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Geriatric orthopaedics

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https://www.readbyqxmd.com/read/29738400/using-a-validated-middle-age-and-geriatric-risk-tool-to-identify-early-48hr-hospital-mortality-and-associated-cost-of-care
#1
Ariana Lott, Jack Haglin, Hesham Saleh, Jordan Hall, Kenneth A Egol, Sanjit R Konda
OBJECTIVES: 1) Demonstrate that a validated trauma triage score for middle-aged and geriatric patients could identify those at high risk for mortality within the first two days of hospitalization and 2) determine the cost of care for this cohort of patients DESIGN:: Prospective cohort study SETTING:: Single Level 1 Trauma Center PATIENTS:: Patients 55 years and older who were evaluated in the emergency department setting by Orthopaedics or who met American College of Surgeons Tier 1-3 criteria INTERVENTION:: Calculation of validated trauma triage score, Score for Trauma Triage in Geriatric and Middle Aged (STTGMA), using patient's demographic, injury severity, and functional statusMain Outcome Measurements: length of stay, inpatient mortality, time between presentation and time of death, and direct variable costs of hospitalization RESULTS:: A total of 1470 consecutive patients (mean age of 72...
May 3, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29716654/psychological-health-is-associated-with-knee-pain-and-physical-function-in-patients-with-knee-osteoarthritis-an-exploratory-cross-sectional-study
#2
Hirotaka Iijima, Tomoki Aoyama, Naoto Fukutani, Takuya Isho, Yuko Yamamoto, Masakazu Hiraoka, Kazuyuki Miyanobu, Masashi Jinnouchi, Eishi Kaneda, Hiroshi Kuroki, Shuichi Matsuda
BACKGROUND: Depressive symptoms are a major comorbidity in older adults with knee osteoarthritis (OA). However, the type of activity-induced knee pain associated with depression has not been examined. Furthermore, there is conflicting evidence regarding the association between depression and performance-based physical function. This study aimed to examine (i) the association between depressive symptoms and knee pain intensity, particularly task-specific knee pain during daily living, and (ii) the association between depressive symptoms and performance-based physical function, while considering other potential risk factors, including bilateral knee pain and ambulatory physical activity...
May 2, 2018: BMC Psychology
https://www.readbyqxmd.com/read/29691612/which-is-the-optimal-orthogeriatric-care-model-to-prevent-mortality-of-elderly-subjects-post-hip-fractures-a-systematic-review-and-meta-analysis-based-on-current-clinical-practice
#3
REVIEW
J Moyet, G Deschasse, B Marquant, P Mertl, Frédéric Bloch
BACKGROUND: While there is a general consensus of the impact of an orthogeriatric organisation in terms of elderly patient mortality post hip fracture, it is unclear which, among these various care models, is the most optimal. METHODS: A systematic review of the literature was undertaken using the keywords "Femoral fractures or total hip replacements or Accidental, falls" and "Aged, 80 and over" and "Mortality". The review is presented following PRISMA guidance...
April 24, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29675629/-geriatric-trauma-center-dgu%C3%A2-evaluation-of-clinical-and-economic-parameters-a-pilot-study-in-a-german-university-hospital
#4
M Knobe, B Böttcher, M Coburn, T Friess, L C Bollheimer, H J Heppner, C J Werner, J-P Bach, M Wollgarten, S Poßelt, C Bliemel, B Bücking
BACKGROUND: Previous studies on orthogeriatric models of care suggest that there is substantial variability in how geriatric care is integrated in the patient management and the necessary intensity of geriatric involvement is questionable. OBJECTIVE: The aim of the current prospective cohort study was the clinical and economic evaluation of fragility fracture treatment pathways before and after the implementation of a geriatric trauma center in conformity with the guidelines of the German Trauma Society (DGU)...
April 19, 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29495553/adherence-to-bisphosphonates-among-people-admitted-to-an-orthopaedic-and-geriatric-ward-at-a-university-hospital-in-sweden
#5
Linnea Abramsson, Maria Gustafsson
Oral bisphosphonates are the first choice of therapy to reduce the risk of osteoporotic fractures. These medications have generally poor oral bioavailability, which may further be reduced by concomitant intake of certain foods and drugs; therefore, it is vital to follow specific instructions. The aim with this study was to assess general adherence to oral bisphosphonates and adherence to specific administration instructions among people admitted to two wards at Umeå University hospital in Sweden. This interview study focuses on elderly patients living at home and prescribed oral bisphosphonates...
February 28, 2018: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/29486947/-assessment-of-clinical-complications-and-their-associated-factors-in-hip-fracture-patients-in-an-acute-geriatric-orthopaedic-unit
#6
Rafael Bielza, Paola Fuentes, David Blanco Díaz, Ricardo Vicente Moreno, Estefanía Arias, Marta Neira, Ana M Birghilescu, Jorge Sanjurjo, Javier Escalera, David Sanz-Rosa, Israel J Thuissard, Jorge F Gómez Cerezo
INTRODUCTION: The incidence of clinical complications in hip fracture (HF) patients is high and variable due to their heterogeneous nature. The aim of the study was to assess the clinical complications and their associated factors in HF patients admitted to the Orthopaedic Geriatric Unit of a 283 bed University Hospital. An average of 200 HF patients is attended yearly. MATERIAL AND METHODS: A prospective, observational and analytical study was conducted on 383 consecutive patients admitted to the unit during the years 2013 and 2014...
May 2018: Revista Española de Geriatría y Gerontología
https://www.readbyqxmd.com/read/29462121/patient-mortality-in-geriatric-distal-femur-fractures
#7
Philip Myers, Patrick Laboe, Kory J Johnson, Peter D Fredericks, Renn J Crichlow, Dean C Maar, Timothy G Weber
OBJECTIVES: To estimate 1-year mortality rates in elderly patients who undergo operative treatment for distal femur fractures and identify potential risk factors for mortality. DESIGN: Retrospective chart review. SETTING: Level 1 and Level 2 trauma centers. PATIENTS/PARTICIPANTS: Two hundred eighty-three elderly patients (average age 76.0 years ± 9.8) who sustained distal femur fractures between 2002 and 2012. INTERVENTION: Fracture fixation of the distal femur...
March 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29325560/feasibility-and-predictive-performance-of-the-hendrich-fall-risk-model-ii-in-a-rehabilitation-department-a-prospective-study
#8
Isabella Campanini, Stefano Mastrangelo, Annalisa Bargellini, Agnese Bassoli, Gabriele Bosi, Francesco Lombardi, Stefano Tolomelli, Mirco Lusuardi, Andrea Merlo
BACKGROUND: Falls are a common adverse event in both elderly inpatients and patients admitted to rehabilitation units. The Hendrich Fall Risk Model II (HIIFRM) has been already tested in all hospital wards with high fall rates, with the exception of the rehabilitation setting. This study's aim is to address the feasibility and predictive performances of HIIFRM in a hospital rehabilitation department. METHODS: A 6 months prospective study in a Italian rehabilitation department with patients from orthopaedic, pulmonary, and neurological rehabilitation wards...
January 11, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29318088/hoffa-fragments-in-the-geriatric-distal-femur-fracture-myth-or-reality
#9
Brian W Hill, Lisa K Cannada
Background: Previous research reported the frequency of coronal plane (Hoffa) fractures in high-energy supracondylar femur fractures in a relatively young population. It is the purpose of this study to identify the frequency of coronal plane fractures seen in elderly patients. Methods: All patients over the age of 18 years treated for supracondylar femur fractures at 2 level I trauma centers were reviewed over a 4-year period. The patients were stratified (≥60 years and <60 years) and compared to determine differences in injury characteristics and fracture patterns with special attention to the prevalence of coronal plane fractures...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29226660/bone-and-joint-diseases-in-present-and-future
#10
REVIEW
Yasuharu Nakashima, Ken Okazak, Koichiet Nakayama, Seiji Okada, Hideki Mizu-uchi
With the increase of elderly population, orthopaedic surgeons need to deal with the diseases related to aging, such as joint disorders and fragility fractures. The number of total joint replacements, for example, is two times more than it was 10 years ago. With these backgrounds, the Japanese Orthopaedic Association (JOA) has proposed the concept of locomotive syndrome; conditions under which the elderly have been receiving care services due to problems of the locomotive organs. To prevent geriatric or disuse syndrome, JOA is currently providing the care‒prevention programs such as the loco-check and loco-training...
January 2017: Fukuoka Igaku Zasshi, Hukuoka Acta Medica
https://www.readbyqxmd.com/read/29224055/peri-operative-antibiotic-treatment-of-bacteriuria-reduces-early-deep-surgical-site-infections-in-geriatric-patients-with-proximal-femur-fracture
#11
Ronny Langenhan, Stefanie Bushuven, Niklas Reimers, Axel Probst
PURPOSE: The aim of this study was to conduct a re-evaluation of current strategies for peri-operative prophylaxis of infections in orthopaedic surgery of geriatric patients (≥65 years) with proximal femoral fractures (PFF). METHODS: Between 01/2010 and 08/2014 all post-operative infections after stabilization of PFF of 1,089 geriatric patients were recorded retrospectively. All patients pre-operatively received a single dose of 1.5 g cefuroxime (group 1). These were compared to prospectively determined post-operative rates of surgical site infection (SSI) of 441 geriatric patients, which were operated on between 09/2014 and 03/2017 due to PFF...
December 9, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29132430/hospital-choice-in-germany-from-the-patient-s-perspective-a-cross-sectional-study
#12
Werner de Cruppé, Max Geraedts
BACKGROUND: In many countries health policy encourages patients to choose their hospital, preferably by considering information of performance reports. Previous studies on hospital choice mainly have focused on patients undergoing elective surgery. This study examined a representative sample of hospital inpatients across disciplines and treatment interventions in Germany. Its research questions were: How many patients decide where to go for hospital treatment? How much time do patients have before admission? Which sources of information do they use, and which criteria are relevant to their decision? METHODS: Cross-sectional observational study covering 1925 inpatients of 46 departments at 17 hospitals in 2012...
November 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29100824/the-25-question-geriatric-locomotive-function-scale-predicts-the-risk-of-recurrent-falls-in-postoperative-patients-with-cervical-myelopathy
#13
Atsushi Kimura, Katsushi Takeshita, Hirokazu Inoue, Atsushi Seichi, Yosuke Kawasaki, Toshitaka Yoshii, Hiroyuki Inose, Takeo Furuya, Kazuhiro Takeuchi, Shunji Matsunaga, Shoji Seki, Mikito Tsushima, Shiro Imagama, Masao Koda, Masashi Yamazaki, Kanji Mori, Hirosuke Nishimura, Kenji Endo, Kei Yamada, Kimiaki Sato, Atsushi Okawa
BACKGROUND: Fall-induced injuries represent a major public health concern for older individuals. The relationship between risk of falling and the severity of locomotive syndrome (LS) remains largely unknown. METHODS: We conducted a retrospective analysis of patients who had undergone surgery from January 2012 to December 2013 and completed at least 1 year of follow-up at 12 participating institutes. Patients completed a questionnaire survey regarding their fall experience during a routine postoperative follow-up...
January 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/29054389/optimizing-surgical-quality-datasets-to-care-for-older-adults-lessons-from-the-american-college-of-surgeons-nsqip-geriatric-surgery-pilot
#14
Julia R Berian, Lynn Zhou, Melissa A Hornor, Marcia M Russell, Mark E Cohen, Emily Finlayson, Clifford Y Ko, Thomas N Robinson, Ronnie A Rosenthal
BACKGROUND: Surgical quality datasets can be better tailored toward older adults. The American College of Surgeons (ACS) NSQIP Geriatric Surgery Pilot collected risk factors and outcomes in 4 geriatric-specific domains: cognition, decision-making, function, and mobility. This study evaluated the contributions of geriatric-specific factors to risk adjustment in modeling 30-day outcomes and geriatric-specific outcomes (postoperative delirium, new mobility aid use, functional decline, and pressure ulcers)...
December 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29041916/early-coordinated-rehabilitation-in-acute-phase-after-hip-fracture-a-model-for-increased-patient-participation
#15
Gillian Asplin, Gunnel Carlsson, Lena Zidén, Gunilla Kjellby-Wendt
BACKGROUND: Studies have shown that patients with hip fracture treated in a Comprehensive Geriatric Care (CGC) unit report better results in comparison to orthopaedic care. Furthermore, involving patients in their healthcare by encouraging patient participation can result in better quality of care and improved outcomes. To our knowledge no study has been performed comparing rehabilitation programmes within a CGC unit during the acute phase after hip fracture with focus on improving patients' perceived participation and subsequent effect on patients' function...
October 17, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28930900/retrospective-evaluation-of-the-impact-of-a-geriatric-trauma-institute-on-fragility-hip-fracture-patient-outcomes
#16
Elizabeth D Katrancha, Jami Zipf, Nancy Abrahams, Richard Schroeder
BACKGROUND: Fragility hip fractures occur in the older than 65-year population at an alarming rate. It is estimated that 260,000 hip fractures occur annually. Patient outcomes following hip fractures are devastating. One of every 5 patients dies within 1 year of injury, and 1 of 3 remains in a nursing home for years after the injury. Published literature recommends an interdisciplinary approach to caring for hip-fractured patients and expediting surgery to improve outcomes. PURPOSE: The purpose of this study was to retrospectively evaluate the impact of the Geriatric Trauma Institute (GTI) on fragility hip fracture patient outcomes...
September 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28919087/outcomes-of-restrictive-versus-liberal-transfusion-strategies-in-older-adults-from-nine-randomised-controlled-trials-a-systematic-review-and-meta-analysis
#17
REVIEW
Geoff I Simon, Alison Craswell, Ogilvie Thom, Yoke Lin Fung
BACKGROUND: Guidelines for patient blood management recommend restrictive transfusion practice for most adult patients. These guidelines are supported by evidence from randomised controlled trials (RCTs); however, one of the patient groups not explicitly examined in these studies is the geriatric population. We examined RCTs relevant to transfusion outcomes in older patients. Our aim was to determine whether special guidelines are warranted for geriatric patients, recognising the different pathophysiological characteristics of this group...
October 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28737617/management-of-acetabular-fractures-in-the-elderly
#18
Nicholas B Antell, Julie A Switzer, Andrew H Schmidt
The incidence of acetabular fractures in the elderly population is increasing. Fractures in this population differ from those in younger patients, with more frequent involvement of the anterior column, more comminution, and more severe articular impaction in elderly patients. Although acetabular fractures in geriatric patients are more likely the result of low-energy trauma, outcomes are generally poorer than those in young patients. Multiple management options have been proposed, but no intervention has become the standard of care for these fractures in the elderly...
August 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28706089/evaluation-of-the-geriatric-co-management-for-patients-with-fragility-fractures-of-the-proximal-femur-geriatric-fracture-centre-gfc-concept-protocol-for-a-prospective-multicentre-cohort-study
#19
Alexander Joeris, Anahí Hurtado-Chong, Denise Hess, Vasiliki Kalampoki, Michael Blauth
INTRODUCTION: Treatment of fractures in the elderly population is a clinical challenge due partly to the presence of comorbidities. In a Geriatric Fracture Centre (GFC), patients are co-managed by a geriatrician in an attempt to improve clinical outcomes and reduce morbidity and mortality. Until now the beneficial effect of orthogeriatric co-management has not been definitively proven. The primary objective of this study is to determine the effect of GFC on predefined major adverse events related to a hip fracture compared to usual care centres (UCC)...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28655169/hospital-at-home-integrated-care-programme-for-the-management-of-disabling-health-crises-in-older-patients-comparison-with-bed-based-intermediate-care
#20
Miquel À Mas, Marco Inzitari, Sergi Sabaté, Sebastià J Santaeugènia, Ramón Miralles
Objective: to analyse the clinical impact of a home-based Intermediate Care model in the Catalan health system, comparing it with usual bed-based care. Design: quasi-experimental longitudinal study. Setting: hospital Municipal de Badalona and El Carme Intermediate Care Hospital, Badalona, Catalonia, Spain. Participants: we included older patients with medical and orthopaedic disabling health crises in need of Comprehensive Geriatric Assessment (CGA) and rehabilitation...
November 1, 2017: Age and Ageing
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