Abstract:
PURPOSE:Large population studies now demonstrate that frailty is prevalent in all adult age groups. Limited data exist on the association between frailty and surgical outcome in younger patients. The aim of the study was to explore the agreement between frailty identification tools and collect pilot data on their predictive value for frailty-associated outcomes in an adult surgical population. STUDY DESIGN:Prospective cohort study. RESULTS:Frailty scores were recorded in 200 patients (91 men), mean (range) age 57 (18-92) years. The prevalence of prefrailty was 52%-67% and that of frailty 2%-32% depending on the instrument used. Agreement between the instruments was poor, kappa 0.08-0.17 in pairwise comparisons. Outcome data were available on 160 patients. Only the frailty phenotype was significantly associated with adverse outcomes, RR 6.1 (1.5-24.5) for postoperative complications. The three frailty scoring instruments studies had good sensitivity (Clinical Frailty Scale (CFS)-90%, Accumulation Deficit (AD)-96%, Frailty Phenotype (FP)-97%) but poor specificity (CFS-12%, AD-13%, FP-18%) for the prediction of postoperative complications. All three instruments were poorly predictive of adverse outcomes with likelihood ratios of CFS-1.02, AD-1.09 and FP-1.17. CONCLUSIONS:This study showed a significant prevalence of prefrailty and frailty in adult colorectal surgical patients of all ages. There was poor agreement between three established frailty scoring instruments. Our data do not support the use of current frailty scoring instruments in all adult colorectal surgical patients. However, the significant prevalence of prefrailty and frailty across all age groups of adult surgical patient justifies further research to refine frailty scoring in surgical patients.
journal_name
Postgrad Med Jjournal_title
Postgraduate medical journalauthors
Dale MacLaine T,Baker O,Burke D,Howell SJdoi
10.1136/postgradmedj-2020-139417subject
Has Abstractpub_date
2021-01-12 00:00:00eissn
0032-5473issn
1469-0756pii
postgradmedj-2020-139417pub_type
杂志文章abstract::A young woman with a previous history of anorexia nervosa presented with severe finger clubbing. Urine samples intermittently contained significant amounts of aspartylglucosamine. Liver biopsy showed abnormal cytoplasmic inclusions in phagocytic cells. The patient was found to be abusing senna laxative. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.56.662.862
更新日期:1980-12-01 00:00:00
abstract::Obstructive sleep apnoea syndrome (OSAS) is a highly prevalent disease and is recognised as a major public health burden. Large-scale epidemiological studies have demonstrated an independent relationship between OSAS and various cardiovascular disorders. The pathogenesis of cardiovascular complications in OSAS is not ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/thx.2008.105577
更新日期:2009-12-01 00:00:00
abstract::A multi-centre double-blind randomized study is reported in which the effect on mortality of oral disopyramide (300 mg loading dose, then 100 mg qds) was compared with placebo in 1985 patients entering hospital with suspected acute myocardial infarction. Treatment was commenced with 24 hr of onset of symptoms (mean ti...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/pgmj.60.700.98
更新日期:1984-02-01 00:00:00
abstract:BACKGROUND:Repetitive laboratory testing in stable patients is low-value care. Electronic health record (EHR)-based interventions are easy to disseminate but can be restrictive. OBJECTIVE:To evaluate the effect of a minimally restrictive EHR-based intervention on utilisation. SETTING:One year before and after interve...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2019-136992
更新日期:2021-02-01 00:00:00
abstract::A case of seminoma of the testis complicated by an extensive granulomatous reaction is reported. This reaction was so florid that a benign condition was initially considered until further material for histology was examined and the correct diagnosis made. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.59.691.334
更新日期:1983-05-01 00:00:00
abstract:OBJECTIVES:Although risk assessment is an integral part of management, there are currently no risk calculators of long-term mortality after acute coronary syndrome (ACS). The aim was to provide risk equations for 10-year and 20-year mortality following ACS. METHODS:Patients hospitalised with ACS from December 1990 to ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2016-134129
更新日期:2017-05-01 00:00:00
abstract::Fasting plasma and urinary calcium and urinary hydroxyproline are known to rise at the menopause, reflecting increased bone resorption. Oestradiol valerate and cyclic oestradiol valerate/DL-norgestrel are shown to reduce this evidence of increased bone loss. It is concluded that these preparations will be effective in...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract::A patient with calcific constrictive pericarditis due to rheumatoid arthritis is presented: the literature reveals only one previous case which was attributed to the long duration of the rheumatoid arthritis. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.66.771.57
更新日期:1990-01-01 00:00:00
abstract::We report a 44 year old man who developed external ophthalmoplegia and predominantly respiratory, truncal and bulbar weakness with brisk reflexes, histological evidence of an inflammatory myopathy and a high titre of acetylcholine receptor antibodies, one month after starting hydroxyurea and allopurinol for chronic my...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.69.810.312
更新日期:1993-04-01 00:00:00
abstract::The management of hyperthyroidism and hypothyroidism in pregnancy is discussed and illustrated with appropriate cases. The dangers of the usage of high doses of antithyroid drugs and of propranolol are described. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.55.643.340
更新日期:1979-05-01 00:00:00
abstract::Testis cancer is an increasing problem, especially in northern European male populations. However, survival has improved dramatically over one generation. Environmental factors may have a role in the aetiology with high oestrogen concentrations implicated. Testis cancer is subdivided between seminoma and non-seminoma....
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2007.057992
更新日期:2007-10-01 00:00:00
abstract::Granulomatous disorders comprise a large family sharing the histological denominator of granuloma formation. A granuloma is a focal compact collection of inflammatory cells, mononuclear cells predominating, usually as a result of the persistence of a non-degradable product and of active cell mediated hypersensitivity....
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pmj.76.898.457
更新日期:2000-08-01 00:00:00
abstract::There is considerable evidence to suggest that the identification and treatment of dyslipidaemia will reduce the risk of premature CHD, i.e. before the age of 65. Diagnosis of the cause of raised plasma lipid levels will enable appropriate decisions to be taken with regard to management. The cornerstone of treatment i...
journal_title:Postgraduate medical journal
pub_type: 指南,杂志文章,实务指引
doi:10.1136/pgmj.69.811.359
更新日期:1993-05-01 00:00:00
abstract::The NHS 'Choose Wisely' campaign places greater emphasis on the clinician-patient dialogue. Patients are often in receipt of their laboratory data and want to know whether they are normal. But what is meant by normal? Comparator data, to a measured value, are colloquially known as the 'normal range'. It is often assum...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2018-135983
更新日期:2018-11-01 00:00:00
abstract::Methicillin-resistant Staphylococcus aureus (MRSA) has emerged worldwide as a significant and difficult-to-treat source of nosocomial infection, emphasizing the ever-present need for reliable and effective antisepsis. Betadine Solution (10% povidone-iodine; PVP-I) and Betadine Cream (5% povidone-iodine) are broad-spec...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::The clinical features of acute chlorine gas inhalation, and its management are reviewed. Current medical views on the chronic effects of an acute overwhelming exposure on lung function (reactive airways dysfunction syndrome), and the more controversial field of lung disease secondary to repeated inhalations of lower c...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.73.865.697
更新日期:1997-11-01 00:00:00
abstract::Erythromelalgia is an unusual condition characterized by attacks of burning pain in the hands and feet with local congestion and increased skin temperature. We report a case of erythromelalgia, with transient hypertension and elevated urinary catecholamines successfully treated by hypnotherapy. Such an association has...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.68.795.44
更新日期:1992-01-01 00:00:00
abstract::People with early-onset dementia have a potential risk of being marginalised with respect to care and social support as a result of the blame and stigma associated with their condition, and because they have reduced access to treatment options and postdiagnostic care. The limited use of community services and the resu...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/postgradmedj-2020-138517
更新日期:2020-09-03 00:00:00
abstract::The prognosis of patients with metastatic adrenal cortical carcinoma is poor, and their disabling symptoms are usually unresponsive to conventional therapy. A patient with Cushing's syndrome secondary to a secretory adrenal cortical carcinoma was treated with octreotide, endocrine therapy and chemotherapy having faile...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.71.834.229
更新日期:1995-04-01 00:00:00
abstract::Multiple lymphomatous polyposis is an uncommon but distinctive form of gastrointestinal lymphoma. Clinical symptoms may closely resemble those of colorectal carcinoma and diagnostic confusion may result. The condition has a characteristic pathological appearance and immunophenotype which is important in allowing disti...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.69.811.401
更新日期:1993-05-01 00:00:00
abstract::A patient with long-standing ischaemic heart disease and severe low output congestive cardiac failure received numerous diuretics, which gradually became ineffective. Resistant oedema was treated by adding demeclocycline to the current diuretic regime of frusemide and metolazone. Diuresis resulted, oedema disappeared ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.56.652.121
更新日期:1980-02-01 00:00:00
abstract::Two patients with lymphoedema of the legs developed recurrent respiratory infections and were found to have panhypogammaglobulinaemia. The early recognition and treatment of this form of immunity deficiency in patients with lymphoedema is important in order to prevent recurrent infections which could cause pulmonary d...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.64.747.63
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND:The diagnosis of spinal tuberculosis (ST) is difficult and it commonly presents at an advanced stage. The management and follow up is complicated by a lack of guidance on the appropriate use and interpretation of spinal magnetic resonance studies (MR). AIMS:A retrospective study was performed at a UK centre...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.2005.032862
更新日期:2006-01-01 00:00:00
abstract:PURPOSE OF THE STUDY:Resistin, a recently discovered proinflammatory cytokine, has been strongly linked to kidney dysfunction. The aim of this study was to determine the relationship of serum resistin with serum cystatin C (sCysC) and albuminuria, two sensitive endogenous markers of renal function, in elderly male pati...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2013-132408
更新日期:2015-03-01 00:00:00
abstract::Attempts were made to reduce defaulting rates for new appointments to see a consultant in a general medical and gastroenterology clinic. Despite optimising the operation of the clinic, the non-attendance rate remained unsatisfactory, and comparable to the average for the NHS. There were short term improvements in defa...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.2003.013797
更新日期:2004-10-01 00:00:00
abstract::Two patients with nephrotic syndrome developed fatal fulminant hepatitis B following withdrawal of prednisolone or cyclophosphamide. Immunosuppressive therapy probably enhanced hepatitis B virus (HBV) replication and widespread infection of hepatocytes; its withdrawal permitted a return of immune competence resulting ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.64.750.325
更新日期:1988-04-01 00:00:00
abstract::Placebo, used here to mean an inert treatment given as if it was a real treatment, means lots of different things to different people. The structure of the article is that it begins by talking about the technical use of placebos in clinical trials, and the extent of the placebo response, then about the mechanism--"How...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2004.024737
更新日期:2005-03-01 00:00:00
abstract::This review examines the appropriate timing of intervention in acute pancreatitis. In gallstone pancreatitis, it is now clear that cholecystectomy during the primary admission carries no greater risk of complications than delayed cholecystectomy and enables earlier recovery to normal activity. This course of action pr...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.69.813.509
更新日期:1993-07-01 00:00:00
abstract::Eight patients with steroid-sensitive nephrotic syndrome which frequently relapsed despite cyclophosphamide treatment were given cyclosporin A (7.5 mg/kg/day to 10 mg/kg/day) for 8 to 12 weeks. Six had minimal change glomerulonephritis and two had focal segmental glomerulonephritis. Cyclosporin A was given to 5 patien...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.63.743.757
更新日期:1987-09-01 00:00:00
abstract::104 consecutive patients with upper gastrointestinal bleeding admitted to a district general hospital over a period of 20 months were considered for laser photocoagulation. 58 patients were found to have peptic ulcers, of which 42 had stigmata of recent haemorrhage accessible to laser photocoagulation. 17 were treated...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/pgmj.61.711.19
更新日期:1985-01-01 00:00:00