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Orthogeriatric

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https://www.readbyqxmd.com/read/27913981/the-challenges-of-anaesthesia-and-pain-relief-in-hip-fracture-care
#1
Rachel Cowan, Jun Hao Lim, Terence Ong, Ashok Kumar, Opinder Sahota
The care of the older person with hip fracture is complicated by their comorbid condition, limited physiological reserve, cognitive impairment and frailty. Two aspects of hip fracture management that have received considerable attention are how best to manage the pain associated with it and the ideal mode of anaesthesia. Existing literature has reported on the suboptimal treatment of pain in this orthogeriatric cohort. With recent advancements in medical care, a number of options have emerged as alternatives to conservative systemic analgesia...
December 3, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27911302/association-between-cognitive-status-before-surgery-and-outcomes-in-elderly-patients-with-hip-fracture-in-a-dedicated-orthogeriatric-care-pathway
#2
Lorene Zerah, Judith Cohen-Bittan, Mathieu Raux, Anthony Meziere, Cendrine Tourette, Christian Neri, Marc Verny, Bruno Riou, Frederic Khiami, Jacques Boddaert
BACKGROUND: Dementia is associated with a worse prognosis of hip fracture, but the impact of a dedicated geriatric care pathway on the prognosis of these patients has not been evaluated. OBJECTIVE: According to the cognitive status before surgery, our main objective was to compare mortality rate at 6 months; secondary outcomes were to compare in-hospital complications, the risk of new institutionalization, and the ability to walk at 6 months. METHODS: Between 2009 and 2015, all patients (>70 years) admitted after hip fracture surgery into a dedicated unit of peri-operative geriatric care were included: patients with dementia (DP), without dementia (NDP), and with cognitive status not determined (CSND)...
November 28, 2016: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/27886945/implementation-of-models-of-care-for-secondary-osteoporotic-fracture-prevention-and-orthogeriatric-models-of-care-for-osteoporotic-hip-fracture
#3
REVIEW
Paul Mitchell, Kristina Åkesson, Manju Chandran, Cyrus Cooper, Kirtan Ganda, Muriel Schneider
As the world's population ages, the prevalence of osteoporosis and its resultant fragility fractures is set to increase dramatically. This chapter focuses on current frameworks and major initiatives related to the implementation of fracture liaison services (FLS) and orthogeriatrics services (OGS), Models of Care designed to reliably implement secondary fracture prevention measures for individuals presenting to health services with fragility fractures. The current evidence base regarding the impact and effectiveness of FLS and OGS is also considered...
June 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27872956/hip-fracture-registries-utility-description-and-comparison
#4
P Sáez-López, F Brañas, N Sánchez-Hernández, N Alonso-García, J I González-Montalvo
: Hip fractures (HF) are prevalent and involve high morbidity and mortality so improving their management is important. HF registries are a good way to improve knowledge about this condition and its quality of care, while at the same time reducing clinical variability, optimizing efficiency, improving outcomes, and reducing costs. INTRODUCTION: Hip fractures (HF) are a prevalent fragility fracture secondary to osteoporosis that involves high morbidity and mortality...
November 21, 2016: Osteoporosis International
https://www.readbyqxmd.com/read/27858179/outcome-parameters-in-orthogeriatric-co%C3%A2-management%C3%A2-a%C3%A2-mini-review
#5
REVIEW
Radko Komadina, Klaus W Wendt, Gerold Holzer, Tomaž Kocjan
Recognizing hip and other fragility fractures as an adverse event of chronic geriatric conditions led to the concept of orthogeriatric co-management (OGC). OGC today represents various forms of structural cooperation between orthopedic trauma surgeons and multiprofessional geriatric teams taking care of frail elderly patients. The models are country specific. Despite several published models there are still no clear recommendations on how this service should be best organized. The 12 outcome parameters published by the Experts' Roundtable in 2013 were recommended to be used for the further assessment of different OCG models...
November 17, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27843662/neck-of-femur-fracture-in-a-patient-with-a-chronic-osteomyelitis-of-the-ipsilateral-foot
#6
Anne-Carolin Döring, Anne J H Vochteloo, Kees van Doorn, Rianne M H A Huis In 't Veld, Anil Peters
This case report describes a successful two-stage treatment in a 75-year-old male with a displaced neck of femur fracture, also suffering from an active chronic osteomyelitis of the ipsilateral calcaneus. In our case, a below-knee amputation was performed first, followed by total hip arthroplasty two weeks later. At 15-month follow-up, full recovery of the prefracture level of activities of daily living without significant impairment was obtained. Only a few cases of total hip arthroplasty in amputees have been published, but the indication for surgery was mainly traumatic or advanced osteoarthritis...
2016: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/27822120/national-database-of-geriatrics
#7
REVIEW
Pia Nimann Kannegaard, Kirsten L Vinding, Helle Hare-Bruun
AIM OF DATABASE: The aim of the National Database of Geriatrics is to monitor the quality of interdisciplinary diagnostics and treatment of patients admitted to a geriatric hospital unit. STUDY POPULATION: The database population consists of patients who were admitted to a geriatric hospital unit. Geriatric patients cannot be defined by specific diagnoses. A geriatric patient is typically a frail multimorbid elderly patient with decreasing functional ability and social challenges...
2016: Clinical Epidemiology
https://www.readbyqxmd.com/read/27788137/postoperative-mortality-after-hip-fracture-surgery-a-3-years-follow-up
#8
Oya Kilci, Canan Un, Ozlem Sacan, Mehmet Gamli, Semih Baskan, Mustafa Baydar, Bulent Ozkurt
BACKGROUND AND AIMS: To determine mortality rates and predisposing factors in patients operated for a hip fracture in a 3-year follow-up period. METHODS: The study included patients who underwent primary surgery for a hip fracture.The inclusion criteria were traumatic, non-traumatic, osteoporotic and pathological hip fractures requiring surgery in all age groups and both genders. Patients with periprosthetic fractures or previous contralateral hip fracture surgery and patients who could not be contacted by telephone were excluded...
2016: PloS One
https://www.readbyqxmd.com/read/27766672/validating-the-4a-s-test-in-screening-for-delirium-in-a-culturally-diverse-geriatric-inpatient-population
#9
Jayita De, Anne P F Wand, Peter I Smerdely, Glenn E Hunt
OBJECTIVE: To measure the diagnostic accuracy of the 4A's test in screening for delirium in geriatric inpatients from culturally diverse backgrounds. METHODS: A prospective study was conducted with patients admitted to the geriatric and orthogeriatric services of a tertiary teaching hospital. Consenting participants aged 65 years and over were screened for delirium with the 4AT by nursing staff within 72 h of admission. The diagnosis of delirium was made separately by expert assessors, responsible for the participant's clinical care, blinded to the 4AT score, within 30 min of the 4AT assessment using the DSM 5 criteria and the Confusion Assessment Method...
October 20, 2016: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27713625/impact-of-pharmacist-interventions-in-older-patients-a-prospective-study-in-a-tertiary-hospital-in-germany
#10
L Cortejoso, R A Dietz, G Hofmann, M Gosch, A Sattler
BACKGROUND: Inappropriate pharmacotherapy among older adults remains a critical issue in our health care systems. Besides polypharmacy and multiple comorbidities, the age-related pharmacokinetic and pharmacodynamic changes may increase the risk of adverse drug reactions and medication errors. OBJECTIVE: The main target of this study was to describe the characteristics of pharmaceutical interventions in two geriatric wards (orthogeriatric ward and geriatric day unit) of a general teaching hospital and to evaluate the clinical significance of the detected medication errors...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/27685479/dedicated-orthogeriatric-service-saves-the-hse-a-million-euro
#11
E Shanahan, C Henderson, A Butler, B Lenehan, T Sheehy, A Costelloe, S Carew, C Peters, M O'Connor, D Lyons, J Ryan
Hip fracture is common in older adults and is associated with high morbidity, mortality and significant health care costs. A pilot orthogeriatrics service was established in an acute hospital. We aimed to establish the cost effectiveness of this service. Length of hospital stay, discharge destination and rehabilitation requirements were analysed for a one year period and compared to patients who received usual care prior to the service. We calculated the costs incurred and savings produced by the orthogeriatric service...
2016: Irish Medical Journal
https://www.readbyqxmd.com/read/27632945/cost-effectiveness-of-orthogeriatric-and-fracture-liaison-service-models-of-care-for-hip-fracture-patients-a-population-based-study
#12
Jose Leal, Alastair M Gray, Samuel Hawley, Daniel Prieto-Alhambra, Antonella Delmestri, Nigel K Arden, Cyrus Cooper, M Kassim Javaid, Andrew Judge
Fracture liaison services are recommended as a model of best practice for organizing patient care and secondary fracture prevention for hip fracture patients, although variation exists in how such services are structured. There is considerable uncertainty as to which model is most cost-effective and should therefore be mandated. This study evaluated the cost- effectiveness of orthogeriatric (OG)- and nurse-led fracture liaison service (FLS) models of post-hip fracture care compared with usual care. Analyses were conducted from a health care and personal social services payer perspective, using a Markov model to estimate the lifetime impact of the models of care...
September 16, 2016: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/27600284/do-we-need-orthogeriatrics-in-poland-changes-in-the-age-structure-and-location-of-hip-fractures
#13
Robert Wilk, Michał Skrzypek, Małgorzata Kowalska, Damian Kusz, Bogdan Koczy, Piotr Zagórski, Wojciech Pluskiewicz
BACKGROUND: Patients with hip fractures present a great challenge for surgeons due to multimorbidity, polypharmacy as well as difficulty in communicating. These could be attributed to a recent trend in the aging patient population (80 years and older) as compared to the past. The aim of this study is to analyze age structure and location in male and female patients' population with hip fracture over 50. MATERIALS AND METHODS: Hospital records between 2005 and 2014 with ICD-10 codes S72,0, S72,1 and S72,2 were included in the analysis...
September 6, 2016: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/27574253/predictors-for-rehabilitation-outcome-in-asian-geriatric-hip-fracture-patients
#14
C Gatot, A Cc Chou, T S Howe, W Yeo, H C Chong, J Sb Koh
PURPOSE: To identify predictors for rehabilitation outcome in Asian geriatric hip fracture patients. METHODS: Records of 153 consecutive Asian patients aged 61 to 99 years who underwent surgery for hip fracture and were followed up for at least one year were reviewed. They were stratified into 4 agegroups: 60-69 years (n=27), 70-79 years (n=70), 80-89 years (n=50), and ≥90 years (n=6). Any comorbidity, regardless of severity, was recorded. Pre-injury and postoperative functional status was evaluated using the 36-item Short Form Health Survey...
August 2016: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/27501701/orthogeriatric-co-management-improves-the-outcome-of-long-term-care-residents-with-fragility-fractures
#15
M Gosch, Y Hoffmann-Weltin, T Roth, M Blauth, J A Nicholas, C Kammerlander
BACKGROUND: Fragility fractures are a major health care problem worldwide. Both hip and non-hip fractures are associated with excess mortality in the years following the fracture. Residents of long-term nursing homes represent a special high-risk group for poor outcomes. Orthogeriatric co-management models of care have shown in multiple studies to have medical as well as economic advantages, but their impact on this high-risk group has not been well studied. OBJECTIVE: We studied the outcome of long-term care residents with hip and non-hip fractures admitted to a geriatric fracture center...
October 2016: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/27499691/the-neutrophil-to-lymphocyte-ratio-on-admission-and-short-term-outcomes-in-orthogeriatric-patients
#16
Alexander Fisher, Wichat Srikusalanukul, Leon Fisher, Paul Smith
AIM: To investigate the association of the neutrophil to lymphocyte ratio (NLR) at admission with presence of fracture, comorbid conditions, and its prognostic value for short-term outcomes in orthogeriatric patients. METHODS: On 415 consecutive patients (mean age 78.8 ±8.7[SD] years, 281 women, 255 with a non-vertebral bone fracture, including 167 with a hip fracture, HF) admitted to the Department of Orthopaedic Surgery at the Canberra hospital (2010 - 2011) data on clinical and laboratory characteristics were collected prospectively...
2016: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/27496719/factors-associated-with-receiving-anti-osteoporosis-treatment-among-older-persons-with-minimal-trauma-hip-fracture-presenting-to-an-acute-orthogeriatric-service
#17
R Gunathilake, E Epstein, S McNeill, B Walsh
BACKGROUND/AIM: The aim of this study was to investigate factors that were associated with receiving anti-osteoporosis treatment (AOT) among patients with minimal trauma hip fracture admitted to an Australian tertiary trauma centre under the Acute Orthogeriatric Service (AOS) over a 6 month period. DESIGN: Observational study using prospectively collected data. METHODS: Demographic and clinical characteristics of 211 patients were extracted from the local hip fracture registry and electronic medical records...
October 2016: Injury
https://www.readbyqxmd.com/read/27458065/value-of-a-coordinated-management-of-osteoporosis-via-fracture-liaison-service-for-the-treatment-of-orthogeriatric-patients
#18
D Schray, C Neuerburg, J Stein, M Gosch, M Schieker, W Böcker, C Kammerlander
INTRODUCTION: The prevalence of osteoporosis in female patients over 75 years of age is 59.2 %. In Germany ~6.3-7.8 million patients are affected by osteoporosis. In 77 % of german patients osteoporosis is not treated adequately. Even after fragility fractures only 16-21 % of female patients and 3 % of male patients are supplied with a specific osteoporosis therapy. Establishing a Fracture Liaison Services (FLS) is a possible addition to co-management for an efficient treatment of osteoporosis in orthogeriatric patients...
October 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27445466/orthogeriatric-care-improving-patient-outcomes
#19
REVIEW
Francisco José Tarazona-Santabalbina, Ángel Belenguer-Varea, Eduardo Rovira, David Cuesta-Peredó
Hip fractures are a very serious socio-economic problem in western countries. Since the 1950s, orthogeriatric units have introduced improvements in the care of geriatric patients admitted to hospital because of hip fractures. During this period, these units have reduced mean hospital stays, number of complications, and both in-hospital mortality and mortality over the middle term after hospital discharge, along with improvements in the quality of care and a reduction in costs. Likewise, a recent clinical trial has reported greater functional gains among the affected patients...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/27443570/improved-1-year-mortality-in-elderly-patients-with-a-hip-fracture-following-integrated-orthogeriatric-treatment
#20
E C Folbert, J H Hegeman, M Vermeer, E M Regtuijt, D van der Velde, H J Ten Duis, J P Slaets
: To improve the quality of care and reduce the healthcare costs of elderly patients with a hip fracture, surgeons and geriatricians collaborated intensively due to the special needs of these patients. After treatment at the Centre for Geriatric Traumatology (CvGT), we found a significant decrease in the 1-year mortality rate in frail elderly patients compared to the historical control patients who were treated with standard care. INTRODUCTION: The study aimed to evaluate the effect of an orthogeriatric treatment model on elderly patients with a hip fracture on the 1-year mortality rate and identify associated risk factors...
July 21, 2016: Osteoporosis International
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