TR-Dizin İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4808
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Item CAN CHOLECYSTECTOMY BE PERFORMED AS SAFELY IN ELDERLY PATIENTS AS IT IS IN YOUNG PATIENTS?(2020) Arslan, Baha; Yilmaz, Tugbahan; Erol, Varlik; Tuncali, Bahattin; Gulay, Huseyin; 0000-0002-9590-0276; 0000-0002-7898-2943; 0000-0002-0442-6178; 0000-0003-4461-4904; AAJ-6354-2021; AAJ-7840-2021; AAJ-6407-2021; AAD-6127-2021Introduction: In this study, we aimed to compare the surgical outcomes between elderly and young patients undergoing surgery for gallstone disease and determine variations in patient characteristics, if any. Materials and Method: Data of patients who underwent surgery for gallstone disease at a single center between 2010 and 2018 were analyzed retrospectively. Two patient groups were evaluated: patients <65 years and >= 65 years. Patient characteristics, preoperative outpatient clinic data, surgical data, and postoperative data were collected. Results: In total, 1,198 patients with a mean age of 54.77 +/- 15.03 (15-91) years were assessed. Comorbid conditions, including cardiovascular disease, pulmonary disease, renal disease, and diabetes mellitus were significantly more common in elderly patients (p<0.001). Acute cholecystitis in the preoperative period was noted in 15.36% of young patients and in 30.4% of elderly patients (p<0.001). Need for emergency surgery was higher in elderly patients than in young patients [13.86% (47) and 9.31% (80), respectively] (p=0.021). Laparoscopic cholecystectomy and open cholecystectomy were performed in 98.37% and 1.04% of young patients, respectively, and in 92.62% and 3.53% of elderly patients, respectively (p<0.001). Among factors affecting the length of hospital stay in elderly patients, the duration of hospitalization was significantly longer in elderly patients who underwent emergency surgery, open surgery, needed additional surgery, and who had high American Society of Anesthesiologists scores (p<0.001, p<0.001, p=0.013, p<0.001, respectively). Conclusion: Complications rates associated with cholecystectomy are similar between young and elderly patients when appropriate surgical preparations are performed. Surgery for gallstone disease can be performed safely in elderly patients with low morbidity and mortality rates.Item THE OUTCOMES OF USING FIXED-DOSE NOMOGRAM-GUIDED UNFRACTIONATED HEPARIN THERAPY IN ELDERLY PATIENTS IN COMPARISON WITH YOUNGER PATIENTS(2020) Acibuca, Aynur; Muderrisoglu, Ibrahim Haldun; 0000-0002-3444-8845; ABG-4047-2020Introduction: In elderly patients, the dosing of unfractionated heparin is difficult because of changing metabolism, which affects the determination of a therapeutic level. The aim of this study was to evaluate the effects of unfractionated heparin therapy in an older population and to determine whether there was any difference from a younger population in terms of the activated partial thromboplastin time results and complication rates when using a standard nomogram. Materials and Methods: A total of 120 patients aged <80 years (Group 1) and 120 patients aged >= 80 years (Group 2), all of whom had been given unfractionated heparin therapy for selected indications in the coronary care unit, were randomly selected and retrospectively enrolled in the study. Infusion time up to a maximum of 48 hours was included, and activated partial thromboplastin time results in that period were categorised as subtherapeutic, therapeutic, or supratherapeutic. The rates of the patients' subtherapeutic, therapeutic, and supratherapeutic results were compared between groups. Results: The peak activated partial thromboplastin time level was higher in patients aged >= 80 years (58.85 [51.28] vs 76.50 [57.45], p<0.001). The supratherapeutic activated partial thromboplastin time percentage (0 [0.25] vs 0.20 [0.43], p<0.001) and numbers of first activated partial thromboplastin time in the supratherapeutic range (10% vs 24.2%, p=0.004) were significantly higher in the older group. Conclusion: Over-anticoagulation may be a problem in the elderly population when using standard nomograms. It was concluded that improvements should be made for a nomogram specific to an older population.Item EFFECTS OF LOWER GASTROINTESTINAL TRACT SURGERY ON SURVIVAL IN ELDERLY AND OCTOGENARIAN PATIENTS(2018) Aydin, Huseyin Onur; Avci, Tevfik; Tezcaner, Tugan; Karagulle, Erdal; Yildirim, Sedat; 0000-0003-3795-5794; 0000-0002-8522-4956; 0000-0002-3641-8674; 0000-0001-5225-959X; 0000-0002-5735-4315; S-8185-2018; C-6247-2017; AAD-9865-2021; AAF-1698-2021; AAF-4610-2019Introduction: Life expectancy has significantly increased in the last decade. The decision to perform surgery has always been challenging in elderly patients. We aimed to evaluate outcomes in patients who underwent surgery for lower gastrointestinal tract diseases and investigate factors influencing morbidity and mortality, particularly in octogenarian patients, and the effects of age on prognosis and survival in the postoperative period. Materials and Method: This study included patients aged >= 70 years who underwent lower gastrointestinal tract surgery; patients were divided into three groups as 70-75 years, 75-79 years, and >= 80 years. Age, gender, type of surgery, ASA score, length of hospital stay, morbidity, 30-day mortality, and overall survival were evaluated. Results: The surgery was performed to 598 patients due to lower gastrointestinal tract diseases. There was a significant increase in the ASA score with increasing age (Chi-square=35.472; p<0.001). The survival rate was significantly higher in patients with malignancies than in those with benign diseases, and in patients who underwent elective surgery than in those who underwent emergency surgery (p<0.001). When patients were examined according to age groups, the overall survival was similar across groups (p=0.217). Conclusion: There was no significant difference between octogenarian and younger patients for complications and survival. Thus, planned surgical interventions in elderly patients will not negatively affect survival and surgical interventions and can be safely performed in these patients.Item FREQUENCY OF POLYPHARMACY AND RISK FACTORS IN THE ELDERLYIN BURDUR(2018) Durukan, Elif; Onal, OzgurIntroduction: Polypharmacy is common among the elderly. This study aimed to determine the frequency of polypharmacy and the risk factors in the elderly. Materials and Method: This cross-sectional study will be analysed in three stages (polypharmacy, drug characteristics and drug interaction). Herein, the first stage (polypharmacy) was conducted at Burdur city centre and the connected villages. A total of 400 of 11,360 subjects aged >= 65 years who were registered with family physicians in Burdur city centre were selected using a systematic sampling method. A questionnaire of 30 questions about socio-demographic variables and rational drug use was distributed among the subjects. Subsequently, the subjects were asked to bring their own drugs from home that they were actively using or not currently using, and their drug-using behaviour was analysed via specific questions. Results: The average number of different drugs possessed by the subjects at home was approximately 6 (5.95 +/- 4.30). A total of 64.9% of the drugs were used regularly, 21.3% were used occasionally and 13.8% were previously used but not currently used. The median number +/- standard deviation of the drugs that were used regularly, used occasionally and previously used but not currently used was 3.86 +/- 3.36, 1.27 +/- 1.75 and 0.82 +/- 1.82, respectively. According to the results of multivariate analysis, the presence of diabetes, hypertension, respiratory system or cardiovascular (except hypertension) diseases, visual impairment or hearing disorders significantly increased the total drug use (p<0.05). Conclusion: Chronic diseases and living in the city centre are the main risk factors leading to polypharmacy. Therefore, interventions must be undertaken by monitoring and reducing chronic diseases and providing training on rational drug use in the provincial centres.