Purpose: The number of elderly patients, especially aged ≥80 years, undergoing emergency surgery is gradually increasing. The aim of this study was to find out the trends and results of emergency general surgery for elderly patients over 9 years in an emergency medical center in South Korea, where the population is aging most rapidly. Methods: The clinical characteristics, outcomes, and medical expenses of emergency general surgery for the elderly (aged 65–79 years) and highly elderly (aged ≥80 years) patients who visited to a regional emergency medical center from 2012 to 2020 were analyzed. Results: The number of highly elderly patients increased with each 3-year interval, whereas the proportion of patients aged 19–79 years was similar, and that of pediatric patients was decreasing. The higher the age group, the higher the mortality (young adult vs. elderly vs. highly elderly: odds ratio [OR], 1 vs. 3.689 vs. 11.293; P < 0.001) and complication rates (OR, 1 vs. 2.840 vs. 4.633; P < 0.001), and longer length of hospital stay (β = 0.949, P = 0.001) even after adjusting for the type of surgery and the American Society of Anesthesiologists physical status classification. Non-covered medical expenses were significantly related to the age groups (β = 151,608.802, P < 0.001). Conclusion The higher age group was associated with increased number of unfavorable outcomes after emergency general surgery, along with increased medical cost. Efforts to prevent emergency surgery for elderly patients and a specialized treatment system are needed.

PURPOSE: The aneurysmal aortitides could be classified into 4 categories by clinical features, and each category has a different principle of treatment and prognosis. The purposes of this study were 1) to classify the CT findings of the aneurysmal aortitides by the 4 categories-aortic aneurysm, aortic dissection, penetrating atheromatous aortic ulcer, and annuloaortic ectasis, and 2) to evaluate the complications of each category. MATERIALS AND METHODS: We reviewed the CT findings of 33 cases of aneurysmal aortitides, and classified them into the above-mentioned 4 categories. Thirty-two patients were examined with CT with or without ultrasound, angiography, echocardiography, or MRI. Among them, 15 cases were confirmed with operation and the rest were diagnosed with radiologic and clinical findings. RESULTS: There were 17 aortic aneurysms, 9 aortic dissections, 4 penetrating atheromatous aortic ulcers, and 3 annuloaortic ectases. Aortic rupture, the most serious complication of aortitides, occurred in 9 cases. The causes of the rupture were aortic dissection, aneurysm, and penetrating aortic ulcer in descending order of frequency. The most frequent site of rupture was retroperitoneum. CONCLUSION: Using CT with or without other diagnostic tools, we could classify the aneurysmal aotitides into 4 categories and evaluate the complications.
Aneurysm* ; Angiography ; Aortic Aneurysm ; Aortic Rupture ; Aortitis* ; Classification* ; Echocardiography ; Humans ; Magnetic Resonance Imaging ; Prognosis ; Rupture ; Ulcer ; Ultrasonography

To evaluate the clinical feasibility of the antibody titer against a chimeric polypeptide (named Core 518), in which a domain of Core and NS3 of hepatitis C virus (HCV) was fused, ELISA was performed in a total of 76 serum samples. Each serum was serially diluted using two-fold dilution method with distilled water into 10 concentrations. They were all positive for second generation anti-HCV assay (HCV EIA II; Abbott Laboratories). Genotyping RT-PCR, quantitative competitive RT-PCR, and RIBA (Lucky Confirm; LG Biotech) were also assayed. Anti-Core 518 antibody was detected in x 12800 or higher dilutions of sera from 35 of 43 chronic hepatitis C (81.4%) and nine of 16 hepatocellular carcinoma sera (56.3%), one of four cirrhosis (25%), 0 of four acute hepatitis C, and one of nine healthy isolated anti-HCV-positive subjects (p=0.0000). The anti-Core 518 antibody titers were well correlated with the presence of HCV RNA in serum (p=0.002). The anti-Core 518 antibody titers decreased significantly in nine of ten responders to IFN-alpha treatment. Monitoring anti-Core 518 titers may be helpful not only for differentiating the status of HCV infection among patients with various type C viral liver diseases, but also for predicting responses to IFN-alpha treatment.
Adult ; Aged ; Female ; Genotype ; Hepatitis C/immunology* ; Hepatitis C/drug therapy* ; Hepatitis C/diagnosis ; Hepatitis C/blood ; Hepatitis C Antibodies/immunology* ; Hepatitis C Antibodies/blood ; Hepatitis C Antigens/immunology* ; Hepatitis C-Like Viruses/immunology* ; Hepatitis C-Like Viruses/genetics ; Human ; Immunoblotting ; Interferon Alfa-2a/therapeutic use* ; Male ; Middle Age ; RNA, Viral/blood ; Recombinant Fusion Proteins/immunology ; Viral Core Proteins/immunology* ; Viral Nonstructural Proteins/immunology*