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Sala RJ, Ery J, Cuesta-Peredo D, Muedra V, Rodilla V. Complete Blood Count Alterations Prior to the Diagnosis of Colorectal Cancer May Help in the Detection of Synchronous Liver Metastases. J Clin Med 2023; 12:6540. [PMID: 37892677 PMCID: PMC10607722 DOI: 10.3390/jcm12206540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/04/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
Background and Aims: Colorectal cancer (CRC) represents 10% of all cancers worldwide with the highest incidence in developed countries; its incidence is also increasing in middle- and low-income countries. Population screening programs facilitate early diagnosis of the disease. When the diagnosis is carried out in advanced stages, approximately 80% of patients with liver metastases (LM) are considered unresectable at the time of diagnosis. In our study, variations in blood counts prior to CRC diagnosis were analyzed to assess whether they could be useful in identifying smaller, more manageable metastases at earlier stages for more effective treatment. Methods: A study was carried out using complete blood counts (CBCs) from CRC patients, obtained from primary health centers and the La Ribera University Hospital within La Ribera Health Department, Valencian Community, Spain, between July 2012 and September 2020. Data from CRC patients who presented synchronous liver metastasis (CRLM) were compared with those with CRC without LM at diagnosis (CRC patients). Results: Our analysis shows that at least 15 months before CRC diagnosis, a progressive alteration was observed in CBC parameters in both groups. A higher incidence of anemia (p < 0.001) was observed among CRLM patients in the three months prior to CRC diagnosis than in CRC patients showing no LM. Conclusions: A statistically significant deterioration of CBC was observed in patients with advanced-stage CRC and synchronous or early LM (CRLM) in the three months prior to diagnosis. The primary goal of incorporating CBC variations into predictive models is to identify individuals who are at a greater risk of developing metastatic colon cancer, leading to early diagnosis. Our research improves these models by highlighting a more pronounced and rapid decline in hemoglobin levels among CRLM patients. Identification of metastases at an earlier stage when they are smaller, more manageable, and more amenable to treatment may be a valuable tool to prevent their further progression.
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Affiliation(s)
- Rafael J. Sala
- Department of General and Digestive Surgery, La Ribera University Hospital, 46600 Alzira, Spain;
- Department of Medicine and Surgery, Faculty of Health Sciences, CEU Cardenal Herrera University, CEU Universities, C/Santiago Ramón y Cajal, s/n., Alfara del Patriarca, 46115 Valencia, Spain;
| | - John Ery
- RiskLab, ETH Zürich, 8092 Zürich, Switzerland;
| | - David Cuesta-Peredo
- Department of Quality Management, La Ribera University Hospital, 46600 Alzira, Spain;
| | - Vicente Muedra
- Department of Medicine and Surgery, Faculty of Health Sciences, CEU Cardenal Herrera University, CEU Universities, C/Santiago Ramón y Cajal, s/n., Alfara del Patriarca, 46115 Valencia, Spain;
- Department of Anesthesiology, Critical Care and Pain Therapy, La Ribera University Hospital, 46600 Alzira, Spain
| | - Vicent Rodilla
- Department of Pharmacy, Faculty of Health Sciences, CEU Cardenal Herrera University, CEU Universities, C/Santiago Ramón y Cajal, s/n., Alfara del Patriarca, 46115 Valencia, Spain
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Belenguer-Varea A, Avellana-Zaragoza JA, Inglés M, Cunha-Pérez C, Cuesta-Peredo D, Borrás C, Viña J, Tarazona-Santabalbina FJ. Effect of Familial Longevity on Frailty and Sarcopenia: A Case-Control Study. Int J Environ Res Public Health 2023; 20:1534. [PMID: 36674289 PMCID: PMC9865421 DOI: 10.3390/ijerph20021534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
Familial longevity confers advantages in terms of health, functionality, and longevity. We sought to assess potential differences in frailty and sarcopenia in older adults according to a parental history of extraordinary longevity. A total of 176 community-dwelling subjects aged 65-80 years were recruited in this observational case-control study, pair-matched 1:1 for gender, age, and place of birth and residence: 88 centenarians' offspring (case group) and 88 non-centenarians' offspring (control group). The main variables were frailty and sarcopenia based on Fried's phenotype and the European Working Group on Sarcopenia in Older People (EWGSOP) definitions, respectively. Sociodemographics, comorbidities, clinical and functional variables, the presence of geriatric syndromes, and laboratory parameters were also collected. Related sample tests were applied, and conditional logistic regression was performed. Cases had a higher percentage of robust patients (31.8% vs. 15.9%), lower percentages of frailty (9.1% vs. 21.6%) and pre-frailty (59.1% vs. 62.5%) (p = 0.001), and lower levels of IL-6 (p = 0.044) than controls. The robust adjusted OR for cases was 3.00 (95% CI = 1.06-8.47, p = 0.038). No significant differences in muscle mass were found. Familial longevity was also associated with less obesity, insomnia, pain, and polypharmacy and a higher education level and total and low-density lipoprotein cholesterol. The results suggest an inherited genetic component in the frailty phenotype, while the sarcopenia association with familial longevity remains challenging.
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Affiliation(s)
- Angel Belenguer-Varea
- Division of Geriatrics, Hospital Universitario de la Ribera, 46600 Valencia, Spain
- School of Doctorate, Universidad Católica de Valencia San Vicente Martir, 46001 Valencia, Spain
| | - Juan Antonio Avellana-Zaragoza
- Division of Geriatrics, Hospital Universitario de la Ribera, 46600 Valencia, Spain
- School of Doctorate, Universidad Católica de Valencia San Vicente Martir, 46001 Valencia, Spain
| | - Marta Inglés
- Freshage Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, CIBERFES-ISCIII, INCLIVA, 46010 Valencia, Spain
| | - Cristina Cunha-Pérez
- School of Doctorate, Universidad Católica de Valencia San Vicente Martir, 46001 Valencia, Spain
| | - David Cuesta-Peredo
- Department of Quality Management, Hospital Universitario de la Ribera, 46600 Valencia, Spain
| | - Consuelo Borrás
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, CIBERFES-ISCIII, INCLIVA, 46010 Valencia, Spain
| | - José Viña
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, CIBERFES-ISCIII, INCLIVA, 46010 Valencia, Spain
| | - Francisco José Tarazona-Santabalbina
- Division of Geriatrics, Hospital Universitario de la Ribera, 46600 Valencia, Spain
- School of Doctorate, Universidad Católica de Valencia San Vicente Martir, 46001 Valencia, Spain
- Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable (CIBERFES), 46010 Valencia, Spain
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Tarazona-Santabalbina FJ, Llabata-Broseta J, Belenguer-Varea Á, Álvarez-Martínez D, Cuesta-Peredo D, Avellana-Zaragoza JA. A daily multidisciplinary assessment of older adults undergoing elective colorectal cancer surgery is associated with reduced delirium and geriatric syndromes. J Geriatr Oncol 2018; 10:298-303. [PMID: 30217699 DOI: 10.1016/j.jgo.2018.08.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 08/01/2018] [Accepted: 08/31/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Comprehensive geriatric assessment (CGA) has shown to benefit older patients undergoing urological and orthopedic surgery. However, this approach has been scarcely assessed in patients elected for colorectal surgery. MATERIALS AND METHODS Retrospective cohort of patients aged ≥70 years admitted for elective colorectal cancer surgery to a single hospital between 2008 and 2012. Upon admission, patients were assigned to a usual care (UC) plan or a CGA-based care (GS) plan conducted by a multidisciplinary team, according to standard clinical criteria.Analyzed outcomes included the incidence of delirium and other geriatric syndromes during hospital stay, mortality, readmissions, andnumber of perioperative complications. RESULTS The cohort included 310 patients, 203 assigned to the GS group and 107 to the UC group. Patients in the GS group had significantly lower Barthel and Lawton scores, higher prevalence of dementia and heart failure, and higher comorbidity burden. Fifty-four (17.5%) patientsexperienced delirium (23 [11.3%] and 31 [29.2%] in the GS and UC groups, respectively; p < .001), and 49 (15.8%) patient experienced other geriatric syndromes (21 [10.3%] and 28 [26.2%] in the GS and UC groups, respectively; p < .001). Serious complications were more frequent in the GS group: 154 (75.9%) vs 60 (56.1%) in the UC group; p < .001. No significant differences were observed between groups regarding readmissions, and in-hospital and post-discharge (1 year follow-up) mortality. CONCLUSIONS Despite the poorer clinical condition of patients in the GS group, the CGA-based intervention resulted in a lower incidence of delirium and other geriatric syndromes compared with the UC group.
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Affiliation(s)
- Francisco J Tarazona-Santabalbina
- Division of Geriatrics, Hospital Universitario de La Ribera (Alzira, Valencia, Spain), School of Nursing and Medicine, Universidad Católica de Valencia, San Vicente Martir, Spain.
| | - Jorge Llabata-Broseta
- Division of Geriatrics, Hospital Universitario de La Ribera (Alzira, Valencia, Spain), School of Nursing and Medicine, Universidad Católica de Valencia, San Vicente Martir, Spain
| | - Ángel Belenguer-Varea
- Division of Geriatrics, Hospital Universitario de La Ribera (Alzira, Valencia, Spain), School of Nursing and Medicine, Universidad Católica de Valencia, San Vicente Martir, Spain
| | - David Álvarez-Martínez
- Division of General and Digestive Surgery, Hospital Universitario de La Ribera (Alzira, Valencia, Spain), Spain
| | - David Cuesta-Peredo
- Division of Records and Medical Documentation, UniversidadCatólica de Valencia, San Vicente Mártir, Spain
| | - Juan A Avellana-Zaragoza
- Division of Geriatrics, Hospital Universitario de La Ribera (Alzira, Valencia, Spain), School of Nursing and Medicine, Universidad Católica de Valencia, San Vicente Martir, Spain
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Llabata-Broseta J, Tarazona-Santabalbina F, Belenguer-Varea Á, Álvarez-Martínez D, Trescoli Serrano C, Cuesta-Peredo D, Avellana-Zaragoza J. PRELIMINARY RESULT ON GERIATRIC-SURGERY ATTENTION IN COLORECTAL SURGERY: A RETROSPECTIVE COHORT STUDY. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- J. Llabata-Broseta
- Geriatric Medicine, Hospital Universitario de la Ribera (Alzira, Valéncia, Spain), Alzira, Valéncia, Spain,
- Universidad Católica de Valencia. San Vicente Mártir, Valéncia, Spain
| | - F.J. Tarazona-Santabalbina
- Geriatric Medicine, Hospital Universitario de la Ribera (Alzira, Valéncia, Spain), Alzira, Valéncia, Spain,
- Universidad Católica de Valencia. San Vicente Mártir, Valéncia, Spain
| | - Á. Belenguer-Varea
- Geriatric Medicine, Hospital Universitario de la Ribera (Alzira, Valéncia, Spain), Alzira, Valéncia, Spain,
- Universidad Católica de Valencia. San Vicente Mártir, Valéncia, Spain
| | | | - C. Trescoli Serrano
- Geriatric Medicine, Hospital Universitario de la Ribera (Alzira, Valéncia, Spain), Alzira, Valéncia, Spain,
| | - D. Cuesta-Peredo
- Geriatric Medicine, Hospital Universitario de la Ribera (Alzira, Valéncia, Spain), Alzira, Valéncia, Spain,
- Universidad Católica de Valencia. San Vicente Mártir, Valéncia, Spain
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Sicras-Mainar A, De Salas-Cansado M, Ruiz-Antorán MB, Cuesta-Peredo D, Lizano-Díez I, Betegón-Nicolas L, Navarro-Artieda R. [Use of health resources and costs associated with the diagnosis and treatment of each episode of deep vein thrombosis and bleeding in patients undergoing orthopaedic surgery for hip or knee]. Rev Esp Cir Ortop Traumatol (Engl Ed) 2013; 56:341-53. [PMID: 23594888 DOI: 10.1016/j.recot.2012.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Revised: 04/16/2012] [Accepted: 04/22/2012] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To determine the use of healthcare resources and costs associated with the diagnosis and treatment of thrombosis and bleeding patients who have undergone elective hip or knee replacement surgery, in routine clinical practice conditions. PATIENTS AND METHODS This multicentre observational and retrospective study extracted data from the medical records of three Spanish public hospitals (2010). Patients ≥ 40 years who had received prophylaxis-anticoagulation were included. They were randomised into three groups: a) control (no hospital complications), b) bleeding, and c) thrombosis. General variables, use of resources and costs were analysed. STATISTICAL ANALYSIS logistic regression and ANCOVA for model correction, (P<.05) was included. RESULTS A total of 141 patients (control: 60; bleeding: 60; and thrombosis: 21), with a mean age 68.7 (SD: 10.4) years, and 68.1% females were identified. Hip arthroplasty was more frequent (71.6%). The bleeding risk was associated with age (OR=1.1) and thrombosis with COPD (OR=1.8); P<.05). The average length of stay for the thrombosis, bleeding and control groups was 13.9, 11.5 and 7.4 days, respectively; P<.001). The total costs for each group were €10,484.3; €8,766.4 and €6,496.1 respectively; P<.05. All grouped results were comparable between them according to the hospital analysed and the type of replacement. CONCLUSIONS Costs were higher for thrombosis and bleeding patients, respectively. Costs were associated with length of stay and hospital-acquired infections.
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Affiliation(s)
- A Sicras-Mainar
- Dirección de Planificación, Badalona Serveis Assistencials, Badalona, Barcelona, España.
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