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Trauma in elderly

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https://www.readbyqxmd.com/read/28445418/hyponatremia-is-associated-with-worse-outcomes-from-fall-injuries-in-the-elderly
#1
Spencer C H Kuo, Pao-Jen Kuo, Cheng-Shyuan Rau, Shao-Chun Wu, Shiun-Yuan Hsu, Ching-Hua Hsieh
Background: Hyponatremia has been proposed as a contributor to falls in the elderly, which have become a major global issue with the aging of the population. This study aimed to assess the clinical presentation and outcomes of elderly patients with hyponatremia admitted due to fall injuries in a Level I trauma center. Methods: We retrospectively reviewed data obtained from the Trauma Registry System for trauma admissions from January 2009 through December 2014. Hyponatremia was defined as a serum sodium level <135 mEq/L, and only patients who had sustained a fall at ground level (<1 m) were included...
April 26, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28441681/complications-and-mortality-following-one-to-two-level-anterior-cervical-fusion-for-cervical-spondylosis-in-patients-above-80-years-of-age
#2
Varun Puvanesarajah, Amit Jain, Adam L Shimer, Anuj Singla, Francis Shen, Hamid Hassanzadeh
STUDY DESIGN: A retrospective database review. OBJECTIVE: The aim of this study was to determine the complication and mortality rates in patients 80 years of age and older who were treated with anterior cervical fusion surgery and to compare these rates against those of other elderly patients. SUMMARY OF BACKGROUND DATA: Cervical spondylosis is frequently observed in the elderly and is the most common cause of myelopathy in older adults. With increasing life expectancies, a greater proportion of patients are being treated with spine surgery at a later age...
May 1, 2017: Spine
https://www.readbyqxmd.com/read/28439613/the-role-of-delayed-head-ct-in-evaluation-of-elderly-blunt-head-trauma-victims-taking-antithrombotic-therapy
#3
D Scantling, C Fischer, R Gruner, A Teichman, B McCracken, J Eakins
INTRODUCTION: Increasing active longevity has created an increasing surge of elderly trauma patients. The majority of these patients suffer blunt trauma and many are taking antithrombotic agents. The literature is mixed regarding the utility of routine repeat head CT in patients taking antithrombotic medications with a GCS of 15 and initial negative head CT. We hypothesized that scheduled delayed CT head 12 h after admission (D-CTH) in elderly blunt trauma victims would not identify clinically significant new hemorrhages or change management...
April 24, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28433450/a-retrospective-cohort-study-of-concomitant-ipsilateral-extra-capsular-and-intra-capsular-fractures-of-the-proximal-femur-are-they-casual-findings-or-an-undervalued-reality
#4
Miquel Videla-Cés, José-Miguel Sales-Pérez, Joan Girós-Torres, Rubén Sánchez-Navés, Sebastián Videla
BACKGROUND: Fractures of the proximal femur constitute a major public health problem, with an annual incidence in Spain of 7.6 cases per 1000 inhabitants over 65 years of age. Hip fractures are frequent in elderly patients, related to osteoporosis and with low energy trauma, which means that they can be considered a geriatric syndrome. Simultaneous ipsilateral extra- and intra-articular hip fractures are considered as very rare are, and generally speaking, classified as extra- or intra-capsular fractures...
April 13, 2017: Injury
https://www.readbyqxmd.com/read/28424138/comparative-analysis-of-the-paravertebral-analgesic-pump-catheter-with-the-epidural-catheter-in-elderly-trauma-patients-with-multiple-rib-fractures
#5
Brian S Shapiro, Tarik Wasfie, Mathew Chadwick, Kimberly R Barber, Raquel Yapchai
Presently, trauma guidelines recommend epidural analgesia as the optimal modality of pain relief from rib fractures. They are not ideally suited for elderly trauma patients and have disadvantages including bleeding risk. The paravertebral analgesic pump (PVP) eliminates such disadvantages and includes ease of placement in the trauma setting. This study compares pain control in patients treated by EPI versus PVP. This is a retrospective, historical cohort study comparing two methods of pain management in the trauma setting...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28424132/outcomes-of-recreational-activity-associated-trauma-in-elderly-persons-on-blood-thinning-medications
#6
Zachary M DeBoard, Jonathan Grotts, Lisa Ferrigno
With increasing life expectancy, the elderly are participating in recreational activities traditionally pursued by younger persons. Elderly patients have many reasons for worse outcomes after trauma, one of which may be the rising use of anticoagulant and/or antiplatelet medications. This study aimed to determine whether preinjury use of these agents yielded worse outcomes in geriatric patients injured during high-impact recreational activities. The National Trauma Data Bank was reviewed from 2007 to 2010 for patients ≥65 years admitted to Level I or II trauma centers with ICD-9 E-codes for specific mechanisms of injury...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28422904/a-comparison-of-prognosis-calculators-for-geriatric-trauma-a-p-a-l-li-a-t-e-consortium-study
#7
Tarik D Madni, Akpofure Peter Ekeh, Scott C Brakenridge, Karen J Brasel, Bellal Joseph, Kenji Inaba, Brandon R Bruns, Jeffrey D Kerby, Joseph Cuschieri, M Jane Mohler, Paul A Nakonezny, Audra Clark, Jonathan Imran, Steven E Wolf, M Elizabeth Paulk, Ramona L Rhodes, Herb A Phelan
BACKGROUND: The nine-center PALLIATE consortium has validated the Geriatric Trauma Outcome Score (GTOS) as a prognosis calculator for injured elders. We compared GTOS' performance to that of the Trauma Injury Severity Score (TRISS) in a multicenter sample. METHODS: Three PALLIATE centers not submitting subjects to the GTOS validation study identified subjects aged 65 to 102 yrs admitted from 2000-2013. GTOS was specified using the formula [GTOS = age + (ISS x 2...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28421283/shunting-of-the-over-80s-in-normal-pressure-hydrocephalus
#8
Simon D Thompson, J D Shand Smith, A A Khan, A M V Luoma, A K Toma, L D Watkins
BACKGROUND: Idiopathic normal pressure hydrocephalus is predominantly a disease of the elderly. By its nature, many of those who present to clinic are in advanced old age with multiple comorbidities. Majority of patients treated are younger than 80 years old. We present the clinical outcomes and complication rates of patients over the age of 80 years at the time of operation, during the past 11 years at a single institution. METHODS: Retrospective analysis of clinical records of all patients over the age of 80 years, who presented to our institution between 2006 and 2016...
April 18, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28408276/low-serum-concentrations-of-irisin-are-associated-with-increased-risk-of-hip-fracture-in-chinese-older-women
#9
Jun Yan, Hai-Juan Liu, Wei-Chun Guo, Jian Yang
OBJECTIVE: Irisin derived from muscle in response to exercise may be the molecular entity responsible for muscle wasting-osteoporosis connectivity in the elderly. The objective of the study was to determine whether serum Irisin (sIrisin) provides information on hip fracture prediction which were independent of bone mineral density (BMD) and the fracture risk assessment tool (FRAX) algorithm. METHODS: This study enrolled 160 older women (ages, 70-90 y) with minimal trauma hip fractures (MTHFs) and 160 age-matched women without fracture serving as controls...
April 10, 2017: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/28400668/nontuberculous-mycobacterial-infection-of-the-musculoskeletal-system-in-immunocompetent-hosts
#10
Manit K Gundavda, Hitendra G Patil, Vikas M Agashe, Rajeev Soman, Camilla Rodriques, Ramesh B Deshpande
BACKGROUND: Nontuberculous mycobacteria (NTM) were considered saprophytic organisms for many years but now are recognized as human pathogens. Although humans are routinely exposed to NTM, the rate of clinical infection is low. Such infections usually occur in the elderly and in patients who are immunocompromised. However, there has been an increasing incidence in recent years of infections in immunocompetent hosts. NTM infections in immunocompetent individuals are secondary to direct inoculation either contamination from surgical procedures or penetrating injuries rather than hematogenous dissemination...
March 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28400068/intracranial-complications-after-minor-head-injury-mhi-in-patients-taking-vitamin-k-antagonists-vka-or-direct-oral-anticoagulants-doacs
#11
Alessandro Riccardi, Beatrice Spinola, Pierangela Minuto, Maria Ghinatti, Grazia Guiddo, Michele Malerba, Roberto Lerza
INTRODUCTION: The correlation between chronic direct oral anticoagulants (DOACs) intake and the incidence of intracranial complications after minor head injury (MHI) is still not well defined. This study examined the incidence of complications in patients receiving vitamin K antagonists (VKA) or DOACs observed in the emergency department (ED) for MHI. METHODS: Two hundred twenty-five patients affected by MHI and receiving oral anticoagulants were recorded between January and December 2016, distinguishing those treated with VKA (118) from those receiving DOACs (107)...
April 1, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28399218/timed-up-and-go-predicts-functional-decline-in-older-patients-presenting-to-the-emergency-department-following-minor-trauma%C3%A2
#12
Debra Eagles, Jeffrey J Perry, Marie-Josée Sirois, Eddy Lang, Raoul Daoust, Jacques Lee, Lauren Griffith, Laura Wilding, Xavier Neveu, Marcel Emond
Background: there is no standardised test for assessing mobility in the Emergency Department (ED). Objective: we wished to evaluate the relationship between the Timed Up and Go (TUG) and frailty, functional decline and falls in community dwelling elders that present to the ED following minor trauma. Methods: this was a secondary analysis of a prospective cohort study conducted at eight Canadian hospitals. Evaluations included: TUG; Study of Osteoporotic Fractures Frailty Index; Older American Resources and Service Functional Scale; and self-reported falls...
March 1, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28391428/do-clinical-outcomes-correlate-with-bone-density-after-open-reduction-and-internal-fixation-of-tibial-plateau-fractures
#13
Elizabeth Gausden, Matthew R Garner, Peter D Fabricant, Stephen J Warner, Andre D Shaffer, Dean G Lorich
INTRODUCTION: The operative management of tibial plateau fractures in elderly patients has historically led to inconsistent results, and these clinical outcomes were thought to be associated with poor bone quality often in elderly patients. The goal of this study was to investigate the relationship between bone density and subjective clinical outcome scores after open reduction and internal fixation of tibial plateau fractures. MATERIALS AND METHODS: This is a retrospective cohort study from a single-surgeon conducted at an Academic, Level 1 Trauma Center...
April 8, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28384504/pelvic-ring-fractures-in-the-elderly-now-and-then-a-pelvic-registry-study
#14
Mika F Rollmann, Steven C Herath, Florian Kirchhoff, Benedikt J Braun, Joerg H Holstein, Tim Pohlemann, Michael D Menger, Tina Histing
OBJECTIVES: To analyze the changes in demographic data stratified for age, sex and type of injury of elderly patients suffering from pelvic ring fractures over a 22-year observation period. DESIGN/SETTING: Data has been collected prospectively, multi-centrically in hospitals participating in the German Pelvic Trauma Registry. PATIENTS: We analyzed the data of 5665 patients with an age ≥60years included in the German Pelvic Trauma Registry from 1991 to 2013...
March 19, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28382254/on-admission-blood-pressure-and-pulse-rate-in-trauma-patients-and-their-correlation-with-mortality-cushing-s-phenomenon-revisited
#15
Prashant Bhandarkar, Ashok Munivenkatappa, Nobhojit Roy, Vineet Kumar, Veda Dhruthy Samudrala, Jyoti Kamble, Amit Agrawal
BACKGROUND: Injury-induced alteration in initial physiological responses such as hypertension and heart rate (HR) has a significant effect on mortality. Research on such associations from our country-India is limited. The present study investigates the injury-induced early blood pressure (BP) and HR changes and their association with mortality. MATERIALS AND METHODS: The data were selected from Towards Improved Trauma Care Outcomes collected from October 1, 2013, to July 24, 2014...
January 2017: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28377990/the-effect-of-an-adverse-psychological-environment-on-salivary-cortisol-levels-in-the-elderly-differs-by-5-httlpr-genotype
#16
Marie-Laure Ancelin, Jacqueline Scali, Joanna Norton, Karen Ritchie, Anne-Marie Dupuy, Isabelle Chaudieu, Joanne Ryan
BACKGROUND: An adverse psychological environment (e.g. stressful events or depression) has been shown to influence basal cortisol levels and cortisol response to stress. This differs depending on the adverse stimuli, but also varies across individuals and may be influenced by genetic predisposition. An insertion/deletion polymorphism in the serotonin transporter gene (5-HTTLPR) is a strong candidate in this regard. OBJECTIVE: To investigate how stressful life events and depression are associated with diurnal cortisol levels in community-dwelling elderly and determine whether this varies according to genetic variability in the 5-HTTLPR...
December 2017: Neurobiology of Stress
https://www.readbyqxmd.com/read/28372970/reverse-shoulder-arthroplasty-for-complex-fractures-of-the-proximal-humerus-in-elderly-patients-impact-on-the-level-of-independency-early-function-and-pain-medication
#17
Fabian Wolfensperger, Patrick Grüninger, Michael Dietrich, Mathias Völlink, Emanuel Benninger, Michel Schläppi, Christoph Meier
BACKGROUND: This study investigated early functional outcome, quality of life, and the level of independency in elderly patients after primary reverse shoulder arthroplasty (RSA) for complex fractures of the proximal humerus. METHODS: This was a prospective case series that included 33 patients, aged ≥70 years, with a high level of independency who received RSA for complex fractures of the humerus (Orthopaedic Trauma Association B2/C) from January 2012 to April 2014...
March 31, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28368543/morbidity-and-mortality-associated-with-surgery-of-traumatic-c2-fractures-in-octogenarians
#18
Sanjay S Dhall, John K Yue, Ethan A Winkler, Praveen V Mummaneni, Geoffrey T Manley, Phiroz E Tarapore
BACKGROUND: Management of axis fractures in the elderly remains controversial. As the US population increasingly lives past 80 years, published C2 fracture morbidity/mortality profiles in younger cohorts (55+) have become less applicable to octogenarians. OBJECTIVE: To report associations between surgery and mortality, hospital length of stay and discharge disposition in octogenarians with traumatic C2 fractures. METHODS: Retrospective cohort study of 3847 patients age ≥ 80 years representing 17 702 incidents nationwide, divided into surgery/nonsurgery cohorts, using the National Sample Program of the National Trauma Data Bank from 2003 to 2012...
March 23, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28367840/the-effect-of-irrigation-solutions-on-recurrence-of-chronic-subdural-hematoma-a-consecutive-cohort-study-of-234-patients
#19
Masashi Kuwabara, Takashi Sadatomo, Kiyoshi Yuki, Keisuke Migita, Yasutaka Imada, Kiyoharu Shimizu, Takeshi Hara, Hideo Oba, Kaoru Kurisu
Chronic subdural hematomas (CSDHs) occur often in elderly persons and can occur with mild head trauma. With burr-hole irrigation as standard treatment, symptoms usually improve and can be cured, and outcomes are good, but postoperative recurrences are a common problem. This study investigated the effectiveness and recurrence rates when using artificial cerebrospinal fluid (ACF) instead of normal saline (NS) as an irrigation solution for burr-hole irrigation in patients with CSDH. This prospective study included 234 consecutive patients who underwent initial surgical treatment by burr-hole irrigation for a CSDH between April 2008 and June 2015...
March 30, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28367388/delayed-recognition-of-thoracic-and-lumbar-vertebral-compression-fractures-in-minor-accident-cases
#20
Jesse Hatgis, Michelle Granville, Robert E Jacobson
Osteoporotic vertebral compression fractures (VCFs) in the elderly are commonly diagnosed after a minor fall or trauma; however, the majority of these patients have either been previously evaluated for osteoporosis or are already under some form of medical treatment for osteoporosis at the time of the fall. Although accidents are a known cause of VCFs, these fractures are too often undiagnosed. In reviewing a group of patients seen after minor falls or automobile accidents who were complaining of general spine pain, we found a smaller subgroup with previously undiagnosed VCFs...
February 23, 2017: Curēus
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