• 제목/요약/키워드: elderly patients

검색결과 1,785건 처리시간 0.039초

한국의 노인환자에 대한 섬망 및 졸음 유발 약물의 사용평가 (Evaluation of Drug Use Causing Delirium and Drowsiness in Elderly Patients of Korea)

  • 조하나;이옥상;임성실
    • 한국임상약학회지
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    • 제22권1호
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    • pp.30-40
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    • 2012
  • In Korea, elderly population aged 65 and older are about 5.0% and 10.7% in 1990 and 2009, respectively. Since elderly people may experience physiologic changes with aging and their pharmacodynamic and pharmcokinetic parameters also have been undergone changes, several adverse drug reactions can occur more frequently than young people. Especially, neuropsychiatric adverse drug reactions such as delirium and drowsiness endanger elderly patients more. The purpose of this study is to evaluate the outpatient prescriptions using drug causing delirium and drowsiness in elderly patients aged 65 and older. We retrospectively reviewed prescriptions for elderly patients collected from four community pharmacies from January 2nd to February 1st, 2010. One pharmacy was located closed to a general hospital, and others were located closed to a internal medicine or an ENT clinic. The each number of the collected prescriptions was followings; Group A (n=496) from internal medicine department of a general hospital; Group B (n=44) from ENT department of general hospital; Group C (n=144) from internal medicine clinic; Group D (n=110) from ENT clinic. In result, in Group A, the average number of prescribed drugs causing delirium or drowsiness per Rx was 2.38 In Group B, the average number of prescribed drugs causing delirium or drowsiness per Rx was 2.09 In Group C, the average number of prescribed drugs causing delirium or drowsiness per Rx was 2.51. In Group D, the average number of prescribed drugs causing delirium or drowsiness per Rx was 2.72. Especially, in Group D, the percentage of prescription that drugs causing delirium or drowsiness per Rx prescribed more than 3 is 52.73% In all the 4 groups, over the 60% of drugs causing delirium and/or drowsiness per prescription of elderly patients were prescribed. It means elderly patients take 2 drugs causing delirium and/or drowsiness among 3 drugs, which is very serious. Frequently prescribed drugs causing delirium and/or drowsiness were followings; GI agents, antitussives & expectorants, histamine H1 antagonist, analgesics, antibiotics. Among these drugs, GI agents was high raking in all the 4 groups, and pharmacists should caution elderly patients when counseling. In the internal medicine groups (Group A,C), drugs concerning chronic diseases were prescribed frequently. In conclusion, pharmacist's role is important. Pharmacists are well informed of the drugs causing delirium or drowsiness and it is important to explain about ADRs slowly and easily to the elderly patients that receive drugs causing delirium or drowsiness. And institutional device is needed. For example, when doctors prescribe drugs for the elderly patients, message is needed that supply some informations about drugs causing delirium or drowsiness.

정상노인과 뇌졸중 환자의 우세측과 비우세측의 골밀도 비교 (Compared to Bone Mineral Density between Dominant Side and Recessive Side in Normal Elderly and Stroke Patients)

  • 민동기
    • PNF and Movement
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    • 제11권2호
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    • pp.127-134
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    • 2013
  • Purpose : The purpose of this study of normal elderly and stroke patients by comparing the dominant side and recessive side was to evaluate the differents between each Methods : Thirty-two elderly participated in this study. They were classified two groups: stroke patients group and the normal elderly group. Outcome measures were: general characteristics and BMD. General characteristics included age, height, weight and body mass index. BMD was represented in the osteoporosis index, T-score and Z-score. The measurements of bone mineral density were evaluated on the calcaneus region of the dominant and recessive side, using OsteoPro. The data analyzed using SPSS 17.0 software and the Paired-sample T-test and the Independent-sample T-test Results : OI, T-score, Z-score showed no significant differences between dominant side and recessive side in normal elderly group. But stroke patients group showed OI, T-score, Z-score significant differences between paretic side and nonparetic side. Change score subtracted recessive side from dominant side was significant differences between stroke patients group and normal elderly group. Conclusion : There is positive relationship between physical activity and BMD in stroke patients. Therefore, improved physical activity can have a beneficial effect by reducing osteoporosis in stroke patients, considering a positive relationship between physical activity and BMD.

Pneumonectomy for Clinical Stage I Non-Small Cell Lung Cancer in Elderly Patients over 70 Years of Age

  • Kim, Tae Ho;Park, Byungjoon;Cho, Jong Ho;Kim, Hong Kwan;Choi, Yong Soo;Kim, Kwhan-Mien;Shim, Young Mog;Zo, Jaeil;Kim, Jhingook
    • Journal of Chest Surgery
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    • 제48권4호
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    • pp.252-257
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    • 2015
  • Background: Lobectomy is the generally accepted standard treatment for early-stage non-small cell lung cancer (NSCLC). However, especially in elderly patients, it is often necessary to perform pneumonectomy in order to maximize the likelihood of curative treatment, although pneumonectomy is a challenging procedure. Methods: We analysed patients who were clinically diagnosed with stage I NSCLC and underwent pneumonectomy with curative intent from 2004 to 2011. The patients were divided into an elderly group (${\geq}70$ years) and a younger group (<70 years). We retrospectively analysed the outcomes of these groups of patients in order to characterize the role of pneumonectomy as a treatment for elderly patients with clinical stage I NSCLC. Results: Thirty patients younger than 70 years of age (younger group) and fourteen patients 70 years of age or older (elderly group) who underwent pneumonectomy were enrolled in the present study. The median follow-up period was 35 months (range, 0 to 125 months). The perioperative mortality rate (within 90 days after the operation) was 7.1% in the elderly group and 6.7% in the younger group (p=0.73). No significant differences between the two groups were observed regarding the occurrence of pneumonia, acute respiratory distress syndrome, cardiac arrhythmia, bronchopleural fistula, and vocal cord paralysis. The overall five-year survival rate was 79.4% in the younger group and 35.7% in the elderly group, which was a significant difference (p=0.018). The five-year disease-free survival rate was 66.7% in the younger group and 35.7% in the elderly group, but this difference was not statistically significant (p=0.23). Conclusion: Although elderly patients with early stage lung cancer showed a worse long-term survival rate after pneumonectomy than younger patients, the outcomes of elderly patients were similar to those of younger patients in terms of perioperative mortality and postoperative complications. Patients should not be denied pneumonectomy solely due to old age.

The effectiveness of group combined intervention using animal-assisted therapy and integrated elderly play therapy

  • Kil, Taeyoung;Kim, Hak-man;Kim, Minkyu
    • Journal of Animal Science and Technology
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    • 제61권6호
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    • pp.371-378
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    • 2019
  • The purpose of this study was to investigate the effects of group combined intervention that combined animal-assisted therapy and integrated elderly play therapy on the depression, self-esteem, and emotional expression of geriatric patients residing in nursing homes. This was achieved by providing cognitive, physical, and emotional activities and social interaction at the same time. The group combined intervention method was applied to twelve elderly patients (six in the control group, six in the experimental group) aged 65 or older who live in a nursing home for the elderly in C province, from May 3, 2019 to June 21, 2019, for a total of 8 times (once a week, 50 minutes at a time). The quantitative evaluation was analyzed through SPSS 21.0 for comparison before and after the program was implemented, using the Korean version of the depression and the self-esteem scale. The qualitative evaluation compared emotional expression pre-test and post-test. The major results of the study were as follows: First, the group combined intervention was effective in reducing depression levels of the experimental group among the elderly patients. Second, it was effective in improving the self-esteem of the experimental group among the elderly patients. Third, it showed a significant difference in the emotional expression of the experimental group among the elderly patients. Therefore, it was found that group combined intervention reduces depression and improves self-esteem and emotional expression of the elderly. Based on these results, it is hoped that this study will be a cornerstone in the development of concrete programs for the benefit of elderly patients living in facilities.

경관급식 노인 환자의 영양공급실태와 영양상태 평가 (Feeding and Nutritional Status of Elderly Patients receiving Enteral Tube Feeding)

  • 윤화영;김혜경
    • 한국식품영양학회지
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    • 제31권1호
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    • pp.52-61
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    • 2018
  • The purpose of this study is to examine the feeding and nutritional status of enteral tube-fed elderly patients. Subjects included 77 elderly hospitalized patients who had received enteral nutrition more than one week before admission. Medical records on admission and actual feeding volume were used to assess anthropometric, biochemical, and nutritional status. Most patients manifested disorders of the nervous system (93.5%) and the average duration of tube feeding was 13.9 months. The average feeding volume of formula was 1,107 mL per day and the mean ratios of calorie and protein (supplied vs. required) were 81.7% and 80.9%, respectively. At admission, 57.4% of the patients were malnourished according to the institutional criteria. Patients receiving less than 80% of the required calories were in worse nutritional status compared with those receiving more than 80% of the required calories. Body mass index, percent ideal body weight, serum albumin level and blood lipid levels (total cholesterol, HDL-cholesterol, triglyceride) were significantly lower in patients receiving less than 80% of the required calories. These results indicate the high prevalence of malnutrition and the need for increased attention and nutritional care of elderly patients undergoing long-term enteral nutrition.

대구 경북지역에서 진단된 노령자 폐암의 임상적 특징과 예후 (The Clinical Characteristics and Prognosis of Elderly Patients with Lung Cancer Diagnosed in Daegu and Gyeongsangbukdo)

  • 김현숙;현대성;김경찬;이상채;정태훈;박재용;김창호;차승익;이관호;정진홍;신경철;전영준;한승범;최원일;김연재;정치영;임건일
    • Tuberculosis and Respiratory Diseases
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    • 제65권1호
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    • pp.15-22
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    • 2008
  • 연구배경: 폐암은 우리나라 암 사망원인 질환의 가장 높은 비율을 차지하는 질환으로 특히 노령 인구에서 증가하는 추세이다. 그러나 노령의 폐암 환자는 동반된 질환, 노령에 따른 장기 기능의 저하 등의 이유로 적절한 치료를 받지못하는 경우가 많다. 이에 70세 이상의 노령 폐암 환자의 임상적 특징과 치료에 따른 생존기간 등을 알아보고자 한다. 방 법: 2005년 1월부터 2005년 12월까지 대구, 경북 지역에 소재하고 있는 대학병원 및 종합병원(경북대학병원, 구미 순천향병원, 대구가톨릭대학병원, 대구파티마병원, 동산의료원, 영남대학병원)에서 세포학적 혹은 조직학적으로 원발성 폐암을 진단받은 706명의 환자들을 70세 이상 환자군과 70세 미만 환자군으로 나누어 후향적으로 연구하였다. 결 과: 전체 환자 중 70세 이상의 환자는273명(38.7%)이었다. 70세 이상의 환자는 70세 미만보다 호흡곤란의 증상이 많았으며(p<0.001), 만성폐쇄성폐질환의 빈도가 높았고(p<0.001), 활동도가 좋은 경우가 적었다(p<0.001). 비소세포폐암 환자의 중앙생존기간은 70세 미만의 환자와 70세 이상의 환자에서 유의한 차이를 보였지만(962일 vs 298일, p=0.001), 한 가지라도 치료를 받았던 환자들을 대상으로 했을 때는 두 군간에 의미 있는 차이가 없었다(1,109일 vs 708일, p=0.14). 결 론: 70세 이상의 비소세포폐암 환자에서 환자의 활동도 등을 고려하여 적극적인 치료를 시행하는 것이 바람직할 것으로 생각된다.

노인과 비노인 외상환자의 손상중증도에 따른 특성 비교 (Comparison of the Characteristics according to Injury Severity Score between Elderly and Non-elderly with Trauma)

  • 김현주;김윤경
    • 한국보건간호학회지
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    • 제32권2호
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    • pp.304-318
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    • 2018
  • Purpose: This study examined the characteristic of the Injury Severity Score (ISS) of Korean geriatric patients with a traumatic injury in a nationally representative sample to determine the optimal cutoff of ISS of mortality according to age. Methods: The subjects were 3,018 non-elderly patients and 1,584 elderly patients with an ISS and Korean Triage and Acuity Scale (KTAS) in 2016 from the data of the Health Insurance Review and Assessment Service. The traumatic characteristics of the elderly and non-elderly were compared by stratifying the ISS. Receiver Operating Characteristic (ROC) curve analysis was used to find the optimal cutoff of ISS of mortality according to age. Results: The elderly were more prone to severe trauma than the non-elderly were. The distribution of KTAS grades was lower, even though the severity of ISS was as high as that of the non-elderly. The optimal cutoff score of the ISS for mortality in the ROC curve was lower in elderly over 65 years than in the other age group. Conclusion: The elderly are more prone to severe trauma and death than non-elderly, even though their ISS is low. Therefore, a strategy to prevent elderly from experiencing serious trauma and managing their geriatric trauma actively is needed.

노인 두경부암 환자의 생존에 있어 노쇠의 의의 (Frailty in Geriatric Patients with Head and Neck Cancer and its Implication in Survivorship)

  • 권민수
    • 대한두경부종양학회지
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    • 제39권2호
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    • pp.1-6
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    • 2023
  • The aging population, particularly those aged 65 and above, is on the rise, with projections indicating a substantial increase in the elderly demographic. This demographic shift brings challenges in managing age-related diseases, including head and neck cancers (HNCs). Frailty, often characterized by physiological decline and vulnerability to stressors, is a crucial factor affecting treatment outcomes of elderly cancer patients. Accordingly, the significance of assessing frailty in elderly HNC patients before their treatment should be emphasized, but current frailty assessment tools may not fully capture the unique challenges faced by HNC patients. Specific indicators, including respiratory and swallowing functions, are proposed for a more tailored assessment. This comprehensive review explores the impact of frailty on various treatment modalities, including surgery, radiation, and chemotherapy, highlighting the need for personalized interventions. Furthermore, it suggests avenues for future research to enhance frailty assessment tools and investigate interventions aimed at improving treatment outcomes in elderly HNC patients.

노인환자와 중년환자의 병원 음식 만족도 비교 분석 (Comparative Analysis of Satisfaction Level on Hospital Foods in Elderly and Middle Aged Patients)

  • 손주현;천종희
    • 한국식생활문화학회지
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    • 제16권5호
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    • pp.442-450
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    • 2001
  • The purpose of this study was to analyze the satisfaction level on hospital foods in elderly and middle aged patients. The subjects were selected among the patients treated in the Inha University hospital during July of 1999. One hundred thirty five elderly patients aged over sixty(68 men, 67 women) and sixty five patients aged in forties(35 men, 30 women) were surveyed through questionnaires in terms of satisfaction level on hospital foods and the food preferences. Satisfaction on general taste, saltiness, serving temperature, appearance, texture and variety of hospital foods was not significantly different according to age. However, elderly men showed significantly higher satisfaction level than elderly women in terms of general taste of hospital foods(p<0.01). The preferences of cooking method for meat, fish, vegetable and the preferred kinds of kimchi and milk & milk products were not significantly different between the two age groups. However, elderly women significantly preferred sauted meat to broiled meat compared to elderly men(p<0.05).

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입원 노인환자의 부적절 약물사용현황 및 용량적절성 평가 (Assessment of Inappropriate Medication Use and Dosage in Elderly Patients)

  • 홍유리;이숙향
    • 약학회지
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    • 제54권3호
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    • pp.205-214
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    • 2010
  • This study aimed to evaluate the patterns of inappropriate medication use and inappropriate dosage in elderly patients in Korea. A retrospective study was performed for the elderly 65 years or older admitted from January 2007 to December 2007 in a medical center, Seoul, Korea. Potentially inappropriate medication (PIM) use in the elderly was evaluated using Beers criteria. Eighteen drugs out of Beers criteria were included in the formulary of the institute. Inappropriate dosage was set using Beers criteria, CMS (the Centers for Medicare& Medicaid Services) guideline, Geriatric Dosage Handbook. As results, the patients with PIM were 2,172 during the study period. The commonly used inappropriate medications were drugs for the nervous system (n=1237, 44.78%), the alimentary System (n=663, 24.54%) and the cardiovascular system (n=494, 18.28%). The elderly patients with prescription of inappropriate dosage were 10% out of patients with PIMs. The commonly inappropriate dosage drugs were digoxin (n=75, 27.27%), diazepam (n=70, 22.55%) and ferrous sulfate (n=66, 24.00%). Logistic regression analysis showed the number of PIM, days of hospital stay as predictors related to inappropriate dosage use. In conclusion, CNS drugs were frequently prescribed as PIM and inappropriate dosages were identified. It is needed to develop a means of decreasing adverse drug events in elderly.