Clinical interventions in aging
-
Case Reports Clinical Trial
Evaluation of Pectoral Nerve Block in Modified Radical Mastectomy: Comparison of Three Concentrations of Ropivacaine.
Pectoral nerve block type I (PECS I Block) and type II (PECS II Block) with ropivacaine are relatively new analgesic methods for breast-cancer surgery. We evaluated the safety and efficacy of different concentrations of ropivacaine given in the same volume for the PECS II Block in patients undergoing modified radical mastectomy (MRM). ⋯ A dose of 0.3% ropivacaine was the optimal concentration for a PECS II Block for patients undergoing MRM because it provided efficacious analgesia during and >48 h after MRM. Increasing the ropivacaine concentration did not improve the analgesia of the PECS II Block significantly.
-
Older adults should be routinely screened for sarcopenia, which threatens healthy, independent aging. The most popular screening tool is the SARC-F questionnaire. As its sensitivity is unsatisfactory, two modified versions of the questionnaire have been published: SARC-CalF (including calf circumference as an additional item) and SARC-F+EBM (assessing additionally age and Body Mass Index). The diagnostic performance of the three versions of the questionnaire has not been compared. The analysis aimed to assess the diagnostic value of SARC-F, SARC-CalF, and SARC-F+EBM questionnaires, and to compare their psychometric properties against two reference standards of sarcopenia diagnosis, ie, EWGSOP1 and modified EWGSOP2 criteria. ⋯ The modified versions of SARC-F have better diagnostic performance as compared to the original questionnaire. Since an ideal screening tool should have reasonably high sensitivity and specificity, and an AUC value above 0.7, the SARC-CalF (33/34cm) seems to be the best screening tool for sarcopenia in community-dwelling older adults.
-
Observational Study
The Association of a Frailty Index and Incident Delirium in Older Hospitalized Patients: An Observational Cohort Study.
Frailty identifies patients that have vulnerability to stress. Acute illness and hospitalization are stressors that may result in delirium and further accelerate the negative consequences of frailty. ⋯ This study demonstrates that a frailty index is independently associated with incident delirium and suggests that admission assessments for frailty may identify patients at high risk of developing delirium.
-
Advancing age is associated with high incidence of colorectal cancer (CRC) and high rates of postoperative complications (POCs). However, the impact of of POC severity - evaluated by Clavien-Dindo classification (CDC) or comprehensive complication index (CCI) - on long-term overall survival (OS) in elderly patients after radical CRC resection is not clear. ⋯ Both CDC grades and the CCI can be used to evaluate POCs and are associated with long-term OS in elderly patients undergoing radical CRC resection.
-
Postoperative pneumonia is a common and devastating complication of hip fracture surgery in older individuals. This study aimed to determine the relationship between early postoperative hypoalbuminaemia and pneumonia after hip fracture surgery. ⋯ This study demonstrated that early postoperative hypoalbuminaemia is an independent risk factor for the development of postoperative pneumonia in patients undergoing hip fracture surgery.