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Geriatric orthopaedics

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
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
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
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
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
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
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...
2016: New Zealand Medical Journal
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
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
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
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
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
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
Najma Siddiqi, Jennifer K Harrison, Andrew Clegg, Elizabeth A Teale, John Young, James Taylor, Samantha A Simpkins
BACKGROUND: Delirium is a common mental disorder, which is distressing and has serious adverse outcomes in hospitalised patients. Prevention of delirium is desirable from the perspective of patients and carers, and healthcare providers. It is currently unclear, however, whether interventions for preventing delirium are effective. OBJECTIVES: To assess the effectiveness of interventions for preventing delirium in hospitalised non-Intensive Care Unit (ICU) patients...
March 11, 2016: Cochrane Database of Systematic Reviews
Anders Prestmo, Ingvild Saltvedt, Jorunn L Helbostad, Kristin Taraldsen, Pernille Thingstad, Stian Lydersen, Olav Sletvold
BACKGROUND: Hip fracture patients are heterogenous. Certain patient characteristics are associated with poorer prognosis, but less is known about differences in response to treatment among subgroups. The Trondheim Hip Fracture trial found beneficial effects on mobility and function from comprehensive geriatric care (CGC) compared to traditional orthopaedic care (OC). The aim of this study was to explore differences in response to CGC among subgroups in this trial. METHODS: Secondary analysis of the complete dataset from Trondheim Hip Fracture Trial, a randomised controlled trial including 397 home-dwelling older adults (≥70 years) with a hip fracture...
2016: BMC Geriatrics
Jacques Boddaert, Marie-Laure Barondeau, Frédéric Khiami, Nathalie Nion, Didier Frandji, Bruno Riou
AIM: Hip fracture management in a dedicated geriatric perioperative unit improves long-term mortality. In this "we report the" health economics evaluation of this geriatric perioperative care unit (UPOG). METHODS: This study was conducted in 2011. Direct expenditures were obtained from the Assistance Publique-Hopitaux de Paris database, indirect expenditures from the hospital cost accounting,and financial incomes from the PMSI Pilot programme. Emergency department incomes and expenditures were estimated together with additional incomes related to orthopaedic surgery...
July 2015: Santé Publique: Revue Multidisciplinaire Pour la Recherche et L'action
A Wh Ho, M Ml Lee, E Wc Chan, H My Ng, C W Lee, W S Ng, S H Wong
INTRODUCTION: Sarcopenia and osteoporosis are age-related declines in the quantity of muscle and bone, respectively. Both contribute in disability, fall, and hip fracture in the elderly. This study reported the prevalence of sarcopenia in Chinese geriatric patients with hip fracture, and the correlation between relative appendicular skeletal muscle mass index and other factors. METHODS: This case series was conducted in Kowloon West Cluster Orthopaedic Rehabilitation Centre in Hong Kong...
February 2016: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
Takaki Shimizu, Takeshi Sawaguchi, Daigo Sakagoshi, Kenichi Goshima, Kenji Shigemoto, Yu Hatsuchi
BACKGROUND: Operative treatment of geriatric tibial plateau fractures is challenging and controversial. There are few studies focusing on the clinical features and operative outcomes of tibial plateau fractures in the elderly. Hence, this study aimed to investigate the clinical features and operative results of these fractures. METHODS: Thirty-three displaced tibial plateau fractures in patients >65 years old (mean age: 72.1 years, range: 65-94 years) were treated operatively...
January 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Kristin Taraldsen, Pernille Thingstad, Olav Sletvold, Ingvild Saltvedt, Stian Lydersen, Malcolm H Granat, Sebastien Chastin, Jorunn L Helbostad
BACKGROUND: This study is part of the Trondheim Hip Fracture Trial, where we compared free-living physical behavior in daily life 4 and 12 months following hip surgery for patients managed with comprehensive geriatric care (CGC) in a geriatric ward with those managed with orthopedic care (OC) in an orthopedic ward. METHODS: This is a single centre, prospective, randomized controlled trial. 397 hip fracture patients were randomized to CGC (n = 199) or OC (n = 198) in the Emergency Department with follow-up assessments performed four and 12 months post-surgery...
2015: BMC Geriatrics
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