The Outcome of Hospitalization for Acute Illness in the Elderly

Lamont, Campbell T.; Sampson, Susan; Matthias, Ruth E.; Kane, Robert L

doi:10.1111/j.1532-5415.1983.tb04872.x

Cited by 132 publications

(73 citation statements)

References 10 publications

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“…This finding confirms that it is very difficult to preserve functional status during hospitalization, since many factors can influence functional status during such a time: physiopathological alterations in the elderly are worsened by acute disease, new surroundings, the absence of points of reference, being alone in the hospital ward without help from relatives, and immobility (16,22,23).…”

Section: © 2 0 0 9 E D I T R I C E K U R T I S F O R P E R S O N a supporting

confidence: 63%

“…Some authors (15,16) have pointed out how hospitalized elderly patients are not able to recover their lost ADL functions, but they are at even higher risk of losing independence in remaining functions, leading to higher management costs and difficulties in discharging patients to their homes.…”

Section: Discussionmentioning

confidence: 99%

“…The negative influence of hospitalization on functional status is greater if it is prolonged: in order to avoid functional decline, old patients should be stimulated and mobilized, if possible by means of specific rehabilitation programs (16).…”

Section: © 2 0 0 9 E D I T R I C E K U R T I S F O R P E R S O N a mentioning

confidence: 99%

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Risk factors of functional decline during hospitalization in the oldest old

et al. 2009

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Section: © 2 0 0 9 E D I T R I C E K U R T I S F O R P E R S O N a supporting

confidence: 63%

Section: Discussionmentioning

confidence: 99%

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Risk factors of functional decline during hospitalization in the oldest old

et al. 2009

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“…For older patients, hospitalization has been associated with a variety of adverse outcomes, including high rates of functional decline, increased risk of medical and iatrogenic events, and increased likelihood of nursing home placement upon discharge [1][2][3][4][5][6][7][8][9][10]. Low mobility, defined as activity that is limited to a bed or chair, is also a common event during hospitalization.…”

Section: Introductionmentioning

confidence: 99%

Validation of use of wireless monitors to measure levels of mobility during hospitalization

Brown

Roth

Allman

2008

JRRD

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Abstract-Accurate methods of measuring levels of mobility during hospitalization are lacking. We validated the use of wireless monitors to measure three levels of mobility during hospitalization: (1) lying, (2) sitting, and (3) standing or walking. Hospitalized medical patients 65 years or older who did not have delirium or dementia and could walk in the 2 weeks before admission were eligible. Wireless monitors, which recorded average position every 20 seconds, were attached to the thigh and ankle of consented patients. Direct behavioral observation by trained observers who recorded mobility level was used as the gold standard. Forty-seven male patients (mean age 73.9 years), with a mean length of stay of 5.3 days, generated 187 two-hour direct behavioral observation periods. Wireless monitors were highly correlated with direct behavioral observations. The median kappa was 0.92 and the kappa across all observations was 0.88, indicating excellent agreement. This study demonstrates that wireless monitors validly measure mobility levels among older hospitalized patients.

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“…Numerous studies have shown the benefi t of laparoscopic resection in terms of short-term complications and quality of life. Furthermore, studies have shown that prolonged hospital stay is independently associated with a large reduction in functional status ( 10,11 ). Th erefore, fewer complications and shorter hospital stays improve the chance of maintaining functional status, which is very important for the elderly population.…”

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confidence: 99%

Laparoscopic Resection of Rectal Cancer in the Elderly

Clark¹,

Peters²

2016

Baylor University Medical Center Proceedings

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Recent published trials have failed to demonstrate that laparoscopic resection is not inferior to open resection of rectal cancer in terms of pathologic outcomes. However, there have been numerous studies showing the benefit of laparoscopic resection in terms of short-term complications and quality of life. Fewer complications and shorter hospital stays improve the chance of maintaining functional status, which is very important for the elderly population. Thus, laparoscopic resection of rectal cancer remains a viable option for the elderly. W hile surgical resection remains the cornerstone of treatment for stage II or III colorectal cancer, there is some debate regarding the effi cacy of a laparoscopic technique in patients with rectal cancer. Th e recently published ACOSOG Z6051 trial failed to demonstrate that laparoscopic resection of rectal cancer was not inferior to open resection in terms of pathologic outcomes. Th e concern is that while laparoscopic surgery might be benefi cial in terms of short-term complications, it might sacrifi ce long-term recurrence prevention and survival. Since the incidence and death rates for colorectal cancer increase with age ( 1 ), determining the best approach to resection in elderly patients with rectal cancer is particularly important.Th e Z6051 trial asked, "Is laparoscopic resection noninferior to open resection for the treatment of rectal cancer?" Th e trial consisted of 462 patients with clinical stage II or III rectal cancer within 12 cm of the anal verge who were randomized to laparoscopic or open low anterior or abdominoperineal resection of the rectum after receiving neoadjuvant therapy. Successful resection was defi ned as a negative distal margin, a circumferential radial margin (CRM) >1 mm between the deepest extent of tumor invasion into the mesorectal fat and inked surface on the fi xed specimen, and a complete or nearly complete total mesorectal excision (TME). A 6% noninferiority margin was chosen for the study. Laparoscopic resection of rectal cancer in the elderly L. August Clark, MD, and Walter R. Peters, MD, MBA A successful resection was achieved in 81.7% of the laparoscopic cases compared with 86.9% of the open cases. While the diff erence in success rates was less than the preset noninferiority margin of 6%, the 95% confi dence limits extended to a possible diff erence of up to 10.8%, forcing the authors to acknowledge possible inferiority of the laparoscopic technique. While the authors admitted to using a "novel composite measure of resection quality," tumor pathologic staging has been shown to be the most important prognostic determinant for the development of recurrent rectal cancer ( 2 ). Th e importance of negative margins also extends to survival data; the 5-year survival of patients with stage III rectal cancer decreased to 42% in those with CRM involvement compared with 81% in those with negative CRM ( 3 ). Because the Z6051 trial failed to show that laparoscopic resection was not inferior to open resection, the authors concluded that the d...

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The Outcome of Hospitalization for Acute Illness in the Elderly

Cited by 132 publications

References 10 publications

Risk factors of functional decline during hospitalization in the oldest old

Risk factors of functional decline during hospitalization in the oldest old

Validation of use of wireless monitors to measure levels of mobility during hospitalization

Laparoscopic Resection of Rectal Cancer in the Elderly

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