Abstract:
OBJECTIVES:To investigate effects of older age, comorbidities, and physiological measures on outcomes of elderly adults requiring prolonged mechanical ventilation (PMV). DESIGN:Retrospective cohort study. SETTING:Public long-term acute care hospital (LTACH) with an active program for ventilator weaning from PMV. PARTICIPANTS:Chronically seriously ill individuals with PMV aged 65 and older divided into six cohorts (65-69, 70-74, 75-79, 80-84, 85-89, ≥ 90) for comparative purposes (n = 540). MEASUREMENTS:Main outcomes were weaning criteria met, weaning success, discharge dispositions, and long-term survival. Other outcomes included weaning duration, LTACH days, discharge physical function, tracheostomy decannulation, and relapses to ventilator support. Weaning success was defined as 4 weeks or longer entirely free from mechanical ventilator support. RESULTS:The main finding from age cohort comparisons was that the likelihood of meeting weaning criteria (P = .001) and subsequent successful weaning (P = .002) decreased with age. Best predictors for weaning success in multivariable analysis were lower comorbidity burden (P < .001) and less-severe illness (P = .001). Other clinically important predictors were more-normal values in the respiratory physiology measures of rapid shallow breathing (P = .001) and static compliance (P = .003). Successful weaning was also associated with a 62% lower risk of death (P < .001). CONCLUSION:Although meeting weaning criteria and being successfully weaned decreased with increasing age, age was not the dominant factor in predicting outcomes. More importantly, individuals with PMV with better respiratory physiology and lower comorbidity burdens were more likely to be weaned and have longer survival, no matter their age.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Dermot Frengley J,Sansone GR,Shakya K,Kaner RJdoi
10.1111/jgs.12597subject
Has Abstractpub_date
2014-01-01 00:00:00pages
1-9issue
1eissn
0002-8614issn
1532-5415journal_volume
62pub_type
杂志文章abstract::Since 2012, the American Geriatrics Society (AGS) has also been collaborating with the American Board of Internal Medicine (ABIM) Foundation, joining its "Choosing Wisely" campaign on two separate lists of Five Things Healthcare Providers and Patients Should Question. The campaign is designed to engage healthcare orga...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/jgs.12770
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVES:To determine the proportion of older people with diabetes mellitus (DM) eligible to enroll in the standard Medicare Part D drug benefit who will exceed the initial $2,250 coverage limit and to determine the effect of hypoglycemic choice on risk of exceeding the coverage limit. DESIGN:Cross-sectional survey....
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2006.00663.x
更新日期:2006-04-01 00:00:00
abstract::A dramatic increase in the number of ethics committees in long-term care facilities (LTCFs) has occurred since 1970 in the 487 nursing homes in Minnesota. Ten percent of the LTCFs had ethics committees which were mostly formed by administrators and nurses. The committees are most often found in large urban facilities ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1987.tb04009.x
更新日期:1987-11-01 00:00:00
abstract:OBJECTIVES:To estimate medical expenditures attributable to older adult falls using a methodology that can be updated annually to track these expenditures over time. DESIGN:Population data from the National Vital Statistics System (NVSS) and cost estimates from the Web-based Injury Statistics Query and Reporting Syste...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15304
更新日期:2018-04-01 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:OBJECTIVES:To evaluate a new alcohol-related risk score for research use. DESIGN:Using data from a previously reported trial of a screening and education system for older adults (Computerized Alcohol-Related Problems Survey), secondary analyses were conducted comparing the ability of two different measures of risk to ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2007.01072.x
更新日期:2007-03-01 00:00:00
abstract:OBJECTIVES:To determine reference values for laboratory tests in individuals aged 85 and older. DESIGN:Cross-sectional cohort study. SETTING:International. PARTICIPANTS:Long Life Family Study (LLFS) participants (N~5,000, age: range 25-110, median 67, 45% male). MEASUREMENTS:Serum biomarkers were selected based on ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14522
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVE:To assess the effectiveness of psychotropic medication withdrawal and a home-based exercise program in reducing falls in older people. DESIGN:A randomized controlled trial with a two by two factorial design. SETTING:Seventeen general practices in Dunedin, New Zealand. PARTICIPANTS:Women and men aged 65 yea...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1532-5415.1999.tb03843.x
更新日期:1999-07-01 00:00:00
abstract:OBJECTIVES:To determine whether patient age is associated with differences in flexible bronchoscopy technique and tolerance. DESIGN:Prospective cohort study. SETTING:University hospital system. PARTICIPANTS:One thousand three hundred fifty-eight adults, including 219 (16.1%) aged 70 and older, undergoing bronchoscop...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1365-2389.2003.51303.x
更新日期:2003-07-01 00:00:00
abstract:OBJECTIVES:To characterize Medicare expenditure and usage trends in individuals with a coded diagnosis of Alzheimer's disease and related dementia (ADRD) or mild cognitive impairment (MCI) during the periods leading up to and after diagnosis. DESIGN:Retrospective observational cohort study. SETTING:Five percent sampl...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14227
更新日期:2016-08-01 00:00:00
abstract::Osteochondritis dessicans of the hip is rare in comparison with occurrence of the disease in other joints. Only about 50 cases have been reported. The literature is reviewed, and a new case is presented. The patients was a 94-year-old Spanish American War Veteran who was unusally active and in good health until the on...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1980.tb00535.x
更新日期:1980-06-01 00:00:00
abstract:OBJECTIVES:To develop and evaluate the psychometric properties of two new urge incontinence-specific instruments that measure quality of life and symptom annoyance. DESIGN:New instruments were developed and validated in racially, ethnically, and age-diverse community-dwelling women with urge or mixed incontinence with...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1999.tb01294.x
更新日期:1999-08-01 00:00:00
abstract::Eighty-seven community-dwelling nonagenarians provided with extensive medical and social services as needed were followed for two years. Fifty-one subjects were admitted to an acute care hospital at least once. Total durations of hospitalization for those who required it averaged 44 days per individual over the two ye...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1984.tb02038.x
更新日期:1984-05-01 00:00:00
abstract:OBJECTIVE:To assess the validity of the Neurobehavioral Rating Scale (NRS) in patients with Alzheimer's disease (AD) or multi-infarct dementia (MID) and to characterize the cognitive, psychiatric, and behavioral disturbances that occur in these patients. DESIGN:Cross-sectional evaluation. SETTING:West Los Angeles VAM...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1992.tb02101.x
更新日期:1992-06-01 00:00:00
abstract:OBJECTIVES:To determine the cross-sectional and longitudinal associations between 25-hydroxyvitamin D (25(OH)D) levels and frailty status in older men. DESIGN:Prospective cohort study. SETTING:Six U.S. community-based centers. PARTICIPANTS:One thousand six hundred six men aged 65 and older. MEASUREMENTS:25(OH)D (li...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1532-5415.2010.03201.x
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVE:To describe the total cost of pressure ulcer prevention, component costs of each intervention, and the relationship of costs to subjects' risk level. DESIGN:3-month cohort trial. SETTING:A 600-bed, state-supported, long-term care facility. PATIENTS:A total of 539 war veterans, 83% of whom were male; mean a...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1995.tb06095.x
更新日期:1995-05-01 00:00:00
abstract:BACKGROUND:Delirium is a common postoperative complication in geriatric patients, especially in those with underlying risk factors. Multicomponent nonpharmacologic interventions are effective in preventing delirium, however, implementation of these measures is variable in perioperative care. The aim of our study was to...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.17006
更新日期:2020-12-31 00:00:00
abstract:OBJECTIVES:To determine whether metabolic syndrome is an independent predictor of decline in mobility in an elderly community sample. DESIGN:Biracial community-based prospective cohort study. SETTING:Urban and rural areas of central North Carolina. PARTICIPANTS:One thousand two hundred twenty-nine older African Amer...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.00607.x
更新日期:2006-03-01 00:00:00
abstract::The implications for society of increasing life span to 120 years can only be guessed, but comparing the diversity of responses to aging in different countries may give insights into the possible effect. A European Union-funded study of the recipients of community care services in 11 European countries illustrates how...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53497.x
更新日期:2005-09-01 00:00:00
abstract::A retrospective analysis was made of the records of 100 consecutive geriatric patients with community-acquired bacteremia, admitted to a suburban hospital. The most frequently identified tissue sources for these bacteremias were the urinary tract (34 percent), biliary tract (20 percent), and lungs (13 percent). In 11 ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1980.tb00622.x
更新日期:1980-07-01 00:00:00
abstract:OBJECTIVE:To test the feasibility of and to validate a self-report weekly postcard diary of health care utilization. DESIGN:Case-series and validation study. SETTING:Community-based sample of fee-for-service and health maintenance organization (HMO) patients. PARTICIPANTS:A convenience sample of 24 community-dwellin...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1995.tb06105.x
更新日期:1995-05-01 00:00:00
abstract:OBJECTIVES:To evaluate the association between regular antiepileptic drug (AED) use and incident dementia. DESIGN:Case-control analysis. SETTING:Finnish public health register and German health insurance data. PARTICIPANTS:Individuals with dementia of any type (German data, N=20,325) and Alzheimer's disease (AD; Fin...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15358
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVES:To assess older urban women's knowledge about sexual transmission of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) and to evaluate the relationship between their HIV/AIDS knowledge level and sources of information. DESIGN:Cross-sectional survey conducted between June 2001 and...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2004.52421.x
更新日期:2004-09-01 00:00:00
abstract::On September 11, 1986, the Supreme Judicial Court of Massachusetts, in a 4-3 decision, authorized removal of the artificial feeding tube. It held that the "substituted judgment" of an incompetent person in a persistent vegetative state to refuse artificially administered sustenance must be honored. The Court also refu...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:
更新日期:1987-07-01 00:00:00
abstract:OBJECTIVES:To analyze the costs for long-stay (>90 days) nursing home (NH) decedents with and without hospice care. DESIGN:Retrospective cohort study using a 1999-2009 data set of linked Medicare and Medicaid claims and minimum data set (MDS) assessments. SETTING:Indiana NHs. PARTICIPANTS:Long-stay NH decedents (N =...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14070
更新日期:2016-04-01 00:00:00
abstract::Tetanus is more common in the elderly, who have a higher case-fatality rate than younger age groups. Immunization against tetanus is recommended for all elderly, including nursing home residents, but the tetanus immunization policies of nursing homes are unknown. Nursing home medical directors in Maryland were surveye...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1990.tb03454.x
更新日期:1990-12-01 00:00:00
abstract:OBJECTIVES:To determine the effect of milk and dairy intake on the development of all-cause dementia and its subtypes in an elderly Japanese population. DESIGN:Prospective cohort study. SETTING:The Hisayama Study, Japan. PARTICIPANTS:Individuals aged 60 and older without dementia (N = 1,081). MEASUREMENTS:Milk and ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12887
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVES:To determine the effect of home-based primary care (HBPC) on Medicare costs and mortality in frail elders. DESIGN:Case-control concurrent study using Medicare administrative data. SETTING:HBPC practice in Washington, District of Columbia. PARTICIPANTS:HBPC cases (n = 722) and controls (n = 2,161) matched ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12974
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVES:To describe the pattern and factors associated with daily medication use in nursing home (NH) residents with advanced dementia. DESIGN:Prospective cohort study. SETTING:Twenty-two Boston-area NHs. PARTICIPANTS:NH residents with advanced dementia (N=323). MEASUREMENTS:Data from residents' records were use...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2010.02819.x
更新日期:2010-05-01 00:00:00