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Although there is a remarkable increase in diagnostic flexible bronchoscopy (FB) in old patients, safety and efficacy of FB in very old patients remain to be elucidated. In this study, we aimed to evaluate the complications and diagnostic yield of FB in patients aged ≥ 80 years with lung cancer compared with those aged

To derive a risk score to predict in-hospital mortality for very old patients with decompensated chronic heart failure (DCHF). Retrospective cohort study that included patients ≥ 80 years admitted to a Geriatric Acute Care Unit with DCHF between January 2012 and December 2014. We analyzed 70 candidate risk factors and in-hospital mortality. We derived a risk model using multivariate logistic regression model and constructed a scale for scoring risk. We used bootstrapping techniques for the internal validation. We included 629 patients with mean age of 90 (SD5) years, 470 (73.1%) being women. Eighty-six (13.7%) patients died during the hospitalization. Factors included in the final risk model were NYHA class III–IV, severe functional dependence (Katz activities of daily living index 5.5 mEq/L and red blood cell distribution width (RDW) > 17%. In-hospital mortality in risk groups was 3.0, 4.6, 9.5, 15.1 and 36.3%, respectively. The area under ROC curve risk for score after bootstrapping was 0.77 (95%: CI 0.70–0.83). This risk score could be useful for stratifying risk for in-hospital mortality among very old patients admitted to hospital for DCHF.

P.O. Lang *, M. Petrovic , O. Dalleur , N. Ferahta , A. Benetos , B. Boland h,i Health and Wellbeing academy, Anglia Ruskin University, Cambridge, United Kingdom Geriatric and Geriatric rehabilitation division, University Hospital of Lausanne, Lausanne , Switzerland Department of Geriatrics, Ghent University Hospital, Ghent, Belgium Clinical Pharmacy Research Group, Louvain Drug Research Institute, Catholic University of Louvain, Brussels, Belgium e Pharmacy, Saint-Luc University Hospital, Brussels, Belgium Department of Geriatrics, University Hospitals of Nancy, 54500 Nancy, France g Inserm U1116, Universite de Lorraine, 54000 Nancy, France Health and Society Research Institute, Catholic University of Louvain, Brussels, Belgium Geriatric division, Saint-Luc University Hospital, Brussels, Belgium

Backgrounds and aims To analyze whether serum cholesterol and albumin may be factors associated with early and late mortality, independent from other variables such as comorbidity, functional and mental status, in very old patients admitted with acute illness. Methods Prospective study of all patients admitted for medical causes in the year 2009. The primary outcome was the mortality at 6 and 36 months in relation to serum levels of albumin (categorized as > 3.5 g/dL; 3–3.5 and Results One thousand two hundred and eighty-eight patients were studied, mean age 86.7 years (SD 6.69), 66.1% female. During follow-up, 848 patients died. In Cox regression multivariate analysis, decreased albumin was significantly associated with increased mortality at 6 months [HR: 1.55 (CI95% = 1.03–2.34) for 3–3.5 g/dL albumin, and HR: 1.82 (CI95% = 1.15–2.86) for albumin Conclusions In very old patients admitted for acute medical conditions decreased levels of albumin may be associated with increased mortality.

Clinical data and evidence-based guidelines for prescriptions for older patients are rare, and older patients are often excluded from clinical trials. The aim of this study was to use a questionnaire to assess the interest of pharmaceutical companies in including patients over 70 years of age in relevant pharmaceutical clinical trials. Additionally, the use of geriatric assessment tools was assessed. Overall, 35 international pharmaceutical companies were selected to report all studies performed over a 10-year period (1999 to 2009), and a total of 26 studies reported by eight companies were evaluated. In 19.2% of the studies, older patients were included but not analyzed separately. In 53.9% of the studies, age was either considered as a covariate or analyzed in a subgroup analysis. Seven studies included only patients aged 70 years and older. However, geriatric assessment tools were only utilized in four studies. Older patients were sufficiently included and analyzed in only a minority of company-initiated pharmaceutical studies. Given current demographic changes, there is an urgent need to address this situation.

Aminoglycosides still represent an important antimicrobial class for the treatment of gram-negative infections. Their spectrum of activity and the possibility to act synergistically with β-lactams offer the opportunity of being used in severe infections or infections sustained by resistant pathogens. However, the fear of side effects, related to their narrow therapeutic index and toxicodynamic profile, limits sometimes the use of aminoglycosides, especially in old or very old patients. Improved knowledge of antimicrobial pharmacokinetics and pharmacodynamics in the last years has allowed improving regimens and dosing on an individual basis, according to the patient's pathophysiological conditions and pathogen's susceptibility profile. Optimised aminoglycoside use yields to a more rapid bacterial killing and, likely, prevention of resistance development. Some advances toward an improved aminoglycoside usage and application of pharmacodynamic concepts to avoid or limit toxicity are herein briefly discussed.

(40%), biological and clinical criteria. Outcomes are: continuing (73%), changing (19%) or stopping (8%) treatment. Reassessment of antibiotherapy is realized 48–72hours after initiation, but bacteriological data are oftenmissing. Frequent continuation of treatment maybe related to fragilityof elderlypatients. Treatmentsaremainly empirical and large use of antibiotics may induce resistance. To improve impact of reassessment involves a collaborative work between geriatricians, infectiologist, bacteriologists and pharmacists as a multidisciplinary team.

cular risk, thewomen’s 87%. The 80.5% of the sample had associated diseases. Thirteen percent of the sample had some kind of cognitive impairment. Fifty-two percent of the sample had an obesity family background, 26.8% suffered from diabetes, 25.4% had arterial hypertension, 10.4% suffered from cognitive impairment. Conclusions.– –Obesity is associatedwith dementia inwomenwith a higher level of obesity and lower cultural background. And it is independent of age and family background. – It is important primary prevention in obese patients since high percentage had family background associated with obese pathology. –Knowing family background can help to delay the beginning of some diseases such as cognitive impairment.