ABSTRACT
OBJECTIVE: This study aims to assess the efficacy of hormone therapy in patients with severe gastrointestinal bleeding due to multiple angiodysplastic lesions. PATIENTS AND METHODS: Between May 2010 and July 2017, we included 12 consecutive patients with anaemia or recurrent bleeding due to angiodysplasia who had been started on hormone therapy. The therapy given was a combination of levonorgestrel (between 0.10 and 0.25 mg) and ethinylestradiol (between 0.02 and 0.05 mg). We determined the mean number of transfusions required in the 6 months before and after the start of the treatment, as well as the mean haemoglobin levels, number of admissions for anaemia due to gastrointestinal bleeding and length of hospital stay in these periods. RESULTS: The mean age of patients included was 77.83 years old and 75% were male. The follow-up period after treatment initiation was 6 months. Of the 12 patients included, only one stopped the treatment owing to it not being effective. Overall, 83.3% of the patients reported subjective improvement. Furthermore, we found significant differences comparing before and after starting treatment regarding the mean number of transfusions (7±4.8 vs. 3.4±4.6; P=0.005), the mean haemoglobin levels (9.5±1.2 vs. 10.8±2.6; P=0.034) and the mean number of admissions (1.6±1.6 vs. 0.2±0.4; P=0.024). On the contrary, differences between pretreatment and post-treatment length of hospital stay were not significant. CONCLUSION: Hormone therapy is a potentially useful therapeutic tool in patients with refractory bleeding and anaemia due to angiodysplasia.
Subject(s)
Anemia/drug therapy , Angiodysplasia/drug therapy , Ethinyl Estradiol/administration & dosage , Gastrointestinal Agents/administration & dosage , Gastrointestinal Hemorrhage/drug therapy , Levonorgestrel/administration & dosage , Aged , Aged, 80 and over , Anemia/diagnosis , Anemia/etiology , Angiodysplasia/complications , Angiodysplasia/diagnosis , Blood Transfusion , Drug Combinations , Ethinyl Estradiol/adverse effects , Female , Gastrointestinal Agents/adverse effects , Gastrointestinal Hemorrhage/diagnosis , Gastrointestinal Hemorrhage/etiology , Hemoglobins/metabolism , Humans , Length of Stay , Levonorgestrel/adverse effects , Male , Patient Admission , Recurrence , Severity of Illness Index , Time Factors , Treatment OutcomeABSTRACT
Introducción: La condición funcional física y psíquica son factores clave en la población anciana. Hay disponibles muchas herramientas de evaluación, pero no se pueden aplicar a la totalidad de la población geriátrica. Presentamos el test Alusti, cuyas 2versiones le permiten abarcar este amplio y complejo espectro de población. Material y métodos: Estudio prospectivo realizado con población institucionalizada, hospitalizada y comunitaria, desarrollado entre septiembre y diciembre del 2016. Se ha realizado el análisis comparativo con otros test: índice de Barthel (IB), velocidad de la marcha (VM), Timed «UP & GO» test (TUG), Short Physical Performance Battery (SPPB) y test Tinetti. Resultados: Se incluyeron 363 sujetos (edad media 83,25 años), con diferentes niveles de situación funcional y cognitiva. La aplicación del test resulta sencilla, rápida (entre 3 y 6min), con un 100% de aplicabilidad y usabilidad, con efecto suelo-techo amplio (0-100 puntos), con un coeficiente de correlación intraclase (CCI) que muestra alta fiabilidad interobservador (CCI = 0,99) y buena correlación en su versión completa con el IB (CCI = 0,86; intervalo de confianza [IC]: 0,82-0,88) y el test Tinetti (CCI = 0,76; IC 95%: 0,71-0,81) así como en la abreviada con IB (CCI = 0,71; IC 95%: 0,65-0,75) y con el test Tinetti (CCI = 0,90; IC 95%: 0,88-0,92). Permite medir la variación de la situación funcional, que en nuestra muestra ha generado un aumento del 10,9%, tras un periodo de hospitalización. Conclusiones: El test Alusti permite la evaluación del rendimiento físico en la totalidad de la población geriátrica. La mayor concordancia se produce con el test Tinetti, al que supera en aplicabilidad
Introduction: Physical and psychological functional conditions are key factors in the elderly population. Many evaluation tools are available, but they cannot be applied to the whole geriatric population. The use Alusti Test is presented. This test consists of 2versions, which enable it to encompass this wide and complex population spectrum. Materials and methods: A prospective study with the institutionalised, hospitalised, and community population, was conducted between September and December 2016. A comparative analysis was conducted using the Barthel Index (BI), Gait Speed Test (GST), Timed «Up & Go» Test (TUG), Short Physical Performance Battery (SPPB), and Tinetti Test. Results: A total of 363 subjects were enrolled (mean age: 83.25 years), with varying levels of functional and cognitive conditions. The test was simple and quick to apply (3-6min), 100% applicable and usable with broad floor and ceiling effects (0-100 points) with an intraclass correlation coefficient (ICC) that shows a high inter-observer reliability (ICC = 0.99), and a good correlation in its full version with BI (ICC = 0.86) (95% CI: 0.82-0.88), and the Tinetti test (ICC = 0.76; 95% CI: 0.71-0.81), as well as in the abbreviated version BI (ICC = 0.71; 95% CI: 0.65-0.75) and Tinetti Test (ICC = 0.90; 95% CI: 0.88-0.92). This allows the variation of the functional condition to be measured, which in our sample showed an increase of 10.9%, after a period of hospital admission. Conclusions: It is considered that Alusti test meets the requirements for physical performance assessment in the whole the geriatric population. The highest level of accuracy is given by the Tinetti test, which has greater applicability
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Geriatric Assessment/methods , Physical Endurance/physiology , Exercise Test/instrumentation , Dementia/epidemiology , Psychometrics/instrumentation , Risk Adjustment/classification , Walking Speed , Prospective StudiesABSTRACT
INTRODUCTION: Physical and psychological functional conditions are key factors in the elderly population. Many evaluation tools are available, but they cannot be applied to the whole geriatric population. The use Alusti Test is presented. This test consists of 2versions, which enable it to encompass this wide and complex population spectrum. MATERIALS AND METHODS: A prospective study with the institutionalised, hospitalised, and community population, was conducted between September and December 2016. A comparative analysis was conducted using the Barthel Index (BI), Gait Speed Test (GST), Timed «Up & Go¼ Test (TUG), Short Physical Performance Battery (SPPB), and Tinetti Test. RESULTS: A total of 363 subjects were enrolled (mean age: 83.25 years), with varying levels of functional and cognitive conditions. The test was simple and quick to apply (3-6min), 100% applicable and usable with broad floor and ceiling effects (0-100 points) with an intraclass correlation coefficient (ICC) that shows a high inter-observer reliability (ICC = 0.99), and a good correlation in its full version with BI (ICC = 0.86) (95% CI: 0.82-0.88), and the Tinetti test (ICC = 0.76; 95% CI: 0.71-0.81), as well as in the abbreviated version BI (ICC = 0.71; 95% CI: 0.65-0.75) and Tinetti Test (ICC = 0.90; 95% CI: 0.88-0.92). This allows the variation of the functional condition to be measured, which in our sample showed an increase of 10.9%, after a period of hospital admission. CONCLUSIONS: It is considered that Alusti test meets the requirements for physical performance assessment in the whole the geriatric population. The highest level of accuracy is given by the Tinetti test, which has greater applicability.
