Abstract:
OBJECTIVE:To describe the long-term outcome and complications of spinal surgery in a population of elderly patients. DESIGN:Retrospective chart review and clinical follow-up. SETTING:A 700-bed tertiary care midwestern hospital. PATIENTS:Patients 70 years of age or older who underwent elective surgical procedures for the treatment of benign lesions of the spinal canal. MAIN OUTCOME MEASURES:Data obtained from chart review included age, sex, nature and duration of neurological symptoms, activities of daily living (ADL), associated illnesses, length of hospitalization, type of surgery, and complications attributable to surgery. Outcome measurements included changes in neurological symptoms and ADL and a standardized scale obtained from consecutive outpatient visits, telephone interviews, or written responses. RESULTS:Seventy-eight patients with lumbar canal stenosis or soft disc herniations underwent laminectomies, foraminotomies or discectomies. Eleven patients underwent cervical laminectomies for multilevel spondylitic myelopathy. Limb and spine pain were the most common neurological symptoms in patients with lumbar lesions; diminished ADLs were present in eight patients with cervical myelopathies. Six patients died of unrelated causes, and 78 were followed for an average of 27.1 months. Twenty-three (85.2%) of 27 patients with lumbar disc herniations reported improvements or resolution of limb pain while 35 (81.4%) of 43 patients with lumbar canal stenosis reported fair or good results. Five of eight patients with multilevel cervical spondylosis reported improvements of myelopathic symptoms. Twenty-six (28.6%) complications were attributable to 91 surgical procedures including five severe complications and one fatality. Patients with three or more associated illnesses demonstrated a significantly higher incidence of postoperative complications. CONCLUSIONS:Elderly patients with benign lesions of the spinal canal may achieve significant reduction in limb pain and increases in ADL following appropriate surgery, with a tolerable rate of severe complications. The preoperative physical condition of the elderly patient served as an indicator for operative morbidity.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Smith EB,Hanigan WCdoi
10.1111/j.1532-5415.1992.tb01981.xsubject
Has Abstractpub_date
1992-09-01 00:00:00pages
867-70issue
9eissn
0002-8614issn
1532-5415journal_volume
40pub_type
杂志文章abstract:OBJECTIVE:To study the effectiveness of rehabilitative and medically oriented day hospital care on community-based long-term care patients. DESIGN:A randomized, controlled trial. SETTING AND PARTICIPANTS:177 patients on home-care in a rural area were randomized into two groups. Patients in one group were offered a 2-...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1532-5415.1998.tb06645.x
更新日期:1998-09-01 00:00:00
abstract:OBJECTIVE:To evaluate the use of pentoxifylline to treat impotence in men with mild to moderate penile vascular insufficiency. DESIGN:Double-blind randomized clinical trial. SETTING:Sexual Dysfunction Clinic at VA Medical Center, Sepulveda, CA. PARTICIPANTS:Convenience sample of couples. INTERVENTION:Twelve weeks o...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1532-5415.1993.tb06941.x
更新日期:1993-04-01 00:00:00
abstract::The 143 physicians who returned to Temple University Medical School a questionnaire on knowledge of prescribing for the elderly constituted 25% of a stratified random sample of general practitioners (GPs), family practitioners (FPs), and practitioners in internal medicine (IMs) reimbursed under Medicare in Pennsylvani...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1985.tb06318.x
更新日期:1985-09-01 00:00:00
abstract:OBJECTIVES:To compare clinical and economic outcomes of early insulin initiation with those of delayed initiation in older adults with type 2 diabetes mellitus (T2DM). DESIGN:Retrospective cohort study. SETTING:Humana Medicare Advantage health insurance plan. PARTICIPANTS:Older (≥65) Medicare beneficiaries with T2DM...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13388
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVE:To examine physician use of stool guaiac testing in order to determine indications for testing, how the test was used, and the consequences of a particular test result. DESIGN:Retrospective case series. SETTING:Large midwestern inpatient nursing home facility. PATIENTS:All patients with positive fecal occu...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1991.tb03569.x
更新日期:1991-12-01 00:00:00
abstract:OBJECTIVES:To determine the effect of four vitamin D supplement doses on falls risk in elderly nursing home residents. DESIGN:Secondary data analysis of a previously conducted randomized clinical trial. SETTING:Seven hundred twenty-five-bed long-term care facility. PARTICIPANTS:One hundred twenty-four nursing home r...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1532-5415.2007.01048.x
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVES:To investigate the effects of dehydroepiandrosterone (DHEA) combined with exercise on bone mass, strength, and physical function in older, frail women. DESIGN:Double-blind, randomized, placebo-controlled trial. SETTING:A major medical institution. PARTICIPANTS:Ninety-nine women (mean age 76.6 ± 6.0) with ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1532-5415.2010.03019.x
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Depression screening and treatment for older adults are recommended in Age-Friendly Health Systems. Few studies have evaluated the association between depressive symptoms and postoperative functioning. We aimed to determine the association between varying levels of depressive symptoms in the preop...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16781
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVES:To determine whether older adults with mild cognitive impairment (MCI), a condition not previously explored as a risk factor, have more hospitalizations and 30-day readmissions than those with normal cognition. DESIGN:Post hoc analysis of prospectively gathered data on incident hospitalization and readmissi...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/jgs.13593
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVES:To determine the association between complementary and alternative medicine (CAM) use and antihypertensive medication adherence in older black and white adults. DESIGN:Cross-sectional. SETTING:Patients enrolled in a managed care organization. PARTICIPANTS:Two thousand were hundred eighty black and white a...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2009.02639.x
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVES:To test whether Stepping On, a multifaceted community-based program using a small-group learning environment, is effective in reducing falls in at-risk people living at home. DESIGN:A randomized trial with subjects followed for 14 months. SETTING:The interventions were conducted in community venues, with a...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1532-5415.2004.52411.x
更新日期:2004-09-01 00:00:00
abstract:OBJECTIVES:To validate the Executive Interview (EXIT25) as a screening instrument for executive cognitive dysfunction in patients with mild dementia. DESIGN:Validation using group comparison and correlation studies. SETTING:The Copenhagen University Hospital Memory Clinic, a multidisciplinary outpatient clinic based ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53470.x
更新日期:2005-09-01 00:00:00
abstract::Because the value of calcium supplementation in age-related bone loss is controversial, we conducted a study to examine the effects of six months of calcium supplementation on parathyroid hormone (PTH) and other indices of bone metabolism. Calcium carbonate (1.2 grams elemental calcium/day) or placebo was administered...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1532-5415.1991.tb01625.x
更新日期:1991-02-01 00:00:00
abstract::Japan implemented a mandatory social long-term care insurance (LTCI) system in 2000, making long-term care services a universal entitlement for every senior. Although this system has grown rapidly, reflecting its popularity among seniors and their families, it faces several challenges, including skyrocketing costs. Th...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.2007.01281.x
更新日期:2007-09-01 00:00:00
abstract:OBJECTIVES:To determine the feasibility and effect of exercise training after stroke. DESIGN:Randomized exploratory trial comparing exercise training (including progressive endurance and resistance training) with relaxation (attention control). SETTING:Interventions were performed in a rehabilitation hospital. PARTI...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1532-5415.2007.01185.x
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the association between selected chronic medical conditions (CMCs) and fall injury events at home among community-dwelling older persons. DESIGN:Population-based case-control study. SETTING:The general community. PARTICIPANTS:Persons aged 65 and older living at home, excluding those using a whe...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1997.tb01480.x
更新日期:1997-06-01 00:00:00
abstract:OBJECTIVES:To use a simple measure of activities of daily living, wounds, and indwelling devices (urinary catheter, feeding tube) to predict prevalent, new, and intermittent multidrug-resistant organism (MDRO) acquisition in nursing home (NH) residents. DESIGN:Secondary analysis, prospective cohort study. SETTING:Sou...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13353
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVES:To compare the ability of five measures of comorbidity to predict mortality and incident disability in basic activities of daily living (BADLs) in unselected older persons. DESIGN:An assessment of the data obtained from the Insufficienza Cardiaca negli Anziani Residenti a Dicomano (ICARe Dicomano) Study, a ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.00572.x
更新日期:2006-02-01 00:00:00
abstract::The relative merits of the hospice, palliative care units, and geriatrics departments as settings for management of the dying patient are considered. ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1983.tb02203.x
更新日期:1983-09-01 00:00:00
abstract:OBJECTIVES:To determine the effectiveness of vitamin D supplementation in preventing decline in physical function in older men. DESIGN:Randomized, double-blind, placebo-controlled clinical trial. SETTING:Single-center study conducted at a Veterans Affairs Healthcare System. PARTICIPANTS:Sedentary men aged 65 to 90 (...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/jgs.14510
更新日期:2017-02-01 00:00:00
abstract::Senile dementia is one of the important medical-social-economic problems facing our society, estimated to affect some 60% of nursing home patients and of persons residing in the community. The course of dementia in these patients is affected not only by their age, medical complications, and the disease itself, but als...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1981.tb01261.x
更新日期:1981-12-01 00:00:00
abstract:OBJECTIVES:To report use of breast cancer treatment (surgery, radiation, and chemotherapy) by patients with Alzheimer's disease (AD). DESIGN:Retrospective cohort study. SETTING:Surveillance, Epidemiology, and End Results (SEER) is a population-based cancer registry covering 14% of the U.S. population. PARTICIPANTS:F...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.00467.x
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Behavioral problems in individuals with Alzheimer's disease (AD) impose major management challenges. Current prevention strategies are anchored to cognitive outcomes, but behavioral outcomes may provide another, clinically relevant opportunity for preemptive therapy. We sought to determine whether...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15182
更新日期:2018-04-01 00:00:00
abstract::Chronic atrial fibrillation is generally thought to cause stroke by atrial thrombus formation with subsequent embolization. Rheumatic heart disease previously led to most cases of atrial fibrillation, but recent substantial declines in the incidence of rheumatic fever have changed the distribution of causes of atrial ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1985.tb07121.x
更新日期:1985-04-01 00:00:00
abstract::Delirium is an organic mental disorder defined as transient, fluctuating global dysfunction of cognition. It is common in elderly medical inpatients, yet its varied presentation is often missed or misdiagnosed. ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1990.tb01505.x
更新日期:1990-11-01 00:00:00
abstract::After a one-year interval, a structured interview designed to assess the quality of life was again conducted with most of the tenants in a single-room occupancy hotel in New York City. Comparisons was made between the two sets of findings. During the year, a program had been in effect to provide social, psychiatric, r...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1975.tb00316.x
更新日期:1975-06-01 00:00:00
abstract:OBJECTIVES:To determine, in healthy older adults, the relationship between postural steadiness, stability limits, and the ability to recover balance from three postural disturbances requiring anteriorly directed stepping responses. DESIGN:Analysis of multiple motor tasks in a cross-sectional sample of healthy older ad...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2000.tb03027.x
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVES:To describe the composition of the US provider workforce for adults with cancer older than 65 years and to determine whether there were differences in patients who received care from different providers (eg, nurse practitioners [NPs], physician assistants [PAs], and specialty physicians). DESIGN:Observation...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15931
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVES:To compare the efficacy of a computer-based physical activity program (Embodied Conversational Agent-ECA) with that of a pedometer control condition in sedentary older adults. DESIGN:Single-blind block-randomized controlled trial stratified according to clinic site and health literacy status. SETTING:Three...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/jgs.12449
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVES:To examine the effects of caring for a spouse with dementia on the caregiver's risk for incident dementia. DESIGN:Population-based study of incident dementia in spouses of persons with dementia. SETTING:Rural county in northern Utah. PARTICIPANTS:Two thousand four hundred forty-two subjects (1,221 married...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2010.02806.x
更新日期:2010-05-01 00:00:00