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Geriatric evaluation and management

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https://www.readbyqxmd.com/read/29139194/advantages-of-care-for-patients-with-hip-fractures-in-the-acute-geriatric-unit-hip-study-anoia
#1
Enric Duaso, Francesc Formiga, Patrícia Marimón, Montserrat Sandiumenge, Maria Teresa Salgado, Victor Murga, Andrés Gamboa, Carlos Rodriguez, Jaume Castellà, Enrique Escalante, Célia Lumbreras, Anna Tarrida, Ramón Sellarès
AIM: Hip fracture as a result of bone fragility is characterized by poor health outcomes in the medium and long term. Our goal was to compare a new orthogeriatric model with the old trauma model and evaluate improvements in clinical management. METHODS: We carried out a comparative unicentric study, a historical sample (trauma model) collected from 1 June 2007 to 31 May 2010, versus a prospective sample (orthogeriatric model) collected from 1 June 2010 until 31 May 2013...
November 15, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29135667/nationwide-analysis-of-femoral-neck-fractures-in-elderly-patients-a-receding-tide
#2
Derek G Ju, Sean S Rajaee, James Mirocha, Carol A Lin, Charles N Moon
BACKGROUND: Geriatric femoral neck fractures are associated with substantial morbidity and medical cost. We evaluated the incidence and management trends of femoral neck fractures in recent years in the U.S. METHODS: Patient data from 2003 through 2013 were obtained from the Nationwide Inpatient Sample database. Femoral neck fractures in patients ≥65 years old were identified and grouped using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedure codes for internal fixation, hemiarthroplasty, or total hip arthroplasty (THA)...
November 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29133765/geriatric-anesthesia-related-morbidity-and-mortality-in-china-current-status-and-trend
#3
REVIEW
Yang Liu, Wei Xiao, Ling-Zhong Meng, Tian-Long Wang
OBJECTIVE: The population of elderly patients and the amount of geriatric anesthesia have been growing rapidly in China. Thus, understanding the morbidity and mortality associated with geriatric anesthesia in China is critical to the improvement of anesthesia quality and outcome. The aim of the review was to discuss the geriatric anesthesia-related morbidity and mortality in China, as well as to point out the future trend. DATA SOURCES: Articles in this review were all searched from Wanfang, China National Knowledge Infrastructure (CNKI), VIP, PubMed, and Web of Science databases, based on the reports originated in China from January 2011 to December 2016...
November 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/29128297/role-of-geriatric-oncologists-in-optimizing-care-of-urological-oncology-patients
#4
REVIEW
Jean-Pierre Droz, Helen Boyle, Gilles Albrand, Nicolas Mottet, Martine Puts
CONTEXT: Urological cancers are common. Since the median age of diagnosis is 60-70 yr, many patients require geriatric as well as urological evaluation if treatment is to be tailored to individual health status including comorbidities and frailty. OBJECTIVE: To review the most important features of geriatric assessment and its expected benefits. We also consider ways in which collaboration between urologists and geriatricians and geriatric teams can benefit patient well-being...
November 8, 2017: European Urology Focus
https://www.readbyqxmd.com/read/29109936/a-study-of-harmful-drug-drug-interactions-due-to-polypharmacy-in-hospitalized-patients-in-goa-medical-college
#5
Akshay Khandeparkar, Padmanabh V Rataboli
Introduction: Concomitant use of multiple drugs is often indicated to manage comorbid conditions and enhance efficacy. Such concomitant use of multiple drugs (five or more drugs) has been defined as "polypharmacy." Polypharmacy has been associated with adverse consequences such as greater healthcare costs, increased risk of adverse drug events, drug-drug interactions (DDIs), medication nonadherence, reduced functional capacity, and multiple geriatric syndromes. This study evaluated number of potential harmful DDIs due to polypharmacy...
October 2017: Perspectives in Clinical Research
https://www.readbyqxmd.com/read/29105507/-factors-affecting-services-offered-to-older-adults-with-psychological-morbidity-an-exploration-of-health-professional-attitudes
#6
Jennifer White, Kath Greer, Grant Russell, Aislinn Lalor, Rene Stolwyk, Cylie Williams, Ted Brown, Terrence Haines
AIM: Poor collaboration between the multiple services involved in hospital discharge planning may contribute to suboptimal patient outcomes post discharge. This study aimed to explore clinician (medical, allied health and nursing) attitudes towards the management of the older patient with psychological morbidity during and following hospitalization. METHODS: Focus groups were held with 54 health professionals comprising of 7 from acute, 20 from subacute (geriatric assessment and rehabilitation), and 27 from community care settings...
November 6, 2017: Aging & Mental Health
https://www.readbyqxmd.com/read/29102322/a-systematic-review-and-meta-analysis-of-the-criterion-validity-of-nutrition-assessment-tools-for-diagnosing-protein-energy-malnutrition-in-the-older-community-setting-the-macro-study
#7
Skye Marshall, Dana Craven, Jaimon Kelly, Elizabeth Isenring
BACKGROUND & AIMS: Malnutrition is a significant barrier to healthy and independent ageing in older adults who live in their own homes, and accurate diagnosis is a key step in managing the condition. However, there has not been sufficient systematic review or pooling of existing data regarding malnutrition diagnosis in the geriatric community setting. The current paper was conducted as part of the MACRo (Malnutrition in the Ageing Community Review) Study and seeks to determine the criterion (concurrent and predictive) validity and reliability of nutrition assessment tools in making a diagnosis of protein-energy malnutrition in the general older adult community...
October 12, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29036823/prevalence-and-correlates-of-behavioral-disorders-in-old-age-subjects-with-cognitive-impairment-results-from-the-regal-project
#8
Virginia Boccardi, Manuela Conestabile Della Staffa, Marta Baroni, Sara Ercolani, Michele Francesco Croce, Carmelinda Ruggiero, Patrizia Mecocci
BACKGROUND: Presence of behavioral and psychological symptoms of dementia (BPSD) is very common in subjects with cognitive impairment, representing an important determinant of disease progression, institutionalization, and worse prognosis. Knowledge of the prevalence and correlates of BPSD in community-living old subjects with cognitive impairment is limited so far, but it is essential for establishing specifically tailored care and cure in such a vulnerable population. OBJECTIVE: With this study, we aimed at investigating, in a large sample of old age subjects with cognitive impairment, BPSD prevalence and correlates including the main demographic, clinical, and socio-environmental characteristics...
October 8, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/29034078/recent-advances-in-cancer-surgery-in-older-patients
#9
REVIEW
Siri Rostoft, Riccardo A Audisio
Age is the most important risk factor for the occurrence of cancer, and a declining mortality from heart disease and other non-cancer causes leaves an older population that is at high risk of developing cancer. Choosing the optimal treatment for older cancer patients may be a challenge. Firstly, older age and associated factors such as comorbidities, functional limitations, and cognitive impairment are risk factors for adverse effects of cancer treatment. Secondly, older patients are often excluded from clinical trials, and current clinical guidelines rarely address how to manage cancer in patients who have comorbidities or functional limitations...
2017: F1000Research
https://www.readbyqxmd.com/read/29028567/accessibility-of-prison-healthcare-for-elderly-inmates-a-qualitative-assessment
#10
Raheleh Heidari, Tenzin Wangmo, Serena Galli, David M Shaw, Bernice S Elger
Aging in custody and the rising population of elderly prisoners are creating compelling challenges for criminal justice, prison and public healthcare systems. Geriatric syndrome and higher prevalence of co-morbidities amongst older inmates result in heightened vulnerability in prison environments. Empirical research addressing older adults' access to medical care in detention is scarce; therefore, this study assessed access to medical care in prison from the perspective of older prisoners in Switzerland. We interviewed a sample of 35 older inmates (average age 61 years) on their experience of healthcare accessibility in prison; data were qualitatively analysed and major themes regarding evaluation of their access to medical services were extracted...
October 4, 2017: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/29016696/a-battery-less-and-wireless-wearable-sensor-system-for-identifying-bed-and-chair-exits-in-a-pilot-trial-in-hospitalized-older-people
#11
Roberto L Shinmoto Torres, Renuka Visvanathan, Derek Abbott, Keith D Hill, Damith C Ranasinghe
Falls in hospitals are common, therefore strategies to minimize the impact of these events in older patients and needs to be examined. In this pilot study, we investigate a movement monitoring sensor system for identifying bed and chair exits using a wireless wearable sensor worn by hospitalized older patients. We developed a movement monitoring sensor system that recognizes bed and chair exits. The system consists of a machine learning based activity classifier and a bed and chair exit recognition process based on an activity score function...
2017: PloS One
https://www.readbyqxmd.com/read/28990244/a-comparison-of-two-tools-to-screen-potentially-inappropriate-medication-in-internal-medicine-patients
#12
A-L Blanc, S Spasojevic, A Leszek, M Théodoloz, P Bonnabry, T Fumeaux, N Schaad
WHAT IS KNOWN: Potentially inappropriate medication (PIM) is an important issue for inpatient management; it has been associated with safety problems, such as increases in adverse drugs events, and with longer hospital stays and higher healthcare costs. OBJECTIVE: To compare two PIM-screening tools-STOPP/START and PIM-Check-applied to internal medicine patients. A second objective was to compare the use of PIMs in readmitted and non-readmitted patients. METHOD: A retrospective observational study, in the general internal medicine ward of a Swiss non-university hospital...
October 8, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28975679/an-emergency-department-observation-unit-is-a-feasible-setting-for-multidisciplinary-geriatric-assessments-in-compliance-with-the-geriatric-emergency-department-guidelines
#13
Lauren T Southerland, Anthony J Vargas, Lalitha Nagaraj, Tanya R Gure, Jeffery M Caterino
BACKGROUND: The Geriatric Emergency Department Guidelines recommend providing multidisciplinary geriatric assessment in the Emergency Department (ED), but these assessments can be difficult to coordinate and may prolong length of stay. Patients who need longer than a typical ED stay can be placed in an ED Observation Unit (Obs Unit). We investigated the effects of offering multidisciplinary assessments for ED patients in an Obs Unit. METHODS: Evaluation by a geriatric hospital consultation team, physical therapist, case manager, and/or pharmacist was made available to all Obs Unit patients...
October 4, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28972834/how-we-care-for-an-older-patient-with-cancer
#14
Armin Shahrokni, Soo Jung Kim, George J Bosl, Beatriz Korc-Grodzicki
As the number of older patients with cancer is increasing, oncology disciplines are faced with the challenge of managing patients with multiple chronic conditions who have difficulty maintaining independence, who may have cognitive impairment, and who also may be more vulnerable to adverse outcomes. National and international societies have recommended that all older patients with cancer undergo geriatric assessment (GA) to detect unaddressed problems and introduce interventions to augment functional status to possibly improve patient survival...
February 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28972243/assessment-of-clinical-practices-for-crushing-medication-in-geriatric-units
#15
M Fodil, D Nghiem, M Colas, S Bourry, A-S Poisson-Salomon, H Rezigue, C Trivalle
OBJECTIVES: To assess the modification of the form of medication and evaluate staff observance of good clinical practices. DESIGN: One-day assessment of clinical practices. SETTING: 17 geriatrics units in the 3 Teaching Hospitals of Paris-Sud (APHP), France. PARTICIPANTS: Elderly in-patients with difficulties swallowing capsules and tablets. MEASUREMENTS: Assessment of target-patient prescriptions and direct observation of nurses' medical rounds...
2017: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/28971468/post-operative-delirium-in-elderly-people-diagnostic-and-management-issues-of-post-operative-delirium-in-elderly-people
#16
Christina Florou, Dimitrios Theofilopoulos, Styliani Tziaferi, Maria Chania
Hippocrates a Greek physician commonly known as the Father of Medicine was the first to describe delirium, 'phrenitis', differencing it from other disorders such as melancholia and mania. Since then, it still remains a clinical problem which is not yet resolved.Postoperative delirium is a common medical problem that occurs preferentially in surgical patients aged 65 years and older. It is a true medical emergency that requires immediate professional attention and treatment. Faced by health professionals and especially nurses it is often undetected, misdiagnosed, and under-treated as a complication by them during clinical care...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28970439/pharmacist-intervention-program-at-different-rent-levels-of-geriatric-healthcare
#17
Conxita Mestres, Anna Agustí, Marta Hernandez, Laura Puerta, Blanca Llagostera
As a pharmacy service giving pharmaceutical care at different levels of health care for elderly people, we needed a standardization procedure for recording and evaluating pharmacists' interventions. Our objective was to homogenize pharmacist interventions; to know physicians' acceptance of our recommendations, as well as the most prevalent drug related problems (DRP); and the impact of the pharmacists' interventions. To achieve this goal we conducted a one year prospective study at two levels of health care: 176 nursing homes (EAR) (8828 patients) and 2 long-term and subacute care hospitals (HSS) (268 beds)...
May 19, 2017: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/28967714/preoperative-risk-evaluation-in-patients-over-75-years-candidates-to-non-cardiac-and-cardiac-surgery
#18
Alessandro Boccanelli, Pompilio Faggiano
In the 24th and 25thof June 2016, 80 national experts were invited to Rome from The Italian Society of Geriatric Cardiology and the Italian Association of Cardiovascular Prevention and Rehabilitation to revise the current knowledge on the perioperative risk in the elderly. Cardiologists, geriatricians, heart and general surgeons and anesthesiologists discussed the topic with the objective of reaching a consensus and to launch observational research and registries in the field of perioperative risk evaluation in the elderly...
July 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28960161/geriatric-comanagement-reduces-perioperative-complications-and-shortens-duration-of-hospital-stay-after-lumbar-spine-surgery-a-prospective-single-institution-experience
#19
Owoicho Adogwa, Aladine A Elsamadicy, Victoria D Vuong, Jessica Moreno, Joseph Cheng, Isaac O Karikari, Carlos A Bagley
OBJECTIVE Geriatric patients undergoing lumbar spine surgery have unique needs due to the physiological changes of aging. They are at risk for adverse outcomes such as delirium, infection, and iatrogenic complications, and these complications, in turn, contribute to the risk of functional decline, nursing home admission, and death. Whether preoperative and perioperative comanagement by a geriatrician reduces the incidence of in-hospital complications and length of in-hospital stay after elective lumbar spine surgery remains unknown...
September 29, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28958650/is-routine-head-ct-indicated-in-awake-stable-older-patients-after-a-ground-level-fall
#20
Rebecca Sartin, Christine Kim, Sharmila Dissanaike
BACKGROUND: Despite the development of several prediction rules to guide head CT imaging, determining whom to screen for head trauma in the geriatric population after a ground level fall remains controversial. The purpose of this study was to assess the impact of head CT on the management of older adult patients who present with a normal GCS after a ground level fall, and to identify factors that could predict the need for neurosurgical intervention. METHODS: A retrospective study was conducted on hemodynamically stable patients >55 years of age with GCS of 15, who presented to a level 1 trauma center after a ground level fall...
September 18, 2017: American Journal of Surgery
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