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Biomedical subjects

I Gerber

Publications and source records attributed to I Gerber.

4 recordsLinked to original sources

Autopsy study of the elderly institutionalized patient. Review of 234 autopsies.

Autopsies are performed much less frequently in the elderly than in younger patients. Little information exists as to causes of death in the institutionalized elderly. The clinical diagnostic error rate documented by autopsy studies ranges from 6% to 68%. We analyzed the clinical and autopsy records of 234 patients who died during a 14 1/2-year period at our chronic care institution to determine the accuracy of clinical cause of death in addition to the pathologic cause of death. The most common causes of death included bronchopneumonia (33%), congestive heart failure (15%), metastatic carcinoma (14%), pulmonary embolism (8%), myocardial infarction (7%), cerebrovascular accident (6%), unknown cause of death (8%), and a miscellaneous group (9%). The highest diagnostic error rate was in the underdiagnosis of pulmonary embolism (39% antemortem accuracy rate). The most accurately diagnosed condition was cerebrovascular accident (92% antemortem accuracy rate). Pneumonia was correctly diagnosed antemortem in 73% of the patients studied. These data suggest that serious and potentially treatable illnesses are underdiagnosed in the elderly institutionalized patient and that there is valuable information to be learned by performing autopsies in the elderly population.

Aged

Anticipatory grief and aged widows and widowers.

The purpose of this investigation was to explore the preventive value of anticipatory grief on the medical adjustment of the aged bereaved. Data were collected for 81 surviving widows and widowers 6 mo. after their loss. Sixteen of the bereaved had spouses who died of a chronic illness. These two groups were compared on three criteria of medical adjustment: physician office visits, feeling ill without contacting a physician, and use of psychotropic medications. The data indicated that the aged bereaved of a lengthy chronic fatal illness did worse than the bereaved of a shorter chronic illness death. By sex, no significant differences were found between widows and widowers of a short-term illness death. However, differences were noted for the chronic illness category, and within this category for length of chronicity. In both cases widowers showed more medical problems than widows.

Acute Disease