ABSTRACT
Peripheral arterial disease (PAD) is common among older people because it often results from atherosclerosis, which becomes more common with age. The disease is particularly common among people who have diabetes. Little information is available on the relation between abdominal aortic diameter and PAD in elderly patients with diabetes. This article studies the relationships between abdominal aortic diameter, PAD, and the cardiovascular risk factors in asymptomatic elderly patients suffering from type 2 diabetes mellitus. A case-control study was conducted on 90 participants aged 60 years and older divided into 60 cases (30 males and 30 females) and 30 age-matched healthy controls (15 males and 15 females). The relationships between the size of the abdominal aorta and ankle-brachial index (ABI), plasma cholesterol, triglycerides (TG), and high-sensitivity C-reactive protein were examined. Approximately, 15% of patients with diabetes had asymptomatic PAD. The patients with diabetes with PAD were of older age (70.4 ± 3.6 vs. 63.4 ± 3.9 years; p = 0.000), had larger abdominal aortic diameter (22.4 ± 3.08 vs. 18.7 ± 2 mm; p = 0.000), and higher CRP levels (8.3 ± 1.1 vs. 5.8 ± 2.2 mg/L; p = 0.002), while other variables revealed no significant difference. Abdominal aortic diameter correlated well with ABI measured by Doppler method in diabetic patients (r = - 0.471, p = 0.000). Older age and larger abdominal aorta are independent risk factors for asymptomatic PAD in the elderly with type 2 diabetes mellitus.
ABSTRACT
AIM: Our aim was to study the outcome and the predictors of in-hospital cardiopulmonary resuscitation (CPR) among elderly patients admitted to Ain Shams University Hospitals, Egypt. METHODS: We carried out a cross-sectional study for all elderly patients (age ≥60 years) who underwent CPR after cardiac arrest at Ain Shams University Hospitals, Egypt, during a 1.5-year study period. We excluded patients who were declared dead on arrival. RESULTS: We found 380 cases of elderly in-hospital cardiac arrest that underwent CPR. Asystole was the most common arrhythmia detected at the time of arrest (85.1%), followed by ventricular tachycardia (8.7%) and ventricular fibrillation (6.2%). Return of spontaneous circulation was achieved in 32.6% of patients and 8.4% survived to discharge from hospital. Multivariate logistic regression analysis identified three independent predictors of better outcome (survival >24 h): response time ≤5 min (OR 5.1, 95% CI 1.9-13.4), location of CPR in emergency department (OR 3.2, 95% CI 1.6-6.4) and pre-arrest morbidity (PAM) score ≤7 (OR 3.1, 95% CI 1.6-6.1). CONCLUSION: Outcome of CPR after in-hospital cardiac arrest in our setting was poor. The response time ≤5 min, CPR in the emergency department and PAM score ≤7 were independent predictors of good outcome.