Navegando por Palavras-chave "elderly patients"

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    Renal transplantation outcomes: a comparative analysis between elderly and younger recipients
    (Blackwell Publishing, 2007-11-01) Mendonca, Helena Moises; Reis, Marlene Antonia dos; Sesso, Ricardo de Castro de Cintra; Camara, Niels Olsen Saraiva; Pacheco-Silva, Alvaro; Universidade Federal de São Paulo (UNIFESP); Univ Fed Triangulo Mineiro; Universidade de São Paulo (USP)
    Renal transplantation is presently the best treatment for end-stage renal disease, although considered contraindicated for elderly patients. However, more investigation is needed due to higher life expectancy rates of the general population and the increasing number of over 60-yr-old patients with chronic renal failure dependant upon dialysis. This study aims to determine graft and patient survival rates of renal transplant patients 60 yr and older compared to a younger group (50-59 yr old). Relevant pre- and post-transplant clinical data related to graft and patient survival in both groups were also investigated. Three-hundred and twenty consecutive renal transplant patients were enrolled in this study and grouped based on age at the time of the transplantation: one-hundred and ten patients at or over 60 yr old (elderly group) and 210 patients ranging from 50 to 59 yr old (younger group). There were no statistical differences in either group regarding clinical characteristics and immunological risk factors. the incidence of acute rejection was higher in the younger group (37.6%) than in the elderly (22.7%) (p = 0.01). Censored to death graft survivals at five yr were respectively 86.7% for patients >= 60 yr and 82.1% for patients 50-59 yr old (p = 0.49). Patient survival rates at five yr were respectively 76.2% for patients >= 60 yr and 81.6% for patients 50-59 yr old (p = 0.33). Our data show that renal transplantation for elderly patients has similar results to those found in younger individuals, which does not make age, in and of itself, a contraindication for transplantation.
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    Systemic inflammatory response syndrome in nosocomial bloodstream infections with Pseudomonas aeruginosa and Enterococcus species: Comparison of elderly and nonelderly patients
    (Blackwell Publishing, 2006-05-01) Marra, A. R.; Bar, K.; Bearman, GML; Wenzel, R. P.; Edmond, M. B.; Universidade Federal de São Paulo (UNIFESP); Virginia Commonwealth Univ
    OBJECTIVES: To determine whether the systemic inflammatory response syndrome (SIRS), clinical course, and outcome of monomicrobial nosocomial bloodstream infection (BSI) due to Pseudomonas aeruginosa or Enterococcus spp. is different in elderly patients than in younger patients.DESIGN: Historical cohort study.SETTING: An 820-bed tertiary care facility.PARTICIPANTS: One hundred twenty-seven adults with P. aeruginosa or enterococcal BSI.MEASUREMENTS: SIRS scores were determined 2 days before the first positive blood culture through 14 days afterwards. Elderly patients (>= 65, n = 37) were compared with nonelderly patients (< 65, n = 90). Variables significant for predicting mortality in univariate analysis were entered into a logistic regression model.RESULTS: No difference in SIRS was detected between the two groups. No significant difference was noted in the incidence of organ failure, 7-day mortality, or overall mortality between the two groups. Univariate analysis revealed that Acute Physiology and Chronic Health Evaluation (APACHE) II score of 15 or greater at BSI onset; adjusted APACHE II score (points for age excluded) of 15 or greater at BSI onset; and respiratory, cardiovascular, renal, hematological, and hepatic failure were predictors of mortality. Age, sex, use of empirical antimicrobial therapy, and infection with imipenem-resistant P. aeruginosa or vancomycin-resistant enterococci did not predict mortality. Multivarlate analysis revealed that hematological failure (odds ratio (OR) = 8.1, 95% confidence interval (CI) = 2.78-23.47), cardiovascular failure (OR = 4.7, 95% Cl = 1.69-13.1.0), and adjusted APACHE 11 >= 15 at BSI onset (OR = 3.1, 95% CI = 1.12-8.81) independently predicted death.CONCLUSION: Elderly patients did not differ from nonelderly patients with respect to severity of illness before or at the time of BSI. Elderly patients with pseudomonal or enterococcal BSIs did not have a greater mortality than nonelderly patients.