No abstract

Purpose We evaluate the association of Geriatric Nutritional Risk Index (GNRI) and the adverse outcome in elderly patients (≥65 years old) with fall injuries. Patients and Methods Total 1071 elderly patients with fall injuries were enrolled. Patients were divided into four groups: high risk, moderate risk, low risk and no risk (GNRI: <82, 82 to <92, 92 to ≤98 and >98) for patient demography, comorbidities, and adverse outcomes analysis. Results After 1:1 propensity score-matched analysis, 97 patients in high-risk group, 144 patients in moderate-risk group, and 114 patients in low-risk group were compared to no risk group. High-risk group patients had a 5.7-fold higher risk of mortality (p = 0.003) and prolong hospital stay (18.0 vs 12.3 days; p = 0.016) when compared to no-risk group patients. Significantly prolong hospital stay were also found in low-risk and moderate-risk group when compared to no risk group. Conclusion A lower GNRI is associated with prolonged hospital stay in the elderly patients with fall injuries. High nutritional risk (GNRI < 82) is associated with an increased in-hospital mortality rate.

Preoperative dipyridamole thallium-201 scintigraphy is useful for SHPTH patients to minimized surgical mortality and morbidity.

Background Liver transplantation (LT) is one of the widely recognised and leading treatments for end-stage liver disease. Nutrition impacts its success. Total parenteral nutrition (TPN) is usually prescribed for patients recommended prolonged fasting after LT. The supplement of SMOFlipid (soybean oil, MCT oil, olive oil, and fish oil) is easily metabolised to produce energy, and it possesses anti-inflammatory effects; however, SMOFlipid emulsion use raises concerns regarding coagulopathy after LT. This study investigated the postoperative correlation between SMOFlipid and coagulation in LT. Materials and methods The medical records of 54 recipients of living donor LT between January 2012 and June 2015 were retrospectively reviewed. Patients with pretransplant platelet count <40,000/μL and >40,000/μL were assigned to the non-SMOFlipid (n = 23) group and the SMOFlipid (n = 31) group, respectively. Results The coagulation and nutrition profile of patients improved significantly after TPN support. No significant difference was observed in the coagulation profile between SMOFlipid and non-SMOFlipid groups. Although the SMOFlipid group exhibited a higher platelet count than the non-SMOFlipid group on day 7 (P < 0.001), no significant differences were observed in the platelet count on 14 and 30 days after TPN support between the 2 groups. Conclusion TPN using SMOFlipid after LT is a good strategy for improving nutritional status without increasing the risks of bleeding and coagulation in patients intolerant of early enteral nutrition. Moreover, SMOFlipid use may not cause coagulopathy up to 14 days after LT. Overall, SMOFlipid provides nutritional benefits without increasing the risk of bleeding.