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Trauma in elderly

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https://www.readbyqxmd.com/read/28645598/efficacy-of-early-surgery-for-neurological-improvement-in-spinal-cord-injury-without-radiographic-evidence-of-trauma-in-the-elderly
#1
Tomoo Inoue, Shinsuke Suzuki, Toshiki Endo, Hiroshi Uenohara, Teiji Tominaga
OBJECT: The optimal timing for surgery for patients with spinal cord injury without radiographic evidence of trauma (SCIWORET) remains unclear. This is especially true in the elderly, because most studies are done with younger patients to avoid age-related comorbidities. We therefore aimed to compare the efficacy of early (less than 24 hours post-injury) versus late (more than 24 hours post-injury) surgery in patients with SCIWORET aged 65 years or older. METHODS: We identified patients aged 65 years or older who underwent surgery for SCIWORET between January 1995 and February 2016...
June 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28643996/age-related-outcome-of-patients-after-traumatic-brain-injury-a-single-centre-observation
#2
Rolf Erlebach, Alberto Pagnamenta, Stephanie Klinzing, Federica Stretti, Silvia Cottini, Reto Schüpbach, Peter Steiger, Giovanna Brandi
BACKGROUND: Study-purpose is to analyze clinical features of patients with traumatic brain injury (TBI), their age-related outcomes and determinants of long- term outcome. METHODS: This retrospective cohort study was conducted in a level I University Swiss trauma center. Consecutive patients with moderate to severe TBI admitted for more than 48 hours to the Intensive Care Unit were included. Patients' and trauma characteristics, management during ICU-stay, prognostic scores and long- term outcomes were analyzed...
June 22, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28637556/pretrauma-functional-independence-measure-score-predicts-survival-in-geriatric-trauma
#3
Brian Fletcher, Eric Bradburn, Christopher Baker, Bryan Collier, Mark Hamill, Katherine Shaver
The Functional Independence Measure (FIM) is used by rehabilitation professionals to access disability. The FIM score combines both motor and cognitive parameters to assess a patient's level of required assistance in performing activities of daily living (ADL). The geriatric trauma patient is becoming an increasingly important cohort for trauma services. FIM has been shown to predict discharge outcomes and those at high risk for falls. We hypothesized pretrauma FIM scores may predict survival in the geriatric trauma population...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28637554/the-g60-trauma-center-a-future-consideration
#4
Marko Bukur, Joshua Simon, Joseph Catino, Margaret Crawford, Ivan Puente, Fahim Habib
With a considerably increasing elderly population, we sought to determine whether the volume of elderly trauma patients treated impacted outcomes at two different Level I trauma centers. This is a retrospective review of all elderly patients (>60 years) at two state-verified Level I trauma centers over the past five years. The elderly trauma center (ETC) saw a greater proportion (52%) of elderly patients than the reference trauma center (30%, TC). Demographic and clinical characteristics were abstracted and stratified into ETC and TC groups for comparison...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28634565/home-based-telepsychiatry-in-us-urban-area
#5
Alireza Amirsadri, Jaclynne Burns, Albert Pizzuti, Cynthia L Arfken
Telepsychiatry expands access to psychiatric care. However, telepsychiatry for elderly adults is only reimbursed in the US if the patient is assessed while in a clinical setting. This case study presents a homebound older woman previously hospitalized for schizophrenia who had not seen a psychiatrist in over 20 years. Care was provided with hybrid telepsychiatry (team-based practice with social worker traveling to the home with electronic tablet for connection with psychiatrist). The intervention resulted in detecting unrecognized depression and complex trauma...
2017: Case Reports in Psychiatry
https://www.readbyqxmd.com/read/28630829/are-we-justified-doing-salvage-or-amputation-procedure-based-on-mangled-extremity-severity-score-in-mangled-upper-extremity-injury
#6
R Siva Kumar, Prahalad Kumar Singhi, M Chidambaram
INTRODUCTION: Mangled upper limb injuries are at surge because of industrialization, modernization, and severe motor vehicle accidents. The utility of various scoring systems are meant for decision making in mangled lower limb injuries, and the same have been extrapolated for mangled upper limb injuries to make a decision of salvage or amputation for the lack of separate scoring system. MATERIALS AND METHODS: We applied mangled extremity severity score (MESS) and mangled extremity syndrome index (MESI) scoring systems to 10 cases of mangled upper limb injuries during the period of November 2010 to September 2012 presented at our tertiary trauma care center...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28630761/partial-proximal-tibia-fractures
#7
Michael J Raschke, Christoph Kittl, Christoph Domnick
Partial tibial plateau fractures may occur as a consequence of either valgus or varus trauma combined with a rotational and axial compression component.High-energy trauma may result in a more complex and multi-fragmented fracture pattern, which occurs predominantly in young people. Conversely, a low-energy mechanism may lead to a pure depression fracture in the older population with weaker bone density.Pre-operative classification of these fractures, by Müller AO, Schatzker or novel CT-based methods, helps to understand the fracture pattern and choose the surgical approach and treatment strategy in accordance with estimated bone mineral density and the individual history of each patient...
May 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28623411/-i-am-not-afraid-of-death-a-survey-on-preferences-concerning-neurosurgical-interventions-among-patients-over-75-years
#8
Claudia Unterhofer, Wing Mann Ho, Katrin Wittlinger, Claudius Thomé, Martin Ortler
INTRODUCTION: Treatment decisions in elderly patients with traumatic brain injury (TBI) are mainly determined by trauma severity and patient age. The aim of this study was to explore personal preferences of potential patients regarding life-prolonging neurosurgical interventions by interviewing ambulatory, autonomous elderly people. METHODS: One hundred consecutive patients older than 75 years frequenting the outpatient clinic of the Department of Neurosurgery were interviewed about their attitudes regarding the hypothetical case of an 81-year-old patient with TBI and a space-occupying acute subdural hematoma (aSDH) using a 21-point questionnaire...
June 16, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28621029/urinary-tract-infection-in-patients-with-hip-fracture-an-underestimated-event
#9
Christopher Bliemel, Benjamin Buecking, Juliana Hack, Rene Aigner, Daphne-Asimenia Eschbach, Steffen Ruchholtz, Ludwig Oberkircher
AIM: Urinary tract infections (UTI) represent a common perioperative complication among elderly patients with hip fracture. To determine the impact of UTI on the perioperative course of elderly patients with hip fractures, a prospective study was carried out. METHODS: A total of 402 surgically-treated geriatric hip fracture patients were consecutively enrolled at a level 1 trauma center. On admission, all patients received an indwelling urinary catheter. Clinically symptomatic patients were screened more closely for UTI...
June 16, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28618921/surgical-evacuation-of-acute-subdural-hematoma-in-octogenarians-a-ten-year-experience-from-a-single-trauma-centerfunding
#10
Michael J McGinity, Joel E Michalek, Jesse S Rodriguez, John R Floyd
BACKGROUND: Elderly patients presenting with an acute subdural hematoma (aSDH) have historically had unfavorable outcomes. METHODS: We retrospectively reviewed patient records from 2005 through 2015 that were ≥80 years of age and underwent surgical evacuation of aSDH. RESULTS: Thirty-four patients met inclusion criteria, with a mean age of 84 years (range 80-91). Glascow Outcome Scale (GOS) of 4-5 was deemed a good outcome and a GOS 1-3 was deemed to be a poor outcome...
June 15, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28617897/recreational-activity-and-facial-trauma-among-older-adults
#11
Andrea Plawecki, Michael Bobian, Aron Kandinov, Peter F Svider, Adam J Folbe, Jean Anderson Eloy, Michael Carron
Importance: As the US population ages, public health agencies have released guidelines encouraging aerobic activity and muscle-strengthening exercises among older individuals. Facial trauma from such activities among elderly individuals has long been underappreciated. Objectives: To evaluate the incidence of recreational activity-associated facial fractures among older adults and to further delineate injury characteristics including demographics, fracture location, and specific activities...
June 15, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/28599966/effect-of-american-college-of-surgeons-trauma-center-designation-on-outcomes-measurable-benefit-at-the-extremes-of-age-and-injury
#12
Michael D Grossman, Jay A Yelon, Lisa Szydiak
BACKGROUND: ACS verification is believed to provide benefits for trauma patients but is associated with direct costs. STUDY DESIGN: One-year retrospective review of the NTDB for 2012. Patients separated into three age groups; Pediatric (PEDS) 0-14, Adult 15-65, and elderly (ELD), >65. We analyzed 2 injury severity cohorts, ISS 9-74 (ALL) and ISS 25-74 (MAJ). Multiple logistic regression to determine significance of ACS verification on mortality and major complications, controlling for age, ISS, shock, GCS, gender, age, co-morbidities and mechanism...
May 18, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28594497/arthroplasty-for-unreconstructable-acute-fractures-and-failed-fracture-fixation-about-the-hip-and-knee-in-the-active-elderly-a-new-paradigm
#13
Richard F Kyle, Paul J Duwelius, George J Haidukewych, Andrew H Schmidt
The techniques, materials, and designs for total joint arthroplasty underwent major improvements in the past 30 years. During this time, trauma surgeons classified the severity of fractures as well as identified certain articular fractures that do not have good outcomes and have a high rate of failure after internal fixation. Advanced improvements in arthroplasty have increased its reliability and longevity. Total joint arthroplasty is becoming a standard of care for some acute articular fractures, particularly displaced femoral neck fractures in the active elderly...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28592739/a-case-of-idiopathic-normal-pressure-hydrocephalus-in-an-elder-diabetic-patient
#14
Kyoko Kawakami, Hiroshi Yoshino, Hiroyuki Igarashi, Yoshiyuki Chiba, Gen Yoshino, Takahisa Hirose
The clinical entity idiopathic normal pressure hydrocephalus (iNPH) is characterized by dementia, urinary incontinence, gait ataxia. An 80-year old man with a past history of Type 2 diabetes mellitus admitted to our hospital. Combination of twice Aspart and Aspart premixed30/70 insulin were used. Although, he was unable to inject insulin by himself recently. On physical examination, he walked in a mildly wide based manner. According to his family, urinary incontinence was existed. Laboratory data were as follows: Postrandial blood glucose 243 mg/dl and glycated hemoglobin 8...
2017: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
https://www.readbyqxmd.com/read/28584740/impact-of-preoperative-echocardiography-on-perioperative-management-in-geriatric-hip-trauma-a-retrospective-observational-study
#15
Chhavi Sawhney, Vivek Trikha, Sai Janani, Sukhminder Jit Singh Bajwa, Vijay Sharma, Menaal Khanna
BACKGROUND AND AIM: Hip fractures are associated with a significant risk of morbidity and mortality in the elderly population. Current guidelines propose that these patients should be operated as early as possible. Preoperative cardiac investigations, especially echocardiography, have been considered to delay surgery with few changes in the patient management. The present study has been conducted to evaluate whether preoperative echocardiography improve or worsen the prognosis in such hip trauma surgery...
April 2017: International Journal of Applied and Basic Medical Research
https://www.readbyqxmd.com/read/28574116/the-influence-of-acetabular-morphology-on-prediction-of-proximal-femur-fractures-types-in-an-elderly-population
#16
Abbas Tokyay, Melih Güven, Mehmet E Encan, Erhan Okay, Ozgur Akbaba
INTRODUCTION: The role of proximal femur morphology to the development of certain proximal femur fracture types both femoral neck and trochanteric fractures has been observed. However, the relavance of acetabular morphology to the development of proximal femur fractures is not extensively questioned. Therefore the aim of the study was to determine whether there is a correlation between acetabular morphology and pathogenesis of 2 different hip fracture types after low energy trauma. METHOD: This retrospective study includes 60 cases (41 women, 19 men) with a proximal femoral fracture after a low energy trauma between July 2012 and December 2014...
May 23, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28553444/role-of-local-infiltration-of-tranexamic-acid-in-reducing-blood-loss-in-peritrochanteric-fracture-surgery-in-the-elderly-population
#17
S R Virani, A A Dahapute, I Panda, S S Bava
Introduction: Peritrochanteric fractures are common injuries occurring in elderly patients. Surgeries for these fractures are associated with significant blood loss. Intravenous tranexamic acid has a proven track record in many orthopaedic surgeries including trauma, arthroplasty and spine surgeries. Objective: To study the effect of local subfascial and intramuscular infiltration of tranexamic acid in reducing blood loss and the requirement for blood transfusion in intertrochanteric fracture surgery. Study Design: Single centre prospective analytical study...
November 2016: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/28551485/spontaneous-submental-hematoma-a-pseudo-ludwig-s-phenomenon-in-101-year-old-patient-case-report-and-literature-review
#18
Uthman Alamoudi, Yasser Alsallumi, Matthew H Rigby, S Mark Taylor, Jonathan R B Trites, Robert D Hart
OBJECTIVE: Submental hematoma or pseudo-Ludwig's phenomenon, is a rare entity seen in anticoagulated patients and can precipitate upper airway obstruction. Our objective is to present a rare case of spontaneous submental hematoma due to poorly controlled hypertension in elderly patient and to perform a literature review. CASE REPORT: 101-year-old female presented to emergency room with sudden painful swelling in the floor of mouth and slurred speech. Not on anticoagulation and no history of trauma or known allergies...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28550953/perinatal-risk-and-protective-factors-for-pediatric-abusive-head-trauma-a-multicenter-case-control-study
#19
Patrick Kelly, John M D Thompson, Jean Koh, Shanthi Ameratunga, Timothy Jelleyman, Teuila M Percival, Hinemoa Elder, Edwin A Mitchell
OBJECTIVE: To estimate associations between factors recorded in pregnancy and the first week of life and subsequent abusive head trauma. STUDY DESIGN: Multicenter, retrospective case-control study of perinatal records from 142 cases of abusive head trauma and 550 controls, matched by date and hospital of birth from 1991 to 2010. Multiple logistic regression assessed the relationship between perinatal exposures and abusive head trauma. RESULTS: The risk of abusive head trauma decreased with increasing maternal age (OR, 0...
May 24, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28547319/systemic-inflammatory-response-syndrome-sirs-score-independently-predicts-poor-outcome-in-isolated-traumatic-brain-injury
#20
Tomas Jacome, Danielle Tatum
INTRODUCTION: Systemic inflammatory response syndrome (SIRS) is frequently observed after various types of acute cerebral injury and has been linked to clinical deterioration in non-traumatic brain injury (TBI). SIRS scores have also been shown to be predictive of length of stay and mortality in trauma patients. We aimed to determine the prognostic utility of SIRS present at admission in trauma patients with isolated TBI. METHODS: This was a 5-year retrospective cohort study of adults (≥18 years) with isolated TBI admitted to a Level II trauma center...
May 25, 2017: Neurocritical Care
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