• Journal of Korean Neurosurgical Society
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• 제41권4호
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• pp.217-223
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• 2007

Objective : The apparent increase in the incidence of the intracranial meningiomas in the elderly is due in part to improved diagnostic tools and improved span of life. The authors carried out a retrospect study to validate the use of the Clinical-Radiological Grading System [CRGS] as a clinical tool to orientate surgical decision making in elderly patients and to explore prognostic factors of survival. Methods : From January 1997 to January 2006, the authors consecutively recruited and surgically treated 20 patients older than 65 years of age with radiologic findings of intracranial meningiomas and a preoperative evaluation based on the CRGS. Results : High CRGS score was associated with a higher probability of good outcome [p=0.004] and a lower probability of postoperative complications [p=0.049]. Among the different subset items of the CRGS score, larger maximum tumor diameters [$D{\geqq}4cm$] and the presence of a severe peritumoral edema were associated with incidence rate of postoperative poor outcome and complications [p<0.05]. Additionally, the critical location of the tumor was also correlated with poor outcome [p<0.05]. Conclusion : A CRGS score higher than 13 is a good prognostic indication of survival. The CRGS score is a useful and practical tool for the selection of elderly patients affected by intracranial meningiomas as surgical candidates.

• 동서간호학연구지
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• 제26권1호
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• pp.52-62
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• 2020

Purpose: This study aimed to verify the effects of preoperative video education on delirium and anxiety in elderly patients with general anesthesia. Methods: This study used quasi-experimental research with a non-equivalent control group non-synchronized design. Participants were 70 elderly patients who had undergone of surgery under general anesthesia (35 in the experimental group and 35 in the control group). Preoperative video education was given to the experimental group. Subjective anxiety, blood pressure, pulse and delirium were measured. Data were analyzed using descriptive statistics, test of homogeneity in pretest, independent t-tests, and two-way repeated measures ANOVA with the SPSS/Win 22.0 program. Results: Delirium of the experimental group was significantly lower than that of the control group. Subjective anxiety measured using visual analogue scale was not significantly different between the two groups. However, there was a significant difference in the interaction between the group and time. There was no significant difference in physiological anxiety measured using systolic blood pressure, diastolic blood pressure and pulse between the two groups. Conclusion: The findings suggest that preoperative video education may contribute to reducing delirium and subjective anxiety for elderly patients after surgery.

• 한국병원경영학회지
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• 제14권3호
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• pp.66-82
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• 2009

The purpose of this study is to investigate the determinants of caregiver's conflict experience in elderly care institutions. This study focused on the three key independent variable groups(e.g., socio-demographic, job-related, and individual personality). The sample used in this study are 311 caregivers who are randomly selected from 21 elderly care institutions in Korea. Data were collected with a structured questionnaire by mail from Oct. 15 to Nov. 30 in 2007. The collected data were analyzed using logistic regression. The major findings of the study are as follows: 1) Nearly 40% percent of the respondents reported that they had experienced conflicts with elderly patients. The conflict with other caregivers ranked as second(20.6%), followed by patients' families(18.6%) and hospital employees(15.1%). 2) The personality, especially uniqueness caused conflict with patients or other caregivers. The professional identity reduced conflict with patients. The negative work experiences caused conflict with patients or family. The service attitude reduced conflict with family. The service-centered culture reduced conflict with hospital employees. Those who lived with the elderly showed lower level of conflict with family or hospital employees.

• Journal of Korean Dental Science
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• 제14권2호
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• pp.61-68
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• 2021

Purpose: The aim of this study was to investigate the outcomes of endodontic treatment of mandibular second molar with C-shaped canal in elderly patients and related factors affecting the survival of the tooth. Materials and Methods: From 2010 to 2015, the survival rate following endodontic treatment was evaluated in elderly patients over 60 years who visited the Veterans Health Service Medical Center for endodontic treatment. The presence of C-shaped canals was confirmed using clinical records and radiographic features. Patient's age, sex, systemic diseases, tooth location, vitality, signs and symptoms, fractures, caries, apical radiolucency, canal shaping methods, sealer leakage, filling voids, and restoration of prosthesis were included in the analyses as confounding variables. The survival rate of teeth was analyzed using Kaplan-Meire analysis and the relationship between the survival rate and variables was analyzed using Simple and Multiple Cox regression analysis. Result: In total, 107 teeth in elderly patients had C-shaped canal. The survival rate of teeth that received endodontic treatment was 63.70%. None of the factors investigated significantly influenced the survival rate (P>0.05). Conclusion: In elderly patients with C-shaped canal, the survival rate after root canal treatment was not significantly different from that of other mandibular molars.

• 대한정형외과학회지
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• 제54권1호
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• pp.18-23
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• 2019

고령화의 진행 및 의학 기술의 발전으로 고령인구의 척추 수술이 증가하고 있다. 하지만 고령인구의 경우 젊은 연령에 비해 수술 범위가 넓어질 수 있고 골다공증이 동반될 수 있기 때문에 성공적인 수술 결과를 얻기 위해서는 세심한 준비가 필요하다. 이에 저자는 고령인구에서 수술적 치료 결과 향상을 위해 수술 전, 후 필요한 약물 요법 중 특별히 골다공증의 치료에 중점을 두어 살펴보고자 한다.

• 대한임상독성학회지
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• 제14권2호
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• pp.129-135
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• 2016

Purpose: This study was conducted to compare demographic and characteristic differences in self-poisoned patients by age groups using a comprehensive trauma database. Methods: This study included 1,823 patients who were admitted to the emergency room following self-poisoning. Three age groups were defined: young patients (less than 19 years), adult patients (19 to 64 years) and elderly patients (65 years and old). From January 2011 to December 2015, data were obtained from in a single emergency medical center. We investigated the materials of poisoning, ingestion time, GCS, systolic blood pressure, heart rate, and outcomes of patients. Results: A total of 1,823 self-poisoned patients visited the hospital during 5 years. Among these, 130 (7.1%) were categorized as young, 1,460 (80.1%) were adults and 233 (12.8%) were elderly. The most common drug of self-poisoning substances was antipyretics (50.0%) for those in the young group, sedative drugs (45.0%) for adults, and pesticides (41.2%) for the elderly. Mortality was 2.7% in the adult group and 14.6% in the elderly group. After adjusting for all factors related to mortality, the odds ratio (OR) of mortality was 2.63 in the elderly group (95% confidence interval [CI]: 1.44-4.81). Conclusion: There were definite differences in the characteristics of three groups. The younger patients used drugs that could be easily obtained while older patients used more lethal drugs.

• Journal of Korean Neurosurgical Society
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• 제59권3호
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• pp.287-291
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• 2016

Objective : Because elderly patients are undergoing more surgeries, the importance of postoperative cognitive impairment (CI) evaluations is rising, especially for spine surgery, which is related to subjective pain. We investigated the prevalence of undiagnosed CI among elderly patients who underwent spine surgery and the impact of CI on postoperative outcomes. Methods : The preoperative cognitive statuses of 129 patients over 65 who underwent lumbar spine surgery from 2012 to 2014 were determined with the Mini-Mental State Examination, and patients with scores under 24 were diagnosed with CI. The patients were then divided into a CI group (n=49) and non-cognitive impairment (NCI) group (n=80). Results : Among the 129 patients, 49 (38.0%) were diagnosed with CI, and 9 (7.0%) had severe CI. The age of the CI group ($72.88{\pm}6.20years$) was significantly greater than that of the NCI group ($69.96{\pm}4.53years$). In contrast, the postoperative visual analog scale scores and performance statuses did not differ significantly. However, postoperative delirium was more frequent and the hospital stay length was longer in the CI group compared with the NCI group (p<0.05). Conclusion : A high prevalence of undiagnosed CI was discovered among elderly patients undergoing spine surgery. The existence of CI was associated with higher rates of postoperative delirium and prolonged hospital stays, which affected clinical outcomes. Thus, CI assessments should be included in preoperative evaluations of elderly patients prior to spine surgery.

• Asian Pacific Journal of Cancer Prevention
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• 제14권3호
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• pp.2029-2032
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• 2013

Background: The geriatric population in Malaysia is predicted to increase from 4% of the total population in 1998 to 9.8% by 2020, in parallel with developments in the socioeconomy. Cancer is expected to be a major medical issue among this population. However, the decision for treatment in Malaysia is always decided by the caregivers instead of the elderly patients themselves. Objective: The aim of the study was to assess the willingness to accept chemotherapy among elderly Malaysians. Materials and Methods: In this cross-sectional study, patients aged 60 and above from various clinics/wards were recruited. Those giving consent were interviewed using a questionnaire. Results: A total of 75 patients were recruited, 35 patients (47%) with a history of cancer. The median age was 73 years old. There were 29 Chinese (38.7%), 22 Indian (29.3%), 20 Malay (26.7%) and four other ethnicity patients. Some 83% and 73% of patients willing to accept strong and mild chemotherapy, respectively. Patients with cancer were more willing to accept strong and mild chemotherapy compared to the non-cancer group (88.6% vs 62.5%, P=0.005, 94% vs 80%, P=0.068). On sub-analysis, 71.4% and 42.9% of Chinese patients without a history of cancer were not willing to receive strong and mild chemotherapy, respectively. Conclusions: The majority of elderly patients in UMMC were willing to receive chemotherapy if they had cancer. Experience with previous treatment had positive influence on the willingness to undergo chemotherapy.

• 한국임상약학회지
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• 제32권1호
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• pp.27-36
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• 2022

Background: Medication-related problems (MRPs) frequently occur during the discharge period. Elderly patients, particularly, are at high risk for these problems due to polypharmacy and the use of potentially inappropriate medications. The purpose of this study was to build and implement collaboration between general hospital and community pharmacies to address MRPs among high-risk elderly patients before/after discharge. Methods: This retrospective study was conducted between June and December of 2020. The inclusion criteria were patients with aged ≥65 years; residents of Jeonju; discharged from Jeonbuk National University hospital; either on medication of exceeding 10 medications (or high-risk medications) after hospitalization through the emergency room, or having severe illness. Patients received medication reconciliation and counselling by hospital pharmacists before discharge and home-visit pharmaceutical care as follow-up by community pharmacists after discharge. Results: Twenty-two patients agreed to home-visit pharmaceutical services. Fifteen and 11 patients completed the first and second home-visit pharmaceutical care service, respectively. Forty-two MRPs were identified in 15 patients. The types of high-frequency MRPs were incorrect administration of drug, adverse drug reactions, medication non-compliance, drug-drug interactions, lifestyle modifications, and expired medication disposal. After consultation with the pharmacist, 34 out of 42 MRPs were resolved. Conclusions: Transitional care for high-risk elderly patients before and after discharge was successfully built and implemented through a collaboration between general hospital and community pharmacies. This study suggests that home-visit pharmaceutical services may have positive effects on the safe use of drugs during the transition period; however, additional research is needed to expand on these findings.

• Archives of Plastic Surgery
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• 제37권5호
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• pp.644-649
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• 2010

Purpose: As the mean life expectancy of people has been prolonged, and the elderly people who participate in the production activities has been increasing, it is expected that the demand on the replantation of amputated digits in elderly patients would increase. But, there are few studies about the replantation of amputated digits in elderly patients. Therefore, we report treatment outcomes of replantation of amputated digits in elderly patients. Methods: From 1998 to 2008, the replantation was performed in 51 completely amputated digits of 33 patients aged 60 years or older. We performed the replantation in the usual manner. Under the brachial plexus block, the surgical procedures carried out in the following sequence: internal fixation using Kirschner wire, tenorrhaphy, arteriorrhaphy, neurorrhaphy and venorrhaphy. If the arterial ends could not be approximated without tension, a vein graft was performed. Results: Of a total of 51 digits, 46 digits (90%) survived. 13 patients (40%) had underlying medical problem preoperatively. But, in all the patients, there were no postoperative medical complications. As the postoperative surgical complications, excluding five cases of the total necrosis of digit, there were three cases of venous congestion, two cases of arterial insufficiency, seven cases of infection and 16 cases of partial necrosis. Conclusion: Age alone does not affect the survival of replanted digits. Type of injury is the most important factor that affects the survival of replanted digits.