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Trauma in elderly

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https://www.readbyqxmd.com/read/28807429/the-incidence-and-trauma-mechanisms-of-acetabular-fractures-a-nationwide-study-in-finland-between-1997-and-2014
#1
Pasi P Rinne, Minna K Laitinen, Tuomas Huttunen, Pekka Kannus, Ville M Mattila
PURPOSE: Information on the incidence of acetabular fractures of the pelvis is limited. Epidemiological data is often based on specific trauma registers, individual trauma centres or on trends of all pelvic fractures grouped together. The primary aim of this study was to determine the incidence and trends of hospital-treated acetabular fractures in the Finnish population from 1997 to 2014. The secondary aim was to assess the trauma mechanisms involved. METHODS: The Finnish National Hospital Discharge Register collects inpatient data from all public and private medical institutions in Finland and covers the entire Finnish population of 5...
August 4, 2017: Injury
https://www.readbyqxmd.com/read/28804877/validation-of-a-geriatric-trauma-prognosis-calculator-a-p-a-l-li-a-t-e-consortium-study
#2
Allyson C Cook, Bellal Joseph, M Jane Mohler, Kenji Inaba, Brandon R Bruns, Paul A Nakonezny, Jeff D Kerby, Karen J Brasel, Steven E Wolf, Joseph Cuschieri, M Elizabeth Paulk, Ramona L Rhodes, Scott C Brakenridge, A Peter Ekeh, Herb A Phelan
BACKGROUND/OBJECTIVES: The P.A.L.Li.A.T.E. (prognostic assessment of life and limitations after trauma in the elderly) consortium has previously created a prognosis calculator for mortality after geriatric injury based on age, injury severity, and transfusion requirement called the geriatric trauma outcome score (GTOS). Here, we sought to create and validate a prognosis calculator called the geriatric trauma outcome score ii (GTOS II) estimating probability of unfavorable discharge. DESIGN: Retrospective cohort...
August 14, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28791071/periorbital-and-mediastinal-emphysema-after-upper-gastrointestinal-endoscopy-case-report-of-a-rare-complication
#3
Thankappan Lekha, Leelakrishnan Venkatakrishnan, Karuppannasamy Divya, Perumal Lavanya
PURPOSE: To report a rare case of periorbital emphysema concurrent with cervicofacial and mediastinal emphysema in an elderly woman who underwent upper gastrointestinal endoscopy for chronic liver disease. CASE REPORT: An elderly woman with decompensated chronic liver disease presented with features of periorbital, facial, and mediastinal emphysema, characterized with crepitant swelling over the right periorbital area, face, neck, and mediastinum after undergoing upper gastrointestinal endoscopy...
July 2017: Journal of Ophthalmic & Vision Research
https://www.readbyqxmd.com/read/28790471/should-total-hip-arthroplasty-be-performed-acutely-in-the-treatment-of-acetabular-fractures-in-elderly-or-used-as-a-salvage-procedure-only
#4
Katharine Hamlin, Gabija Lazaraviciute, Michalis Koullouros, Tarak Chouari, Iain M Stevenson, Steven W Hamilton
BACKGROUND: Total hip arthroplasty (THA) is now an increasingly common procedure for people sustaining acetabular fractures. The incidence of acetabular fractures among the elderly population is increasing, and contemporary treatment aims to avoid the risks of prolonged incumbency associated with poor bone stock for fixation or inability to comply with limited weightbearing in this patient group. The concept of acute hip arthroplasty as a treatment for acetabular fracture is, therefore, becoming more topical and relevant...
July 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28780503/late-mortality-after-acute-hypoxic-respiratory-failure
#5
Hallie C Prescott, Michael W Sjoding, Kenneth M Langa, Theodore J Iwashyna, Daniel F McAuley
BACKGROUND: Acute hypoxic respiratory failure (AHRF) is associated with significant acute mortality. It is unclear whether later mortality is predominantly driven by pre-existing comorbid disease, the acute inciting event or is the result of AHRF itself. METHODS: Observational cohort study of elderly US Health and Retirement Study (HRS) participants in fee-for-service Medicare (1998-2012). Patients hospitalised with AHRF were matched 1:1 to otherwise similar adults who were not currently hospitalised and separately to patients hospitalised with acute inciting events (pneumonia, non-pulmonary infection, aspiration, trauma, pancreatitis) that may result in AHRF, here termed at-risk hospitalisations...
August 5, 2017: Thorax
https://www.readbyqxmd.com/read/28780196/can-we-reduce-morphine-use-in-elderly-proximal-femoral-fracture-patients-using-a-fascia-iliac-block
#6
Al-Amin M Kassam, Anthony T Gough, Joanna Davies, Rathan Yarlagadda
Proximal femoral fractures are becoming increasingly common with an ageing population. Many patients have multiple comorbidities increasing their risk of opiate complications. 40 consecutive patients presenting with a proximal femoral fracture to a trauma centre in the UK were given either a Fascia Iliaca Block (FIB) with oral analgesia or just oral analgesia to control their pre-operative pain. Numeric pain scores and morphine consumption were used as outcome measures. Patients receiving a FIB had significant reduction in their pain scores compared to patients only receiving oral pain relief...
August 2, 2017: Geriatric Nursing
https://www.readbyqxmd.com/read/28777886/lower-levels-of-il-1%C3%AE-gene-expression-are-associated-with-impaired-langerhans-cell-migration-in-aged-human-skin
#7
Suzanne M Pilkington, Stephanie Ogden, Laura Eaton, Rebecca J Dearman, Ian Kimber, Christopher Em Griffiths
Langerhans' cells (LC) play pivotal roles in skin immune responses, linking innate and adaptive immunity. In aged skin there are fewer LC and migration is impaired compared with young skin. These changes may contribute to declining skin immunity in the elderly, including increased skin infections and skin cancer. Interleukin (IL)-1β and tumour necrosis factor (TNF)-α are mandatory signals for LC migration and previous studies suggest IL-1β signalling may be dysregulated in aged skin. Therefore, we sought to explore the mechanisms underlying these phenomena...
August 4, 2017: Immunology
https://www.readbyqxmd.com/read/28768968/isolated-adrenocorticotropic-hormone-deficiency-following-chronic-subdural-hematoma-in-an-elderly-man-is-there-a-connection
#8
Satoshi Suzuki, Keiko Suzuki
The delayed diagnosis of adrenal insufficiency is relatively common because its symptoms are non-specific. One of the causes of adrenal insufficiency is isolated adrenocorticotropic hormone deficiency (IAD), which is sometimes caused by traumatic brain injury. Indeed, severe head trauma is considered to contribute to the incidence of this disease. However, the relationship between milder head trauma-such as chronic subdural hematoma - and the occurrence of hormonal deficiency is uncertain. We herein report the case of a 79-year-old man with IAD who presented with leg edema and pain in his extremities following a recent history of chronic subdural hematoma...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28768787/factors-affecting-the-rate-of-surgical-site-infection-in-patients-after-hemiarthroplasty-of-the-hip-following-a-fracture-of-the-neck-of-the-femur
#9
L de Jong, T M A L Klem, T M Kuijper, G R Roukema
AIMS: Surgical site infection can be a devastating complication of hemiarthroplasty of the hip, when performed in elderly patients with a displaced fracture of the femoral neck. It results in a prolonged stay in hospital, a poor outcome and increased costs. Many studies have identified risk and prognostic factors for deep infection. However, most have combined the rates of infection following total hip arthroplasty and internal fixation as well as hemiarthroplasty, despite the fact that they are different entities...
August 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28767563/incidence-and-risk-factors-of-long-term-opioid-use-in-elderly-trauma-patients
#10
Raoul Daoust, Jean Paquet, Lynne Moore, Sophie Gosselin, Céline Gélinas, Dominique M Rouleau, Mélanie Bérubé, Judy Morris
OBJECTIVE: Evaluate the incidence and risk factors of opioid use 1 year after injury in elderly trauma patients. BACKGROUND: The current epidemic of prescription opioid misuse and overdose observed in North America generally concerns young patients. Little is known on long-term opioid use among the elderly trauma population. METHODS: In a retrospective observational multicenter cohort study conducted on registry data, all patients 65 years and older admitted (hospital stay >2 days) for injury in 57 adult trauma centers in the province of Quebec (Canada) between 2004 and 2014 were included...
August 1, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28752182/the-challenging-surgical-treatment-of-closed-distal-humerus-fractures-in-elderly-and-octogenarian-patients-radiographic-and-functional-outcomes-with-a-minimum-follow-up-of-24%C3%A2-months
#11
Carlo Biz, Silvano Pierluigi Sperotto, Nicola Maschio, Matteo Borella, Claudio Iacobellis, Pietro Ruggieri
INTRODUCTION: The main purpose of this retrospective, non-randomized, case series study was to evaluate the clinical and radiographic outcomes of distal humerus fractures (DHFs) in a consecutive series of elderly patients operatively treated by two surgeons, and second, to identify proper indications for two elderly age ranges and two fracture pattern groups. MATERIALS AND METHODS: From January 2009 to June 2014, 51 patients (pts) underwent open reduction and internal fixation (ORIF) using the locking compression plate (LCP) distal humerus plate (DHP) system at our institution...
July 27, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28742787/functional-outcomes-of-elderly-patients-with-nonoperatively-treated-acetabular-fractures-that-meet-operative-criteria
#12
Scott P Ryan, Theodore T Manson, Marcus F Sciadini, Jason W Nascone, Christopher T LeBrun, Renan C Castillo, Ragu Muppavarapu, Brian Schurko, Robert V O'Toole
OBJECTIVES: To report functional outcomes of displaced acetabular fractures treated nonoperatively in the geriatric patient population. DESIGN: Retrospective case series. SETTING: Two Level I trauma centers. PATIENTS: Twenty-seven patients age 60 years or older who sustained displaced acetabular fractures during an 11-year period. INTERVENTION: Nonoperative treatment. MAIN OUTCOME MEASUREMENTS: Primary outcome measurements were Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores and Short Form 8 (SF-8) scores...
July 24, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28738950/a-decade-evaluation-of-a-state-trauma-system-has-access-to-inpatient-trauma-care-at-designated-trauma-centers-improved
#13
Dennis W Ashley, Etienne E Pracht, Regina S Medeiros, Elizabeth V Atkins, Elizabeth G Nesmith, Tracy J Johns, James R Dunne, Jeffrey M Nicholas
Recently, the trauma center component of the Georgia trauma system was evaluated demonstrating a 10 per cent probability of increased survival for severely injured patients treated at designated trauma centers (DTCs) versus nontrauma centers. The purpose of this study was to determine the effectiveness of a state trauma system to provide access to inpatient trauma care at DTCs for its residents. We reviewed 371,786 patients from the state's discharge database and identified 255,657 treated at either a DTC or a nontrauma center between 2003 and 2012...
July 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28737617/management-of-acetabular-fractures-in-the-elderly
#14
Nicholas B Antell, Julie A Switzer, Andrew H Schmidt
The incidence of acetabular fractures in the elderly population is increasing. Fractures in this population differ from those in younger patients, with more frequent involvement of the anterior column, more comminution, and more severe articular impaction in elderly patients. Although acetabular fractures in geriatric patients are more likely the result of low-energy trauma, outcomes are generally poorer than those in young patients. Multiple management options have been proposed, but no intervention has become the standard of care for these fractures in the elderly...
August 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28733846/implementation-of-a-standardized-protocol-to-manage-elderly-patients-with-low-energy-pelvic-fractures-can-service-improvement-be-expected
#15
Nikolaos K Kanakaris, Tess Greven, Robert M West, Arie B Van Vugt, Peter V Giannoudis
PURPOSE: The incidence of low energy pelvic fractures (FPFs) in the elderly is increasing. Comorbidities, decreased bone-quality, problematic fracture fixation and poor compliance represent some of their specific difficulties. In the absence of uniform management, a standard operating procedure (SOP) was introduced to our unit, aiming to improve the quality of services provided to these patients. METHODS: A cohort study was contacted to test the impact of (1) using a specific clinical algorithm and (2) using different antiosteoporotic drugs...
July 21, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28733043/perioperative-hypotension-and-discharge-outcomes-in-non-critically-injured-trauma-patients-a-single-centre-retrospective-cohort-study
#16
Nadav Sheffy, Itay Bentov, Brianna Mills, Bala G Nair, G Alec Rooke, Monica S Vavilala
BACKGROUND: There is a lack of information on the effect of age on perioperative care and outcomes after minor trauma in the elderly. We examined the association between perioperative hypotension and discharge outcome among non-critically injured adult patients. METHODS: We conducted a retrospective study of non-critically ill patients (ISS <9 or discharged within less than 24h) who received anaesthesia care for surgery and Recovery Room care at a level-1 trauma centre between 5/1/2012 and 11/30/2013...
June 24, 2017: Injury
https://www.readbyqxmd.com/read/28716132/a-patient-safety-and-professional-perspective-on-non-conveyance-in-ambulance-care-a-systematic-review
#17
REVIEW
Remco H A Ebben, Lilian C M Vloet, Renate F Speijers, Nico W Tönjes, Jorik Loef, Thomas Pelgrim, Margreet Hoogeveen, Sivera A A Berben
BACKGROUND: This systematic review aimed to describe non-conveyance in ambulance care from patient-safety and ambulance professional perspectives. The review specifically focussed at describing (1) ambulance non-conveyance rates, (2) characteristics of non-conveyed patients, (3) follow-up care after non-conveyance, (4) existing guidelines or protocols, and (5) influencing factors during the non-conveyance decision making process. METHODS: We systematically searched MEDLINE, PubMed, CINAHL, EMBASE, and reference lists of included articles, in June 2016...
July 17, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28711594/hepatic-mitochondrial-bioenergetics-in-aged-c57bl-6-mice-exhibit-delayed-recovery-from-severe-burn-injury
#18
Christopher Auger, Thibacg Sivayoganathan, Abdikarim Abdullahi, Alexandra Parousis, Marc G Jeschke
Severe burn injuries initiate a cascade of downstream events, culminating in multiple organ dysfunction, sepsis, and even death. The elderly are in particular vulnerable to such outcomes, due primarily to a scarcity of knowledge on trauma progression at the biomolecular level in this population. Mitochondria, the cellular powerhouses, have been increasingly scrutinized recently for their contribution to trauma outcomes. We hypothesized that elderly have a worse outcome compared to adult patients due to failed recovery of hepatic mitochondria...
July 12, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28706764/neuroradiological-endovascular-intervention-for-diplopia-in-a-case-of-aneurysmal-aberrant-regeneration-of-the-third-nerve
#19
Anupam C A Rao, Saumil A Shah, Benjamin W C Sim, Steven T H Yun, Neeranjali S Jain, Yashar Kalani, Ian C Francis
Aberrant regeneration of the third nerve occurs as a result of synkinetic 'miswiring' of the third nerve following its injury, such as in third cranial nerve palsy due to tumor, trauma, or aneurysm. The case presented is an elderly woman with new vertical diplopia, which led to a diagnosis of a third cranial nerve palsy, thought to be caused by a 5 mm blister aneurysm of the posterior communicating artery. However, neuro-ophthalmological evaluation diagnosed aberrant regeneration of the third nerve, with the cause of her new vertical diplopia being an ipsilateral fourth nerve palsy...
June 12, 2017: Curēus
https://www.readbyqxmd.com/read/28706089/evaluation-of-the-geriatric-co-management-for-patients-with-fragility-fractures-of-the-proximal-femur-geriatric-fracture-centre-gfc-concept-protocol-for-a-prospective-multicentre-cohort-study
#20
Alexander Joeris, Anahí Hurtado-Chong, Denise Hess, Vasiliki Kalampoki, Michael Blauth
INTRODUCTION: Treatment of fractures in the elderly population is a clinical challenge due partly to the presence of comorbidities. In a Geriatric Fracture Centre (GFC), patients are co-managed by a geriatrician in an attempt to improve clinical outcomes and reduce morbidity and mortality. Until now the beneficial effect of orthogeriatric co-management has not been definitively proven. The primary objective of this study is to determine the effect of GFC on predefined major adverse events related to a hip fracture compared to usual care centres (UCC)...
July 12, 2017: BMJ Open
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