Clinical outcomes of radiofrequency catheter ablation of atrial fibrillation in octogenarians lO-year experience of a one high-volume center

Background Prevalence of atrial fibrillation （AF） increases with age. Radiofrequency catheter ablation （RFCA） is an establishedtreatment option superior to antiarrhythmics （AAs）. In this study, we investigated safety and efficacy of RFCA of AF in octogenarians.Methods From our database, we extracted procedural and follow-up data for patients 〉 80 years with symptomatic AF undergoing RFCAand compared this population to RFCA patients 〈 50 years. All patients underwent pulmonary vein isolation （PVI） supplemented by linearlesions in PVI-nonresponders. Arrhythmia-free survival was assessed using seven day Holter every three months post procedure. All patientscompleted their 12 months follow-up. Results Fifty patients aged ≥80 years （80.5 ± 1.6 years） were compared to 259 patients aged 〈 50years （43.5±5.5 years）. The RFCA complication rate did not vary between groups. No differences in procedural characteristics were seenafter being analyzed by type of AF. Among patients with paroxysmal AF, 71.4% octogenarian vs. 84.7% young patients was free of anyarrhythmia, without AAs, after single procedure. For non-paroxysmal AF, arrhythmia-free survival without AAs, was considerably lower（58.6% octogenarians vs. 81.2% younger patients, P = 0.023）. If AAs were used, arrhythmia-free survival for paroxysmal AF increased to90.5% and 92.1% in octogenarians and younger patients, respectively; and in non-paroxysmal AF it increased to 79.3% vs. 88.4%. ConclusionsRFCA is a safe and effective strategy to achieve normal sinus rhythm in a highly selected group of octogenarians. Paroxysmal AF ablation inoctogenarians has similar clinical effectiveness as that seen in much younger patients. Non-paroxysmal AF ablation has lower, but still rea-sonable clinical effectiveness.

Outcomes of elective laparoscopic colorectal operations in octogenarians at a district general hospital in South East England

AIM:To assess the outcomes of laparoscopic colorectal cancer resection in the octogenarian population at our institution.METHODS:Retrospective analysis of registry data accumulated prospectively were used in conjunction with the data obtained from patient notes to identify outcome data for octogenarians who had undergone elective laparoscopic colorectal cancer resection.RESULTS:Laparoscopic colorectal cancer resections were performed in 68 octogenarians between 2003 and 2011 at our institution.Four operations(6%) were converted to an open technique.There were twelve cases of morbidity(18%) and two cases of mortality(3%).The overall median hospital stay was 8 d.The median time for a patient to be deemed surgically fit for discharge was 5 d reflecting a delay in provision of social care or stoma education.CONCLUSION:Our results support the view that laparoscopic surgery in octogenarians is safe,feasible and with a reduced length of stay.This is well reflected in our results which are compatible with United Kingdom national figures.

Percutaneous nephrolithotomy in octogenarians and beyond:How old is too old?

Objective:To specifically report perioperative characteristics and outcomes in patients 80 years and older undergoing percutaneous nephrolithotomy(PCNL).PCNL has been established as feasible in the elderly;however,to our knowledge no one has specifically reported feasibility in patients 80 years and older.Methods:We retrospectively reviewed perioperative data of octogenarians who underwent PCNL at a high stone volume single institution,and matched them to patients<65 years of age by stone burden and sex.Patient demographics,perioperative outcomes and postoperative complications were compared.Results:Thirty-three octogenarians(mean age 83.6 years)with 36 renal units were matched to 67 controls(mean age 48.6 years)with 72 renal units.Octogenarians had a higher mean American Society of Anesthesiologists(ASA)score,more comorbidities,and worse renal function.There were no differences in operative characteristics,length of hospital stay or stone free rates.Of the patients with preoperative urinary decompression(ureteral stent or nephrostomy tube)prior to PCNL,the elderly were more likely to have a history of urosepsis.Octogenarians did not experience more minor Clavien(Ⅰ-Ⅱ)or major Clavien(Ⅲa-Ⅳb)complications.Conclusion:Octogenarians who undergo PCNL were more likely to have cardiovascular comorbidities and a prior history of sepsis.Despite these risk factors,in appropriately selected patients PCNL can be safely and successfully performed in octogenarians without increased perioperative complications relative to a younger cohort.

Evaluation of long stent implantation in diffuse coronary lesions for octogenarians

Objective To evaluate angiographic and clinical outcomes of ≥ 20mm long stents or overlapped stent implantation in diffuse coronary lesions for octogenarians, in comparison with patients under sixty. Methods Two groups (Group O: 47 lesions in 44 octogenarians, aged 81± 3 years; Group Y: 64 lesions in 58 patients under sixty, aged 54 ± 4 years) were compared with a 6-month follow-up. Results Success rate of the procedures was 100%. None had in-hospital major adverse cardiac events (MACE). There was no significant difference in angiographic restenosis between the groups at follow-up (Group O vs Group Y, 29.8 % vs 26.6 %, P = NS). The revascularization of target vessel and MACE was less in Group Y, but these showed no statistical significance (15.6% vs 23.4% and 20.7% vs 25.0%, respectively). Conclusions Long stent implantation for diffuse coronary lesions in octogenarians appears safe and feasible, with high procedural success and favorable long-term outcomes.

Steerable microcatheters for complex percutaneous coronary interventions in octogenarians: from Venture to Swift Ninja

0ctogenarians represent the fastest growing group of patients undergoing percutaneous coronary intervention(PCI),now constituting more than one in five patients treated with PCI in real-world practice.[1,2]Comparing coronary lesion characteristics of patients aged<≥80 years to those≥80 years undergoing PCI,the octogenarians have a higher prevalence of calcified and ostial lesions,tortuous coronary anatomy,multi-vessel disease and left main stem(LMS)stenosis.⑶Furthermore,they often have greater ischemic burden than their younger counterparts,suggesting an even greater benefit following revascularization.

Cardiac Surgery in Octogenarians and Beyond: Single Center Experience

Background: Increasing numbers of octogenarians and improvements in surgical techniques and postoperative care have resulted in increasing cardiac operations in this age. The aim is to analyze our experience of cardiac surgery on octogenarians and beyond concerning postoperative morbidities and mortality. Methods: 67 octogenarians and nonagenarians underwent open heart surgery in our hospital between 2001 to 2009 were retrospectively reviewed. Data included baseline preoperative status, intraoperative and perioperative course, and immediate outcomes. Results: The mean age was 86.22 ± 6.1 years. 86.6% patients were males. Symptoms were dyspnea;Class II in 13.4%, Class III in 55.2%, Class IV in 31.4% patients;angina in 82.1%, and CHF in 25.4% patients. The mean EF was 37.8% ± 10. Risk factors include smoking in 52.2%, DM in 37.3%, hypertension in 28.4%, obesity in 25.4%, previous MI in 22.4%, COPD in 17.9%, renal insufficiency in 11.9%, pulmonary hypertension in 7.5%, PVD in 6%, and cerebrovascular disease in 3% patients. The procedures were isolated CABG in 73%, AVR in 9%, MVR in 6%, CABG/valve in 9%, and MVR and AVR in 3% patients. Complications were 18%. It included renal impairment in 18%, arrhythmias in 14.9%, bleeding in 6%, prolonged ventilation in 13.4%, CHF in 4.5%, gastrointestinal bleeding in 4.5%, wound infection in 7.5%, and cerebrovascular accident in 3%. Hospital mortality was 9% patients. Conclusions: Cardiac surgery can be performed safely with acceptable hospital morbidity and mortality in octogenarians and beyond. Early referral and proper selection of patients are mandatory to improve immediate postoperative survival.

Coronary artery bypass grafting in the octogenarians： should we intervene, or leave them be？

ObjectiveCoronary 动脉绕过 grafting (CABG ) 逐渐地在老人口正在增加。我们试图在 80 的年龄和 older.MethodsBetween 2002年1月和2011年12月在病人与长期的幸存一起调查风险因素和 CABG 的结果，在 80 的年龄的 101 个连续病人的一个总数并且更旧在我们的医院里经历了 CABG 的人，在学习被包括。病人被跟随，长期的幸存是病人的 estimated.ResultsThe 平均数年龄是 82.98 &#x000b1；2.27 年。(63.4%) 64 是男性，(36.6%) 37 是女性。紧急情况外科，持续时间心肺绕过，特别护理单位(ICU ) 停留， inotropic 支持，大动脉的汽球跳动申请，红血球输送的数量和新鲜冻结的血浆输送和通风时期是的 intra 在在医院里死了的病人显著地更高。持续时间心肺绕过(CPB ) 被发现是死亡的一个独立预言者(或：1.18， 95% CI 1.01 &#x02212； 1.38， P = 0.034 ) 。在里面医院死亡是 16.8% 。Kaplan-Meier 分析在一年揭示了 91.3% 的幸存比率， 82.9% 在三年并且 69.0% 在五 years.ConclusionsPatients 在 80 岁时并且更旧 CABG 过程的候选人能正在牢记他们可以有一个更长的通风时期和特别护理单位停留。这个年龄组的病态和死亡在一个可接受的范围以内被考虑。最小化 CPB 的途径，或离开泵外科的选择，可以是一个预防方法降低死亡的发生。因此， CABG 可以与令人满意的幸存比率在这个年龄组被执行。

Real-world comparison of non-vitamin K antagonist oral anticoagulants and warfarin in Asian octogenarian patients with atrial fibrillation

BackgroundThe 功效和非维生素 K 对手的安全口头的抗凝剂(NOAC ) 和在亚洲八十至八十九岁的 atrial 的 warfarin 纤维性颤动(AF ) 病人没在一个真实世界的背景被建立。我们试图 &#x02265 在 293 个连续病人全部的朝鲜八十至八十九岁的 patients.MethodsA 评估 NOAC 和 warfarin 的功效和安全；有非瓣膜的 AF 的 80 年拿了任何一个 NOAC (148 个盒子， 50.5%) 或 warfarin (145 个盒子， 49.5%) 回顾地被考察。功效结果是击或全身的栓塞合成。安全结果是主要 bleeding.ResultsThe 后续持续时间是 375 耐心年(172 与 NOAC 耐心年并且 203 与 warfarin 耐心年) 。NOAC 上的病人稍微更老(P = 0.006 ) 并且有的稍微更高的有流血分数(P = 0.034 ) 。两抗凝剂的功效高(1.16% 为 NOAC 对 2.98% 为 warfarin 每 100 耐心年， P = 0.46 ) 。安全结果在 NOAC 和 warfarin 组相对高(8.96% 对 12.46% ， P = 0.29 ) 。功效和安全结果趋于比在普通剂量 NOAC 或 warfarin 在低剂量 NOAC 非显著地减少(0.85% 对 1.84% 对 2.98% 在功效结果， P = 0.69；并且 6.97% 对 13.29% 对 12.46% 在安全结果， P = 0.34 ).ConclusionsNOACs 在亚洲八十至八十九岁的 AF 病人为击或全身的栓塞的预防是高度有效的。然而，主要流血在两个抗凝剂组高过分地发生了。进一步的学习在八十至八十九岁的人口在最佳的抗凝剂政体上被要求。

Intermediate-term mortality and incidence of ICD therapy in octogenarians after cardiac resynchronization therapy

在超过 80 岁的病人的心脏的再同步治疗(CRT ) 的 BackgroundClinical 结果一直不是回顾地识别的井 described.MethodsWe 96 连续病人 &#x02265；80 岁经历了一起始植入或升级到 CRT，与或没有使用高压脉冲来消减心脏(CRT-D 对 CRT-P ) ，在我们在 2003 年 1 月和 2008 年 7 月之间的机构。控制队由 177 随机选择的病人 &#x0003c 组成了；经历 CRT 的 80 岁在一样的时间时期期间植入。主要功效端点是在 36 个月的所有原因死亡，到第一事件 curves.ResultsIn 的 Kaplan-Meier 时间估计了八十至八十九岁的队，在 CRT 的吝啬的年龄植入是 83.1 &#x000b1；2.9 年对 60.1 &#x000b1；在控制之中的 8.8 年(P &#x0003c；0.001 ) 。越过两个组， 70% 是男性的，吝啬的左室的喷射部分(LVEF ) 是 24.8%&#x000b1；14.1% 并且 QRS 持续时间是 154 &#x000b1；24.8 ms，没有组之间的重要差别。Octogenarians 是更可能的有 ischemic 心肌症(74% 对 37% ， P &#x0003c；0.001 ) 并且可能经历的更多升级到 CRT 而不是一起始植入(42% 对 19% ， P &#x0003c；0.001 ) 。适当使用高压脉冲来消减心脏震动的率在 octogenarians 之中是更低的(14% 对 27% ， P = 0.02 ) 而不恰当的震动的率是类似的(3% 对 6% ， P = 0.55 ) 。在 36 个月，处于在 octogenarians (11%) 和控制之间的所有原因死亡的率没有重要差别(8% ， P = 0.381 ).ConclusionAppropriately 选择的 octogenarians 是 CRT 的候选人与收到 CRT 的更年轻的病人相比有类似的中间术语的死亡。

Comparison of in-hospital outcomes between octogenarians and nonagenarians undergoing transcatheter aortic valve replacement： a propensity matched analysis

BackgroundAortic 阀门狭窄(作为) 在在 80 年上面的老病人是很普通的。在如此的病人的 Transcatheter 大动脉的阀门代替(TAVR ) 逐渐地正在被执行。寻求在与严重 AS.MethodThe 学习人口经历 TAVR 的九十至九十九岁的人估计死亡的 octogenarians 和九十至九十九岁的人和预言者之间的在里面医院结果差别的这研究从国家住院病人样品(网络信息服务) 被导出 2012-2014 使用 ICD-9 厘米过程为 TAVR 编码 35.05 和 35.06 的年。低于 80 岁的住院被排除。在执行倾向 20 以后匹配(1：2 ) ，在里面医院结果在匹配的队被比较。然后， multivariate 模型被开发在 nonagenarians.ResultsThere 分析在里面医院死亡的预言者是 11,630 个住院在八十至八十九岁并且在九十至九十九岁的人组的 5815 个住院。在里面医院死亡的主要结果(6% 对 4.1% ， P 0.001 ) 在与 octogenarians 相比的九十至九十九岁的人是更高的。第二等的结果包括击(3.4%对2.8%， P 0.001 )，肾的失败(18.9%对17.3%， P 0.001 )，输血(35%对32.6%， P 0.001 )，脉管的复杂并发症(4.5%对3.5%， P 0.001 )，并且心律调整器培植(27.8%对24.8%， P 0.001 )在九十至九十九岁的人是更高的。在他们停留的长度没有差别。中部的费用(70,374 $ 对 65,381 $ ， P 0.001 ) 与 nonagenarian.ConclusionsAlthough 在里面医院是稍微更高的死亡在九十至九十九岁的人是稍微更高的，它是可接受的。在死亡的这差别被更高的复杂并发症部分至少在九十至九十九岁的人解释。努力应该被成为能进一步在在这些组之间的在里面医院死亡缩小差别的复杂并发症到减少。

Octogenarian patients with colorectal cancer: Characterizing an emerging clinical entity

AIM To characterize colorectal cancer(CRC) in octogenarians as compared with younger patients.METHODS A single-center, retrospective cohort study which included patients diagnosed with CRC at the age of 80 years or older between 2008-2013. A control group included consecutive patients younger than 80 years diagnosed with CRC during the same period. Clinicopathological characteristics, treatment and outcome were compared between the groups. Fisher's exact test was used for dichotomous variables and χ2 was used for variables with more than two categories. Overall survival was assessed by Kaplan-Meier survival analysis, with the log-rank test. Cancer specific survival(CSS) and disease-free survival were assessed by the Cox proportional hazards model, with the Fine and Gray correction for non-cancer death as a competing risk.RESULTS The study included 350 patients, 175 patients in each group. Median follow-up was 40.2 mo(range 1.8-97.5). Several significant differences were noted. Octogenarians had a higher proportion of Ashkenazi ethnicity(64.8% vs 47.9%, P < 0.001), a higher rate of personal history of other malignancies(22.4% vs 13.7%, P = 0.035) and lower rates of family history of any cancer(36.6% vs 64.6%, P < 0.001) and family history of CRC(14.4% vs 27.3%, P = 0.006). CRC diagnosis by screening was less frequent in octogenarians(5.7% vs 20%, P < 0.001) and presentation with performance status(PS) of 0-1 was less common in octogenarians(71% vs 93.9%, P < 0.001). Octogenarians were more likely to have tumors located in the right colon(45.7% vs 34.3%, P = 0.029) and had a lower prevalence of well differentiated histology(10.4% vs 19.3%, P = 0.025). They received less treatment and treatment was less aggressive, both in patients with metastatic and non-metastatic disease, regardless of PS. Their 5-year CSS was worse(63.4% vs 77.6%, P = 0.009), both for metastatic(21% vs 43%, P = 0.03) and for non-metastatic disease(76% vs 88%, P = 0.028).CONCLUSION Octogenarians presented with several distinct characteristics and had worse outcome. Further research is warranted to better define this growing population.

Random forests to predict survival of octogenarians with brain metastases from nonsmall-cell lung cancer

Background:To create and validate nomograms for the personalized prediction of survival in octogenarians with newly diagnosed nonsmall-cell lung cancer(NSCLC)with sole brain metastases(BMs).Methods:Random forests(RF)were applied to identify independent prognostic factors for building nomogram models.The predictive accuracy of the model was evaluated based on the receiver operating characteristic(ROC)curve,C-index,and calibration plots.Results:The area under the curve(AUC)values for overall survival at 6,12,and 18 months in the validation cohort were 0.837,0.867,and 0.849,respectively;the AUC values for cancer-specific survival prediction were 0.819,0.835,and 0.818,respectively.The calibration curves visualized the accuracy of the model.Conclusion:The new nomograms have good predictive power for survival among octogenarians with sole BMs related to NSCLC.

Feasibility of cabazitaxel in octogenarian prostate cancer patients

Background:To evaluate the effectiveness and safety of cabazitaxel in castration-resistant prostate cancer patients aged>80 years,we performed a retrospective study on a sample of patients from 11 Italian cancer centers.Materials and methods:Fifty-seven patients aged>80 years were treated with cabazitaxel after previous failure with docetaxel;39 completed a comprehensive geriatric assessment questionnaire(34 fit and 5 vulnerable)and 8 patients(14%)had an Eastern Cooperative Oncology Group performance status(PS)>2,while most had a PS of 0-1(86%).Cabazitaxel was administered at a dose of 25 mg/m^(2)in 30(52%)patients and 20 mg/m^(2)or adapted schedules in 27(48%)patients.These schedules were adopted mainly in patients>85 years(75%),with a PS>2(87.5%),and those classified as vulnerable(100%).Results:The duration of treatment was 4.8 months and was comparable in all subgroups;disease control rate was reported in 36 patients(63%);prostate-specific antigen response was recorded in 18 patients(31.5%).Median overall survival was 13.1 months regardless of age(<85/>85 years),but overall survival was reduced in vulnerable(7.2 months)and PS>2 patients(6.8 months).The most frequently documented grade 3-4 toxicities were neutropenia(14%)and diarrhea(10.5%).Six patients(10.5%)dropped out due to severe toxicity.Conclusions:Octogenarian patients can be treated with cabazitaxel with reduced doses or alternative schedules that are associated with less toxicity and fewer treatment interruptions.Comprehensive geriatric assessment could facilitate more appropriate patient selection.

Clinical efficacy of different treatments and their impacts on the quality of life of octogenarians with coronary artery disease

Background:Coronary artery disease(CAD)in octogenarians(age of>80 years)has a high risk of mortality and high expenses.Research shows that the prevalence of CAD is higher among octogenarians than that among younger people,but few such patients undergo percutaneous coronary intervention(PCI)or coronary artery bypass grafting(CABG).This study aimed to evaluate different treatments w让h respect to their clinical effects and impacts on quality of life of octogenarians with CAD.Methods:Data of 519 octogenarians with CAD consecutively treated at Beijing Anzhen Hospital,Capital Medical University(Beijing,China)from January 2010 to January 2016 were collected in this study.The patients were categorized into three groups based on the treatments they received:the PCI group(n=292),CABG group(n=110),and medical treatment group(n=117).The followings were recorded during follow-up:clinical data,death(all-cause and cardiovascular-related),re-hospitalization time,Seattle Angina Questionnaire(SAQ)score,and occurrence of hemorrhagic events(cerebral bleeding,gastrointestinal bleeding,and dermal ecchymosis).Results:The median follow-up duration was 25.0(25th,75th percentile:17.0,55.5)months among 417 patients.The all-cause death rates(28.2%vs.12.0%and 14.6%,respectively)and cardiovascular-related death rates(15.4%us.3.8%and 6.4%,respectively)were significantly higher in the medical treatment group than those in the PCI group and CABG group(all P<0.05).The re-hospitalization rate for cardiovascular events was significantly lower in the CABG group than those in the PCI group and medical treatment group(3.8%vs.12.8%and 14.9%,respectively)(x^2=8.23&P=0.018).The SAQ scores of physical limitation,angina frequency,treatment satisfaction,and disease perception were significantly higher in the PCI group and CABG group than those in the medical treatment group(all P<0.05).No significant difference in the angina stability score was observed among the three groups(F=3.179,P=0.204).Conclusion:PCI and CABG result in reduced mortality and better quality of life in octogenarians with CAD.

OCTOGENARIAN PARTY MEMBER

Nlu Ben, an 83-year-old actor, was encouraged by President Xi Jinping to play a vanguardand exemplary rote as a member of the Communist Party of China （CPC） in a letter on June25.

Microwave ablation of hepatocellular carcinomas in octogenarians

Aim:To evaluate wether it is safe and meaningful to treat octogenarians with microwave ablation for hepatocellular carcinoma.With an ageing population being healthier than previous generations,old limits for treating disease founded on patient age need to be revised.One of the most common tumour related death causes is hepatocellular carcinoma(HCC).With the development of minimally invasive therapies with curative potential,new ground is being broken offering treatments to older patients in the hope of achieving prolongation and better quality of life.Methods:In this retrospective single centre study of patients having a first microwave ablation therapy for HCC in a national referral centre for ablative liver treatments,septuagenarians(n=161,age 70-80)were compared with octogenarians(n=32,age 80-90).Results:Octogenarians selected for microwave ablation of HCC at a regional multidisciplinary team conference have similar outcomes as their younger control group.Survival,complications and length of stay are not different.Conclusion:Octogenarians who are fit for ablative treatment of HCC should not be disqualified on grounds of age,recognising that this group has an obvious immortality,or lead-time,bias as well as a probable selection bias in part explaining their good results.

Survival after resection of colorectal liver metastases in octogenarians and sexagenarians compared to their respective age-matched national population

Background: The aim of the current study was to investigate survival after resection of colorectal liver metastases (CLM) in octogenarians. The survival of octogenarian patients was compared to the survival of the national population of octogenarians and the survival of sexagenarians, the latter representing the average-age patient undergoing resection of CLM. Methods: Octogenarian and sexagenarian were defined as person 80–89 and 60–69 years of age, respectively. Survival analyses of patients who underwent resection of CLM between 2002 and 2014 were performed. Data from Statistics Norway were used to estimate the survival of the age-matched national population of octogenarians (ageM-Octo) and the age-matched national population of sexagenarians (ageM-Sexa). Results: During the study period, 59 octogenarians underwent resection of CLM. The majority of patients underwent a minor liver resection (n=50). In octogenarians, the 5-year survival was 32.5% and 66.3%[difference, 33.8 percentage points (pp)] in patients and ageM-Octo, respectively. The 10-year survival was 14.1% and 31.2% (difference, 17.1 pp) in patients and ageM-Octo, respectively. In sexagenarians, the 5-year survival was 50.9% and 96.2% (difference, 45.3 pp) in patients and ageM-Sexa, respectively. The 10-year survival was 35.7% and 90.3% (difference, 54.6 pp) in patients and ageM-Sexa, respectively. The 5-year cancer-specific survival and 5-year recurrence-free survival (RFS) after resection of CLM in octogenarians were 43.1% and 32.9%, respectively. Conclusions: After resection of CLM, the survival was poorer in octogenarians than in sexagenarians. However, the difference between the survival curves of patients and their age-matched population was smaller in octogenarians. In practice, this finding may indicate a greater benefit of resection in the elderly than the survival rates alone would suggest.

Post-transplant biliary complications using liver grafts from deceased donors older than 70 years:Retrospective case-control study

BACKGROUND The shortage of liver grafts and subsequent waitlist mortality led us to expand the donor pool using liver grafts from older donors.AIM To determine the incidence,outcomes,and risk factors for biliary complications(BC)in liver transplantation(LT)using liver grafts from donors aged>70 years.METHODS Between January 1994 and December 31,2019,297 LTs were performed using donors older than 70 years.After excluding 47 LT for several reasons,we divided 250 LTs into two groups,namely post-LT BC(n=21)and without BC(n=229).This retrospective case-control study compared both groups.RESULTS Choledocho-choledochostomy without T-tube was the most frequent technique(76.2%in the BC group vs 92.6%in the non-BC group).Twenty-one patients(8.4%)developed BC(13 anastomotic strictures,7 biliary leakages,and 1 nonanastomotic biliary stricture).Nine patients underwent percutaneous balloon dilation and nine required a Rouxen-Y hepaticojejunostomy because of dilation failure.The incidence of post-LT complications(graft dysfunction,rejection,renal failure,and non-BC reoperations)was similar in both groups.There were no significant differences in the patient and graft survival between the groups.Moreover,only three deaths were attributed to BC.While female donors were protective factors for BC,donor cardiac arrest was a risk factor.CONCLUSION The incidence of BC was relatively low on using liver grafts>70 years.It could be managed in most cases by percutaneous dilation or Roux-en-Y hepaticojejunostomy,without significant differences in the patient or graft survival between the groups.

老年综合评估筛查高龄肌少症危险因素的研究

目的应用老年综合评估技术(CGA)筛查高龄人群中肌少症的发病情况及其危险因素。方法选取在江阴市人民医院医疗集团就诊的718例老年患者,根据年龄分为非高龄组(<80岁,288例)和高龄组(≥80岁,430例),观察2组人群的肌少症发病率。将高龄组患者进一步分为非肌少症组(222例)和肌少症组(208例),采用CGA进行全面评估,从一般情况、实验室检测指标、老年共病和老年综合征等方面比较2组的差异,采用二元Logistic回归分析高龄人群肌少症的影响因素。结果高龄组患者肌少症的患病率(48.3%)明显高于非高龄组(30.9%),差异有统计学意义(P<0.05);肌少症组与非肌少症组的年龄、婚姻状况、吸烟史、体质量指数(BMI)、共病指数、服用药物数量、日常生活能力、社会参与功能、衰弱、听力障碍、视力障碍、认知功能障碍、睡眠障碍、抑郁、营养风险、便秘、低密度脂蛋白、总胆固醇、空腹血糖和尿酸的差异有统计学意义(P<0.05)。二元Logistic回归分析显示,婚姻状况、吸烟史、BMI、总胆固醇、共病指数、衰弱、听力障碍、认知功能障碍和抑郁是高龄肌少症的影响因素(P<0.05)。结论高龄人群肌少症发病率高,CGA可以全方位地筛查高龄肌少症的影响因素,为制定个体化的高龄肌少症管理方案提供可靠依据。