Comparison of Incidence, Predictors, and the Impact of Co-Morbidity and Polypharmacy on the Risk of Recurrent Syncope in Patients &lt;85 Versus ≥85 Years of Age

Ruwald, Martin H.; Hansen, Morten Lock; Lamberts, Morten; Hansen, Carolina Malta; Numé, Anna-Karin; Vinther, Michael; Køber, Lars; Torp‐Pedersen, Christian; Hansen, Jim; Gislason, Gunnar

doi:10.1016/j.amjcard.2013.07.041

Cited by 46 publications

(25 citation statements)

References 27 publications

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“…Complications, if they occur, seem minor and transient in nature 15 . Multiple medications additionally increase the risk of syncope in elderly patients 16,17 , which is in accordance with the results of our study. Cardiovascular drugs (antihypertensive agents, vasodilators and diuretics) are associated with orthostatic and postprandial hypotension, and predispose older patients to the development of syncope 18,19 .…”

Section: Discussionsupporting

confidence: 82%

“…Ovo je u skladu s rezultatima drugih autora koji potvrđuju da administracija lokalnih anestetika ima malo neželjenih efekata te komplikacije, ukoliko se i dogode, su prolaznog i blagog karaktera 15 . Više propisanih lijekova kod starijih pacijenata dodatno povećava rizik od nastanka sinkope 16,17 , što je u skladu s rezultatima naše studije. Lijekovi za kardiovaskularni system (antihipertenzivi, vazodilatatori i diuretici) su povezani s ortostatskom i postoprandijalnom hipotenzijom te predisponiraju starije pacijente za nastanak sinkope 18,19 .…”

Section: Discussionunclassified

See 1 more Smart Citation

Perioperative complications of oralsurgical procedures in cardiovascular geriatric patients

Secic¹,

Prohić²,

Komšić³

2014

Acta stomatologica Naissi

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SažetakUvod: Gerijatrijska populacija je dio populacije stanovništva s najbržim rastom koja čini 14% stanovništva Bosne i Hercegovine. Starosne promjene, politerapija, primarno kardiovaskularno oboljenje i komorbiditet su karakteristike gerijatrijskog kardiovaskularnog pacijenta u stomatološkoj praksi. Kako bi se minimizirali rizici vezani za oralno-hirurške intervencije kod takvih pacijenata, pažljiva preoperativna priprema bi trebala uvijek uključivati procjenu sistemskog oboljenja i propisane internističke terapije. Cilj: Cilj ove studije je odrediti prevalencu kardiovaskularnih oboljenja i analizirati propisane lijekove i perioperativne komplikacije kod gerijatrijskih pacijenata s kardiovaskularnim oboljenjima koji se podvrgavaju oralno-hirurškim zahvatima na Katedri za oralnu hirurgiju Stomatološkog fakulteta Univerziteta u Sarajevu. Materijal i metode: Ukupno 107 pacijenata je uključeno u studiju: 48 (45%) muškaraca i 59 (55%) žena, omjer 1:1,2 u korist žena, u rasponu godina od 65-81, sa srednjom vrijednosti ± SD= 69±4 godina. Rezultati: 79% pacijenata sa sistemskim oboljenjima ima dijagnosticirano oboljenje kardiovaskularnog sistema. Jedina komplikacija vezana uz administraciju lokalne anestezije je sinkopa. Sinkopa je češća kod pacijenata sa kardiovaskularnim oboljenjima i većim brojem propisanih lijekova. Fraktura zuba je najčešća komplikacija tokom ekstrakcije (n=15; %=18) pri čemu se rizik od frakture povećava s dobi (p<0,05). Veća incidenca postekstrakcionih komplikacija je uočena kod pacijenata s većim brojem sistemskih oboljenja i propisanih lijekova (p<0,05). Veća incidenca postoperativnog krvarenja je zabilježena kod kardiovaskularnih pacijenata (p<0,05). Zaključak: Fiziološke starosne promjene uz kompromitirajući medicinski status pacijenta karakteriziranih komorbiditetom i politerapijom, mogu komplikovati oralno-hirurški zahvat.Ključne riječi: kardiovaskularna oboljenja, gerijatrija, perioperativna njega, lokalna anestezija AbstractIntroduction: Geriatric population is the fastest growing segment of population and comprises 14% of the population of Bosnia and Herzegovina. Aging effects, polypharmacy, primary cardiovascular disease and comorbidity are the characteristics of cardiovascular geriatric patient in dental practice. Careful preoperative assessment should always include identifying of compromising medical conditions and prescribed medications in order to minimize the risk of complications related to oralsurgery procedures in geriatric patients. The aim: The aim of this study was to determine the prevalence of cardiovascular diseases, prescribed medications and perioperative complications of oral surgical procedures in geriatric patients with cardiovascular diseases undergoing oralsurgical procedures at Department of Oral Surgery, University of Sarajevo. Material and methods: The total of 107 patients were included: 48 (45%) males and 59 (55%) females, gender ratio 1:1,2 in favour of females, the age range was 65-81 years, with mean age ± SD= 69±4 years. Results: Seventy-nine percent of...

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Section: Discussionsupporting

confidence: 82%

Section: Discussionunclassified

Perioperative complications of oralsurgical procedures in cardiovascular geriatric patients

Secic¹,

Prohić²,

Komšić³

2014

Acta stomatologica Naissi

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“…109,679,680 Although some of the risk is attributable to the aspects of syncope described in this guideline, among older adults such risks are usually compounded by multiple morbidities and frailty, which add to age-related vulnerability to syncope, 671,681,682 and by the physical injuries associated with falls, collisions, or trauma, which more commonly result from syncope in old age. 670 Furthermore, recurrent syncope can lead to nursing home admission and a devastating loss of independence.…”

Section: Geriatric Patients: Recommendationsmentioning

confidence: 99%

2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society

Sheldon²,

et al. 2017

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“…However, the prevalence of this subgroup in our sample is low (6 %). In the older population, it is already well known that subjects with syncope have a greater incidence of cardiovascular comorbidities and the related use of multiple cardio-active medications increases the risk of orthostatic hypotension and related recurrence syncope episodes [15]. This phenomenon is also particularly relevant in older patients without dementia [16].…”

Section: Discussionmentioning

confidence: 97%

The “syncope and dementia” study: a prospective, observational, multicenter study of elderly patients with dementia and episodes of “suspected” transient loss of consciousness

et al. 2015

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Background and aim Syncope and related falls are one of the main causes and the predominant cause of hospitalization in elderly patients with dementia. However, the diagnostic protocol for syncope is difficult to apply to patients with dementia. Thus, we developed a ''simplified'' protocol to be used in a prospective, observational, and multicenter study in elderly patients with dementia and transient loss of consciousness suspected for syncope or unexplained falls. Here, we describe the protocol, its feasibility and the characteristics of the patients enrolled in the study. Methods Patients aged C65 years with a diagnosis of dementia and one or more episodes of transient loss of consciousness during the previous 3 months, subsequently referred to a Geriatric Department in different regions of Italy, from February 2012 to May 2014, were enrolled. A simplified protocol was applied in all patients. Selected patients underwent a second-level evaluation. Results Three hundred and three patients were enrolled; 52.6 % presented with episodes suspected to be syncope, 44.5 % for unexplained fall and 2.9 % both. Vascular dementia had been previously diagnosed in 53.6 % of participants, Alzheimer's disease in 23.5 % and mixed forms in 12.6 %. Patients presented with high comorbidity (CIRS score = 3.6 ± 2), severe functional impairment, (BADL lost = 3 ± 2), and polypharmacy (6 ± 3 drugs). Conclusion Elderly patients with dementia enrolled for suspected syncope and unexplained falls have high comorbidity and disability. The clinical presentation is often atypical and the presence of unexplained falls is particularly frequent.

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Comparison of Incidence, Predictors, and the Impact of Co-Morbidity and Polypharmacy on the Risk of Recurrent Syncope in Patients <85 Versus ≥85 Years of Age

Cited by 46 publications

References 27 publications

Perioperative complications of oralsurgical procedures in cardiovascular geriatric patients

Perioperative complications of oralsurgical procedures in cardiovascular geriatric patients

2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society

The “syncope and dementia” study: a prospective, observational, multicenter study of elderly patients with dementia and episodes of “suspected” transient loss of consciousness

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