Abstract:
BACKGROUND:Cardiac surgery is widely believed to be an excessively high-risk intervention for very elderly patients with coronary artery or valvular disease. However, as life expectancy and the prospect of sustained quality of life into older age increase, this assumption should be challenged so that surgery is not denied to patients who may derive significant symptomatic benefit with acceptable levels of operative risk. OBJECTIVE:To evaluate outcomes from cardiac surgery in nonagenarian patients. DESIGN:Analysis of prospectively collected single-centre data and review of outcomes reported in the literature. RESULTS:Twenty-three patients (13 males) aged 90 years or more underwent open cardiac surgery between 1998 and 2007. Four patients died within 30 days of surgery (surgical mortality 17.4%) and all-cause in-hospital morbidity was 74%. Actuarial survival at 1 and 5 years was estimated at 72 and 54%, respectively. Comparison of patients' survival against age-matched life tables for the English population found a standardised mortality ratio of 0.57 (95% CI: 0.24-0.99; one-sample log-rank test chi(2) = 3.93; p < 0.05) representing a significant survival benefit associated with surgery. The majority of patients reported symptomatic improvement reflected by significant decreases in angina and dyspnoea scores. Six single-centre series of nonagenarians and 3 reviews from national databases in the US and UK were identified in the literature. Pooled surgical mortality was 12.7% (95% CI: 8.7-17.3%) with no significant heterogeneity (chi(2) = 4.12; p = 0.77; I(2) = 0). CONCLUSION:Cardiac surgery in the elderly carries higher operative risk than in younger patients. However, in selected nonagenarians, surgery can be performed with acceptable morbidity and early mortality, and patients gain significant symptomatic relief and survival benefit.
journal_name
Gerontologyjournal_title
Gerontologyauthors
Guilfoyle MR,Drain AJ,Khan A,Ferguson J,Large SR,Nashef SAdoi
10.1159/000271602subject
Has Abstractpub_date
2010-01-01 00:00:00pages
378-84issue
4eissn
0304-324Xissn
1423-0003pii
000271602journal_volume
56pub_type
杂志文章,评审相关文献
GERONTOLOGY文献大全abstract:OBJECTIVE:In Germany, there is an ongoing concern about the high prevalence of underweight on admission to health-care institutions. In order to assess possible sex-specific differences, the aim of this study is to provide valid figures about the prevalence and risk factors of underweight of men and women in German nur...
journal_title:Gerontology
pub_type: 杂志文章
doi:10.1159/000512459
更新日期:2021-01-20 00:00:00
abstract::In mammals, aging is often viewed as a progressive decline in physiological competence with a corresponding inability to adapt to stressful stimulation. Several current theories of aging have implicated the sympathetic nervous system in many of the metabolic, cardiovascular and behavior changes which attend advancing ...
journal_title:Gerontology
pub_type: 杂志文章
doi:10.1159/000212785
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND:Six-metre walking speed (SMWS) is a commonly used test for measuring functional performance in older people. However, apart from lower limb strength, few studies have examined the range of physiological and psychological factors that influence performance in this test. OBJECTIVE:To investigate the relative ...
journal_title:Gerontology
pub_type: 杂志文章
doi:10.1159/000088703
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:Older adults are stereotypically considered to be risk averse compared to younger age groups, although meta-analyses on age and the influence of gain/loss framing on risky choices have not found empirical evidence for age differences in risk-taking. OBJECTIVE:The current study extends the investigation of a...
journal_title:Gerontology
pub_type: 杂志文章
doi:10.1159/000487636
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Although a relationship between diet and mortality is well recognized, there is little information on the extent to which different food sources contribute to survival in elderly people. OBJECTIVE:To examine the effect of individual food groups on mortality in institutionalized elderly people from Asturias ...
journal_title:Gerontology
pub_type: 杂志文章
doi:10.1159/000135069
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:One of the earliest and most persistent inquiries in developmental psychology is that of the relative contributions of nature and nurture to human ontogeny. One way of studying this distinction is by doing cross-cultural studies, in which culture provides a powerful way to operationalize the influence of nur...
journal_title:Gerontology
pub_type: 杂志文章,评审
doi:10.1159/000094610
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE:To examine the relationships between upper extremity function (UEF) and mortality, need for social assistance and change of residence, at discharge from hospital and at 1 month following discharge. METHODS:Observational, cohort study. SETTING:Acute Geriatric Unit of a Tertiary Teaching Hospital. SUBJECTS:3...
journal_title:Gerontology
pub_type: 杂志文章
doi:10.1159/000102541
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND AND AIMS:Moderate physical exercise, dietary restriction as well as enriched environment in separate studies have been reported to delay some of the adverse effects of aging on brain function, parallel to an increase in brain-derived neurotrophic factor (BDNF). In order to elucidate these influences in a com...
journal_title:Gerontology
pub_type: 杂志文章
doi:10.1159/000095117
更新日期:2006-01-01 00:00:00
abstract::Historically, family ties have been understood as the primary source of support for aging adults, and past empirical and theoretical work has highlighted the tendency of older adults to focus on close family. However, in line with demographic changes and historical increases in the diversity of social structures, frie...
journal_title:Gerontology
pub_type: 杂志文章,评审
doi:10.1159/000505547
更新日期:2020-01-01 00:00:00
abstract::Mechanisms underlying the decreased febrile response in the elderly have not been elucidated. One hypothesis is that elderly persons have a decreased response at the hypothalamic or peripheral effector level to endogenous pyrogen (EP). We studied the response to human monocyte-derived EP in young adult and aged Fische...
journal_title:Gerontology
pub_type: 杂志文章
doi:10.1159/000212723
更新日期:1985-01-01 00:00:00
abstract::Aging is a complex biological phenomenon which involves progressive loss of different physiological functions of various tissues of living organisms. It is the inevitable fate of life and is a major risk factor for death and different pathological disorders. Based on a wide variety of studies performed in humans as we...
journal_title:Gerontology
pub_type: 杂志文章,评审
doi:10.1159/000097865
更新日期:2007-01-01 00:00:00
abstract::In the present study, we examined the changes that occur with age in anti-idiotype-blocked, hapten-augmentable PFC in the mucosal-associated lymph nodes (MLN and BLN) and spleen of various strains of mice. 2-month-old 129/J, AKR/J, and C57L/J mice had a high percentage of hapten-augmentable PFC in their spleen, MLN, a...
journal_title:Gerontology
pub_type: 杂志文章
doi:10.1159/000212708
更新日期:1985-01-01 00:00:00
abstract::The glucose uptake of lizard brain slices decreased between young and middle-aged groups. There was a significant increase in the parameter between the middle-aged and old-age groups. Cold shock induced a decrease in glucose uptake of brain slices in the old, with no appreciable effect in the young and middle aged. ...
journal_title:Gerontology
pub_type: 杂志文章
doi:10.1159/000213005
更新日期:1989-01-01 00:00:00
abstract::Differences between women and men in terms of gender gaps at late stages of their lives are the focus of this mini-review. We approach the matter by taking up the position of complex yet promising standpoints, the bio-psycho-social perspective on the one hand and approaches of developmental psychology on the other. Li...
journal_title:Gerontology
pub_type: 杂志文章,评审
doi:10.1159/000323154
更新日期:2011-01-01 00:00:00
abstract::One of the problems associated with using random-source dogs to study in vivo vascular responses is their unknown background. Since aging is known to influence vascular responses, unknown variations in age could influence experimental results. The vast majority of aging studies examine arteries in vitro. This study wa...
journal_title:Gerontology
pub_type: 杂志文章
doi:10.1159/000213318
更新日期:1992-01-01 00:00:00
abstract::To evaluate the requirement for provocative cystometry in urodynamic investigation in the elderly with urinary incontinence, 100 consecutive patients, who were referred on the basis of defined clinical criteria, were first studied by supine cystometry followed by provocative tests where necessary. The most satisfactor...
journal_title:Gerontology
pub_type: 杂志文章
doi:10.1159/000212791
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND:The results of the very few histochemical studies that have been performed so far on the lectin-binding profile of normal human epidermis are mostly controversial; thus, the carbohydrate residue composition of the cell surface in the latter still remains in dispute and the possible alterations in the epiderm...
journal_title:Gerontology
pub_type: 杂志文章
doi:10.1159/000083986
更新日期:2005-05-01 00:00:00
abstract::Acquisition of immunologic self-tolerance by clonal deletion in the thymus is concluded to be a critical process in immune aging and is found to be transiently protected from genetic instability by means of a feedback surveillance which functions at the expense of chronic thymic involution. In the immune control of ma...
journal_title:Gerontology
pub_type: 杂志文章,评审
doi:10.1159/000213604
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:The link between longevity and diet is of great interest to biological and gerontological research. The fact that relevant knowledge has generally been available for many centuries is often not remarked upon. OBJECTIVE:This article examines three aspects of early modern Western medicine which thematize the ...
journal_title:Gerontology
pub_type: 历史文章,杂志文章
doi:10.1159/000082198
更新日期:2005-03-01 00:00:00
abstract::The 'use it or lose it' hypothesis of cognitive aging predicts that engagement in intellectual, social, and physical activities offers protective benefits from age-related cognitive decline and lowers dementia risk. Although this hypothesis has not yet been supported conclusively, there is some empirical evidence in f...
journal_title:Gerontology
pub_type: 杂志文章,评审
doi:10.1159/000264918
更新日期:2010-01-01 00:00:00
abstract::The effect of ageing on the threshold firing rate of motor units from the first dorsal interosseous muscle was investigated. Two groups of 9 healthy male subjects between the ages of 20-29 and 60-69 years took part in the study. The threshold firing rate of motor units in young subjects showed close agreement with pre...
journal_title:Gerontology
pub_type: 杂志文章
doi:10.1159/000212939
更新日期:1988-01-01 00:00:00
abstract::The concentrations of noradrenaline and adrenaline were studied in specimens of the posterior tibial artery obtained from 18 subjects at postmortem examination. The mean noradrenaline concentration was 167 ng/g artery (range 17-449 ng/g) and the mean adrenaline concentration was 5 ng/g (range 0--21 ng/g). There was no...
journal_title:Gerontology
pub_type: 杂志文章
doi:10.1159/000212263
更新日期:1978-01-01 00:00:00
abstract::The pharmacokinetics of indomethacin (Indo) was studied in 10 healthy elderly male volunteers (age 67-81 years) following the oral administration of a single 75-mg dose of a sustained release form of Indo. The total and free plasma and erythrocyte concentrations of Indo were determined by a specific high-pressure liqu...
journal_title:Gerontology
pub_type: 杂志文章
doi:10.1159/000212802
更新日期:1986-01-01 00:00:00
abstract::Antinuclear antibodies, anticardiolipin antibodies and IgM rheumatoid factor were determined in 300 healthy aged subjects, comparing their prevalence to that in 100 healthy subjects aged between 19 and 44 years and 352 patients under 65 years of age, affected by various systemic rheumatic diseases. Increased productio...
journal_title:Gerontology
pub_type: 杂志文章
doi:10.1159/000213183
更新日期:1990-01-01 00:00:00
abstract::As populations age globally, the health of older adults is looming larger on the agendas of public health bodies. In particular, the priority is to ensure that older adults remain healthy, independent, and engaged in their communities. In other words, ensuring that increasing life spans are matched by increasing "heal...
journal_title:Gerontology
pub_type: 杂志文章,评审
doi:10.1159/000503141
更新日期:2020-01-01 00:00:00
abstract::(Na+-K+)-ATPase is an enzyme responsible for ionic homeostasis in excitable tissues. Thus, the activity of this enzyme is essential for the maintenance of optimal function of the cerebral cortex. Although abnormalities of cerebral oxidative metabolism have been described in aging, these abnormalities do not appear to ...
journal_title:Gerontology
pub_type: 杂志文章
doi:10.1159/000213123
更新日期:1983-01-01 00:00:00
abstract::The immunocompetence of 22 subjects aged 85-104 years (mean 90 +/- 1 years) was studied and compared to 21 young subjects aged 19-37 years (mean 30 +/- 1 years). The absolute lymphocyte number and the percentage of T and B lymphocytes in the peripheral blood was similar in the two groups. A marked decrease in phytohem...
journal_title:Gerontology
pub_type: 杂志文章
doi:10.1159/000213095
更新日期:1983-01-01 00:00:00
abstract::Aging is associated with a decline in renal concentrating ability in response to dehydration-induced arginine vasopressin (AVP) release. To examine target tissue sensitivity, cortical collecting tubules (CCT) were individually microdissected from young (3 months), middle-aged (2-3 years) and old (4-5.5 years) rabbits ...
journal_title:Gerontology
pub_type: 杂志文章
doi:10.1159/000213348
更新日期:1992-01-01 00:00:00
abstract::The heat shock protein (HSP) system is a mechanism of cell defense induced by stress, constitutively expressed during basal conditions and essential to the maintenance of cellular integrity. Acutely induced HSP synthesis decreases with aging, but the effect of age on the basal expression of HSP70 has not been specific...
journal_title:Gerontology
pub_type: 杂志文章
doi:10.1159/000021977
更新日期:1998-01-01 00:00:00
abstract::A morphometric analysis of neuronal loss during normal aging was performed in the nucleus basalis Meynert complex of the basal forebrain (Nbm) (nucleus septi medialis, nucleus of Broca's diagonal band, nucleus basalis) and the ciliary ganglion, a peripheral cholinergic structure, in patients free of neurological and p...
journal_title:Gerontology
pub_type: 杂志文章
doi:10.1159/000212872
更新日期:1987-01-01 00:00:00