Acute Care for the Elderly: A Literature Review

Ahmed, Nasiya N.; Pearce, Shannon

doi:10.1089/pop.2009.0058

Cited by 56 publications

(51 citation statements)

References 17 publications

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“…Our centre will be exploring how to improve outcomes by examining new care models, such as acute care for the elderly (ACE) units applied to a surgical setting where there is a focus on screening for early identification of geriatric syndromes, family and caregiver involvement at all stages of care, interdisciplinary assessments and an environment supportive of discharge planning and community services. [15][16][17] Our study reinforces that higher ASA class is associated with mortality following emergency general surgery in elderly patients. It should be mentioned that despite being a statistically significant variable, the ASA class had a wide CI, likely associated with our relatively small data set, and therefore we cannot accurately describe the direct magnitude of its effect on mortality.…”

Section: Discussionsupporting

confidence: 80%

Perioperative factors predicting poor outcome in elderly patients following emergency general surgery: a multivariate regression analysis

et al. 2015

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Perioperative factors predicting poor outcome in elderly patients following emergency general surgery: a multivariate regression analysis Background: Older adults (≥ 65 yr) are the fastest growing population and are presenting in increasing numbers for acute surgical care. Emergency surgery is frequently life threatening for older patients. Our objective was to identify predictors of mortality and poor outcome among elderly patients undergoing emergency general surgery. Methods:We conducted a retrospective cohort study of patients aged 65-80 years undergoing emergency general surgery between 2009 and 2010 at a tertiary care centre. Demographics, comorbidities, in-hospital complications, mortality and disposition characteristics of patients were collected. Logistic regression analysis was used to identify covariate-adjusted predictors of in-hospital mortality and discharge of patients home.Results: Our analysis included 257 patients with a mean age of 72 years; 52% were men. In-hospital mortality was 12%. Mortality was associated with patients who had higher American Society of Anesthesiologists (ASA) Conclusion: American Society of Anesthesiologists class and in-hospital complications are perioperative predictors of mortality and disposition in the older surgical population. Understanding the predictors of poor outcome and the importance of preventing in-hospital complications in older patients will have important clinical utility in terms of preoperative counselling, improving health care and discharging patients home.Contexte : La population qui connaît la croissance la plus rapide est celle des adultes âgés (≥ 65 ans). Ces personnes nécessitent un nombre croissant d'interventions chirurgicales urgentes. Or, la chirurgie d'urgence comporte souvent un risque de décès pour les patients âgés. Notre objectif était d'identifier les prédicteurs de la mortalité et d'une issue négative chez les patients âgés soumis à une chirurgie générale d'urgence.Méthodes : Nous avons procédé à une étude de cohorte rétrospective chez des patients de 65 à 80 ans soumis à une chirurgie générale d'urgence entre 2009 et 2010 dans un centre de soins tertiaires. Nous avons recueilli les données démographiques, les comorbidités, les complications perhospitalières, la mortalité et les détails sur l'état général de santé des patients. Nous avons utilisé l'analyse de régression logistique afin de dégager les prédicteurs ajustés en fonction des covariables pour la mortalité perhospitalière et les congés hospitaliers des patients vers leur domicile.Résultats : Notre analyse a regroupé 257 patients âgés en moyenne de 72 ans; 52 % étaient des hommes. La mortalité perhospitalière a été de 12 %. La mortalité a été associée à des patients qui se classaient dans une catégorie ASA (American Society of Anesthesiologists) plus élevée (rapport des cotes [RC]

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Section: Discussionsupporting

confidence: 80%

Perioperative factors predicting poor outcome in elderly patients following emergency general surgery: a multivariate regression analysis

et al. 2015

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“…A recent review conducted by Ahmed et al showed that acute care for the elderly units are associated with reduced functional decline, costs, hospital length of stay, and lower readmission rates to acute care hospitals compared with usual care [35]. The results of the prevalence and reduction of delirium were mixed.…”

Section: Strategies To Cope With the Burden Of Elderly Patients Who Rmentioning

confidence: 99%

The challenge of admitting the very elderly to intensive care

Nguyen

Angus

Boumendil

et al. 2011

Ann. Intensive Care

196

121

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The aging of the population has increased the demand for healthcare resources. The number of patients aged 80 years and older admitted to the intensive care unit (ICU) increased during the past decade, as has the intensity of care for such patients. Yet, many physicians remain reluctant to admit the oldest, arguing a "squandering" of societal resources, that ICU care could be deleterious, or that ICU care may not actually be what the patient or family wants in this instance. Other ICU physicians are strong advocates for admission of a selected elderly population. These discrepant opinions may partly be explained by the current lack of validated criteria to select accurately the patients (of any age) who will benefit most from ICU hospitalization. This review describes the epidemiology of the elderly aged 80 years and older admitted in the ICU, their long-term outcomes, and to discuss some of the solutions to cope with the burden of an aging population receiving acute care hospitalization.

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“…Traditionally, acute medical care has been insufficient to meet the complex care needs of frail older adults 30. These units are in hospital wards with protocols to ensure that elderly patients are thoroughly evaluated for potential iatrogenic problems before they occur, and any such problems are identified and appropriately managed 13.…”

Section: Preventionmentioning

confidence: 99%

Iatrogenic disease in the elderly: risk factors, consequences, and prevention

Permpongkosol¹

2011

CIA

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The epidemiology of iatrogenic disease in the elderly has not been extensively reported. Risk factors of iatrogenic disease in the elderly are drug-induced iatrogenic disease, multiple chronic diseases, multiple physicians, hospitalization, and medical or surgical procedures. Iatrogenic disease can have a great psychomotor impact and important social consequences. To identify patients at high risk is the first step in prevention as most of the iatrogenic diseases are preventable. Interventions that can prevent iatrogenic complications include specific interventions, the use of a geriatric interdisciplinary team, pharmacist consultation and acute care for the elderly units.

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Acute Care for the Elderly: A Literature Review

Cited by 56 publications

References 17 publications

Perioperative factors predicting poor outcome in elderly patients following emergency general surgery: a multivariate regression analysis

Perioperative factors predicting poor outcome in elderly patients following emergency general surgery: a multivariate regression analysis

The challenge of admitting the very elderly to intensive care

Iatrogenic disease in the elderly: risk factors, consequences, and prevention

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