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David Lieberman

Publications and source records attributed to David Lieberman.

35 records · Page 2Linked to original sources
PubMed2004

Endoscopic evaluation of patients with dyspepsia: results from the national endoscopic data repository.

BACKGROUND & AIMS: Endoscopy is commonly performed to evaluate symptoms of dyspepsia. The aim of this study was to characterize patients who receive endoscopy for dyspepsia and measure predictors of primary endoscopic outcomes, utilizing a large national endoscopic database. METHODS: The Clinical Outcomes Research Initiative (CORI) receives endoscopy reports from a network of 74 sites in the United States. Sixty-one percent of reports come from private practice settings. Patients with reflux dyspepsia and nonreflux dyspepsia were identified from January 2000 to June 2002. Patients with dysphagia and known Barrett's esophagus were excluded. Primary endoscopic outcomes included esophageal inflammation and stricture, gastric ulcer, duodenal ulcer, suspected Barrett's esophagus (> or =2 cm), and suspected esophageal and gastric malignancy. The presence or absence of alarm symptoms (vomiting, weight loss, and evidence of GI blood loss) was determined. Adjusted relative risk (RR) for predicting serious outcomes was calculated in a multivariate model. RESULTS: We received 117,497 endoscopic reports, representing 99,558 unique patients. Dyspepsia, with and without reflux symptoms, accounted for 43% of upper endoscopies. Among dyspeptic patients, 36.5% were younger than 50 years of age without alarm symptoms. Esophageal or gastric malignancy in patients with dyspepsia was associated with increasing age, male sex, Asian race, Native American race, and symptoms of weight loss and vomiting. Suspected Barrett's esophagus (> or =2 cm) was associated with reflux symptoms, male sex, age, and white race. Ulcers were associated with evidence of bleeding, vomiting, male sex, black race, and Hispanic ethnicity. CONCLUSIONS: These practice-based data reveal important practice behaviors and outcomes.

Adult↗
PubMed2004

Visual and hearing impairment in elderly patients hospitalized for rehabilitation following hip fracture.

In a prospective study, we assessed the prevalence and significance of visual and hearing impairment in 896 patients who were hospitalized for rehabilitation following hip fracture. Visual impairment was defined as visual acuity equal to worse than 6/60 in the better of the two eyes. Hearing impairment was defined as mean decibel level equal to or higher than 60 in the better of the two ears. Visual impairment was found in 210 patients (23.4%) and hearing impairment was found in 231 patients (25.8%). Simultaneous visual and hearing impairment was seen in 72 patients (8%). In univariate analysis, the absolute efficacy of rehabilitation was significantly lower in patients with visual impairment compared to those without (p = 0.00001) and in patients with hearing impairment compared to those without (p = 0.002). However, in multivariate analysis, visual, but not hearing, impairment was found to be independently associated with the absolute efficacy of rehabilitation (p = 0.001). In light of these results, we propose that in the first phase of rehabilitation, patients' visual acuity needs to be optimized.

Aged↗
PubMed2003

Screening and surveillance for Barrett esophagus in high-risk groups: a cost-utility analysis.

BACKGROUND: Once-in-a-lifetime screening for Barrett esophagus has been proposed for patients with gastroesophageal reflux disease (GERD), but there is little evidence of its cost-effectiveness. OBJECTIVE: 1) To determine the cost-effectiveness of screening high-risk groups for Barrett esophagus and providing surveillance to patients with Barrett esophagus and dysplasia or to all patients with Barrett esophagus and 2) to compare the results with the cost-effectiveness of no screening or surveillance. DESIGN: A decision analytic model was developed to examine no screening or surveillance and screening and surveillance for Barrett esophagus with dysplasia only or Barrett esophagus without dysplasia every 2 to 5 years. Low- or high-grade dysplasia received surveillance every 6 or 3 months, respectively. DATA SOURCES: Published literature and the Health Care Financing Administration. TARGET POPULATION: 50-year-old white men with symptoms of GERD. TIME HORIZON: 50 years of age until 80 years of age or death. PERSPECTIVE: Third-party payer. OUTCOME MEASURE: Incremental cost-effectiveness ratio. RESULTS OF BASE-CASE ANALYSIS: Screening with surveillance limited to patients with Barrett esophagus with dysplasia required $10 440 per quality-adjusted life-year (QALY) saved compared to no screening or surveillance. The incremental cost-effectiveness ratio of surveillance every 5 years in patients with Barrett esophagus without dysplasia compared to surveillance of patients with Barrett esophagus with dysplasia was $596 000 per QALY saved. RESULTS OF SENSITIVITY ANALYSIS: The annual incidence of adenocarcinoma must exceed 1 case per 54 patient-years of follow-up (1.9%) for surveillance of Barrett esophagus without dysplasia every 5 years to yield an incremental cost-effectiveness ratio less than $50 000 per QALY saved. CONCLUSIONS: Screening 50-year-old men with symptoms of GERD to detect adenocarcinoma associated with Barrett esophagus is probably cost-effective. However, subsequent surveillance of patients with Barrett esophagus but no dysplasia, even at 5-year intervals, is an expensive practice.

Adenocarcinoma↗
PubMed2003

Pseudomonal infections in patients with COPD: epidemiology and management.

COPD is a common disease with increasing prevalence. The chronic course of the disease is characterized by acute exacerbations that cause significant worsening of symptoms. Bacterial infections play a dominant role in approximately half of the episodes of acute exacerbations of COPD. The importance of pseudomonal infection in patients with acute exacerbations of COPD stems from its relatively high prevalence in specific subgroups of these patients, and particularly its unique therapeutic ramifications. The colonization rate of Pseudomonas aeruginosa in patients with COPD in a stable condition is low.A review of a large number of clinical series of unselected outpatients with acute exacerbations of COPD revealed that P. aeruginosa was isolated from the patients' sputum at an average rate of 4%. This rate increased significantly in COPD patients with advanced airflow obstruction, in whom the rate of sputum isolates of P. aeruginosa reached 8-13% of all episodes of acute exacerbations of COPD. However, the great majority of bacteria isolated in these patients were not P. aeruginosa, but the three classic bacteria Streptococcus pneumoniae, Hemophilus influenzae, and Moraxella catarrhalis. The subgroup of patients, with acute exacerbations of COPD, with the highest rate of P. aeruginosa infection, which approaches 18% of the episodes, is mechanically ventilated patients. However, even in this subgroup the great majority of bacteria isolated are the above-mentioned three classic pathogens. In light of these epidemiologic data and other important considerations, and in order to achieve optimal antibacterial coverage for the common infectious etiologies, empiric antibacterial therapy should be instituted as follows. Patients with acute exacerbations of COPD with advanced airflow obstruction (FEV(1) <50% of predicted under stable conditions) should receive once daily oral therapy with one of the newer fluoroquinolones, i.e. levofloxacin, moxifloxacin, gatifloxacin, or gemifloxacin for 5-10 days. Patients with severe acute exacerbations of COPD who are receiving mechanical ventilation should receive amikacin in addition to one of the intravenous preparations of the newer fluoroquinolones or monotherapy with cefepime, a carbapenem or piperacillin/tazobactam. In both subgroups it is recommended that sputum cultures be performed before initiation of therapy so that the results can guide further therapy.

Chronic Disease↗
PubMed2003

Diagnosis of ambulatory community-acquired pneumonia. Comparison of clinical assessment versus chest X-ray.

OBJECTIVES: When evaluating patients with respiratory tract infections (RTI), physicians have to judge and decide whether the patient has pneumonia or not. This decision is usually made by clinical assessment alone and/or by performing a chest X-ray. The aim of this study was to determine the reliability of physicians' judgements relating to the presence of pneumonia in RTI patients by clinical assessment alone compared with chest X-ray. DESIGN: A prospective, clinical study. SETTING: Primary care clinics and a university hospital in southern Israel. SUBJECTS: Two-hundred-and-fifty ambulatory patients with febrile RTI were included in a prospective study. On the basis of a medical interview and physical examination alone physicians were asked to make judgements relating to the study question, and these judgements were compared with the results of chest X-rays. RESULTS: Physicians' judgements of pneumonia had a sensitivity of 74% (49-90%), a specificity of 84% (78-88%), a negative predictive value of 97% (94-99%) and a positive predictive value of only 27% (16-42%), compared to the results of chest X-ray. CONCLUSION: We conclude that the ability of physicians to negate X-ray confirmed pneumonia by clinical assessment in febrile adult RTI patients is good, but that their ability to successfully predict this condition is poor.

Adult↗
PubMed2003

Infectious aetiologies in elderly patients hospitalised with non-pneumonic lower respiratory tract infection.

OBJECTIVE: to identify the infectious aetiologies of non-pneumonic lower respiratory tract infections in hospitalised elderly patients, and to characterise the patients in terms of demographic, clinical and therapeutic variables. DESIGN: a prospective, non-interventional, purely serologically based diagnostic study. SETTING: a tertiary university hospital in southern Israel. SUBJECTS: 133 elderly patients hospitalised for non-pneumonic lower respiratory tract infections. METHODS: paired sera were obtained for each of the hospitalisations and were tested using immunofluorescence or enzyme immunoassay methods to identify 13 different pathogens. Only significant changes in antibody titers or levels between the paired sera were considered diagnostic. RESULTS: at least one infectious aetiology was identified in 77 patients (58%). At least one of seven viral aetiologies was identified in 52 patients (39%). A bacterial aetiology was identified in 27 patients (20%) including Streptococcus pneumoniae in 24 (18%). An atypical bacterium was found in 27 patients (20%) including Mycoplasma pneumoniae in 15 (11%) and Legionella spp. in nine (7%). More than one aetiology was found in 23 patients (17%). One hundred and twenty nine patients (96%) suffered from serious chronic co-morbidity. One hundred and twenty one patients received antibiotics during their hospitalisation, 106 (80%) with a beta-lactam and 42 (31%) with another antibiotic. CONCLUSIONS: non-pneumonic lower respiratory tract infection is caused in hospitalised elderly patients by a broad spectrum of aetiological agents, primarily respiratory viruses with a significant, though lesser, prevalence of classical and atypical bacteria. Despite this distribution of aetiologies, most patients are treated with beta-lactam antibiotics. The indication for antibiotic therapy in these patients and the choice of antibiotic preparation should be addressed in further studies.

Aged↗
PubMed2003

Management of respiratory infections in the elderly.

Respiratory infections are common at all ages but are particularly sinister among the elderly because of the fragility and chronic comorbidity associated with this age group. The three types of respiratory infection in the elderly are community-acquired pneumonia, acute exacerbation of chronic obstructive pulmonary disease and nonpneumonic respiratory tract infection. The etiology of these three types of infection includes classic bacteria, atypical pathogens and respiratory viruses. The relative frequency of each of the etiological groups as the causative agent of the infection varies significantly among these types of infection, but in all three types a significant proportion of infections involves more than one pathogen. The causative agent of respiratory infection in the elderly cannot be determined on the basis of clinical manifestation or the results of routine imaging procedures or laboratory tests. Thus, initial antibiotic therapy in these patients should be empiric, based on accepted guidelines. In recent years, the antipneumococcal fluoroquinolones have gained in stature as one of the best options to treat these infections. Pneumococcal and influenza vaccinations can reduce morbidity and mortality from respiratory infections in the elderly, so it is important that all elderly individuals are vaccinated through a structured program in the framework of primary care. The economic impact of respiratory infections in the elderly is primarily associated with the requirement for hospitalization in many of the cases. Any action that can reduce hospitalization rates has important economic ramifications. In light of the difficulty in reaching an early etiologic diagnosis in respiratory infections, it is essential to invest in the development of a compact diagnostic kit for the early stages of the disease, which could change reality in this important area of medicine.

Aged↗
PubMed2002

Atypical pathogen infection in adults with acute exacerbation of bronchial asthma.

In a serologically based prospective study, acute infections with four atypical pathogens were determined in 100 adults hospitalized for acute exacerbation of bronchial asthma, and compared with the corresponding rate in a matched control group. Paired sera were tested using immunofluorescence or enzyme immunoassay methods to establish the serologic diagnosis. In 18 patients (18%), there was evidence of acute infection with Mycoplasma pneumoniae, compared with 3% in the control group (p = 0.0006). In 10 of these patients there was evidence of infection with at least one additional pathogen, a respiratory virus in 7. There was no significant difference between the study groups in the rates of acute infection by Chlamydia pneumoniae (8% in the hospitalized patients versus 6% in the control subjects), Legionella spp. (5 versus 3%, respectively), or Coxiella burnettii (no patients in either group). We conclude that of these four atypical pathogens, only infection with M. pneumoniae is associated with hospitalization for acute exacerbation of bronchial asthma. In most of these M. pneumoniae patients there is evidence of infection with a respiratory virus as well. The pathophysiologic and therapeutic significance of these findings should be tested in further studies specifically designed to address these questions.

Acute Disease↗
PubMed2002

A comparative study of the etiology of adult upper and lower respiratory tract infections in the community.

Lower respiratory tract infection and upper respiratory tract infection (URTI) are very common, but the etiology is not diagnosed in routine practice. The objective of this study was to determine and compare the frequency distribution of the various infectious etiologies for these diseases. One hundred seventy five adults in the community with febrile LRTI and 75 with febrile URTI were included in a purely serologically based prospective study. Paired sera were obtained for each of the patients and were tested by EIA or immunofluorescence methods to identify 14 different pathogens. Only a significant change in antibody titers between the paired sera was considered diagnostic. At least one infectious etiology was identified in 167 patients (67%). In the LRTI group, infection with at least one of 7 respiratory viruses was found in 88 patients (50%). One of the atypical pathogens was found in 40 patients (23%), of these Legionella spp. in 19 (11%) and Mycoplasma pneumoniae in 18 (10%). A bacterial etiology was found in 19 patients (11%), of these Streptococcus pneumoniae in 8 (5%) and beta-hemolytic streptococci group A in 5 (3%). The frequency distribution of etiologies in the URTI group was not significantly different from the LRTI group, except for M. pneumoniae that was identified in only one patient with URTI (p = 0.015). More than one etiologic agent was found in 42 (17%) of the patients. LRTI is caused by a broad spectrum of etiologies, with respiratory viruses predominating and a moderate, but significant, prevalence of atypical pathogens. The frequency distribution of etiologies for URTI is similar to LRTI. In a significant proportion of patients with URTI and LRTI there is serologic evidence of infection with more than one pathogen. The justification and benefit of distinguishing between URTI and LRTI in routine clinical work is doubtful. When a decision is reached to treat RTI patients with an antibiotic, it is logical to use a macrolide or tetracycline.

Adult↗
PubMed2002

Serological evidence of Mycoplasma pneumoniae infection in acute exacerbation of COPD.

A prospective study was conducted to identify and characterize hospitalizations for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with serologic evidence of infection with Mycoplasma pneumoniae (Mp). Two hundred forty hospitalizations for AECOPD were included in a 17-month prospective study. Paired sera were obtained for each of the hospitalizations and were tested serologically for Mp using a commercial enzyme immunoassay (EIA) kit. Only significant changes, according to the formula in the manufacturer's instructions, in antibody titers for IgM and/or IgG and/or IgA were considered diagnostic for Mp infection. In 34 hospitalizations (14.2%) the serologic tests for Mp were positive (MpH). In 29 of these hospitalizations (85%) a significant change in IgA was found. In 11 of these hospitalizations (32%) the only change identified was in IgA. In 24 MpH (71%) there was serologic evidence for infection with at least one other respiratory pathogen. In comparison to the 206 hospitalizations without serologic evidence of infection with Mp, MpH had higher rates of inhaled steroid therapy (41% vs. 24%, p = 0.033) and a longer time interval between the appearance of dyspnea and hospitalization (6.6 +/- 3.8 days vs. 5.0 +/- 3.5 days, p = 0.012). There were no significant differences between these two groups in a broad spectrum of patient- and exacerbation-related clinical variables. Specific antibiotic therapy for Mp in the MpH group did not shorten the hospital stay. Serologic evidence of Mp infection is common in patients hospitalized for AECOPD, and is usually based on changes in specific IgA antibody titers. In most MpH another respiratory pathogen can be identified. The vast majority of clinical characteristics are the same in patients with and without serologic evidence of infection with Mp. The practical implications of these findings should be clarified in further studies.

Acute Disease↗
PubMed2002

Rehabilitation after proximal femur fracture surgery in the oldest old.

OBJECTIVE: To assess the course and results of rehabilitation after proximal femur fracture (PFF) in patients 85 years of age or older, compared with younger elderly patients, with an emphasis on functional status. DESIGN: Prospective cohort study. SETTING: A rehabilitation geriatric ward in a tertiary university hospital in southern Israel. PARTICIPANTS: The study group included 127 elderly patients 85 years of age or older who were hospitalized for rehabilitation following surgery for PFF. The comparison group was comprised of 297 patients aged 75 to 84 years who were hospitalized for the same indication in the same time period. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Functional studies by FIM trade mark instrument, mental status by the Folstein Mini-Mental State Examination, Geriatric Depression Screening (GDS) scale, length of rehabilitation, and complications and mortality during rehabilitation. RESULTS: Compared with patients aged 75 to 84 years, the older study group was in a worse mental state (P=.00005), even though the groups did not differ in their GDS scores. There were no significant differences between the groups in rehabilitation length of stay, in the rate of most postoperative complications, or in death rates during rehabilitation. FIM values before PFF, at the beginning of rehabilitation and at its end, and the difference between the beginning and end of rehabilitation were lower in the older group (P<.00001 for all tests). CONCLUSIONS: From the functional standpoint, rehabilitation after PFF surgery is much less successful in the 85+ age group than in the 75-to-84 age group but did not differ in its duration, rates of most complications, or mortality. Nonetheless, a significant percentage of patients in this age group have successful rehabilitation so they should not be deprived the chance.

Aged↗
PubMed2002

Legionella species infection in adult febrile respiratory tract infections in the community.

Legionella spp. (Lsp) are well recognized as etiologic factors in pneumonia but less so in respiratory tract infections (RTI) in the community. The objective of the present study was to characterize febrile RTI patients with a documented Legionella etiology, in terms of specific serogroups, clinical manifestations of the disease, disease course and the effect of antibiotic therapy. Ambulatory adults with febrile RTI (n = 250) were included in a prospective study in which the etiological causes of the infection were identified using sophisticated serological techniques. Paired sera were obtained for each of the patients and were tested for 41 different serotypes of Lsp using micro-immuno-fluorescence (MIF) serology. Only a significant change in IgG and/or IgM antibody titers was considered diagnostic. In 28 patients (11.2%) there was serological evidence of acute infection with 1 of the types of Lsp. The infections were manifested clinically as upper RTI in 9 patients and as lower RTI in the other 19 patients (community-acquired pneumonia in 2 of these). L. pneumophila serogroup 1 was identified in 3 patients, L. pneumophila serogroups higher than 1 were identified in 13 patients and L. non-pneumophila serogroups in 18 patients. The clinical and laboratory findings in patients with acute Lsp infection were not significantly different from those in patients without evidence of this infectious agent. The length and course of the disease were similar in the 12 patients treated with specific antibiotics for Lsp and in those who were not. We conclude that Lsp can be identified in a significant percentage of patients with acute febrile RTI. No specific clinical or laboratory features were observed for these patients and specific antibiotic therapy does not affect the course of the disease.

Adult↗
PubMed2002

Proximal deep vein thrombosis after hip fracture surgery in elderly patients despite thromboprophylaxis.

OBJECTIVE: Hip fracture is very common in the elderly population and is a highly significant risk factor for the development of deep vein thrombosis. Thus, deep vein thrombosis prophylaxis is indicated in these patients. The objective of this study was to determine the prevalence of proximal deep vein thrombosis in patients receiving usual prophylaxis, to characterize patients with deep vein thrombosis, and to assess the effect of deep vein thrombosis on the course and outcome of rehabilitation. DESIGN: An interventional prospective study in a rehabilitation geriatric ward in a tertiary university hospital in southern Israel involving 644 elderly patients undergoing rehabilitation after surgery for hip fracture. Thromboprophylaxis included graduated compression stockings and subcutaneous low-molecular-weight heparin. All patients underwent Doppler ultrasonography to identify proximal deep vein thrombosis. Conventional scales were used to measure functional and cognitive status. RESULTS: Thirty-nine patients developed proximal deep vein thrombosis despite thromboprophylaxis. The patients with deep vein thrombosis, compared with those without, had more episodes of stroke in the past, lower FIM trade mark transfer subscores at the beginning of rehabilitation, a longer rehabilitation period, and a higher mortality rate during hospitalization. CONCLUSIONS: Despite thromboprophylaxis, patients undergoing surgery for hip fracture are at significant risk to develop proximal deep vein thrombosis, which prolongs the rehabilitation time and increases mortality rates. Thus, screening Doppler sonography should be performed on all these patients to identify deep vein thrombosis. Further studies are needed to determine the optimal timing for this procedure.

Aged↗
PubMed2002

Pneumonic vs nonpneumonic acute exacerbations of COPD.

STUDY OBJECTIVE: To describe and compare the background, clinical manifestations, disease course, and infectious etiologies of pneumonic acute exacerbations (PNAE) vs nonpneumonic acute exacerbations (NPAE) of COPD. DESIGN: A prospective, observational study. SETTING: A tertiary university medical center in southern Israel. PATIENTS: Twenty-three hospitalizations for PNAE and 217 hospitalizations for NPAE were included in the study. Paired sera were obtained for each of the hospitalizations and were tested serologically for 12 pathogens. Only a significant change in antibody titers or levels was considered diagnostic. RESULTS: No significant differences were found between the two groups for any of the parameters related to COPD or comorbidity. The clinical type of the exacerbation was not significantly different between the groups. Compared to NPAE, patients with PNAE had lower PO(2) values at hospital admission (p = 0.004) but higher rates of abrupt onset (p = 0.005), ICU admissions (p = 0.006), invasive mechanical ventilation (p = 0.01), mortality (p = 0.007), and longer hospital stay (p = 0.001). In 22 PNAE hospitalizations (96%) and in 153 NPAE hospitalizations (71%), at least one infectious etiology was identified (p = 0.001). Mixed infection was found in 13 patients with PNAE (59%) and in 59 patients with NPAE (39%; not significant [NS]). Viral etiology was identified in 18 patients with PNAE (78%) compared with 99 patients with NPAE (46%; p = 0.003). Pneumococcal etiology was found in 10 patients with PNAE (43%) and in 38 patients with NPAE (18%; p = 0.006). An atypical etiology was identified in 8 patients with PNAE (35%) and 64 patients with NPAE (30%; NS). CONCLUSIONS: Community-acquired pneumonia is common among patients hospitalized for an acute exacerbation of COPD and is generally manifested by more severe clinical and laboratory parameters. In PNAE, compared to NPAE, viral and pneumococcal etiologies are more common, but the rate of atypical pathogens is similar. The therapeutic significance of these findings should be investigated further.

Acute Disease↗
PubMedDate not supplied

Clinical and laboratory profile of febrile respiratory infections in general practice.

BACKGROUND: Respiratory tract infection (RTI) is a common diagnosis in the primary care setting. The aim of the study was to characterize the clinical course and laboratory manifestations of febrile RTI in Israeli adults presenting to primary care clinics. METHODS: A prospective study over a 3-month winter period in 3 urban university primary care clinics of 122 consecutive adult patients seen by their family practitioners. All participants were interviewed and had chest radiographs, tests of oxygen saturation, and blood tests. RESULTS: Study group included 122 adults (mean age, 44.8 +/- 14.2 years; men, 38%). Fever lasted for a mean of 4.0 +/- 1.7 days, and the mean number of days off work/activities was 5.3 +/- 1.0. Pneumonia was clinically suspected in 33 patients (27%), but documented in 7 (6%). Antibiotics were given to 94 patients (77%). The group of treated patients had a lower mean oxygen saturation (P <.05) and a higher erythrocyte sedimentation rate (P <.05). Blood tests were found to be abnormal, although not clinically significant, in some patients, and all resolved spontaneously. CONCLUSIONS: RTIs are usually of short duration with a benign course where laboratory blood tests have no clinical implication. Radiographs may distinguish the 6% of patients having pneumonia from the 27% with suspected cases.

Adult↗
PubMedDate not supplied

Rehabilitation following stroke in patients aged 85 and above.

To assess the course and results of rehabilitation following stroke in the oldest old, we conducted a prospective study to compare 45 patients 85 years and above and 220 consecutive patients aged 75 to 84 years who were hospitalized for rehabilitation following stroke. Functional status was measured and compared by the Functional Independence Measuretrade mark(FIM) scale and successful rehabilitation was defined as FIM > 80 at discharge. Eighteen patients in the 85+ group (40%) underwent successful rehabilitation compared with 115 (52%) in the 75 to 84 group (not significant). No significant differences were found between the groups in any other parameters that measure success and/or efficacy of rehabilitation, but in all these parameters, without exception, there were lower values in the 85+ group. No differences in the length of rehabilitation and complications rates were found between groups. We conclude that although the success rate for rehabilitation following stroke is lower in the oldest old, it appears that the effort invested in rehabilitating patients in this group is no less justified than in younger elderly patients.

Age Factors↗