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  1 / 9025 MEDLINE  
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[PMID]:29328894
[Au] Autor:Joyce E
[Ad] Endereço:Section of Heart Failure and Cardiac Transplantation, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, USA. joycee@ccf.org.
[Ti] Título:Frailty and cardiovascular disease: A two-way street?
[So] Source:Cleve Clin J Med;85(1):65-68, 2018 01.
[Is] ISSN:1939-2869
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Doenças Cardiovasculares
Fragilidade
[Mh] Termos MeSH secundário: Idoso Fragilizado
Avaliação Geriátrica
Seres Humanos
[Pt] Tipo de publicação:EDITORIAL; COMMENT
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180113
[St] Status:MEDLINE
[do] DOI:10.3949/ccjm.85a.17075


  2 / 9025 MEDLINE  
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[PMID]:29179839
[Au] Autor:Gavazzi G
[Ad] Endereço:Clinique de médecine gériatrique, CHU Grenoble Alpes, CS 10217, 38700, La Tronche, France; Équipe Grépi, EA 7408, université de Grenoble Alpes, France. Electronic address: ggavazzi@chu-grenoble.fr.
[Ti] Título:[Frailty and ageing, concept and definitions].
[Ti] Título:Fragilité et vieillissement, concept et définitions..
[So] Source:Rev Infirm;66(236):18-20, 2017 Dec.
[Is] ISSN:1293-8505
[Cp] País de publicação:France
[La] Idioma:fre
[Ab] Resumo:Increased life expectancy, ageing and the accumulation of chronic pathologies leads to a certain functional dependence. The term 'frailty' is used to refer to the state of 'predependence' in elderly people. It is therefore important to detect and prevent frailty and provide frail elderly people with the adapted care. Training caregivers to recognise signs of frailty is essential.
[Mh] Termos MeSH primário: Envelhecimento/fisiologia
Fragilidade/prevenção & controle
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Idoso Fragilizado
Fragilidade/diagnóstico
Fragilidade/fisiopatologia
Avaliação Geriátrica
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE


  3 / 9025 MEDLINE  
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[PMID]:28453849
[Au] Autor:Erlandson KM; Wu K; Koletar SL; Kalayjian RC; Ellis RJ; Taiwo B; Palella FJ; Tassiopoulos K
[Ad] Endereço:Department of Medicine, University of Colorado-Anschutz Medical Campus, Aurora, USA.
[Ti] Título:Association Between Frailty and Components of the Frailty Phenotype With Modifiable Risk Factors and Antiretroviral Therapy.
[So] Source:J Infect Dis;215(6):933-937, 2017 03 15.
[Is] ISSN:1537-6613
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The impact of antiretroviral therapy (ART) on frailty among human immunodeficiency virus (HIV)-infected adults has not been well described. HIV-infected participants aged ≥40 years with initial ART receipt through a randomized, controlled AIDS Clinical Trials Group trial completed a frailty assessment. Ordinal logistic regression models examined factors associated with frailty. Of 1016 participants, 6% were frail, and 38% were prefrail. Frailty was associated with lower education, older age, Medicare/Medicaid, initial efavirenz, smoking, obesity, and neurocognitive impairment; physical activity and alcohol use were protective. The associations with ART require further investigation, and associations between frailty and modifiable factors provide targets for future interventions.
[Mh] Termos MeSH primário: Terapia Antirretroviral de Alta Atividade
Idoso Fragilizado/estatística & dados numéricos
Infecções por HIV/tratamento farmacológico
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Modelos Logísticos
Masculino
Meia-Idade
Fenótipo
Fatores de Risco
Estados Unidos
Velocidade de Caminhada
Perda de Peso
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1706
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/infdis/jix063


  4 / 9025 MEDLINE  
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[PMID]:29351295
[Au] Autor:Spoorenberg SLW; Wynia K; Uittenbroek RJ; Kremer HPH; Reijneveld SA
[Ad] Endereço:University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Groningen, Groningen, The Netherlands.
[Ti] Título:Effects of a population-based, person-centred and integrated care service on health, wellbeing and self-management of community-living older adults: A randomised controlled trial on Embrace.
[So] Source:PLoS One;13(1):e0190751, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate the effects of the population-based, person-centred and integrated care service 'Embrace' at twelve months on three domains comprising health, wellbeing and self-management among community-living older people. METHODS: Embrace supports older adults to age in place. A multidisciplinary team provides care and support, with intensity depending on the older adults' risk profile. A randomised controlled trial was conducted in fifteen general practices in the Netherlands. Older adults (≥75 years) were included and stratified into three risk profiles: Robust, Frail and Complex care needs, and randomised to Embrace or care as usual (CAU). Outcomes were recorded in three domains. The EuroQol-5D-3L and visual analogue scale, INTERMED for the Elderly Self-Assessment, Groningen Frailty Indicator and Katz-15 were used for the domain 'Health.' The Groningen Well-being Indicator and two quality of life questions measured 'Wellbeing.' The Self-Management Ability Scale and Partners in Health scale for older adults (PIH-OA) were used for 'Self-management.' Primary and secondary outcome measurements differed per risk profile. Data were analysed with multilevel mixed-model techniques using intention-to-treat and complete case analyses, for the whole sample and per risk profile. RESULTS: 1456 eligible older adults participated (49%) and were randomized to Embrace (n(T0) = 747, n(T1) = 570, mean age 80.6 years (SD 4.5), 54.2% female) and CAU (n(T0) = 709, n(T1) = 561, mean age 80.8 years (SD 4.7), 55.6% female). Embrace participants showed a greater-but clinically irrelevant-improvement in self-management (PIH-OA Knowledge subscale effect size [ES] = 0.14), and a greater-but clinically relevant-deterioration in health (ADL ES = 0.10; physical ADL ES = 0.13) compared to CAU. No differences in change in wellbeing were observed. This picture was also found in the risk profiles. Complete case analyses showed comparable results. CONCLUSIONS: This study found no clear benefits to receiving person-centred and integrated care for twelve months for the domains of health, wellbeing and self-management in community-living older adults.
[Mh] Termos MeSH primário: Prestação Integrada de Cuidados de Saúde/organização & administração
Vida Independente
Assistência Centrada no Paciente
Qualidade de Vida
Autocuidado
[Mh] Termos MeSH secundário: Atividades Cotidianas
Idoso
Idoso de 80 Anos ou mais
Feminino
Idoso Fragilizado
Seres Humanos
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180120
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190751


  5 / 9025 MEDLINE  
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Registro de Ensaios Clínicos
Texto completo SciELO Brasil
[PMID]:29211225
[Au] Autor:Mejía OAV; Sá MPBO; Deininger MO; Dallan LRP; Segalote RC; Oliveira MAP; Atik FA; Santos MAD; Silva PGMBE; Milani RM; Hueb AC; Monteiro R; Lima RC; Lisboa LAF; Dallan LAO; Puskas J; Jatene FB
[Ad] Endereço:Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InCor-HCFMUSP), São Paulo, SP, Brazil.
[Ti] Título:Off-pump versus On-pump Coronary Artery Bypass Grafting in Frail Patients: Study Protocol for the FRAGILE Multicenter Randomized Controlled Trial.
[So] Source:Braz J Cardiovasc Surg;32(5):428-434, 2017 Sep-Oct.
[Is] ISSN:1678-9741
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Advances in modern medicine have led to people living longer and healthier lives. Frailty is an emerging concept in medicine yet to be explored as a risk factor in cardiac surgery. When it comes to CABG surgery, randomized controlled clinical trials have primarily focused on low-risk (ROOBY, CORONARY), elevated-risk (GOPCABE) or high-risk patients (BBS), but not on frail patients. Therefore, we believe that off-pump CABG could be an important technique in patients with limited functional capacity to respond to surgical stress. In this study, the authors introduce the new national, multicenter, randomized, controlled trial "FRAGILE", to be developed in the main cardiac surgery centers of Brazil, to clarify the potential benefit of off-pump CABG in frail patients. METHODS: FRAGILE is a two-arm, parallel-group, multicentre, individually randomized (1:1) controlled trial which will enroll 630 patients with blinded outcome assessment (at 30 days, 6 months, 1 year, 2 years and 3 years), which aims to compare adverse cardiac and cerebrovascular events after off-pump versus on-pump CABG in pre-frail and frail patients. Primary outcomes will be all-cause mortality, acute myocardial infarction, cardiac arrest with successful resuscitation, low cardiac output syndrome/cardiogenic shock, stroke, and coronary reintervention. Secondary outcomes will be major adverse cardiac and cerebrovascular events, operative time, mechanical ventilation time, hyperdynamic shock, new onset of atrial fibrillation, renal replacement therapy, reoperation for bleeding, pneumonia, length of stay in intensive care unit, length of stay in hospital, number of units of blood transfused, graft patency, rate of complete revascularization, neurobehavioral outcomes after cardiac surgery, quality of life after cardiac surgery and costs. DISCUSSION: FRAGILE trial will determine whether off-pump CABG is superior to conventional on-pump CABG in the surgical treatment of pre-frail and frail patients. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT02338947. Registered on August 29th 2014; last updated on March 21st 2016.
[Mh] Termos MeSH primário: Ponte de Artéria Coronária sem Circulação Extracorpórea/métodos
Ponte de Artéria Coronária/métodos
[Mh] Termos MeSH secundário: Idoso
Ponte de Artéria Coronária/efeitos adversos
Ponte de Artéria Coronária/mortalidade
Ponte de Artéria Coronária sem Circulação Extracorpórea/efeitos adversos
Ponte de Artéria Coronária sem Circulação Extracorpórea/mortalidade
Seguimentos
Idoso Fragilizado
Seres Humanos
Medição de Risco
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171207
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE


  6 / 9025 MEDLINE  
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[PMID]:29293511
[Au] Autor:Roy N; Dubé R; Després C; Freitas A; Légaré F
[Ad] Endereço:Interdisciplinary Research Group on Suburbs (GIRBa), Laval University, Quebec, Qc, Canada.
[Ti] Título:Choosing between staying at home or moving: A systematic review of factors influencing housing decisions among frail older adults.
[So] Source:PLoS One;13(1):e0189266, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Most older adults wish to stay at home during their late life years, but physical disabilities and cognitive impairment may force them to face a housing decision. However, they lack relevant information to make informed value-based housing decisions. Consequently, we sought to identify the sets of factors influencing the housing decision-making of older adults. METHODS: We performed a systematic literature search for studies evaluating any factors influencing the housing decisions among older adults over 65 years old without cognitive disabilities. Primary research from any study design reported after 1990 in a peer-reviewed journal, a book chapter or an evaluated doctoral thesis and written in English, French or Spanish were eligible. We extracted the main study characteristics, the participant characteristics and any factors reported as associated with the housing decision. We conducted a qualitative thematic analysis from the perspective of the meaning and experience of home. RESULTS: The search resulted in 660 titles (after duplicate removal) from which 86 studies were kept for analysis. One study out of five reported exclusively on frail older adults (n = 17) and two on adults over 75 years old. Overall, a total of 88 factors were identified, of which 71 seem to have an influence on the housing decision-making of older adults, although the influence of 19 of them remains uncertain due to discrepancies between research methodologies. No conclusion was made regarding 12 additional factors due to lack of evidence. CONCLUSION: A wealth of factors were found to influence housing decisions among older adults. However, very few of them have been studied extensively. Our results highlight the importance of interdisciplinary teamwork to study the influence of a broader range of factors as a whole. These results will help older adults make the best possible housing decision based on their unique situation and values.
[Mh] Termos MeSH primário: Comportamento de Escolha
Idoso Fragilizado
Habitação
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180103
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189266


  7 / 9025 MEDLINE  
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[PMID]:27779573
[Au] Autor:McAdams-DeMarco MA; Ying H; Olorundare I; King EA; Haugen C; Buta B; Gross AL; Kalyani R; Desai NM; Dagher NN; Lonze BE; Montgomery RA; Bandeen-Roche K; Walston JD; Segev DL
[Ad] Endereço:1 Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD. 2 Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD. 3 Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. 4 Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD.
[Ti] Título:Individual Frailty Components and Mortality in Kidney Transplant Recipients.
[So] Source:Transplantation;101(9):2126-2132, 2017 09.
[Is] ISSN:1534-6080
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Frailty increases early hospital readmission and mortality risk among kidney transplantation (KT) recipients. Although frailty represents a high-risk state for this population, the correlates of frailty, the patterns of the 5 frailty components, and the risk associated with these patterns are unclear. METHODS: Six hundred sixty-three KT recipients were enrolled in a cohort study of frailty in transplantation (12/2008-8/2015). Frailty, activities of daily living (ADL)/instrumental ADL (IADL) disability, Centers for Epidemiologic Studies Depression Scale depression, education, and health-related quality of life (HRQOL) were measured. We used multinomial regression to identify frailty correlates. We identified which patterns of the 5 components were associated with mortality using adjusted Cox proportional hazards models. RESULTS: Frailty prevalence was 19.5%. Older recipients (adjusted prevalence ratio [PR], 2.22; 95% confidence interval [CI], 1.21-4.07) were more likely to be frail. The only other factors that were independently associated with frailty were IADL disability (PR, 3.22; 95% CI, 1.72-6.06), depressive symptoms (PR, 11.31; 95% CI, 4.02-31.82), less than a high school education (PR, 3.10; 95% CI, 1.30-7.36), and low HRQOL (fair/poor: PR, 3.71; 95% CI, 1.48-9.31). The most common pattern was poor grip strength, low physical activity, and slowed walk speed (19.4%). Only 2 patterns of the 5 components emerged as having an association with post-KT mortality. KT recipients with exhaustion and slowed walking speed (hazards ratio = 2.43; 95% CI, 1.17-5.03) and poor grip strength, exhaustion, and slowed walking speed (hazard ratio, 2.61; 95% CI, 1.14-5.97) were at increased mortality risk. CONCLUSIONS: Age was the only conventional factor associated with frailty among KT recipients; however, factors rarely measured as part of clinical practice, namely, HRQOL, IADL disability, and depressive symptoms, were significant correlates of frailty. Redefining the frailty phenotype may be needed to improve risk stratification for KT recipients.
[Mh] Termos MeSH primário: Idoso Fragilizado/psicologia
Nível de Saúde
Falência Renal Crônica/cirurgia
Transplante de Rim/mortalidade
Transplantados/psicologia
[Mh] Termos MeSH secundário: Atividades Cotidianas
Adolescente
Adulto
Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Baltimore/epidemiologia
Depressão/diagnóstico
Depressão/mortalidade
Depressão/psicologia
Avaliação da Deficiência
Escolaridade
Tolerância ao Exercício
Feminino
Avaliação Geriátrica
Força da Mão
Seres Humanos
Falência Renal Crônica/diagnóstico
Falência Renal Crônica/mortalidade
Transplante de Rim/efeitos adversos
Masculino
Saúde Mental
Meia-Idade
Fenótipo
Valor Preditivo dos Testes
Prevalência
Estudos Prospectivos
Qualidade de Vida
Fatores de Risco
Inquéritos e Questionários
Fatores de Tempo
Resultado do Tratamento
Caminhada
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE
[do] DOI:10.1097/TP.0000000000001546


  8 / 9025 MEDLINE  
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[PMID]:29419697
[Au] Autor:Petit N; Enel P; Ravaux I; Darque A; Baumstarck K; Bregigeon S; Retornaz F; Visage group
[Ad] Endereço:Department of Internal, Geriatric and Therapeutic Medicine, University Hospital Center AP-HM.
[Ti] Título:Frail and pre-frail phenotype is associated with pain in older HIV-infected patients.
[So] Source:Medicine (Baltimore);97(6):e9852, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:As HIV-infected patients grow older, some accumulate multiple health problems earlier than the noninfected ones in particular frailty phenotypes. Patients with frailty phenotype are at higher risk of adverse outcomes (worsening mobility, disability, hospitalization, and death within three years).Our study aimed to evaluate prevalence of frailty in elderly HIV-infected patients and to assess whether frailty is associated with HIV and geriatric factors, comorbidities, and precariousness in a French cohort of older HIV infected.This 18-month cross-sectional multicenter study carried in 2013 to 2014 had involved 502 HIV-infected patients aged 50 years and older, cared in 18 HIV-dedicated hospital medical units, located in South of France.Prevalence of frailty was 6.3% and of pre-frailty 57.2%. Low physical activity and weakness were the main frailty markers, respectively 49.4% and 19.9%. In univariate models, precariousness, duration of HIV antiretroviral treatment >15 years, 2 comorbidities or more, risk of depression, activities of daily living disability, and presence of pain were significantly associated with frail and pre-frail phenotype. Multivariate logistic regression analyses showed that only pain was significantly different between frail and pre frail phenotype versus non frail phenotype (odds ratio = 1.2; P = .002).Our study is the first showing a significant association between pain and frailty phenotype in older patients infected by HIV. As frailty phenotype could be potentially reversible, a better understanding of the underlying determinant is warranted. Further studies are needed to confirm these first findings.
[Mh] Termos MeSH primário: Idoso Fragilizado/estatística & dados numéricos
Fragilidade
Infecções por HIV
Dor
[Mh] Termos MeSH secundário: Idoso
Antirretrovirais/uso terapêutico
Comorbidade
Avaliação da Deficiência
Feminino
Fragilidade/diagnóstico
Fragilidade/epidemiologia
Fragilidade/etiologia
França/epidemiologia
Avaliação Geriátrica/métodos
Infecções por HIV/tratamento farmacológico
Infecções por HIV/epidemiologia
Infecções por HIV/fisiopatologia
Hospitalização/estatística & dados numéricos
Seres Humanos
Masculino
Meia-Idade
Limitação da Mobilidade
Dor/diagnóstico
Dor/epidemiologia
Fenótipo
Prevalência
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Retroviral Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180209
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009852


  9 / 9025 MEDLINE  
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[PMID]:29391120
[Au] Autor:Ho B; Lewis A; Paz IB
[Ad] Endereço:Huntington Hospital, Pasadena, California, USA.
[Ti] Título:Laparoscopy Can Safely Be Performed in Frail Patients Undergoing Colon Resection for Cancer.
[So] Source:Am Surg;83(10):1179-1183, 2017 Oct 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The present study aims to evaluate the role of laparoscopy in frail patients undergoing colorectal surgery for colorectal cancer. A review of the 2011 to 2014 American College of Surgeons National Surgical Quality Improvement Program database was performed to identify frail patients (using a frailty index), who underwent resection for colorectal cancer. Univariable and multivariable analyses were performed to evaluate 30-day mortality and Clavien-Dindo grade IV (CD-IV) complications. A total of 52,087 patients with colorectal cancer were identified, of which frailty accounted for 2.63 per cent (index score ≥5). Patients above the age 85 were considered frail 6.8 per cent of the time and accounted for 24.5 per cent of patients with frailty. Laparoscopic surgery was performed in 32.9 and 53.1 per cent of patients with and without frailty (P < 0.001). Patients with frailty were less likely to die within 30 days of surgery if younger (P = 0.004), performed electively (P < 0.001), or laparoscopically (P < 0.001). On multivariate analysis, laparoscopy and elective surgery were associated with better perioperative survival; whereas, older age, male sex, and tobacco use were associated with 30-day mortality. Laparoscopy and lower body mass index were associated with fewer Clavien-Dindo grade IV complications. Although laparoscopy is performed less commonly in the frail, this study indicated better perioperative outcomes for patients undergoing elective surgery who were <85 years old.
[Mh] Termos MeSH primário: Colectomia/métodos
Neoplasias Colorretais/cirurgia
Procedimentos Cirúrgicos Eletivos/métodos
Fragilidade
Laparoscopia
Complicações Pós-Operatórias/etiologia
Reto/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Neoplasias Colorretais/mortalidade
Bases de Dados Factuais
Feminino
Idoso Fragilizado
Seres Humanos
Modelos Logísticos
Masculino
Meia-Idade
Complicações Pós-Operatórias/epidemiologia
Fatores de Risco
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE


  10 / 9025 MEDLINE  
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[PMID]:29287124
[Au] Autor:Ogawa M; Izawa KP; Satomi-Kobayashi S; Tsuboi Y; Komaki K; Gotake Y; Sakai Y; Tanaka H; Okita Y
[Ad] Endereço:Division of Rehabilitation Medicine, Kobe University Hospital, Kobe, Japan.
[Ti] Título:Impact of delirium on postoperative frailty and long term cardiovascular events after cardiac surgery.
[So] Source:PLoS One;12(12):e0190359, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Postoperative delirium (POD) is a common and critical complication after cardiac surgery. However, the relationship between POD and postoperative physical frailty and the effect of both on long-term clinical outcomes have not been fully explored. OBJECTIVE: We aimed to examine the associations among POD, postoperative frailty, and major adverse cardiac events (MACE). DESIGN: This was a prospective cohort study. METHODS: We studied 329 consecutive patients undergoing elective cardiac surgery. The intensive care delirium screening checklist was used to assess POD. Postoperative frailty was defined by handgrip strength and walking speed. Patients were subsequently followed-up to detect MACE. RESULTS: POD was present in 13.2%, while the incidence of postoperative frailty was 27.0%. POD was independently associated with development of postoperative frailty (adjusted odds ratio = 2.98). During follow-up, MACE occurred in 14.1% of all participants. On multivariate Cox proportional hazard analysis, POD (adjusted hazard ratio (HR) = 3.36), postoperative frailty (HR = 2.21), postoperative complications (HR = 1.54), and left ventricular ejection fraction (HR = 0.95) were independently associated with increased risk of MACE. LIMITATIONS: It is a single-center study with a risk of bias. We did not investigate follow up cognitive function. CONCLUSIONS: POD was a predictor of postoperative frailty after cardiac surgery. Both postoperative frailty and POD were associated with the incidence of MACE, while POD was the stronger predictor of MACE. Thus, POD and frailty play critical roles in the risk stratification of patients undergoing cardiac surgery.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos Cardíacos/efeitos adversos
Doenças Cardiovasculares/etiologia
Delírio/diagnóstico
Idoso Fragilizado
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Estudos de Coortes
Procedimentos Cirúrgicos Eletivos/efeitos adversos
Feminino
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171230
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190359



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