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Trauma in elderly

Harish Kempegowda, Raveesh Richard, Amrut Borade, Akhil Tawari, Abby M Howenstein, Erik N Kubiak, Michael Suk, Daniel S Horwitz
OBJECTIVES: The purpose of this study was to evaluate the role and the necessity of radiographs and office visits obtained during follow-up of intertrochanteric hip injuries. DESIGN: Retrospective study SETTING:: Two level I trauma centers. PATIENTS: 465 elderly patients who were surgically treated for an intertrochanteric fracture of the femur at two level I trauma centers between January 2009 and August 2014 were retrospectively identified from orthopaedic trauma databases...
August 16, 2016: Journal of Orthopaedic Trauma
David Sanders, Dianne Bryant, Christina Tieszer, Abdel Lawendy, Mark MacLeod, Steven Papp, Liew Allan, Viskontas Darius, Coles Chad, Gurr Kevin, Carey Tim, Gofton Wade, Bailey Chris, Bartley Debra, Andrew Trenholm, Stone Trevor, Leighton Ross, Julia Foxall, Mauri Zomar, Kelly Trask
OBJECTIVES: To compare outcomes in elderly patients with intertrochanteric hip fractures treated with either the sliding hip screw (SHS) or InterTAN intramedullary device (IT). DESIGN: Prospective, randomized, multi-centre clinical trial SETTING:: Five level 1 trauma centresPatients/Participants: 249 patients aged 55 years or older with AO/OTA 31A1 (43) and OA/OTA 31A2 (206) fractures were prospectively enrolled and followed for 12 months. INTERVENTION: Computer generated randomization to either IT (n=123) or SHS (n=126)...
September 30, 2016: Journal of Orthopaedic Trauma
Fredrik Röding, Marie Lindkvist, Ulrica Bergström, Jack Lysholm
BACKGROUND: The injury spectrum published in the literature has mainly been presented for a certain age group, as elderly or for a certain type of injury, as fracture and often restricted to in-hospital care cases. Our objective was to give an overview of the major types of injuries for all age groups and trends in the adult population. METHODS: We analyzed 68,159 adult injury events, which occurred between 1999 and 2008 and was treated at the Emergency Department of Umea University Hospital...
December 2015: Injury Epidemiology
Fredrik Röding, Marie Lindkvist, Ulrica Bergström, Olle Svensson, Jack Lysholm
BACKGROUND: To inform targeted prevention, we studied patterns of trauma recidivism and whether a first injury predicts the risk for a recurrent injury. METHODS: In a population-based study of 98,502 adult injury events 1999-2012, at the emergency department of Umeå University Hospital, Sweden, we compared non-recidivists with recidivists in terms of patients' sex, age, type of injury and severity of the injury. RESULTS: Thirty-six percent of all patients suffered recurrent injuries, which were associated with a higher proportion of inpatient care and more hospital days...
December 2016: Injury Epidemiology
Cynthia Lien, Tony Rosen, Elizabeth M Bloemen, Robert C Abrams, Maria Pavlou, Mark S Lachs
OBJECTIVES: To identify patterns of personal experience or behavior in self-neglect by exploring narratives of cognitively intact older adults. DESIGN: Descriptive study involving semistructured interviews and unstructured narratives. SETTING: A parent study of self-neglect characteristics. PARTICIPANTS: Cognitively intact, self-neglecting older adults referred from 11 community-based senior services agencies (N = 69)...
October 14, 2016: Journal of the American Geriatrics Society
Stefan Candefjord, Johan Winges, Ahzaz Ahmad Malik, Yinan Yu, Thomas Rylander, Tomas McKelvey, Andreas Fhager, Mikael Elam, Mikael Persson
Traumatic brain injury is the leading cause of death and severe disability for young people and a major public health problem for elderly. Many patients with intracranial bleeding are treated too late, because they initially show no symptoms of severe injury and are not transported to a trauma center. There is a need for a method to detect intracranial bleedings in the prehospital setting. In this study, we investigate whether broadband microwave technology (MWT) in conjunction with a diagnostic algorithm can detect subdural hematoma (SDH)...
October 13, 2016: Medical & Biological Engineering & Computing
Yuping Li, Ke Pan, Lin Chen, Jiao-Lin Ning, Xiaojun Li, Ting Yang, Niccolò Terrando, Jianteng Gu, Guocai Tao
BACKGROUND: Postoperative cognitive dysfunction (POCD) is a common complication after surgery, especially amongst elderly patients. Neuroinflammation and iron homeostasis are key hallmarks of several neurological disorders. In this study, we investigated the role of deferoxamine (DFO), a clinically used iron chelator, in a mouse model of surgery-induced cognitive dysfunction and assessed its neuroprotective effects on neuroinflammation, oxidative stress, and memory function. METHODS: A model of laparotomy under general anesthesia and analgesia was used to study POCD...
October 12, 2016: Journal of Neuroinflammation
Harlan M Krumholz, Angela Hsieh, Rachel P Dreyer, John Welsh, Nihar R Desai, Kumar Dharmarajan
BACKGROUND: The risk of rehospitalization is elevated in the immediate post-discharge period and declines over time. It is not known if the extent and timing of risk vary across readmission diagnoses, suggesting that recovery and vulnerability after discharge differ by physiologic system. OBJECTIVE: We compared risk trajectories for major readmission diagnoses in the year after discharge among all Medicare fee-for-service beneficiaries hospitalized with heart failure (HF), acute myocardial infarction (AMI), or pneumonia from 2008-2010...
2016: PloS One
Valeria Markova, Gro M Sandal
Objective: Refugees are at high risk of experiencing mental health problems due to trauma in their pasts and to acculturation stress as they settle in a new country. To develop efficient health services that meet the needs of refugees from different regions, an understanding is required of how they make sense of and prefer to cope with mental health problems. This study aims to investigate lay explanatory models of depression and preferred coping strategies among Somali refugees in Norway. Methods: The study used a mixed-method design with a vignette describing a moderately depressed person based on ICD-10 criteria...
2016: Frontiers in Psychology
Corinne E Wee, Tyler D Ames, Khoi M Le, Tiffany Wang, Laura S Phieffer, Carmen E Quatman
Fragility fractures, or fractures occurring from a low-trauma event, are extremely prevalent among the elderly population worldwide and associated with significant mortality and morbidity. This study evaluated the relationship between FES-I Fear of Falling Survey results, self-reported activity restrictions via the SF-36 survey, and scores recorded by portable, inexpensive clinical assessment tools (CATs) during dynamic functional tasks. Low scores during these tasks may indicate functional deficits that put patients at risk for falls and subsequent fragility fractures...
October 2016: Aging and Disease
Juan Antonio Llompart-Pou, Mario Chico-Fernández, Marcelino Sánchez-Casado, Fermín Alberdi-Odriozola, Francisco Guerrero-López, María Dolores Mayor-García, Javier González-Robledo, María Ángeles Ballesteros-Sanz, Rubén Herrán-Monge, Rafael León-López, Lucía López-Amor, Ana Bueno-González
BACKGROUND: Injury patterns may differ in trauma patients when age is considered. This information is relevant in the management of trauma patients and for planning preventive measures. METHODS: We included in the study all patients admitted for traumatic disease in the participating ICUs from November 23(rd), 2012 to July 31(st), 2015 with complete records. Data on epidemiology, injury patterns, severity scores, acute management, resources utilisation and outcome were recorded and compared in the following groups of age: ≤55years (young adults), 56-65 years (adults), 66-75 years (elderly), >75years (very elderly)...
September 2016: Injury
Verónica Jiménez Díaz, Alfonso Carlos Prada Cañizares, Ismael Auñón Martín, Miguel Aroca Peinado, Pedro Caba Doussoux
BACKGROUND: Factors that impede closed reduction in intertrochanteric fractures remain unknown. This study was designed with the aim of establishing radiological variables that can predict an open reduction when nailing those type of fractures. MATERIALS AND METHODS: Observational prospective study carried out between March 2013 and March 2015. Patients of both gender who suffered an intertrochanteric fracture, and who were surgically treated by intramedullary nailing (PFN-A), were included...
September 2016: Injury
Charlotte E Wittekind, Lena Jelinek, Birgit Kleim, Christoph Muhtz, Steffen Moritz, Fabrice Berna
BACKGROUND AND OBJECTIVES: Post-traumatic stress disorder (PTSD) is accompanied by altered autobiographical memories (AM) of the traumatic incident itself as well as of non-trauma-related events. Several studies have shown that trauma-exposed individuals developing PTSD have a reduced capacity to access specific past events that are not related to the traumatic event compared to those who do not develop PTSD. However, one study including a group of elderly adults did not find significant differences in AM between PTSD and non-PTSD participants...
September 15, 2016: Journal of Behavior Therapy and Experimental Psychiatry
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
Prashanth J Rao, Kevin Phan, Ralph J Mobbs, David Wilson, Jonathon Ball
BACKGROUND: Immobilization of the cervical spine is a cornerstone of spinal injury management. In the context of suspected cervical spine injury, patients are immobilized in a 'neutral position' based on the head and trunk resting on a flat surface. It is hypothesized that the increased thoracic kyphosis and loss of cervical lordosis seen in elderly patients may require alternative cervical immobilization, compared with the 'neutral position'. METHODS: To investigate this, an audit of pan-scan CT performed on consecutive major trauma patients aged over 65 years was carried out over a 6-month period...
March 2016: J Spine Surg
Masanari Takami, Motohiro Okada, Yoshio Enyo, Hiroshi Iwasaki, Hiroshi Yamada, Munehito Yoshida
PURPOSE: Noncontiguous double-level unstable spinal injuries (NDUSI) are uncommon and have not been well described. In this study, we aimed to better understand the patterns of NDUSI, in order to recommend proper diagnostic and treatment methods, as well as to raise awareness among traumatologists about the possibility of these uncommon injuries. METHODS: A total of 710 consecutive patients with spine fractures were treated for >9 years since 2007 at a single regional trauma center...
September 28, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
M S Reich, A J Dolenc, T A Moore, H A Vallier
BACKGROUND: Previous work established resuscitation parameters that minimize complications with early fracture management. This Early Appropriate Care (EAC) protocol was applied to patients with advanced age to determine if they require unique parameters to mitigate complications. METHODS: Between October 2010 and March 2013, 376 consecutive skeletally mature patients with unstable fractures of the pelvis, acetabulum, thoracolumbar spine, and/or proximal or diaphyseal femur fractures were treated at a level I trauma center and were prospectively studied...
September 26, 2016: Journal of Orthopaedic Surgery and Research
William B Elder, Jessica L Domino, Timothy O Rentz, Emma L Mata-Galán
Objective: Male sexual trauma is understudied, leaving much to be known about the unique mental health needs of male survivors. This study examined veteran men's perceptions of the effects of military sexual trauma. Method: Military sexual trauma was defined as physically forced, verbally coerced, or substance-incapacitated acts experienced during military service. Interviews were conducted with 21 male veterans who reported experiencing military sexual trauma. Data were drawn together using a grounded theory methodology...
September 26, 2016: Psychological Trauma: Theory, Research, Practice and Policy
Antonia Rizzuto, Raffaele Serra, Chiara Mignogna, Ilaria Palaia, Franz Ulrich Zittel, Rosario Sacco
BACKGROUND: Laparoscopy is a surgical approach recommended for the treatment of gall bladder disease. It is recommended also in geriatric patients. Recently Single Incision Laparoscopic Cholecystectomy (SILC) has been proposed to minimize surgical trauma, recovery and hospitalization time. However, the results and advantages of SILC in the geriatric population have received minimal attention. This case series review is focused on the results of SILC in the geriatric population. METHODS: The records of 355 patients who had undergone SILC were reviewed...
September 20, 2016: International Journal of Surgery
Kathleen O'Connell, Ronald Maier
PURPOSE OF REVIEW: The benefits of palliative care for critically ill patients are well recognized, yet acceptance into surgical culture is lagging. With the increasing proportion of geriatric trauma patients, integration of palliative medicine within daily intensive care services to facilitate goal-concordant care is imperative. RECENT FINDINGS: Misconceptions of palliative medicine as it applies to trauma patients linger among trauma surgeons and many continue to practice without routine consultation of a palliative care service...
September 21, 2016: Current Opinion in Critical Care
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