Mortality and high haematrocrit in the very aged

A series of 543 people, aged 85 years or more was studied and divided into groups according to haematocrit value. The mortality of the subjects was followed over the next 5 years. The mortality in the lowest haematocrit groups was highest during the whole observation period. Further, in the haematocrit bracket greater than or equal to 0.48, the mortality in the first year was higher than in those with haematocrit 0.40-0.47. In the second year this increased mortality had disappeared and in the third-fifth years decreased mortality was found with high haematocrit. Initially high haematocrit also decreased during the observation period. Since the increased mortality associated with high haematocrit disappeared it cannot be based on any chronic disease but on some disappearing factor, e.g. simply the high haematocrit itself.     

Blood pressure and five year survival in the very old

During 1977-8 we measured blood pressure in 561 old people (83% of those aged 85 or more living in Tampere) and analysed their five year survival according to their blood pressure group. The subjects were divided into six groups on the basis of their blood pressures (from less than 120 to greater than 200 mm Hg systolic, from less than 70 to greater than 110 diastolic). The greatest mortality was observed in those in the lowest systolic and lowest diastolic groups. Mortality was least in subjects with systolic pressures of 160 mm Hg or more and diastolic pressures of 90 mm Hg or more. The most essential finding in this series of the very old was an increased mortality in the lowest blood pressure groups.     

Pseudoaneurysms complicating organ transplantation: roles of CT, duplex sonography, and angiography

In a retrospective study of proved pseudoaneurysms (PAs) in 15 patients with transplanted organs (11 liver, three kidney, one pancreas), the results of computed tomography (CT), duplex sonography, and angiography were reviewed. Of the 15 cases of PA, eight occurred at the arterial anastomosis and seven were nonanastomotic. Three of the eight anastomotic PAs were caused by infection. Of the seven nonanastomotic PAs, four were caused by percutaneous biopsy, two were caused by infection, and one was of undetermined cause. In nine (60%) of the 15 patients the PAs were incidentally detected at imaging studies performed for other reasons. Diagnosis requires a high degree of suspicion. CT was performed in nine cases and duplex sonography in ten. The diagnosis of PA was made with CT in six (67%) patients and with duplex sonography in five (50%). CT and duplex sonography could not enable diagnosis when the PA was small, when the arterial anastomosis was not included in the field of study, or when enhancement with intravenously administered contract material was suboptimal. Angiography depicted the PAs in all 15 patients. In three liver transplant recipients with gastrointestinal tract bleeding, the causative PAs were detected only with angiography.