Abstract:
INTRODUCTION:Using biomarkers to predict mortality in patients with sepsis is important because these patients frequently have high mortality rates and unsatisfactory outcomes. The performance of N-terminal pro-brain natriuretic peptide (NT-pro-BNP) and C-reactive protein (CRP) to predict clinical outcomes in elderly sepsis patients is unimpressive. We aimed to assess the prognostic value of NT-pro-BNP, CRP and the combination of both in selected medical ICU sepsis patients more than 75 years old. METHODS:In total, 245 consecutive patients were screened for eligibility and followed during their ICU stays. We collected the patients' baseline characteristics, including their Acute Physiology and Chronic Health Evaluation II (APACHE II) scores and NT-pro-BNP and CRP levels. The primary outcome was ICU mortality. Potential predictors were analyzed for their possible associations with the outcome. We also evaluated the ability of NT-pro-BNP and CRP levels combined with the APACHE II score to predict ICU mortality by calculating the C-index and net reclassification improvement (NRI). RESULTS:Univariate regression revealed that CRP, NT-pro-BNP, APACHE II score, lactic acid level, NEU count(neutrophil count)and HCT level independently predicted ICU mortality (all P < 0.01). The C-index for the prediction of ICU mortality by the APACHE II score (0.847 ± 0.029; P < 0.001) was greater than that for NT-pro-BNP (0.673 ± 0.039; P < 0.01) or CRP (0.626 ± 0.039; P < 0.01) (all P < 0.01). Compared with the APACHE II score (0.847 ± 0.029; P < 0.001), the combination of CRP (0.849 ± 0.029; P < 0.01) or NT-pro-BNP (0.853 ± 0.028; P < 0.01) or both (0.853 ± 0.030; P < 0.01) with the APACHE II score did not significantly increase the C-index for predicting ICU mortality (all P > 0.05). However, the addition of NT-pro-BNP to the APACHE II score gave an NRI of 8.6% (P = 0.000), the addition of CRP to the APACHE II score provided an NRI of 11.34% (P = 0.012), and the addition of both markers to the APACHE II score yielded an NRI of 29.0% (P = 0.000). In the MOF subgroup (N = 118), CRP (OR = 2.62, P < 0.05) but not NT-pro-BNP (OR = 1.73, p > 0.05) independently predicted ICU mortality, and the addition of CRP to the APACHE II score obviously increased its predictive ability (NRI = 13.88%, P = 0.000). In the non-MOF group (N = 127), neither CRP (OR = 5.447, P = 0.078) nor NT-pro-BNP (OR = 2.239, P = 0.016) was an independent predictor of ICU mortality. CONCLUSIONS:In sepsis patients older than 75 years, NT-pro-BNP and CRP can serve as independent predictors of mortality, and the addition of NT-pro-BNP or CRP or both to the APACHE II score significantly improves the ability to predict ICU mortality. CRP appears to be useful for predicting ICU outcomes in elderly sepsis patients with multiple-organ failure.
journal_name
Aging Clin Exp Resjournal_title
Aging clinical and experimental researchauthors
Li H,Shan-Shan Z,Jian-Qiang K,Ling Y,Fang Ldoi
10.1007/s40520-019-01244-0subject
Has Abstractpub_date
2020-03-01 00:00:00pages
389-397issue
3eissn
1594-0667issn
1720-8319pii
10.1007/s40520-019-01244-0journal_volume
32pub_type
杂志文章abstract:BACKGROUND AND AIMS:The process applied to identify fall risks in frail elderly persons remains a matter of debate. We intended to develop a fall screening instrument for clinically defined subgroups of long-term care residents, to be administered by nursing staff. METHODS:Fall risk indicators were selected by multipl...
journal_title:Aging clinical and experimental research
pub_type: 杂志文章
doi:10.1007/BF03324595
更新日期:2005-06-01 00:00:00
abstract:BACKGROUND AND AIMS:Osteoporosis and fall fractures are increasing problems amongst the elderly. The aim of this study was to explore whether combined population-based and individual interventions directed at risk factors for osteoporosis and falls result in behavioral changes in an elderly population. METHODS:A quasi...
journal_title:Aging clinical and experimental research
pub_type: 杂志文章
doi:10.1007/BF03324654
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND:Art-based activities like painting workshops demonstrated health benefits in older individuals living in home care facilities. Few studies examined the effects of painting workshops in geriatric inpatients. AIM:The study aims to examine whether the participation in painting workshops performed in patients a...
journal_title:Aging clinical and experimental research
pub_type: 临床试验,杂志文章
doi:10.1007/s40520-020-01675-0
更新日期:2020-12-01 00:00:00
abstract::Alzheimer and Parkinson's diseases are neurodegenerative aging-related pathological conditions, mainly caused by the interplay of genetic and non-genetic factors and whose incidence rate is going to drastically increase given the growing life expectancy. To address these complex multifactorial traits, a systems biolog...
journal_title:Aging clinical and experimental research
pub_type: 杂志文章,评审
doi:10.1007/s40520-020-01485-4
更新日期:2020-02-06 00:00:00
abstract:AIMS:This study aimed at examining whether ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV) were independently associated with carotid Intima-media thickness (CIMT) or carotid artery plaque (CAP) in elderly people. METHODS:A cross-sectional analysis was performed in 155 individuals aged over 7...
journal_title:Aging clinical and experimental research
pub_type: 杂志文章
doi:10.1007/s40520-019-01415-z
更新日期:2020-11-01 00:00:00
abstract:AIM:The main purpose of the present study was to verify the feasibility of wearable inertial sensors (IMUs) in a clinical setting to screen gait and functional mobility in Italian older persons. In particular, we intended to verify the capability of IMUs to discriminate individuals with and without cognitive impairment...
journal_title:Aging clinical and experimental research
pub_type: 杂志文章
doi:10.1007/s40520-020-01715-9
更新日期:2020-09-25 00:00:00
abstract:BACKGROUND:Falling is a significant concern for many elderly adults but identifying individuals at risk of falling is difficult, and it is not clear how elderly adults adapt to challenging walking. AIMS:The aim of the current study was to determine the effects of walking at non-preferred speeds on the coordination bet...
journal_title:Aging clinical and experimental research
pub_type: 杂志文章
doi:10.1007/s40520-018-1036-4
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND AND AIMS:Monochromatic pulsating light may have effects on wound healing. In an earlier study of grade II ulcers, there was a tendency toward better healing in the phototherapy group (p=0.06). The present study on patients with grade II ulcers was performed to verify these findings. Data from this study were...
journal_title:Aging clinical and experimental research
pub_type: 杂志文章,随机对照试验
doi:10.1007/BF03324734
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:The incidence and costs of acute myocardial infarction (AMI) in Europe represent a substantial problem due to population aging. METHODS:Between 2001 and 2005, Italian hospitalization records were examined to evaluate hospital admissions and costs of AMI in adults aged ≥ 45 and in elderly people ≥ 65 or ≥ 75...
journal_title:Aging clinical and experimental research
pub_type: 杂志文章
doi:10.1007/BF03337744
更新日期:2011-02-01 00:00:00
abstract::Prevention is an important but neglected issue in geriatric medicine. Vaccination plays a major role in prevention of infectious diseases, but its implementation in clinical practice is far from perfect. To improve practice, a group of French experts composed of geriatricians and infectious disease specialists prepare...
journal_title:Aging clinical and experimental research
pub_type: 杂志文章
doi:10.1007/BF03324906
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND AND AIMS:Frailty is a geriatric syndrome that predicts increased morbidity and mortality. In order to investigate specific immune system modulations that may contribute to frailty, eleven age- and sex-matched pairs of community-dwelling frail and non-frail older adults were identified. METHODS:Peripheral bl...
journal_title:Aging clinical and experimental research
pub_type: 杂志文章
doi:10.1007/BF03327392
更新日期:2004-06-01 00:00:00
abstract:BACKGROUND AND AIMS:An accurate diagnosis of sarcopenia is required. The aim of this study is to correlate the results of two methods to define sarcopenia using cross sectional body composition data, with actual loss of fat free mass. METHODS:Healthy older subjects (926 females and 381 males aged 70 years or more) and...
journal_title:Aging clinical and experimental research
pub_type: 杂志文章
doi:10.1007/BF03324705
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND:Gait disorders are common in the elderly populations, and their prevalence increases with age. Abnormal gait has been associated with greater risk for adverse outcomes in older adults, such as immobility and falls, which in turn lead to loss of functional independence and death. AIM:The purpose of this revi...
journal_title:Aging clinical and experimental research
pub_type: 杂志文章,评审
doi:10.1007/s40520-015-0420-6
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND AND AIM:Sarcopenia and sarcopenic obesity (SO) are associated with adverse health outcomes in older people. Data on sarcopenia- and SO-related mortality are insufficient for hospitalized older people. The aim of this study was to evaluate the relationship between sarcopenia, SO and mortality among hospitaliz...
journal_title:Aging clinical and experimental research
pub_type: 杂志文章
doi:10.1007/s40520-019-01277-5
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:The association between cumulative metabolic syndrome (MS) factors and knee osteoarthritis (KOA) has been highlighted over the past two decades. AIMS:To clarify the relationship between cumulative MS factors and symptomatic KOA. METHODS:A cross-sectional survey involving 119 women aged 45-88 years who were...
journal_title:Aging clinical and experimental research
pub_type: 杂志文章
doi:10.1007/s40520-017-0808-6
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND AND AIMS:There is no conclusive evidence that hospital fall prevention programs can reduce the number of falls. We aimed to investigate the effect of a targeted individualized falls prevention program in a geriatric rehabilitation hospital. METHODS:This was a two-stage cluster-controlled trial carried out i...
journal_title:Aging clinical and experimental research
pub_type: 杂志文章,随机对照试验
doi:10.1007/s40520-015-0330-7
更新日期:2015-10-01 00:00:00
abstract::Thailand is facing a dramatic challenge of how to ensure good health and quality of life for its rapidly increasing number of elderly citizens. The modern health services system established a century ago has a larger proportion of public providers, but only 35-40% share public spending on health. The health services a...
journal_title:Aging clinical and experimental research
pub_type: 杂志文章,评审
doi:10.1007/BF03324448
更新日期:2002-08-01 00:00:00
abstract:BACKGROUND AND AIMS:To evaluate the effect of interdisciplinary outpatient geriatrics on the use, cost, and quality of health services in a fee-for-service (FFS) environment of two networks of primary care clinics operated by a not-for-profit provider organization in Dallas County, Texas. METHODS:The Senior Health Net...
journal_title:Aging clinical and experimental research
pub_type: 杂志文章
doi:10.1007/BF03324884
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND AND AIMS:Functional brain imaging has shown that bilateral brain reorganization may occur after unilateral cerebral damage. The present study searched for evidence of bilateral motor control changes in gait in patients with chronic unilateral stroke. METHODS:Gait variables (temporal and spatial parameters, ...
journal_title:Aging clinical and experimental research
pub_type: 杂志文章
doi:10.1007/BF03324759
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND AND AIMS:Although several investigations have tested physical activity a few months or one year after hip fracture, only a few have assessed physical activity shortly after hip fracture. The aim of this study was to evaluate how physical function two weeks after hip fracture operation predicts 12-month morta...
journal_title:Aging clinical and experimental research
pub_type: 杂志文章
doi:10.1007/BF03327405
更新日期:2004-12-01 00:00:00
abstract::Epidemiological studies of suicide in the elderly indicate that, in the last few decades, there has been a relevant increase in suicide rates in old age in a number of Asian and Latin nations, with an almost parallel decrease in Anglo-Saxon counties. Mental disorders, particularly depression, physical illness, persona...
journal_title:Aging clinical and experimental research
pub_type: 杂志文章,评审
doi:10.1007/BF03324486
更新日期:2003-04-01 00:00:00
abstract:BACKGROUND:Physical exercise and nutrition seem to have a key role in the management of hip fracture patients. AIM:To evaluate the impact of a 2-month rehabilitative protocol combined with dietetic counseling, with or without essential amino acid supplementation, on functioning in hip fracture patients. METHODS:In th...
journal_title:Aging clinical and experimental research
pub_type: 杂志文章,随机对照试验
doi:10.1007/s40520-018-1090-y
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:To investigate the feasibility and significance of the clinical application of ultrasound score in assessing the clinical severity of acute cholecystitis in the elderly. METHODS:Pre-surgery ultrasonography was performed on 72 elderly patients with acute cholecystitis who were scheduled for cholecystectomy to...
journal_title:Aging clinical and experimental research
pub_type: 杂志文章
doi:10.1007/s40520-014-0236-9
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:Statins therapy in the secondary prevention of coronary artery disease (CAD) is associated with a lower risk of adverse cardiovascular events. However, little is known regarding the association of elderly patients with nutritional risk on statin therapy. AIMS:To investigate whether older patients with CAD w...
journal_title:Aging clinical and experimental research
pub_type: 杂志文章
doi:10.1007/s40520-017-0881-x
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVES:The objective of this article is to review the literature regarding the effectiveness and safety of Nordic walking (NW) in therapeutic rehabilitation in patients of an advanced age. METHODS:Randomized studies comparing NW with different patterns of long-lasting physical rehabilitation in older adults (avera...
journal_title:Aging clinical and experimental research
pub_type: 杂志文章,评审
doi:10.1007/s40520-016-0531-8
更新日期:2016-12-01 00:00:00
abstract::Frailty has been indicated as a way for capturing biological aging of the individual and Frailty Index (FI) may serve for this purpose. This study designed the FI in a cohort of centenarians, their offspring and control subjects sex- and age-matched with offspring. The FI mean value was 0.47 (SD 0.13) in centenarians,...
journal_title:Aging clinical and experimental research
pub_type: 杂志文章
doi:10.1007/s40520-019-01283-7
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND AND AIMS:The aim of this study was to ascertain whether there are gender-related differences in the morphological characteristics of the soleus and tibialis anterior muscles in young adult and old Fischer 344/Brown Norway F1 rats. METHODS:We tested 1) whether there was a gender-related difference between th...
journal_title:Aging clinical and experimental research
pub_type: 杂志文章
doi:10.1007/BF03324508
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND AND AIMS:External hip protectors have been shown to have a good preventive effect against hip fractures in many studies. However, these studies were carried out either entirely or mostly among older persons living in institutions. The aim of this study was to investigate whether health nurses can, after brie...
journal_title:Aging clinical and experimental research
pub_type: 杂志文章
doi:10.1007/BF03324530
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND AND AIMS:The objective of this non-randomized study was to determine the influence of a specific physical activity program on the postural stability of older people. METHODS:Seventy-four subjects (72.4 +/- 0.7 yrs) participated in an individualized three-month physical activity program designed to improve p...
journal_title:Aging clinical and experimental research
pub_type: 杂志文章
doi:10.1007/BF03324564
更新日期:2004-10-01 00:00:00
abstract::We present a 61-year-old man with marked peripheral blood eosinophilia, feature of hypereosinophilic syndrome, that later evolved into acute lymphocytic leukemia (ALL-L2). Initially the patient suffered from significant complications related to eosinophilic toxicity, including large urticarial hyperpigmented plaques, ...
journal_title:Aging clinical and experimental research
pub_type: 杂志文章,评审
doi:10.3275/8337
更新日期:2012-10-01 00:00:00