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Geriatric orthopaedics

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https://www.readbyqxmd.com/read/28134674/clostridium-difficile-infection-an-orthopaedic-surgeon-s-guide-to-epidemiology-management-and-prevention
#1
Paul A Anderson, James Bernatz, Nasia Safdar
Clostridium difficile infection is a growing concern in health care and is a worrisome complication in orthopaedics. The incidence and severity of this infection are increasing, although the incidence following orthopaedic surgery is comparatively lower than that seen in patients in most other surgical specialties. The typical geriatric orthopaedic patient may have many risk factors that increase the likelihood of C difficile infection, including advanced age, residence in a long-term care facility, multiple comorbidities, the use of perioperative antibiotics, and a long length of stay...
March 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28088377/intracapsular-hip-fractures-in-the-elderly-do-we-know-what-is-important
#2
Diana Crego-Vita, Coral Sanchez-Perez, Jose Adolfo Orellana Gomez-Rico, Celia Clemente de Arriba
BACKGROUND: Hip fractures in the elderly are a common reason for admission to the department of orthopaedic surgery, this condition asks an important part of health resources and is associated with high levels of co-morbidity and mortality. Many improvements have been introduced in the treatment of these patients, preoperative regional analgesia, intensive physical therapy, interdisciplinary care program; but still remain unresolved gaps. The aim of this study is to document the natural history of early versus delayed surgical intervention in elderly patients with hip fractures and to establish the prognostic factors of mortality and walking ability after discharge...
January 9, 2017: Injury
https://www.readbyqxmd.com/read/27990194/predictors-of-bone-status-by-quantitative-ultrasound-measurements-in-a-mountain-village-in-japan
#3
Tsuyoshi Tajika, Atsushi Yamamoto, Takashi Ohsawa, Noboru Oya, Haku Iizuka, Kenji Takagishi
BACKGROUND: It seems to be important to recognize predictors of bone health condition in Japanese super-aged society. The purpose of this study was to investigate predictors of the speed of sound (SOS) of calcaneus by quantitative ultrasound measurements of mountain village residents. MATERIALS AND METHODS: Medical examinations were conducted on 214 participants (69 men, 145 women; average age of 63.6 years). Each had completed a self-administered questionnaire including items such as gender, dominant hand, occupation, and history of smoking and drinking alcohol, experience of falls, and the EuroQol-5-dimensions-3-level Japanese version and a 25-question geriatric locomotive function scale proposed by the Japanese Orthopaedic Association...
2016: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/27974304/improving-hip-fracture-outcomes-with-integrated-orthogeriatric-care-a-comparison-between-two-accepted-orthogeriatric-models
#4
Mark Middleton, Bettina Wan, Ruy da Assunçāo
BACKGROUND: our orthopaedic trauma unit serves a large elderly population, admitting 400-500 hip fractures annually. A higher than expected mortality was detected amongst these patients, prompting a change in the hip fracture pathway. The aim of this study was to assess the impact of a change in orthogeriatric provision on hip fracture outcomes and care quality indicators. PATIENTS AND METHODS: the hip fracture pathway was changed from a geriatric consultation service to a completely integrated service on a dedicated orthogeriatric ward...
December 14, 2016: Age and Ageing
https://www.readbyqxmd.com/read/27904220/pfna-ii-protrusion-over-the-greater-trochanter-in-the-asian-population-used-in-proximal-femoral-fractures
#5
Sun-Jun Hu, Shi-Min Chang, Zhuo Ma, Shou-Chao Du, Liang-Ping Xiong, Xin Wang
BACKGROUND: The treatment of proximal femoral fractures in geriatric osteoporotic patients continues to be a challenge in orthopaedic trauma. Various kinds of cephalomedullary nails, such as gamma nail, InterTan and PFNA were used clinically. The latest generation PFNA II, specially designed for Asian population, is commonly used for geriatric per-/intertrochanteric fractures. The aim of this study was to determine whether the current PFNA-II proximal segment length is suitable for the greater trochanter height, as assessed by postoperative radiograph measurements...
November 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27868331/patient-resilience-in-the-fracture-orthopaedic-rehabilitation-geriatric-environment
#6
Sabrina Kohler, Sze Ming Loh
OBJECTIVE: To explore the relationship between resilience and rehabilitation outcomes in older orthopaedic patients. METHODS: Geriatric rehabilitation patients admitted to a general metropolitan hospital following a fracture were interviewed face-to-face. Their resilience was assessed using the Connor-Davidson Resilience Scale (CD-RISC), and rehabilitation outcomes were assessed according to functional independence measure (FIM) gain, length of stay, discharge destination and mortality rate...
November 20, 2016: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/27685613/-malnutrition-in-elderly-trauma-patients-comparison-of-two-assessment-tools
#7
C Ihle, C Bahrs, T Freude, M Bickel, I Spielhaupter, E Wintermeyer, L Stollhof, L Grünwald, P Ziegler, S Pscherer, U Stöckle, A Nussler
Background: The prevalence of malnutrition in hospitalised patients is reported to be between 16 and 55 % across disciplines. Within hospital care, screening for malnutrition is required. However, in orthopaedics and trauma surgery, there is still no generally accepted recommendation for the methods for such a data survey. In the present study, the following aspects are to be investigated with the help of two established scores: (1) the prevalence of malnutrition in the patient population of geriatric trauma care, and (2) the correlation between methods of data survey...
September 29, 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/27677265/locomotive-syndrome-is-associated-with-body-composition-and-cardiometabolic-disorders-in-elderly-japanese-women
#8
Misa Nakamura, Yosuke Kobashi, Hiroshi Hashizume, Hiroyuki Oka, Ryohei Kono, Sachiko Nomura, Akihiro Maeno, Munehito Yoshida, Hirotoshi Utsunomiya
BACKGROUND: A concept referred to as locomotive syndrome (LS) was proposed by the Japanese Orthopaedic Association in order to help identify middle-aged and older adults who may be at high risk of requiring healthcare services because of problems associated with locomotion. Cardiometabolic disorders, including obesity, hypertension, diabetes, and dyslipidemia, have a high prevalence worldwide. The purpose of this study was to determine the associations between LS and both body composition and cardiometabolic disorders...
September 27, 2016: BMC Geriatrics
https://www.readbyqxmd.com/read/27604512/costs-associated-with-geriatric-ankle-fractures-operative-versus-nonoperative-management
#9
Rishin J Kadakia, Briggs M Ahearn, Shay Tenenbaum, Jason T Bariteau
: Introduction Ankle fractures are the third most common orthopaedic injury seen in the geriatric patient. Studies have identified mortality benefits with operative management, but treatment must be considered on a case-by-case basis. In the era of value-based analysis, a thorough of understanding of outcomes and costs of treatment is required. The purpose of this study was to analyze the inpatient and readmission costs associated with operative and nonoperative management of geriatric ankle fractures...
September 7, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27579814/total-hip-and-knee-arthroplasty-in-patients-older-than-age-80-years
#10
Lee Eric Rubin, Travis D Blood, Julio C Defillo-Draiby
A rapidly aging population is currently reshaping the demographic profile of the United States. Among older patients, the cohort aged >80 years is not only living longer but also is electing to undergo more total hip and knee arthroplasties. To improve perioperative safety, orthopaedic surgeons should understand the risks and clinical outcomes of arthroplasty in patients of advanced age. Although morbidity and mortality rates are higher for patients aged >80 years than for younger patients undergoing total hip and knee arthroplasties and revision surgeries, functional outcomes, pain relief, and patient satisfaction are consistent between groups...
October 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27554319/baseline-vulnerability-and-inpatient-frailty-status-in-relation-to-adverse-outcomes-in-a-surgical-cohort
#11
H-S Lin, N M Peel, R E Hubbard
This study aimed to derive measures of baseline vulnerability and inpatient frailty in elderly surgical patients and to study their association with adverse post-operative outcomes. Data from comprehensive geriatric assessment of 208 general surgical and orthopaedic patients aged 70 and over admitted to four acute hospitals in Queensland, Australia, were analysed to derive a baseline and inpatient Frailty Index (FI). The association of these indices with adverse outcomes was examined in logistic regression...
2016: Journal of Frailty & Aging
https://www.readbyqxmd.com/read/27496661/predictors-of-30-day-mortality-following-hip-pelvis-fractures
#12
A C Dodd, C Bulka, A Jahangir, H R Mir, W T Obremskey, M K Sethi
INTRODUCTION: With the cost of healthcare in the United States reaching $2.9 trillion in 2013 and expected to increase with a growing geriatric population, the Center for Medicare and Medicaid Services (CMS) and Hospital Quality Alliance (HQA) began publicly reporting 30-day mortality rates so that hospitals and physicians may begin to confront clinical problems and promote high-quality and patient-centered care. Though the 30-day mortality is considered a highly effective tool in measuring hospital performance, little data actually exists that explores the rate and risk factors for trauma-related hip and pelvis fractures...
October 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27362595/auckland-city-hospital-s-ortho-geriatric-service-an-audit-of-patients-aged-over-65-with-fractured-neck-of-femur
#13
Bodhi Wimalasena, Roger Harris
AIMS: The aims of this audit were to collect the Minimum Data Set outlined by the Australia New Zealand Hip Fracture Registry (ANZHFR), assess patient characteristics, analyse process of care, and evaluate how this compares to NICE guidelines for hip fracture care, as well as to Auckland Hospital data from 2007. METHOD: Retrospective case record audit of patients with fractured neck of femur aged 65 years and over admitted under Orthopaedics over a 4-month period in 2013...
July 1, 2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27221100/readmission-and-mortality-one-year-after-acute-hospitalization-in-older-patients-with-explained-and-unexplained-anemia-a-prospective-observational-cohort-study
#14
Jenny Foss Abrahamsen, Anne-Lise Bjorke Monsen, Francesco Landi, Cathrine Haugland, Roy Miodini Nilsen, Anette Hylen Ranhoff
BACKGROUND: Few studies have examined whether specific subtypes of anemia in older persons are more related to adverse outcomes such as hospital readmissions and death after acute hospitalization and post-acute care. METHODS: An observational prospective cohort study was conducted between 2011 and 2014. A total of 884 community-dwelling patients, ≥70 years of age were transferred from acute medical and orthopaedic hospital departments to a skilled nursing home where they were examined by comprehensive geriatric assessment and had laboratory tests taken for the investigation of anemia...
2016: BMC Geriatrics
https://www.readbyqxmd.com/read/27147696/rethinking-orthopaedic-decision-making-for-frail-patients-with-hip-fracture-commentary-on-an-article-by-marilyn-heng-md-frcsc-et-al-abnormal-mini-cog-is-associated-with-higher-risk-of-complications-and-delirium-in-geriatric-patients-with-fracture
#15
https://www.readbyqxmd.com/read/27147687/abnormal-mini-cog-is-associated-with-higher-risk-of-complications-and-delirium-in-geriatric-patients-with-fracture
#16
Marilyn Heng, Caitlin E Eagen, Houman Javedan, Jennifer Kodela, Michael J Weaver, Mitchel B Harris
BACKGROUND: The Mini-Cog test is a validated and simple tool to screen for dementia. The purpose of this study was to investigate the relationship of cognitive impairment as measured by Mini-Cog testing as a predictor for in-hospital complications and mortality in geriatric patients with fracture. METHODS: From 2011 to 2014, patients who were seventy years of age or older, had a fracture, and were admitted to co-managed orthopaedic trauma and geriatrics services embedded at two Level-I trauma centers were enrolled in our study...
May 4, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27105701/hospital-at-home-integrated-care-programme-for-older-patients-with-orthopaedic-conditions-early-community-reintegration-maximising-physical-function
#17
Miquel Àngel Mas, Conxita Closa, Sebastià J Santaeugènia, Marco Inzitari, Aida Ribera, Miquel Gallofré
OBJECTIVE: Older citizens with orthopaedic conditions need specialised care for the facilitation of early community reintegration and restitution of physical function. We introduced a new community care programme as an alternative to usual hospital rehabilitation for orthopaedic patients. STUDY DESIGN: This was an observational study of a cohort of older orthopaedic patients attending a hospital-at-home integrated care programme (HHU), compared with a contemporary cohort of users of a geriatric rehabilitation unit (GRU) in the urban area of Badalona, Catalonia, Spain...
June 2016: Maturitas
https://www.readbyqxmd.com/read/27059996/dedicated-orthogeriatric-service-reduces-hip-fracture-mortality
#18
C Y Henderson, E Shanahan, A Butler, B Lenehan, M O'Connor, D Lyons, J P Ryan
BACKGROUND: Hip fracture is a common serious injury afflicting the geriatric population and is associated with poor clinical outcomes, functional and walking disabilities and high 1-year mortality rates. A multidisciplinary approach has been shown to improve outcomes of geriatric patients with fragility fracture. AIMS: We piloted a dedicated orthogeriatric service for hip fracture patients to determine if the service facilitated a change in major patient outcomes, such as mortality, length of stay and dependency...
April 8, 2016: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/27049195/treating-the-aging-spine
#19
Theodore J Choma, Glenn Rechtine, Robert A McGuire, Darrel S Brodke
Demographic trends make it incumbent on orthopaedic spine surgeons to recognize the special challenges involved in caring for older patients with spine pathology. Unique pathologies, such as osteoporosis and degenerative deformities, must be recognized and treated. Recent treatment options and recommendations for the medical optimization of bone health include vitamin D and calcium supplementation, diphosphonates, and teriparatide. Optimizing spinal fixation in elderly patients who have osteoporosis is critical; cement augmentation of pedicle screws is promising...
2016: Instructional Course Lectures
https://www.readbyqxmd.com/read/26999246/three-different-outcomes-in-older-community-dwelling-patients-receiving-intermediate-care-in-nursing-home-after-acute-hospitalization
#20
J F Abrahamsen, C Haugland, R M Nilsen, A H Ranhoff
OBJECTIVES: To evaluate the recovery and outcome of older communitydwelling patients admitted to intermediate care (IC) in nursing homes after acute hospitalization, and to compare patients who were able and unable to return directly to their own homes. DESIGN: Prospective, observational, cohort study conducted between June 2011 and 2014. SETTING: A 19- bed IC unit in a nursing home with increased multidisciplinary staffing. PARTICIPANTS: A total of 961 community-dwelling patients, ≥70 years of age, considered to have a rehabilitation potential and no major cognitive impairment or delirium, transferred from internal medicine, cardiac, pulmonary and orthopaedic hospital departments...
April 2016: Journal of Nutrition, Health & Aging
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