Utility of geriatric assessments in evaluation of older adults for kidney transplantation.
Utility of geriatric assessments in evaluation of older adults for kidney transplantation.
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DOI：
10.1111/ctr.14813
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发表时间：
2022-12
影响因子：
2.1
通讯作者：
中科院分区：
文献类型：
--
作者：
虽然肾移植在65岁及以上的患者中具有良好的结局，但许多患者尽管没有禁忌症，但并未进行评估。我们想确定是否将老年医学和老年评估（GA）作为芝加哥大学医学院肾移植评估的一部分，将有助于确定合适的候选人并改善老年人的移植结果。在2012年至2016年期间，作为多学科移植评估的一部分，171名患者接受了研究老年病医生的初步GA，他们对他们进行了从“差”到“优秀”的五分制评分，并将他们的病例提交给多学科移植审查会议。患者随访至2021年6月1日。预测变量包括老年人推荐、临床特征和人口统计学。关注的结果是死亡率、接受移植和等待名单的位置。与被评为“差”、“边缘”或“一般”的患者相比，我们发现老年病医生推荐为“好”或“优秀”的患者更有可能被列入等待名单并接受移植。评分良好的患者也不太可能因医学上不适合而从等待名单中删除，这意味着医学发病率，虚弱和认知状态恶化。包括老年病学家进行遗传算法作为移植评估过程的一部分，可以帮助确定合适的老年候选人。
While kidney transplantation has favorable outcomes in patients aged 65 years and older, many are not referred for evaluation despite having no contraindications. We wanted to determine whether incorporating geriatrics and geriatric assessments (GA), as part of kidney transplant evaluation at the University of Chicago Medicine, would help identify suitable candidates and improve transplantation outcomes among older adults. Between 2012 and 2016, as part of their multi‐disciplinary transplant evaluation, 171 patients underwent an initial GA with the study geriatrician, who rated them on a five‐point scale from “poor” to “excellent,” and presented their cases to multidisciplinary transplant review meetings. Patients were followed until June 1st, 2021. Predictor variables included geriatric recommendation, clinical characteristics, and demographics. Outcomes of interest were mortality, receipt of transplant, and waitlist placement. Compared to patients rated “poor,” “marginal,” or “fair,” we found that patients that the geriatrician recommended as “good” or “excellent” were more likely to be waitlisted and receive a transplant. Favorably rated patients were also less likely to be removed from the waitlist due to becoming medically unfit, meaning worsening medical morbidity, frailty, and cognitive status. Including geriatricians to perform GAs as part of the transplant evaluation process can help identify suitable elderly candidates.
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影响因子：
6.2
作者：
Sorensen, Vibeke Romming;Heaf, James;Sorensen, Soren Schwartz
通讯作者：
Sorensen, Soren Schwartz
影响因子：
10.1
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影响因子：
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Zagonel, V
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通讯作者：
Nagler, Evi
影响因子：
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作者：
STUCK, AE;SIU, AL;RUBENSTEIN, LZ
通讯作者：
RUBENSTEIN, LZ