PRO CARE, Год журнала: 2022, Номер 27(4), С. 24 - 29
Опубликована: Май 1, 2022
BMC Health Services Research, Год журнала: 2024, Номер 24(1)
Опубликована: Фев. 13, 2024
Abstract Background Despite evidence supporting the effectiveness of prehabilitation as a new preoperative care pathway to optimise perioperative outcomes, its implementation into routine health is widely pending. Frail patients might particularly benefit from interventions, but facilitating and hindering factors need be considered in process. Thus, our aim was derive programme theory on what programmes work for frail circumstances why. Methods Following Pawson’s realist review approach, preliminary theories facilitators barriers were established. General topic-specific databases searched systematically patients. Articles included if they dealt with multimodal prior surgery population contained information during process full text. Based these articles, refined generated. Results From 2,609 unique titles, 34 retained synthesis. Facilitating individualisation meet patients’ needs abilities, multimodality, adaption local setting system, endorsement by an ambassador sharing responsibilities among multidisciplinary team. Central transportation, lack social support, inadequate, overwhelming provision. Conclusions Implementing requires organisational readiness adaptability setting. On individual level, clear understanding intervention’s goal providers are necessary. Added attention must paid fit restrictions This makes resource-intense, promising intervention Trial registration PROSPERO (CRD42022335282).
Язык: Английский
Процитировано
7
Deleted Journal, Год журнала: 2025, Номер 96(2), С. 102 - 107
Опубликована: Янв. 8, 2025
Multimorbidity is characterized by the presence of at least 3 chronic diseases with a prevalence more than 50% patients over 60 years old. The Charlson comorbidity index (CCI) enables description severity multimorbidity and also provides correlation postoperative outcome after liver resection. According to this, multimorbid are increased risk morbidity mortality resection, mostly due failure. In particular, open major resection biliary reconstruction primary tumors linked metabolic associated fatty disease (MAFLD) pose an for patients. contrast, minimally invasive leads clear reduction in mortality. Preconditioning implementation perioperative strategies according enhanced recovery surgery (ERAS) concept can lead improvement outcome.
Язык: Английский
Процитировано
0
Deleted Journal, Год журнала: 2025, Номер unknown
Опубликована: Янв. 15, 2025
Die Altersstruktur auf der Warteliste für Nierentransplantationen (NTx) geht zunehmend in Richtung höhere Altersgruppen. NTx gilt als die beste Therapieoption bei irreversiblem Nierenversagen, birgt jedoch mit höherem Alter Risiken wie erhöhte Komorbiditäten. Hierbei ist das chronologische von untergeordneter Bedeutung im Vergleich zum biologischen. Dieses wird maßgeblich bestimmt durch geriatrietypische Veränderungen, oft klassifiziert dem Begriff "Frailty". Frailty ein Zustand erhöhter Anfälligkeit gesundheitliche Stressoren, Dialysepflichtigen bereits jüngeren Jahren auftritt. Akzeptanz Warteliste, postoperativen Verläufe, Lebensqualität und Überleben nach NTx. Um Risiken, assoziiert sind, zu erkennen, werden geriatrisches Screening ggf. multidimensionales Assessment empfohlen. Es gibt vielversprechende Hinweise, dass sich hierbei identifizierte Probleme spezifische Maßnahmen, aber auch eine Prähabilitation bessern damit Outcome einer optimieren lässt. Zudem kann Grad abnehmen. besteht weiterhin Bedarf an Studien zur Ermittlung Interventionen, um dieser Patientengruppe verringern.
Процитировано
0
Die Gynäkologie, Год журнала: 2025, Номер unknown
Опубликована: Март 11, 2025
Процитировано
0
European Journal of Trauma and Emergency Surgery, Год журнала: 2022, Номер 48(4), С. 3033 - 3042
Опубликована: Фев. 2, 2022
Abstract Purpose Acute appendicitis in the elderly is becoming increasingly recognized for its often severe course. For various elective and urgent operations older patients, frailty a risk factor poor outcomes. However, there lack of data on patients with acute appendicitis. Methods Patients over 65 years old who underwent surgery three hospitals between January 2015 September 2020 were assessed Hospital Frailty Risk Score (HFRS) modified Index (mFI). Outcomes interest, including morbidity, mortality, length stay, recorded. Results While can be measured both tests, mFI has better applicability takes significantly less time to implement compared HFRS (21.6 s vs. 80.3 s, p < 0.0001) while providing same information value. exhibited according either assessment had higher rate milder (OR 5.85/2.87, 0.0001/0.009) serious 4.92/3.61, 0.011/0.029) complications, more admissions intensive care unit 5.16/7.36, 0.0001), an almost doubled stay (12.7 days 6.6 days, 0.005). Up 31% these required institutional after discharge, which than those without ( 0.0001). Furthermore, mortality frail was elevated 17%, 1% non-frail = 0.018). Conclusion In significant negative quickly reliably HFRS.
Язык: Английский
Процитировано
9
BMC Geriatrics, Год журнала: 2024, Номер 24(1)
Опубликована: Янв. 24, 2024
Abstract Background The prevalence of sarcopenia and its impact in older patients undergoing inpatient cardiac rehabilitation (iCR) after procedure has been insufficiently studied. main aim this study was to evaluate the quantify functional capacity sarcopenic non-sarcopenic participating iCR. Methods Prospective, observational cohort within framework ongoing multicenter prehabilitation “PRECOVERY”. A sample 122 ≥75 years iCR were recruited four German facilities followed up 3 months later by telephone. At (baseline), Strength, Assistance with walking, Rise from a chair, Climb stairs Falls (SARC-F) questionnaire used identify patients. In addition, Katz-Index, Clinical Frailty Scale (CFS), handgrip strength (HGS), Short Physical Performance Battery (SPPB) 6-minute walk distance (6MWD) measured frailty at baseline. Outcomes correlation baseline as well SARC-F score follow-up. Wilcoxon test applied for pre-post-test analysis. Correlation between 6MWD, SPPB HGS tested eta coefficient one-way ANOVA. Results Complete assessments collected 101 (79.9 ± 4.0 years; 63% male). baseline, mean 2.7 2.1; 35% sarcopenia. Other results Katz-Index 5.7 0.9, CFS 3.2 1.4, 24.9 9.9 kg, 7.5 3.3 6MWD 288.8 136.5 m. Compared fewer (23% versus 35%) subgroup ( n = 35), pre-post comparison resulted significant improvement p 0.017). There poor < 0.001; r > 0.546). Conclusions is high (35%) remains follow-up (23%). Sarcopenia screening important since diagnosis these correlates significantly capacity. indicate that may benefit aimed improving perioperative outcomes, increasing mitigating adverse effects. Trial registration Trials Register (DRKS; http://www.drks.de ; DRKS00032256). Retrospectively registered on 13 July 2023.
Язык: Английский
Процитировано
1
European Geriatric Medicine, Год журнала: 2024, Номер unknown
Опубликована: Июль 26, 2024
Язык: Английский
Процитировано
1
JMIR Human Factors, Год журнала: 2022, Номер 9(1), С. e31823 - e31823
Опубликована: Март 16, 2022
Maintaining nutrition and exercise strategies after rehabilitation can be difficult for older people with malnutrition or limited mobility. A technical assistance system such as an e-coach could help to positively influence changes in dietary behavior contribute a sustainable improvement one's mobility status. Most apps do not provide combination of content. In most cases, these were evaluated healthy individuals aged <70 years, making transferability vulnerable patients, functional limitations assumed lower affinity technology, geriatric unlikely.This study aims identify the potential optimization enhance usability through iterative test phases develop suitable adults (≥65 years) based on individual health change stages setting.Iterative testing was performed patients ≥65 years center. During testing, participants used prototype educational elements active input options 1-time application test. The navigation comprehension tasks subsequently provided feedback design aspects. Hints by team when required, documented, improvements. After asked rate using System Usability Scale (SUS).In all, 3 (T1-T3) conducted 49 (24/49, 49% female; mean 77.8, SD 6.2 years). Improvements made each phase, adding explanatory notes overview screens consistent chart types. use user-centered this specific target group facilitated increase average SUS score from 69.3 (SD 16.3; median 65) at T1 78.1 11.8; 82.5) T3. Fewer hints required (T1: 14.1%; T2: 26.5%; T3: 17.2%) than questions 30.5%; 21.6%; 20%). However, proportion unsolved tasks, calculated across all higher 0%, 15.2%, 4.3%) 1.9%, 2.5%).The extensive addition sentences terms, instead shorter keywords, make it easier users navigate comprehend content major adjustment. Thus, good (SUS: 80th-84th percentile) achieved optimizations within design. Long-term any possible effects nutritional physical activity need additional which should able increasing independence, thereby helping them gain access that support their long-term change.
Язык: Английский
Процитировано
6
Urologie in der Praxis, Год журнала: 2023, Номер 25(3), С. 96 - 102
Опубликована: Сен. 20, 2023
Zusammenfassung Das durchschnittliche Alter sowie die Zahl von zu operierenden älteren Patienten nehmen seit Jahren stetig zu, weshalb eine sorgfältige Operabilitätsabklärung hinsichtlich Prognose und möglichen peri- postoperativen Komplikationen grossen Sinn macht. Eine auf Alltagsfunktionalität basierte Gebrechlichkeitsklassifikation (wie nach Fried) kann hier nicht nur schnell Klarheit möglich einzugehender Risiken schaffen, sondern auch Indikation für ein weiterführendes multidimensionales geriatrisches Assessment oder gezielte Einleitung therapeutischer Massnahmen zur Verminderung des operativen Risikos bedeuten. Kann kein standardmässiges Gebrechlichkeitsassessment durchgeführt werden, können einfache Screeningtests wie der „timed up & go test“ seine weiterentwickelte Version „imagined timed mögliche postoperative motorischer kognitiver hinweisen.
Процитировано
2
DMW - Deutsche Medizinische Wochenschrift, Год журнала: 2023, Номер 149(01/02), С. 1 - 2
Опубликована: Дек. 29, 2023
Drug Prescribing for Patients with Chronic Kidney Disease in General Practice: a Cross-Sectional Study
Язык: Английский
Процитировано
2