Effect of obesity, serum lipoproteins, and apolipoprotein E genotypes on mortality in hospitalized elderly patients.

Background: The aim of this study was to investigate the relationship among apolipoprotein E (APOE) polymorphism, body mass index (BMI), and dyslipidemia and how these factors modify overall mortality in a cohort of hospitalized elderly patients.

Methods: Plasma concentrations of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), BMI, and APOE genotype were evaluated in 1,012 hospitalized elderly patients, who were stratified into three groups according to their baseline BMI and APOE allele status. Multivariate logistic regression analysis was used to assess whether APOE genotype, BMI, and dyslipidemia are associated with mortality, adjusting for potential confounders.

A multidimensional approach to the geriatric patient with chronic kidney disease.

The prognostic evaluation of elderly patients with chronic kidney disease (CKD) plays a key role in the decision analyses of care processes. It is increasingly evident that the prognosis of older patients with CKD is strongly affected by functional and cognitive status, body composition and nutrition, comorbidity and treatments and other factors that are not directly related to the index disease. The comprehensive geriatric assessment (CGA) is a multidimensional diagnostic process intended to determine an elderly person?s medical, functional and psychosocial capacity and problems, with the objective of developing an overall plan for treatment and follow-up.

Angiotensin-converting enzyme (ACE) genotypes and disability in hospitalized older patients.

The association between angiotensin-converting enzyme (ACE) genotypes and functional decline in older adults remains controversial. To assess if ACE gene variations influences functional abilities at older age, the present study explored the association between the common ACE insertion/deletion (I/D) polymorphism and disability measured with activities of daily living (ADL) in hospitalized older patients. We analyzed the frequency of the ACE genotypes (I/I, I/D, and D/D) in a population of 2,128 hospitalized older patients divided according to presence or absence of ADL disability.

Non-steroidal anti-inflammatory drug use in the elderly.

The efficacy of non-steroidal anti-inflammatory drugs (NSAIDs) for the treatment of inflammation and pain of various origins is well established. Prescribing these drugs, however, remains a challenge because a great variety of gastrointestinal and cardiovascular safety issues need to be considered, particularly in older patients. Recent recommendations suggest that the prescription of non-selective NSAIDs and/or selective cyclo-oxygenase-2 inhibitors (coxibs) may be appropriate in patients with low gastrointestinal risk (no prior gastrointestinal events, no concomitant treatments with other damaging drugs).

The multidimensional prognostic index predicts short- and long-term mortality in hospitalized geriatric patients with pneumonia.

Background: Multidimensional impairment of older patients may influence the clinical outcome of acute or chronic diseases. Our purpose is to evaluate the usefulness of a multidimensional prognostic index (MPI) based on a comprehensive geriatric assessment (CGA) for predicting mortality risk in older patients with community-acquired pneumonia (CAP).

Methods: This prospective study included 134 hospitalized patients aged 65 and older with a diagnosis of CAP.

Prevalence, clinical features and avoidability of adverse drug reactions as cause of admission to a geriatric unit: a prospective study of 1756 patients.

Background: Drug use increases with advancing age, and in older patients it is associated with an increase in adverse drug reactions (ADRs). ADRs are a primary cause of morbidity and mortality worldwide.

Objectives: To evaluate the prevalence, clinical characteristics and avoidability of ADR-related hospital admissions in elderly patients.

Development and validation of a multidimensional prognostic index for one-year mortality from comprehensive geriatric assessment in hospitalized older patients.

Our objective was to construct and validate a Multidimensional Prognostic Index (MPI) for 1-year mortality from a Comprehensive Geriatric Assessment (CGA) routinely carried out in elderly patients in a geriatric acute ward. The CGA included clinical, cognitive, functional, nutritional, and social parameters and was carried out using six standardized scales and information on medications and social support network, for a total of 63 items in eight domains. A MPI was developed from CGA data by aggregating the total scores of the eight domains and expressing it as a score from 0 to 1.

Comparison of four proton pump inhibitors for the short-term treatment of esophagitis in elderly patients.

Aim: To compare efficacy and tolerability of four proton pump inhibitors (PPIs) commonly used in the short-term therapy of esophagitis in elderly patients.

Methods: A total of 320 patients over 65 years with endoscopically diagnosed esophagitis were randomly assigned to one of the following treatments for 8 wk: (1) omeprazole 20 mg/d; (2) lansoprazole 30 mg/d; (3) pantoprazole 40 mg/d, or (4) rabeprazole 20 mg/d. Major symptoms, compliance, and adverse events were recorded.

Genetic susceptibility to nonsteroidal anti-inflammatory drug-related gastroduodenal bleeding: role of cytochrome P450 2C9 polymorphisms.

Background And Aims: Several nonsteroidal anti-inflammatory drugs (NSAIDs) are metabolized by the cytochrome P450 2C9 (CYP2C9). Two common variants of the CYP2C9 gene (CYP2C9*2 and *3) were reported to significantly affect the activity of the CYP2C9 enzyme. The aim of this study was to evaluate the impact of CYP2C9 polymorphisms on the risk of gastroduodenal bleeding in acute NSAID users.

Usefulness of the comprehensive geriatric assessment in older patients with upper gastrointestinal bleeding: a two-year follow-up study.

Background: The potential usefulness of standardized comprehensive geriatric assessment (CGA) in evaluating treatment and follow-up of older patients with upper gastrointestinal bleeding is unknown.

Aim: To evaluate the usefulness of the CGA as a 2-year mortality multidimensional prognostic index (MPI) in older patients hospitalized for upper gastrointestinal bleeding.

Materials And Methods: Patients aged > or =65 years consecutively hospitalized for acute upper gastrointestinal bleeding were included.

Clinical features of reflux esophagitis in older people: a study of 840 consecutive patients.

Objectives: To compare symptoms and other clinical characteristics of reflux esophagitis in patients of different ages.

Design: Observational cross-sectional study of consecutive patients.

Setting: Geriatric Unit, Casa Sollievo della Sofferenza Hospital, Istituto di Ricovero e Cura a Carattere Scientifico.

Deep venous thrombosis in elderly hospitalized patients: prevalence and clinical features.

Background And Aims: It is not known whether old age influences the clinical outcome of deep venous thrombosis (DVT) in patients admitted to acute internal medicine wards. This study aimed at evaluating the effect of age on the prevalence and clinical features of DVT in patients admitted to acute medical wards in a general hospital.

Methods: All patients with a discharge diagnosis of DVT during a 4-year period from 1999 to 2002 were identified.