7 results on '"Charlotte Tomeo"'
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2. Corticosteroid Therapy in COVID-19 Associated With In-hospital Mortality in Geriatric Patients: A Propensity Matched Cohort Study
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Valentine Lidou-Renault, Edouard Baudouin, Pauline Courtois-Amiot, Celine Bianco, Hélène Esnault, Audrey Rouet, Margaux Baque, Charlotte Tomeo, Antonio Rainone, Sara Thietart, Romain Veber, Clementine Ayache, Marion Pepin, Carmelo Lafuente-Lafuente, Emmanuelle Duron, Pierre-Emmanuel Cailleaux, Didier Haguenauer, Nadège Lemarié, Elena Paillaud, Agathe Raynaud-Simon, Caroline Thomas, Jacques Boddaert, Lorène Zerah, and Hélène Vallet
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Aged, 80 and over ,Male ,Aging ,SARS-CoV-2 ,COVID-19 ,Cohort Studies ,Adrenal Cortex Hormones ,Activities of Daily Living ,Humans ,Female ,Hospital Mortality ,Geriatrics and Gerontology ,Aged ,Retrospective Studies - Abstract
Background Few data are available on the prognosis of older patients who received corticosteroids for COVID-19. We aimed to compare the in-hospital mortality of geriatric patients hospitalized for COVID-19 who received corticosteroids or not. Methods We conducted a multicentric retrospective cohort study in 15 acute COVID-19 geriatric wards in the Paris area from March to April 2020 and November 2020 to May 2021. We included all consecutive patients aged 70 years and older who were hospitalized with confirmed COVID-19 in these wards. Propensity score and multivariate analyses were used. Results Of the 1 579 patients included (535 received corticosteroids), the median age was 86 (interquartile range 81–91) years, 56% of patients were female, the median Charlson Comorbidity Index (CCI) was 2.6 (interquartile range 1–4), and 64% of patients were frail (Clinical Frailty Score 5–9). The propensity score analysis paired 984 patients (492 with and without corticosteroids). The in-hospital mortality was 32.3% in the matched cohort. On multivariate analysis, the probability of in-hospital mortality was increased with corticosteroid use (odds ratio [OR] = 2.61 [95% confidence interval (CI) 1.63–4.20]). Other factors associated with in-hospital mortality were age (OR = 1.04 [1.01–1.07], CCI (OR = 1.18 [1.07–1.29], activities of daily living (OR = 0.85 [0.75–0.95], oxygen saturation < 90% on room air (OR = 2.15 [1.45–3.17], C-reactive protein level (OR = 2.06 [1.69–2.51], and lowest lymphocyte count (OR = 0.49 [0.38–0.63]). Among the 535 patients who received corticosteroids, 68.3% had at least one corticosteroid side effect, including delirium (32.9%), secondary infections (32.7%), and decompensated diabetes (14.4%). Conclusions In this multicentric matched-cohort study of geriatric patients hospitalized for COVID-19, the use of corticosteroids was significantly associated with in-hospital mortality.
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- 2022
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3. Early Life Quality on Instrumental, Daily and Neuropsychological Activities of Lewy Body Disease about 70 Patients in the Geriatric Department at the Pitié Salpêtrière Hospital of Paris, France
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Andia Abdoulkader, Audrey Rouet, Benedicte Dieudonné, Jacque Boaddert, Charlotte Tomeo, Sandrine Greffard, and Marc Verny
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General Medicine - Published
- 2022
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4. Diagnostics différentiels d’AVC, les pièges à éviter
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Marc Verny, Sandrine Greffard, and Charlotte Tomeo
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Geriatrics ,medicine.medical_specialty ,Pediatrics ,business.industry ,Medicine ,In patient ,cardiovascular diseases ,General Medicine ,Medical diagnosis ,Differential diagnosis ,business ,Neurological deficit - Abstract
Strokes are a significant issue in geriatric medicine as more than half occur in patients over the age of 75. However, not all the symptoms of a focal neurological deficit in the elderly are indicative of a stroke. There are a number of differential diagnoses and only a detailed examination of the patient can enable an accurate diagnosis to be established. However, in no case must this delay the urgent treatment of the patient suspected of having a stroke.
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- 2019
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5. Fecal impaction is associated with postoperative urinary retention after hip fracture surgery
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Lorène Zerah, M. Teng, Marc Verny, Judith Cohen-Bittan, Audrey Rouet, Rebecca Haddad, Jacques Boddaert, and Charlotte Tomeo
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Hip fracture surgery ,Fecal Impaction ,fluids and secretions ,Postoperative Complications ,Lower urinary tract symptoms ,medicine ,Humans ,Orthopedics and Sports Medicine ,Aged ,Aged, 80 and over ,Hip fracture ,Rehabilitation ,Urinary retention ,business.industry ,technology, industry, and agriculture ,food and beverages ,Fecal impaction ,Perioperative ,Length of Stay ,Urinary Retention ,equipment and supplies ,medicine.disease ,Surgery ,Cross-Sectional Studies ,Female ,medicine.symptom ,business ,Complication - Abstract
Postoperative urinary retention (POUR) is a common hip fracture (HF) complication. Although fecal impaction (FI) is one of the oft-cited causes of POUR in clinical practice, evidence regarding this association is scarce.The aim of this study was to determine whether FI was associated with POUR after HF surgery in older patients.All patients consecutively admitted after a HF surgery in a geriatric perioperative unit were included in this cross-sectional study. FI was systematically assessed by a digital rectal exam at admission and according to clinical suspicion during the hospital stay. The dependent variable was POUR, systematically screened according to the department protocol and defined as a bladder volume400ml requiring catheterization. The association between FI and POUR was assessed by multivariable analysis.A total of 256 patients were included (mean [SD] age 86 [6] years), (76% women): 108 (42%) presented FI and 63 (25%) POUR. The frequency of FI was higher with than without POUR (73% vs. 32%, P0.001). On multivariable analysis, after adjusting for age, sex, Cumulative Illness Rating Scale score and anticholinergic load, FI was the only factor independently associated with POUR (odds ratio 4.78) [95% confidence interval 2.44-9.71], P0.001.FI was the only independent factor associated with POUR after HF surgery in older adults. Further studies are needed to optimize perioperative geriatric care including FI and POUR assessment and management.
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- 2020
6. Clinical Characteristics and Outcomes of 821 Older Patients With SARS-Cov-2 Infection Admitted to Acute Care Geriatric Wards
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Jean-Philippe David, Alexandra Monti, Virginie Fossey-Diaz, Antoine Dureau, Lauriane Bourdonnec, Cédric de Villelongue, Marion Pépin, Pauline de Malglaive, Céline Bianco, Elena Paillaud, Nadège Lemarié, Jacques Boddaert, Bruno Riou, Clémence Boully, Elise Mercadier, Eric Bouvard, Sébastien Krypciak, Marie-Astrid Desoutter, H. Vallet, Mouna Romdhani, Edouard Baudouin, Olivier Hanon, Sophie Bastiani, Flora Ketz, Caroline Thomas, Lorène Zerah, Swasti Roux, Mathilde Lacrampe, Emmanuelle Duron, Charlotte Tomeo, Ariane Gross, Morgane Mary, Gestionnaire, Hal Sorbonne Université, Service de Médecine Gériatrique [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Hôpital Ambroise Paré [AP-HP], Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Hôpital Paul Brousse, CHU Henri Mondor, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre d'Immunologie et des Maladies Infectieuses (CIMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Hôpital Corentin Celton [Issy-les-Moulineaux], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), CIC - CHU Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Tenon [AP-HP], Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), Hôpital Rothschild [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), AP-HP - Hôpital Antoine Béclère [Clamart], CHU Charles Foix [AP-HP], AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Hôpital Bretonneau, Hôpital Européen Georges Pompidou [APHP] (HEGP), IMRB - CEPIA/'Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health' [Créteil] (U955 Inserm - UPEC), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service d'Accueil des Urgences [CHU Pitié-Salpêtrière] (SAU), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, Centre d'Immunologie et de Maladies Infectieuses (CIMI), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service des Urgences [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Service de gériatrie [CHU Pitié-Salpêtrière], and Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases [IHU ICAN]
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Male ,Aging ,medicine.medical_specialty ,Paris ,Multivariate analysis ,[SDV]Life Sciences [q-bio] ,Pneumonia, Viral ,03 medical and health sciences ,AcademicSubjects/MED00280 ,0302 clinical medicine ,Interquartile range ,Internal medicine ,Acute care ,Outcome Assessment, Health Care ,Medicine ,Humans ,030212 general & internal medicine ,Hospital Mortality ,Geriatric Assessment ,Pandemics ,Aged ,Retrospective Studies ,Geriatrics ,Aged, 80 and over ,geriatrics ,business.industry ,SARS-CoV-2 ,COVID-19 ,Retrospective cohort study ,Odds ratio ,Confidence interval ,3. Good health ,Hospitalization ,[SDV] Life Sciences [q-bio] ,Ageing ,Delirium ,AcademicSubjects/SCI00960 ,Female ,Geriatrics and Gerontology ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Research Article ,in-hospital mortality - Abstract
Background There is limited information describing the characteristics and outcomes of hospitalized older patients with confirmed coronavirus disease 2019 (COVID-19). Method We conducted a multicentric retrospective cohort study in 13 acute COVID-19 geriatric wards, from March 13 to April 15, 2020, in Paris area. All consecutive patients aged 70 years and older, with confirmed COVID-19, were enrolled. Results Of the 821 patients included in the study, the mean (SD) age was 86 (7) years; 58% were female; 85% had ≥2 comorbidities; 29% lived in an institution; and the median [interquartile range] Activities of Daily Living scale (ADL) score was 4 [2–6]. The most common symptoms at COVID-19 onset were asthenia (63%), fever (55%), dyspnea (45%), dry cough (45%), and delirium (25%). The in-hospital mortality was 31% (95% confidence interval [CI] 27–33). On multivariate analysis, at COVID-19 onset, the probability of in-hospital mortality was increased with male gender (odds ratio [OR] 1.85; 95% CI 1.30–2.63), ADL score Conclusions This study provides new information about older patients with COVID-19 who are hospitalized. A quick bedside evaluation at admission of sex, functional status, systolic arterial pressure, consciousness, respiratory rate, and asthenia can identify older patients at risk of unfavorable outcomes.
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- 2020
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7. [Differential diagnosis of strokes, the traps to avoid]
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Charlotte, Tomeo, Sandrine, Greffard, and Marc, Verny
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Diagnosis, Differential ,Stroke ,Humans ,Aged - Abstract
Strokes are a significant issue in geriatric medicine as more than half occur in patients over the age of 75. However, not all the symptoms of a focal neurological deficit in the elderly are indicative of a stroke. There are a number of differential diagnoses and only a detailed examination of the patient can enable an accurate diagnosis to be established. However, in no case must this delay the urgent treatment of the patient suspected of having a stroke.
- Published
- 2019
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