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Trauma in elderly

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https://www.readbyqxmd.com/read/28238043/cementless-and-locked-prosthesis-for-the-treatment-of-3-part-and-4-part-proximal-humerus-fractures-prospective-clinical-evaluation-of-hemi-and-reverse-arthroplasty
#1
E Boyer, G Menu, F Loisel, R Saadnia, J Uhring, A Adam, S Rochet, P Clappaz, E Baudouin, T Lascar, R Cermeno, L Obert
INTRODUCTION: Cemented stem remains the gold standard for prosthesis in trauma. The purpose of this study was to evaluate the functional and radiological outcomes of a cementless, trauma-specific locked stem (hemi and reverse) for 3- and 4-part proximal humeral fractures. MATERIALS AND METHODS: One hundred and thirty-four 3- and 4-part fractures have been treated by locked stem, 69 with hemiarthroplasty [mean age 68 years (50-90)] and 65 with reversed [mean age 78 years (66-91)]...
February 25, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28230652/a-case-of-postmortem-canine-depredation
#2
Dennis J Chute, Robert J Bready
We report the case of postmortem animal depredation that produced initial confusion for investigators who responded to the scene. A decomposing elderly woman was found in her presumed home with bilateral upper extremity amputations and craniocerebral trauma. This raised suspicion of foul play. Subsequent investigations together with autopsy led the medical examiner to conclude that the cause of death was natural disease and that those injuries found on her body were produced by at least one of the dogs who shared the premises...
February 23, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28225741/redefining-the-association-between-old-age-and-poor-outcomes-after-trauma-the-impact-of-frailty-syndrome
#3
Bellal Joseph, Tahereh Orouji Jokar, Ahmed Hassan, Asad Azim, Martha Jane Mohler, Narong Kulvatunyou, Shirin Siddiqi, Herb Phelan, Mindy Fain, Peter Rhee
BACKGROUND: Frailty syndrome (FS) is a well-established predictor of outcomes in geriatric patients. The aim of this study was to quantify the prevalence of FS in geriatric trauma patients and to determine its association with trauma readmissions, repeat falls, and mortality at 6 months. METHODS: we performed a 2-year (2012-2013) prospective cohort analysis of all consecutive geriatric (age, ≥ 65 years) trauma patients. FS was assessed using a Trauma-Specific Frailty Index (TSFI)...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28206934/increased-age-predicts-failure-to-rescue
#4
Galinos Barmparas, Matthew J Martin, Douglas A Wiegmann, Ken R Catchpole, Bruce L Gewertz, Eric J Ley
Failure to rescue (FTR), defined as any death after the development of in-hospital complications, is an important quality measure, but the relationship with age after a traumatic injury, has not been well defined. We sought to examine whether older trauma patients are at higher risk for FTR. The National Trauma Databank (NTDB) research datasets 2007 to 2011 were queried for patients ≥16 years who had any reported complication. Those who survived (non-FTR) were compared with those who did not (FTR) using a forward logistic regression model...
November 1, 2016: American Surgeon
https://www.readbyqxmd.com/read/28206931/a-comprehensive-investigation-of-comorbidities-mechanisms-injury-patterns-and-outcomes-in-geriatric-blunt-trauma-patients
#5
Carlos V R Brown, Kevin Rix, Amanda L Klein, Brent Ford, Pedro G R Teixeira, Jayson Aydelotte, Ben Coopwood, Sadia Ali
The geriatric population is growing and trauma providers are often tasked with caring for injuries in the elderly. There is limited information regarding injury patterns in geriatric trauma patients stratified by mechanism of injury. This study intends to investigate the comorbidities, mechanisms, injury patterns, and outcomes in geriatric blunt trauma patients. A retrospective study of the 2012 National Trauma Databank was performed. Adult blunt trauma patients were identified; geriatric (>/=65) patients were compared with younger (<65) patients regarding admission demographics and vital signs, mechanism and severity of injury, and comorbidities...
November 1, 2016: American Surgeon
https://www.readbyqxmd.com/read/28202056/normal-gastric-emptying-time-of-a-carbohydrate-rich-drink-in-elderly-patients-with-acute-hip-fracture-a-pilot-study
#6
Per M Hellström, Bodil Samuelsson, Amer N Al-Ani, Margareta Hedström
BACKGROUND: Guidelines for fasting in elderly patients with acute hip fracture are the same as for other trauma patients, and longer than for elective patients. The reason is assumed stress-induced delayed gastric emptying with possible risk of pulmonary aspiration. Prolonged fasting in elderly patients may have serious negative metabolic consequences. The aim of our study was to investigate whether the preoperative gastric emptying was delayed in elderly women scheduled for surgery due to acute hip fracture...
February 15, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28186446/de-novo-avm-formation-following-venous-sinus-thrombosis-and-prior-avm-resection-in-adults-report-of-2-cases
#7
Siyu Shi, Raghav Gupta, Justin M Moore, Christoph J Griessenauer, Nimer Adeeb, Rouzbeh Motiei-Langroudi, Ajith J Thomas, Christopher S Ogilvy
Brain arteriovenous malformations (AVMs) are traditionally considered congenital lesions, arising from aberrant vascular development during the intrauterine period. Rarely, however, AVMs develop in the postnatal period. Individual case reports of de novo AVM formation in both pediatric and adult patients have challenged the traditional dogma of a congenital origin. Instead, for these cases, a dynamic picture is emerging of AVM growth and development, initially triggered by ischemic and/or traumatic events, coupled with genetic predispositions...
February 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28184359/predictive-factors-of-dependency-in-activities-of-daily-living-following-limb-trauma-in-the-elderly
#8
Azade Safa, Negin Masoudi Alavi, Masoumeh Abedzadeh-Kalahroudi
BACKGROUND: Traumatic injuries in the elderly often lead to permanent disabilities and long-term treatments that can adversely influence their activities of daily of living (ADL). The effect on ADL is an important outcome in elderly trauma. OBJECTIVES: The present study was designed to evaluate the predictive factors of dependency in ADL following limb trauma in elderly referred to Shahid Beheshti Hospital, Kashan, Iran, in 2013. PATIENTS AND METHODS: This descriptive study was conducted on 200 traumatic patients admitted to the trauma emergency ward of Shahid Beheshti hospital in 2013...
November 2016: Trauma Monthly
https://www.readbyqxmd.com/read/28180986/what-are-the-differences-in-injury-patterns-of-young-and-elderly-traffic-accident-fatalities-considering-death-on-scene-and-death-in-hospital
#9
Daniela Heinrich, Christopher Holzmann, Anja Wagner, Anja Fischer, Roman Pfeifer, Matthias Graw, Sylvia Schick
Older traffic participants have higher risks of injury than the population up to 65 years in case of comparable road traffic accidents and further, higher mortality rates at comparable injury severities. Rib fractures as risk factors are currently discussed. However, death on scene is associated with hardly survivable injuries and might not be a matter of neither rib fractures nor age. As 60% of traffic accident fatalities are estimated to die on scene, they are not captured in hospital-based trauma registries and injury patterns remain unknown...
February 8, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28180912/-epidemiology-of-dupuytren-s-disease
#10
P Hahn
Dupuytren's disease is a chronic disease of the elderly. Assuming that life expectancy will increase considerably in the coming decades, Dupuytren's disease will gain more medical and socioeconomic relevance. In addition to well-known familial and genetic causes, other environmental factors (nicotine, diabetes, alcohol, trauma, work) are discussed. Knowledge of all factors and their influence on the onset and severity of the disease is important for diagnosis, therapy, and prevention of the disease.
February 8, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28168702/biparietal-thinning-accidental-death-by-a-fall-from-standing-height
#11
Robert W Mann, Masahiko Kobayashi, Alan L Schiller
Biparietal thinning resulting in bilateral and symmetrical resorption and loss of thickness of the parietal bones is an uncommon to rare condition in the anthropological and clinical literature. This enigmatic condition of unknown etiology was first reported in the 18th century and has been variously described as a nonmetric trait, anatomical variant, anomaly, and pathology. Biparietal thinning presents grossly and radiographically as oval-shaped depressions in 0.25-0.8% and 0.4-0.5% of individuals and with a higher frequency in females over the age of 60 years...
February 7, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28162786/base-excess-a-useful-marker-in-the-prognosis-of-chest-trauma-in-the-geriatric-population
#12
Y Peñasco, A González-Castro, J C Rodríguez-Borregán, J Llorca
OBJECTIVE: To determine the usefulness of the determination of base excess in a cohort of elderly patients admitted to an intensive care unit (ICU) with a diagnosis of chest trauma. MATERIAL AND METHOD: Two hundred and forty-nine patients were included aged 65 years and over with a diagnosis of thoracic trauma who required admission to the ICU. We made a statistical analysis in order to determine the association of the first base excess levels with mortality during the unit stay...
February 2, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28160967/unmet-palliative-care-needs-in-elderly-trauma-patients-can-the-palliative-performance-scale-help-close-the-gap
#13
Christopher M McGreevy, Sarah Bryczkowski, Sri Ram Pentakota, Ana Berlin, Sangeeta Lamba, Anne C Mosenthal
BACKGROUND: The elderly injured have significant palliative care (PC) needs due to increased mortality and poor functional outcomes. We hypothesized the Palliative Performance Scale (PPS) could be predictive of poor outcomes in elderly trauma patients. METHODS: Retrospective study of trauma patients 55 years or older admitted to the surgical intensive care unit. Using logistic regression, PPS was assessed as a predictor of mortality, Glasgow Outcome Scale, and discharge destination...
June 18, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28159475/risk-factors-for-reoperation-after-total-elbow-arthroplasty
#14
Donato Perretta, Wouter F van Leeuwen, George Dyer, David Ring, Neal Chen
BACKGROUND: Total elbow arthroplasty (TEA) is a treatment option for arthritic conditions of the elbow and for complex distal humerus fractures in the elderly. Complications are common, however, and rates of survivorship vary. The goal of this study was to describe the factors associated with reoperation and revision after TEA. METHODS: We retrospectively reviewed primary TEAs performed at 2 tertiary academic medical centers. We identified 102 primary TEAs in 82 patients by 9 surgeons...
January 31, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28151094/spontaneous-resolution-of-ruptured-intracranial-pial-arteriovenous-fistula-following-spinal-surgery
#15
Mark K Lyons, Joseph M Hoxworth, Jamal McClendon, Chandan X Krishna, Naresh P Patel
Pial arteriovenous fistulae (AVFs) are rare vascular abnormalities that are distinct from arteriovenous malformations and dural AVFs. These vascular lesions have been linked with trauma, ischemic syndromes, venous thrombotic diseases, and intracranial surgical procedures. In this report we describe a case of an intracranial ruptured pial AVF immediately following uneventful spinal surgery in an elderly patient with subsequent spontaneous resolution. He was a previous heavy smoker with a 60-pack-year history and alcohol abuse...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28145950/increased-mortality-in-elderly-patients-with-sarcopenia-and-acetabular-fractures
#16
Matthew E Deren, Jacob Babu, Eric M Cohen, Jason Machan, Christopher T Born, Roman Hayda
BACKGROUND: Sarcopenia is a condition of clinically relevant loss of muscle mass and function. Acetabular fractures in elderly patients are common and difficult to treat. This study aimed to determine if sarcopenia is common in elderly patients with acetabular fractures and correlates with lower-energy mechanisms of injury, higher rates of complications, and higher mortality than patients with normal muscle mass. METHODS: The Rhode Island Hospital Trauma Database was queried for patients who were ≥60 years of age from 2005 to 2014 using the International Classification of Diseases, Ninth Revision, code for closed acetabular fracture, 808...
February 1, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28132729/malnutrition-an-underestimated-factor-in-the-inpatient-treatment-of-traumatology-and-orthopedic-patients-a-prospective-evaluation-of-1055-patients
#17
Christoph Ihle, Thomas Freude, Christian Bahrs, Eva Zehendner, Janick Braunsberger, Hans Konrad Biesalski, Christine Lambert, Ulrich Stöckle, Elke Wintermeyer, Julia Grünwald, Leonard Grünwald, Gunnar Ochs, Ingo Flesch, Andreas Nüssler
INTRODUCTION: Suboptimal nutritional status is often observed among hospitalized patients across all medical specialties. The objective of the present study was to (1) analyze the prevalence of malnutrition in hospitalized orthopedic and trauma patients and (2) to evaluate the relationship between malnutrition and selected clinical outcomes. MATERIALS AND METHODS: The prospective field study was conducted between 06/2014 and 06/2015 in a German level I trauma center (Department of Traumatology, Septic Trauma Surgery and Arthroplasty) with a total number of 1055 patients...
January 22, 2017: Injury
https://www.readbyqxmd.com/read/28120436/flail-chest-following-failed-cardiopulmonary-resuscitation
#18
Melissa Thompson, Neil E I Langlois, Roger W Byard
Following the death of a woman with blunt force chest trauma, the question was asked how common was the finding at autopsy of a flail chest in decedents after failed cardiopulmonary resuscitation. It was suggested in court that this was an uncommon occurrence. To address this issue, autopsy cases in adults (>18 years) with rib fractures attributable to cardiopulmonary resuscitation were taken from the files of Forensic Science SA over a 7-year period from 2008 to 2014. Flail chest injuries were defined as those arising from fractures at two sites in at least three consecutive ribs...
January 25, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28116262/acetabular-prosthetic-protrusio-after-bipolar-hemi-arthroplasty-of-the-hip-case-report-and-review-of-the-literature
#19
Jason Bt Lim, Chia Liang Ang, Hee Nee Pang
INTRODUCTION: Bipolar hemi-arthroplasty of the hip is a commonly performed procedure in elderly patients with intra-capsular fracture of the neck of the femur with good short-term results for pain relief, return to activity and morbidity. The incidence of intra-pelvic prosthesis migration or protrusion is rare and one of the inciting factors is chronic low-grade sepsis. Acetabular prosthesis protrusion poses a difficult and challenging surgical problem due to surrounding neurovascular structures...
July 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28110930/antithrombotic-agents-intake-prior-to-injury-does-not-affect-outcome-after-a-traumatic-brain-injury-in-hospitalized-elderly-patients
#20
Jessica Julien, Ghusn Alsideiri, Judith Marcoux, Mohammed Hasen, José A Correa, Mitra Feyz, Mohammed Maleki, Elaine de Guise
BACKGROUND: The purpose of this study is to investigate the effect of risk factors including International Normalized Ratio (INR) as well as the Partial Thromboplastin Time (PTT) scores on several outcomes, including hospital length of stay (LOS) and The Extended Glasgow Outcome Scale (GOSE) following TBI in the elderly population. METHODS: Data were retrospectively collected on patients (n=982) aged 65 and above who were admitted post TBI to the McGill University Health Centre-Montreal General Hospital from 2000 to 2011...
January 16, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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