The prevalence of gallstone disease in very old institutionalized persons

Article Abstract:

In the US and other industrialized countries, people 85 and older represent the fastest-growing segment of the population; gall bladder inflammation (cholecystitis) with gallstones is the most common acute abdominal condition requiring emergency treatment among the elderly. It is likely that, even with this awareness, the condition is underdiagnosed in older people, and this was explored by examining 117 residents (82 women, 35 men) of a nursing home with ultrasonography (a noninvasive procedure that enables examination of the internal organs). Patients who had undergone removal of the gallbladder were classified as having gallstone disease. Results showed that 66 percent of the women and 51 percent of the men had gallstone disease. Eighty percent of the residents older than 90 had this condition. These high prevalences are surprising; most studies of the subject have focused on younger patients and found lower rates. It is known that gallstone disease occurs more frequently in women. Reasons that these findings may not be generalizable to all groups are presented. The presence of gallstones should not, in itself, be grounds for removal of the gallbladder, especially in an older population who are at greater risk for surgery. In many cases, gallstones are present without causing symptoms. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Demographic aspects, Gallstones, Cholecystitis

---

Mechanical ventilation for the elderly patient in intensive care: incremental charges and benefits

Article Abstract:

Prolonged mechanical ventilation may not be cost effective for elderly patients in a hospital intensive care unit (ICU), especially since ICU patients are the most severely ill of hospital patients. Among 45 patients over 80 years old in a hospital ICU who received mechanical ventilation between Apr 1985 and Oct 1987, 35 did not survive hospitalization, while 10 survived to be discharged from the hospital. Two patients were still alive in Dec 1991, and one could no longer be found. The actual survival of the 10 patients who survived to be discharged from the hospital was only one-fourth of their predicted life expectancy. The cost per year of life saved was estimated at between $51,854 and $75,090 for the entire group of patients. The cost per year of life saved was estimated at $181,308 for the patients who received prolonged mechanical ventilation and survived to leave the hospital.

Usage, Economic aspects, Artificial respiration, Mechanical ventilation, Critical care medicine

---

The naturalness of dying

Article Abstract:

Very elderly healthy people may deteriorate physically and mentally in the absence of disease during the natural dying process. As elderly people approach the end of the human lifespan, they begin to decline in an ultimately fatal, progressive, downward spiral. Historically, death was seen as a natural, expected event that had deep personal and spiritual meaning. In the 1990s, modern medicine changed the perception of death to a disease-related event. Most people in the US die in institutions surrounded by technologically-oriented medical care. Death is stripped of its naturalness, patients' autonomy is revoked, and financial resources are squandered. Elderly people who are experiencing natural death need spiritual attention and pain relief. Collaborative working environments may help physicians cope with the stresses associated with death that contribute to overtreatment.

Social aspects, Terminal care, Ethical aspects, Death

Similar abstracts:

• Abstracts: In vitro comparison of different gall stone dissolution solvents. Pancreatic duct abnormalities in gall stone disease: an endoscopic retrograde cholangiopancreatographic study
• Abstracts: Dependence among host response parameters used to diagnose urinary tract infection. part 2 Renal Function 16 to 26 Years After the First Urinary Tract Infection in Childhood
• Abstracts: Safety assessment of gadopentetate dimeglumine in U.S. clinical trials
• Abstracts: Absence of a gastrin inhibitory factor in the IgG fraction of serum from patients with pernicious anaemia
• Abstracts: The clinical and endocrine outcome to trans-sphenoidal microsurgery of nonsecreting pituitary adenomas

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.