• Title/Summary/Keyword: octogenarians

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Comparison of Off-Pump Coronary Artery Bypass between Octogenarians and Septuagenarians: A Propensity Score Analysis

  • Lee, Sang On;Lee, Heemoon;Cho, Yang Hyun;Jeong, Dong Seop;Lee, Young Tak;Kim, Wook Sung
    • Journal of Chest Surgery
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    • v.52 no.3
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    • pp.155-161
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    • 2019
  • Background: Coronary artery bypass grafting (CABG) is being offered increasingly frequently to octogenarians. However, old age is known to be an independent risk factor in CABG. The aim of this study was to compare the outcomes of off-pump coronary artery bypass (OPCAB) between octogenarians and septuagenarians. Methods: We retrospectively reviewed the data of 1,289 consecutive patients aged ${\geq}70years$ who underwent OPCAB at a single institution between 2001 and 2016. We compared the outcomes of 115 octogenarians and 1,174 septuagenarians. Using propensity score matching, based on preoperative clinical characteristics, 114 octogenarians were matched with 338 septuagenarians. Results: Propensity score analysis revealed that the incidence of acute kidney injury (14.9% vs. 7.9%, p=0.028) and respiratory complications (8.8% vs. 4.2%, p=0.040) was significantly higher in octogenarians. The early mortality rate (2.6% vs. 1.0%, p=0.240) and 1-year survival rate (89.5% vs. 94.4%, p=0.097) were not statistically significant between the groups. However, the 5-year survival rate (67.3% vs. 79.9%, p<0.001) was significantly lower in octogenarians. Previous myocardial infarction and a left ventricular ejection fraction ${\leq}35%$ were associated with a poor 1-year survival rate. Conclusion: Early and 1-year outcomes of OPCAB in octogenarians were tolerable when compared with those in septuagenarians. OPCAB could be a suitable option for octogenarians.

Clinical outcomes of nonvariceal upper gastrointestinal bleeding in nonagenarians and octogenarians: a comparative nationwide analysis

  • Khaled Elfert;James Love;Esraa Elromisy;Fouad Jaber;Suresh Nayudu;Sammy Ho;Michel Kahaleh
    • Clinical Endoscopy
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    • v.57 no.3
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    • pp.342-349
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    • 2024
  • Background/Aims: Nonagenarians will purportedly account for 10% of the United States population by 2050. However, no studies have assessed the outcomes of nonvariceal upper gastrointestinal bleeding (NVUGIB) in this age group. Methods: The National Inpatient Sample database between 2016 and 2020 was used to compare the clinical outcomes of NVUGIB in nonagenarians and octogenarians and evaluate predictors of mortality and the use of esophagogastroduodenoscopy (EGD). Results: Nonagenarians had higher in-hospital mortality than that of octogenarians (4% vs. 3%, p<0.001). EGD utilization (30% vs. 48%, p<0.001) and blood transfusion (27% vs. 40%, p<0.001) was significantly lower in nonagenarians. Multivariate logistic regression analysis revealed that nonagenarians with NVUGIB had higher odds of mortality (odds ratio [OR], 1.5; 95% confidence interval [CI], 1.3-1.7) and lower odds of EGD utilization (OR, 0.86; 95% CI, 0.83-0.89) than those of octogenarians. Conclusions: Nonagenarians admitted with NVUGIB have a higher mortality risk than that of octogenarians. EGD is used significantly in managing NVUGIB among nonagenarians; however, its utilization is comparatively lower than in octogenarians. More studies are needed to assess predictors of poor outcomes and the indications of EGD in this growing population.

The influence of ankle strategy exercise on equilibrium ability in women of octogenarians (발목관절 전략 운동이 80대 노인 여성의 균형능력에 미치는 영향)

  • Lee, Woo-Hyung
    • Journal of Korean Physical Therapy Science
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    • v.17 no.1_2
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    • pp.67-76
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    • 2010
  • Background: The purpose of this study was to evaluate the influence of ankle strategy exercise on balance ability in the women of octogenarians. Methods: Ankle strategy exercise group(n=14), leg strengthening exercise group(n=14) were measured an balance ability by Berg Balance Scale(BBS) scores and Balance Performance Monitor(BPM) at pre-intervention and post-intervention in 6weeks. Results: This study were summarized as follows : 1. The BBS scores, sway area, sway path length, sway maximum velocity of ankle strategy exercise group and leg strengthening exercise group were significantly different among the intervention period(p<.05). 2. The improvement of BBS scores, sway area, sway path length, sway maximum velocity were significantly different between ankle strategy exercise group and leg strengthening exercise group at in 6weeks(p<.05). Conclusion: Learned from the ankle strategy exercise could improve BBS scores, sway area, sway path length, sway maximum velocity and a balance for the women of octogenarians. Ankle strategy exercise need to be applied clinically for balance ability of the women of octogenarians.

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Comparison of Surgical Outcomes and Survival between Octogenarians and Younger Patients after Pulmonary Resection for Stage I Lung Cancer

  • Hong, Seokbeom;Moon, Young Kyu;Park, Jae Kil
    • Journal of Chest Surgery
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    • v.51 no.5
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    • pp.312-321
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    • 2018
  • Background: Treatment strategies for octogenarians with lung cancer remain controversial. The purpose of this study was to compare surgical outcomes and survival between octogenarians and younger patients with stage IA and IB lung cancer. Methods: We reviewed the medical records of 34 consecutive octogenarians and 457 younger patients (<70 years) with stage I lung cancer who underwent surgical resection from January 2007 to December 2015. We analyzed the survival and surgical outcomes of the 2 groups according to the lung cancer stage (IA and IB). Results: The only significant differences in the clinicopathological features between the groups were the higher proportion of sublobar resection (56.3% vs. 18.9%) and the smaller number of dissected lymph nodes (LNs) in octogenarians. There was no significant difference in hospital stay (11 days vs. 9 days), pneumonia (5.8% vs 1.9%), or operative mortality (0% vs 0.6%) between the 2 groups. Among patients with stage IA lung cancer, 5-year recurrence-free survival was not significantly different between the octogenarians (n=16) and younger patients (n=318) (86.2% vs. 89.1%, p=0.548). However, 5-year overall survival was significantly lower in octogenarians than in younger patients (79.4% vs. 93.4%, p=0.009). Among patients with stage IB lung cancer, there was no significant difference in 5-year recurrence-free survival (62.1% vs. 73.5%, p=0.55) or overall survival (77.0% vs 85.0%, p=0.75) between octogenarians (n=18) and younger patients (n=139). In multivariable analysis, male sex, the number of dissected LNs, and tumor size were factors related to survival (hazard ratio [HR], 5.795; p=0.017; HR, 0.346, p=0.025; and HR, 1.699; p=0.035, respectively). Conclusion: Surgical outcomes and survival after pulmonary resection for stage I lung cancer were comparable in octogenarians and younger patients. Continued careful selection of octogenarians for pulmonary resection is important to achieve good results.

Right anterior mini-thoracotomy aortic valve replacement versus transcatheter aortic valve implantation in octogenarians: a single-center retrospective study

  • Ji Eun Im;Eun Yeung Jung;Seok Soo Lee;Ho-Ki Min
    • Journal of Yeungnam Medical Science
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    • v.41 no.2
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    • pp.96-102
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    • 2024
  • Background: The aim of this study was to compare the early outcomes of octogenarians undergoing minimally invasive right anterior mini-thoracotomy aortic valve replacement (RAT-AVR) with those undergoing transcatheter aortic valve implantation (TAVI) for aortic valve disease. Methods: In this single-center retrospective study, data were collected from octogenarians before and after RAT-AVR and TAVI between January 2021 and July 2022. Short-term outcomes, including the length of hospital stay, in-hospital mortality, all-cause mortality, and other major postoperative complications, were compared and analyzed. Results: There were no significant differences in in-hospital mortality, stroke, acute kidney dysfunction requiring renal replacement therapy, length of intensive care unit stay, or length of hospital stay. However, the TAVI group had a higher incidence of permanent pacemaker insertion (10% vs. 0%, p=0.54) and paravalvular leaks (75% vs. 0%, p<0.001). Conclusion: In the present study on octogenarians, both TAVI and RAT-AVR showed comparable short-term results. Although both procedures were considered safe and effective in the selected group, RAT-AVR had a lower incidence of complete atrioventricular block and paravalvular regurgitation.

The Clinical Impact of Advanced Age on the Postoperative Outcomes of Patients Undergoing Gastrectomy for Gastric Cancer: Analysis Across US Hospitals Between 2011-2017

  • Lee, David Uihwan;Fan, Gregory Hongyuan;Chang, Kevin;Lee, Ki Jung;Han, John;Jung, Daniel;Kwon, Jean;Karagozian, Raffi
    • Journal of Gastric Cancer
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    • v.22 no.3
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    • pp.197-209
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    • 2022
  • Purpose: This study systematically evaluated the implications of advanced age on post-surgical outcomes following gastrectomy for gastric cancer using a national database. Materials and Methods: The 2011-2017 National Inpatient Sample was used to isolate patients who underwent gastrectomy for gastric cancer. From this, the population was stratified into those belonging to the younger age cohort (18-59 years), sexagenarians, septuagenarians, and octogenarians. The younger cohort and each advanced age category were compared in terms of the following endpoints: mortality following surgery, length of hospital stay, charges, and surgical complications. Results: This study included a total of 5,213 patients: 1,366 sexagenarians, 1,490 septuagenarians, 743 octogenarians, and 1,614 under 60 years of age. Between the younger cohort and sexagenarians, there was no difference in mortality (2.27 vs. 1.67%; P=0.30; odds ratio [OR], 1.36; 95% confidence interval [CI], 0.81-2.30), length of stay (11.0 vs. 11.1 days; P=0.86), or charges ($123,557 vs. $124,425; P=0.79). Compared to the younger cohort, septuagenarians had higher rates of in-hospital mortality (4.30% vs. 1.67%; P<0.01; OR, 2.64; 95% CI, 1.67-4.16), length of stay (12.1 vs. 11.1 days; P<0.01), and charges ($139,200 vs. $124,425; P<0.01). In the multivariate analysis, septuagenarians had higher mortality (P=0.01; adjusted odds ratio [aOR], 2.01; 95% CI, 1.18-3.43). Similarly, compared to the younger cohort, octogenarians had a higher rate of mortality (7.67% vs. 1.67%; P<0.001; OR, 4.88; 95% CI, 3.06-7.79), length of stay (12.3 vs. 11.1 days; P<0.01), and charges ($131,330 vs. $124,425; P<0.01). In the multivariate analysis, octogenarians had higher mortality (P<0.001; aOR, 4.03; 95% CI, 2.28-7.11). Conclusions: Advanced age (>70 years) is an independent risk factor for postoperative death in patients with gastric cancer undergoing gastrectomy.

Differences in Longevity Factors amongst Korean Centenarians, Octogenarians, and Sexagenarians (한국 백세인, 팔순인, 환갑인의 장수요인의 차이)

  • Kim, Jong-In
    • Korean Journal of Health Education and Promotion
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    • v.24 no.5
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    • pp.55-68
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    • 2007
  • The purpose of this study was to investigate differences in longevity factors for 3 age groups: centenarians, octogenarians, and sexagenarians. There were 389 elderly Korean subjects who participated in this study. This included 109 centenarians who participated in the 1-wave study that examined the longevity factors using the health behaviors and psychological reactions. The study that examined the longevity factors by using odds ratio of the logistic regression analysis. The major findings indicate that female centenarians and octogenarians scored the highest in abstinence from alcoholic drinking than males from these same 2 age groups (OR=9.04, CI=4.04, 20.24). Centenarians scored higher in non-visiting hospitals (OR=11.48, CI=5.56, 23.70) and showed little emotion when watching sad scenes, upon comparison with the younger 2 age groups. Also, centenarians scored higher in laughter (OR=11.59, CI=5.04, 26.63), showing no anxiety (OR=12.49, CI=6.42, 24.32), and displaying indifference towards games, when compared with the younger 2 age groups. The findings imply that Korean centenarian leads to a life of longevity is the result not only of psychological reactions but also of health behaviors. Also, these results support future studies of improvement of longevity factors.

Rehabilitation af Geriatric Patient (노인환자의 재활)

  • Bae Sung-Soo;Park Rae-Joon
    • The Journal of Korean Physical Therapy
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    • v.2 no.1
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    • pp.95-101
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    • 1990
  • The numbers of older patients increase year by year as the effect of care in illness prolongs the average life span, and it will be quite common to find octogenarians and nonogenarians. The philosophy and technics used in the rehabilitation of older patients are essentially the same as those in general rehabilitation, modified to comply with the physiology of the aging patient. Rehabilitation of the elderly is essentially a matter of teamwork and an attitude of mind. Mo one of us can accomplish a cure by ourselves and there must be confidence and continuing consultation between all members of the team.

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Outcomes of Gastrectomy for Gastric Cancer in Patients Aged >80 Years: A Systematic Literature Review and Meta-Analysis

  • Zelalem Chimdesa Merga ;Ji Sung Lee ;Chung-Sik Gong
    • Journal of Gastric Cancer
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    • v.23 no.3
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    • pp.428-450
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    • 2023
  • This meta-analysis examined the surgical management of older patients (>80 years) with gastric cancer, who were often excluded from randomized controlled trials. We analyzed 23 retrospective cohort studies involving 18,372 patients and found that older patients had a higher in-hospital mortality rate (relative risk [RR], 3.23; 95% confidence interval [CI], 1.46-7.17; P<0.01) and more post-operative complications (RR, 1.36; 95% CI, 1.19-1.56; P<0.01) than did younger patients. However, the surgical complications were similar between the two groups. Older patients were more likely to undergo less extensive lymph node dissection and longer hospital stays. Although older patients had statistically significant post-operative medical complications, they were not deprived of surgery for gastric cancer. The comorbidities and potential risks of post-operative complications should be carefully evaluated in older patients, highlighting the importance of careful patient selection. Overall, this meta-analysis provides recommendations for the surgical management of older patients with gastric cancer. Careful patient selection and evaluation of comorbidities should be performed to minimize the risk of post-operative complications in older patients, while recognizing that they should not be deprived of surgery for gastric cancer.