Biomedical subjects

P Kasviki-Charvati

Publications and source records attributed to P Kasviki-Charvati.

5 recordsLinked to original sources

PubMed1996

Survival in the oldest old: death risk factors in old and very old subjects.

Factors predicting death in the ninth decade of life may differ from predictors in younger age groups. A prospective study was carried out on 210 subjects entering a residential home at the age of 68 to 79 years and of 287 subjects aged greater than or equal to 80 years who included 91 survivors from the first group; all subjects were followed until 78% of them had died. A Cox analysis was carried out with death as end point and 13 potential risk factors as covariates. Mildly impaired mobility at entry, defined as the need for help to walk 300-400 yards for various reasons, smoking, bacteriuria, and presence of ECG abnormalities were significant death risk predictors before age 80. Beyond this age, only mildly impaired mobility and serum cholesterol levels less than or equal to 5.9 mmol/L, as compared with levels greater than or equal to 8.0 mmol/L, remained significant. Higher hematocrit levels were predictors of survival before and after age 80. Systolic blood pressure, age, sex, weight, and socioeconomic status had no effect in either group. The data show that survival after age 80 is related only to adequate physical mobility and high hematocrit and cholesterol levels, regardless of the levels of other common risk factors.

Age Factors↗

PubMed1991

Survival in a residential home: an eleven-year longitudinal study.

The length of survival and various risk factors were studied utilizing 408 residents (141 men, 267 women) of a large residential home. The subjects, aged 68 years or more at entry, admitted between 1978 and 1983, were physically independent, continent, and non-diabetic. They were followed until December 31, 1988, by which time 78% had died. The multivariate proportional hazard analysis showed the following entry variables to have the indicated effects on relative mortality rate ratios: 5-years' higher age (+10%, NS), persistent bacteriuria (+13%, NS), abnormal ECG (+26%, NS), current smoking (+63%, P less than 0.01), mildly impaired mobility (+96%, P less than 0.001), higher levels of in-study systolic pressure in 10-mm Hg steps (-4%, NS), higher entry serum cholesterol in 1-mmol/L steps (-7%, NS), and higher hematocrit in 5% steps (-14%, P less than 0.02). Female sex was associated with a +25% (NS) rate ratio; socioeconomic status and body weight were without effect. These data highlight the relative importance of specific factors associated with survival of persons within retirement homes and indicate that: (1) the presence of mild impairment of mobility at entry is by far the strongest predictor of early death; (2) smoking and lower hematocrit also exert important adverse effects; and (3) certain "risk factors", ie elevated systolic blood pressure and serum cholesterol, have a minimal protective effect, if any, in this age group.

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PubMed1982

Turnover of bacteriuria in old age.

Among 352 residents of a home for the elderly, who were fully mobile and devoid of most predisposing factors for bacteriuria, 19% of men and 27% of women had two positive cultures within two months. Positive conversion at one year among men and women negative at entry was 11% and 23% respectively, negative conversion of bacteriurics 22% and 27%. Subjects bacteriuric at entry but sterile at six months had a 77% (men) and 44% (women) reinfection rate at 12 months. The data indicate firstly that a significant proneness to infection does exist in old age, coupled with a lesser trend toward spontaneous cure; the latter is equal to that of younger ages. Thus, prevalence rises steadily in old age. Secondly a previous history of bacteriuria in a subject with currently sterile urine increases his chances of reinfection or recurrence two to seven times compared to those of subjects without past infection.

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PubMed1981

Bacteriuria and survival in old age.

We studied the effect of asymptomatic bacteriuria on survival in 342 healthy residents of a home for the aged. At entry into the study 76 subjects (22 per cent) had bacteriuria on two consecutive urine cultures. There were no differences in age distribution, blood pressure, hematocrit, smoking habits, cholesterol, or myocardial changes between bacteriuric and nonbacteriuric subjects. Median survival was 53 and 75 months in nonbacteriuric men and women 70 to 79 years old, and 45 months in all nonbacteriuric subjects over 79; median survival of bacteriuric men and women aged 70 to 79 was 33 and 34 months, and that of those older was 31 and 29.5 months; the shorter survival of bacteriuric subjects was significant (P less than 0.003). These differences in mortality among subjects living under identical conditions and with equal prevalence of risk factors indicate that bacteriuria in old age is associated with a reduction in survival of 30 to 50 per cent.

Age Factors↗

PubMed1976

Significance of diuresis-provoked bacteriuria.

Of 52 clinically healthy, ambulant elderly subjects with urine that was sterile or contained less than 0.2 X 10(5) bacteria/ml before diureisi, 11 (21.2%) responded to oral water loading and intravenous treatment with furosemide with a bacterial excretion rate of greater than 2.4 X 10(5)/min. Subjects with bacteriuria had decreased blood pressure, rate of creatinine clearance, maximal level of urinary creatinine, and maximal urinary flow. Twenty-nine of the nonbacteriuric and eight of the subjects who developed bacteriuria after diuresis were retested one to two years later. No subject had received antibacterial agents in the interim. The infections of four of the original subjects who had developed bacteriuria had cleared up and showed functional improvement. The remaining four subjects who had developed bacteriuria during the first study and three subjects who had been nonbacteriuric during the first study had concentrations of bacteria ranging from 0.05 X 10(5) to 1.80 X 10(5)/ml before diuresis in the second study, and excreted increasing numbers of bacteria (from 0.12 X 10(5) to 9.0 X 10(5)/min) in response to the diuretic loading. Two of the subjects who were bacteriuric in both surveys were infected with different bacteria during the two studies. The data show the high frequency of occult bacteriuria in ostensibly healthy elderly patients that is revealed only by forced diuresis, the detectable functional deficits, the improvement after clearing of the infections, and the rapid turnover between infected and clear periods.

Aged↗