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Background: There are only a few reports on the nutritional status and mortality of patients with idiopathic pulmonary fibrosis (IPF). As such, this study aims to investigate the relationship between controlling nutritional status (CONUT) and the mortality of elderly patients with IPF. Methods: A total of 170 IPF patients aged ≥65 years old who visited the rehabilitation department of our hospital between July 2014 and July 2021 (mean age: 75.7 ± 6.3 years, sex (male/female): 138/32, %FVC: 78.3 ± 18.3%) were retrospectively analyzed. The Kaplan–Meier method and log-rank test were applied. Furthermore, using a Cox proportional hazards model with multivariate analysis, we analyzed the relationship between all-cause mortality and baseline characteristics including CONUT. Results: Based on the CONUT score, the normal group included 101 cases, the mild group included 58 cases, the moderate group included 11 cases, and the severe group had 0 cases. There were 49 cases of all-cause mortality events, suggesting that the mortality of the moderate group was significantly poorer than that of the normal and mild groups (p < 0.05). Furthermore, multivariate analysis identified GAP stage (HR: 5.972, 95%CI: 2.901~12.291, p < 0.0001), mMRC scale (HR: 0.615, 95%CI: 0.389~0.971, p = 0.009), and CONUT (HR: 2.012, 95%CI: 1.192~3.395, p = 0.037) as factors significantly influencing mortality. Conclusions: Severe malnutrition was not observed in elderly patients with IPF. Moderate malnutrition was associated with a significantly higher risk of all-cause mortality, suggesting that CONUT is an important indicator for predicting mortality. [ABSTRACT FROM AUTHOR]

The aging global population poses significant medical and social challenges, necessitating efforts to promote healthy aging. Comprehensive Geriatric Assessment (CGA) is a multidimensional diagnostic approach for older adults that aims to improve overall health. Remote CGA, facilitated by technological advancements, offers convenience and other potential advantages. It enables early disease detection, monitors chronic disease progression, delivers personalized care, and optimizes healthcare resources for better health outcomes in older individuals. However, remote CGA also has limitations, including technological requirements, data security, and the need for comprehensive evaluation and simplicity. Collaborative efforts are essential to developing a digital home‐based CGA platform that addresses accessibility issues and tailors the assessment process to meet the needs of older adults. Continuous optimization of remote CGA can become a pivotal tool for advancing geriatric care and ensuring the well‐being of the aging population. Geriatr Gerontol Int 2024; 24: 67–73. [ABSTRACT FROM AUTHOR]

Background: Streptococcal toxic shock syndrome (STSS) is a notifiable disease under Japan's Infectious Disease Control Law and has become a pandemic following COVID-19. STSS often leads to necrotizing fasciitis, with a mortality rate exceeding 30%. Even in surviving patients, limb amputations are common., Case: A 39-year-old woman developed STSS. She underwent 18 surgeries and vacuum-assisted closure therapy, which resulted in ultra-short right transfemoral amputation. With a strong desire to walk again, she began fitting for a provisional prosthesis 3 months post-amputation. Given the preserved hip muscle strength, an ultra-short transfemoral prosthesis was selected over a hip disarticulation prosthesis. The key components included a plug-in quadrilateral socket, a belt used to suspend the transfemoral prosthesis, a hydraulic knee joint, and an energy-storing foot. She regained walking ability using crutches. To address pain and skin issues in the stump load-bearing area, compression and adhesion were improved using thick fabric spats. Muscle mass, including that of the paraspinal muscles, was maintained during follow-up evaluations using computed tomography, dual-energy X-ray absorptiometry, and bioelectrical impedance analysis. The phantom limb pain in the right leg diminished with medication and prosthetic training. Her quality-of-life scores measured using the 36-item Short Form Questionnaire and the Prosthesis Evaluation Questionnaire also showed improvement. She was discharged home 5 months post-amputation., Discussion: This case highlights the importance of high motivation, multidisciplinary collaboration, preservation of the trunk muscle reserve from pre-illness exercise habits, and early trunk rehabilitation to achieve successful gait acquisition with a customized transfemoral prosthesis., Competing Interests: CONFLICTS OF INTEREST: The authors declare no conflict of interest., (2024 The Japanese Association of Rehabilitation Medicine.)