statistically significant negative correlation was found between fear of falling and self-efficacy (r:-0.849; p < 0.001) and fear of falling and quality of life (r:-0.846; p < 0.001). The simple linear regression analysis indicates that Tinetti Falls Efficacy Scale had a statistically significant effect on Stroke Self Efficacy Questionnaire (p < 0.001). Tinetti Falls Efficacy Scale had a significant effect on Stroke Specific Quality of Life Scale (p < 0.001). Conclusion: Fear of falling in older stroke survivors significantly affects their self-efficacy and quality of life. It is recommended that fear of falling should be evaluated in detail and comprehensively in older stroke survivors. Keywords: Aged; Fear; Self Efficacy; Stroke; Quality of Life.
{"title":"THE EFFECT OF FEAR OF FALLING OF OLDER STROKE SURVIVORS ON THEIR SELF-EFFICACY AND QUALITY OF LIFE: A CROSS-SECTIONAL STUDY","authors":"Hasret ERDEN, Burcu AKPINAR SÖYLEMEZ","doi":"10.29400/tjgeri.2023.354","DOIUrl":"https://doi.org/10.29400/tjgeri.2023.354","url":null,"abstract":"Introduction: The study was conducted to examine the effect of fear of falling on self-efficacy and quality of life in older stroke survivors. Methods: A descriptive cross-sectional study design was used. One hundred and twenty-one older adults who had had a stroke and admitted to hospital between March and December 2021 were included. Data were collected using the Sociodemographic Characteristics Form, Stroke Specific Quality of Life Scale, Tinetti Falls Efficacy Scale, Stroke Self-Efficacy Questionnaire, Barthel Activities of Daily Living Index, and Standardized Mini Mental Test. Descriptive statistics, numbers, percentages, means, Pearson correlation analysis, and simple linear regression analysis were used. Results: The mean age of participants was 74.19±6.66 years, Tinetti Falls Efficacy score was 47.67±17.38, Stroke Self Efficacy Questionnaire score was 22.49±7.64, and Stroke Specific Quality of Life Scale score was 3.13 ± 0.68. A statistically significant negative correlation was found between fear of falling and self-efficacy (r:-0.849; p < 0.001) and fear of falling and quality of life (r:-0.846; p < 0.001). The simple linear regression analysis indicates that Tinetti Falls Efficacy Scale had a statistically significant effect on Stroke Self Efficacy Questionnaire (p < 0.001). Tinetti Falls Efficacy Scale had a significant effect on Stroke Specific Quality of Life Scale (p < 0.001). Conclusion: Fear of falling in older stroke survivors significantly affects their self-efficacy and quality of life. It is recommended that fear of falling should be evaluated in detail and comprehensively in older stroke survivors. Keywords: Aged; Fear; Self Efficacy; Stroke; Quality of Life.","PeriodicalId":51196,"journal":{"name":"Turkish Journal of Geriatrics-Turk Geriatri Dergisi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135595768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.29400/tjgeri.2023.356
Özge PEKŞEN KIZILIŞIK, Havva KOCAYİĞİT, Ali Fuat ERDEM
Introduction: High mortality rates after hip fracture surgery are an essential health problem. We evaluated the factors affecting mortality in the postoperative 30-day period. Materials and Methods: A total of 906 patients aged 65 years and over who underwent hip fracture surgery were included. The patients were divided into two groups: those who died within 30 days of surgery and those who survived. Demographic data, ASA classifications, comorbidities, method of anesthesia, length of stay in hospitals and intensive care units, and the effects of these parameters on postoperative 30-day mortality were analysed. Results: The postoperative 30-day mortality of the patients was 8.6%. The mean age of the patients who died during this period was 83.49 ± 6.9 years, while the mean age of the survivors was 78.7 ± 7.6 years. In our study, age (OD: 1.091; CI 95%, 1.051–1.132), The American Society of Anesthesiologists (ASA) physical status classification (OD: 12.69; CI 95%, 1.074–150.17), coronary artery disease (OD: 0.521; CI 95%, 0.287–0.944), general anesthesia administration (OD: 0.305; CI 95%, 0.140–0.667), and creatinine values (OD: 1.045; CI 95%, 1.114–1.892) were determined to be independent risk factors. Conclusions: Detailed examination of elderly hip fracture patients considering these risk factors and close perioperative follow-up will reduce mortality. Keywords: Aged; Anesthesia; Hip Fractures; Mortality.
{"title":"ANALYSIS OF RISK FACTORS AFFECTING MORTALITY IN GERIATRIC PATIENTS OPERATED ON FOR HIP FRACTURES","authors":"Özge PEKŞEN KIZILIŞIK, Havva KOCAYİĞİT, Ali Fuat ERDEM","doi":"10.29400/tjgeri.2023.356","DOIUrl":"https://doi.org/10.29400/tjgeri.2023.356","url":null,"abstract":"Introduction: High mortality rates after hip fracture surgery are an essential health problem. We evaluated the factors affecting mortality in the postoperative 30-day period. Materials and Methods: A total of 906 patients aged 65 years and over who underwent hip fracture surgery were included. The patients were divided into two groups: those who died within 30 days of surgery and those who survived. Demographic data, ASA classifications, comorbidities, method of anesthesia, length of stay in hospitals and intensive care units, and the effects of these parameters on postoperative 30-day mortality were analysed. Results: The postoperative 30-day mortality of the patients was 8.6%. The mean age of the patients who died during this period was 83.49 ± 6.9 years, while the mean age of the survivors was 78.7 ± 7.6 years. In our study, age (OD: 1.091; CI 95%, 1.051–1.132), The American Society of Anesthesiologists (ASA) physical status classification (OD: 12.69; CI 95%, 1.074–150.17), coronary artery disease (OD: 0.521; CI 95%, 0.287–0.944), general anesthesia administration (OD: 0.305; CI 95%, 0.140–0.667), and creatinine values (OD: 1.045; CI 95%, 1.114–1.892) were determined to be independent risk factors. Conclusions: Detailed examination of elderly hip fracture patients considering these risk factors and close perioperative follow-up will reduce mortality. Keywords: Aged; Anesthesia; Hip Fractures; Mortality.","PeriodicalId":51196,"journal":{"name":"Turkish Journal of Geriatrics-Turk Geriatri Dergisi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135594489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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