Assessing the impact of an ageing population on complication rates and in-patient length of stay

McVeigh, Terri P; Al-Azawi, Dhafir; O’Donoghue, Gerrard; Kerin, Michael J.

doi:10.1016/j.ijsu.2013.07.016

Cited by 36 publications

(26 citation statements)

References 12 publications

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“…This effect of age on complication rates is consistent with reports from previous studies. 3 , 23 , 29 The results of the present study are in accordance with those of Saltzman et al 30 who reported on 111 patients who had a mean age of 74 years who underwent primary TSA and found that 25% of patients developed any complication, with 9% major and 20% minor complications, including pulmonary embolus, renal insufficiency, asystole, and transfusion. However, our study differs from Ricchetti et al 31 who reported on the 90-day outcomes of 40 patients who were 80 years or older and 46 patients who were less than age 70 years who underwent TSA.…”

Section: Discussionsupporting

confidence: 92%

Total shoulder arthroplasty in octogenarians: Is there a higher risk of adverse outcomes?

Newman

Stroud

Yang

et al. 2018

Journal of Orthopaedics

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This study used the National Surgical Quality Improvement Program to evaluate octogenarians who underwent total shoulder arthroplasty (TSA). Specifically, we evaluated: (1) patient demographics; (2) perioperative factors; and (3) 30-day postoperative complications. Compared to controls, the octogenarians had more females, white patients, lower BMIs, fewer smokers, less functionally independent, higher ASA scores, shorter operative times, and longer LOS. Octogenarians had greater odds for developing any (OR = 2.05; 95%CI, 1.70-2.46), any major (OR = 2.28; 95%CI, 1.66-3.13), and any minor (OR = 1.99; 95%CI, 1.63-2.45) complications. Perioperative risk management strategies for elective TSA in the elderly may help mitigate the increased perioperative risks associated with age.

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Section: Discussionsupporting

confidence: 92%

Total shoulder arthroplasty in octogenarians: Is there a higher risk of adverse outcomes?

Newman

Stroud

Yang

et al. 2018

Journal of Orthopaedics

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“…Population aging has raised great challenges to health policies and services ( 1 ), and aging may pose multiple adverse influences on people, increasing morbidity, disability, mortality, and length of hospital stay ( 2 ). Skeletal muscle atrophy can be observed in the aged people due to causes such as neuromuscular disorders, disuse, and aging ( 3 ).…”

mentioning

confidence: 99%

Antioxidant Apigenin Relieves Age-Related Muscle Atrophy by Inhibiting Oxidative Stress and Hyperactive Mitophagy and Apoptosis in Skeletal Muscle of Mice

Wang

Yang

Zou

et al. 2020

The Journals of Gerontology: Series A

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Skeletal muscle atrophy in the elderly causes loss in muscle mass and functions. Naturally-occurring antioxidant flavonoid apigenin is able to ameliorate obesity-and denervation-induced muscle atrophies, but its effects on age-related muscle atrophy remains unknown. We hypothesized that apigenin can relieve muscle atrophy in aged mice, probably through special effects on reactive oxygen species and enzymes with antioxidant functions. For the male mice of the study, apigenin showed significant dose-dependent effects in relieving aging-related muscle atrophy according to results of frailty index as indicator of frailty associated with ageing, grip strength and running distance. Apigenin also improved myofiber size and morphological features and increased mitochondria number and volume, as manifested by succinate dehydrogenase staining and transmission electron microscopy. Our tests also suggested that apigenin promoted activities of enzymes such as superoxide dismutase and glutathione peroxidase for antioxidation and those for aerobic respiration such as mitochondrial respiratory enzyme complexes I, II and IV, increased ATP, and enhanced expression of genes such as peroxisome proliferator-activated receptor-γ coactivator 1α, mitochondrial transcription factor A, nuclear respiratory factor-1, and ATP5B involved in mitochondrial biogenesis. The data also suggested that apigenin inhibited Bcl-2/adenovirus E1B 19kD-interacting protein 3 and DNA fragmentation as indicators of mitophagy and apoptosis in aged mice with skeletal muscle atrophy. Together, the results suggest that apigenin relieves age-related skeletal muscle atrophy through reducing oxidative stress and inhibiting hyperactive autophagy and apoptosis.

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“…The number of unscheduled emergency department visits by this population has increased by 30% during the last 10 years [ 2 ]. Aging populations have increased the number of older patients presenting for emergency surgery, with patients over 60 representing greater than 30% of all emergency general surgery cases [ 3 ]. Given the significant proportion of older patients in the population, it is important to determine the impact of older age on healthcare outcomes.…”

Section: Introductionmentioning

confidence: 99%

Association between mortality and frailty in emergency general surgery: a systematic review and meta-analysis

Fehlmann

Patel

McCallum

et al. 2021

Eur J Trauma Emerg Surg

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Purpose The purpose of this review was to determine the association between frailty and mortality among adults ≥ 65 years old undergoing emergency general surgery (EGS). Methods This systematic review followed the PRISMA guidelines (CRD42020172482 on PROSPERO). A search in MEDLINE, PubMed, EMBASE, Scopus, Web of Science, and the Cochrane Database of Systematic Reviews was conducted from inception to March 5, 2020. Studies with patients ≥ 65 years undergoing EGS were included. The primary exposure was frailty, measured using the Clinical Frailty Scale or the Modified Frailty Index. The primary outcome was 30-day mortality. Secondary outcomes were 90-day and 1-year mortality, length of stay, complications, change in level of care at discharge, and loss of independence. Two independent reviewers screened articles and extracted data. Risk of bias was assessed according to the Newcastle–Ottawa Scale and quality of evidence was assessed using the GRADE approach. A meta-analysis was performed for 30-day mortality using a random-effects model. Results Our search yielded 847 articles and six cohort studies were included in the systematic review. There were 1289 patients, 283 being frail. The pooled OR from meta-analysis for frail compared to non-frail patients was 2.91 (95% CI 2.00, 4.23) for 30-day mortality. Frailty was associated with increased odds of all secondary outcomes. Conclusion Frailty is significantly associated with worse outcomes after emergency general surgery in adults ≥ 65 years of age. The Clinical Frailty Scale could be used to improve preoperative risk assessment for patients and shared decision-making between patients and healthcare providers. Registration number CRD42020172482 (PROSPERO).

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Assessing the impact of an ageing population on complication rates and in-patient length of stay

Abstract: Increasing age is associated with increased complication rates and increased hospital length of stay.

Cited by 36 publications

References 12 publications

Total shoulder arthroplasty in octogenarians: Is there a higher risk of adverse outcomes?

Total shoulder arthroplasty in octogenarians: Is there a higher risk of adverse outcomes?

Antioxidant Apigenin Relieves Age-Related Muscle Atrophy by Inhibiting Oxidative Stress and Hyperactive Mitophagy and Apoptosis in Skeletal Muscle of Mice

Association between mortality and frailty in emergency general surgery: a systematic review and meta-analysis

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