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Trauma in elderly

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https://www.readbyqxmd.com/read/28087547/risk-of-pneumonia-in-patients-with-isolated-minor-rib-fractures-a-nationwide-cohort-study
#1
Sai-Wai Ho, Ying-Hock Teng, Shun-Fa Yang, Han-Wei Yeh, Yu-Hsun Wang, Ming-Chih Chou, Chao-Bin Yeh
OBJECTIVES: Isolated minor rib fractures (IMRFs) after blunt chest traumas are commonly observed in emergency departments. However, the relationship between IMRFs and subsequent pneumonia remains controversial. This nationwide cohort study investigated the association between IMRFs and the risk of pneumonia in patients with blunt chest traumas. DESIGN: Nationwide population-based cohort study. SETTING: Patients with IMRFs were identified between 2010 and 2011 from the Taiwan National Health Insurance Research Database...
January 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28074459/comparison-of-revised-trauma-score-injury-severity-score-and-trauma-and-injury-severity-score-for-mortality-prediction-in-elderly-trauma-patients
#2
Shahrokh Yousefzadeh-Chabok, Marieh Hosseinpour, Leila Kouchakinejad-Eramsadati, Fatemeh Ranjbar, Reza Malekpouri, Alireza Razzaghi, Zahra Mohtasham-Amiri
BACKGROUND: Trauma is the fifth leading cause of death in patients 65 years and older. This study is a comparison of results of Revised Trauma Score (RTS), Injury Severity Score (ISS), and Trauma and Injury Severity Score (TRISS) in prediction of mortality in cases of geriatric trauma. METHODS: This is a cross-sectional study of records of 352 elderly trauma patients who were admitted to Pour-Sina Hospital in Rasht between 2010 and 2011. Injury scoring systems were compared in terms of specificity, sensitivity, and cut-off points using receiver operating characteristic curve of patient prognosis...
November 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28073488/plasma-mitochondrial-dna-levels-were-independently-associated-with-lung-injury-in-elderly-hip-fracture-patients
#3
Jian-Zheng Zhang, Juan Wang, Wen-Chun Qu, Xiao-Wei Wang, Zhi Liu, Ji-Xin Ren, Li Han, Tian-Sheng Sun
INTRODUCTION: Hip fracture in the elderly can induce systemic inflammatory response (SIRS) and lung injury which increases the risk of lung infection and death. Mitochondrial DNA (mtDNA) plays a role in SIRS and lung injury in patients with multi-trauma, and also in patients with hip fractures. This study evaluated the potential value of plasma mtDNA in the early prognosis of lung injury in elderly fracture patients. METHODS: This study enrolled 156 elderly patients with intertrochanteric fracture...
January 4, 2017: Injury
https://www.readbyqxmd.com/read/28063678/debridement-interbody-graft-using-titanium-mesh-cages-posterior-instrumentation-and-fusion-in-the-surgical-treatment-of-multilevel-noncontiguous-spinal-tuberculosis-in-elderly-patients-via-a-posterior-only
#4
Yu-Xiang Wang, Hong-Qi Zhang, Min Li, Ming-Xing Tang, Chao-Feng Guo, Ang Deng, Qile Gao, Jian-Huang Wu, Jin-Yang Liu
PURPOSE: To analyse the efficacy and feasibility of surgical management for elderly patients with multilevel non-contiguous spinal tuberculosis(MNSTB)by using one-stage posterior focus debridement, interbody graft using titanium mesh cages, posterior instrumentation and fusion. METHODS: From September 2009 to October 2013, 15 elderly patients with MNSTB were treated with one-stage posterior focus debridement, interbody graft using titanium mesh cages, posterior instrumentation and fusion...
December 28, 2016: Injury
https://www.readbyqxmd.com/read/28056159/obturator-artery-injury-resulting-in-massive-hemorrhage-from-a-low-energy-pubic-ramus-fracture
#5
Mark K Solarz, Justin M Kistler, Saqib Rehman
Pelvic ring fractures are common in the elderly population and are usually a result of low-energy trauma, such as falls from standing. In most cases, low-energy pelvic ring injuries can be treated with appropriate analgesia and early mobilization. Arterial injury resulting in hemodynamic instability from a low-energy pelvic ring injury is rare but, given the poor compliance of vessels in the elderly population, possible. These patients must be carefully monitored after the initial injury. The purpose of this report is to describe an elderly patient who sustained a superior pubic ramus fracture and arterial injury following a low-energy fall from standing that required angiographic intervention...
January 5, 2017: Orthopedics
https://www.readbyqxmd.com/read/28033135/omega-3-fatty-acid-supplementation-and-warfarin-a-lethal-combination-in-traumatic-brain-injury
#6
Brian W Gross, Maria Gillio, Cole D Rinehart, Caitlin A Lynch, Frederick B Rogers
Polyunsaturated fatty acids such as omega-3 eicosapentaenoic acid and omega-6 docosahexaenoic acid, found in over-the-counter fish oil supplements, are often consumed for their beneficial, prophylactic, anti-inflammatory effects. Although the mechanisms of action are not fully known, a diet rich in polyunsaturated fats may reduce the risk of hyperlipidemia, atherosclerosis, high low-density lipoprotein cholesterol levels, hypertension, and inflammatory diseases. Masked by its many benefits, the risks of omega-3 fatty acid supplementation are often underappreciated, particularly its ability to inhibit platelet aggregation and promote bleeding in patients taking anticoagulant medications...
January 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28032058/epidemiology-of-geriatric-trauma-in-an-urban-kazakhstani-setting
#7
Aidos S Tlemissov, Marzhan A Dauletyarova, Tolkyn A Bulegenov, Tolebay K Rakhypbekov, Andrej M Grjibovski
BACKGROUND: External causes of death are still among the main causes of death in the countries of the former Soviet Union. We studied epidemiology of injuries among elderly in a typical Kazakhstani city. METHODS: Data on all injuries among individuals aged 60 yr or older in the city of Semey (former Semipalatinsk) from 2010 to 2012 was collected from medical files. We present absolute numbers and incidence rates for the main ICD-codes in Chapters XIX and XX of ICD-10 by gender, ethnic background and place where the injury occurred...
November 2016: Iranian Journal of Public Health
https://www.readbyqxmd.com/read/28026728/-influence-of-the-weather-on-the-incidence-of-fractures-in-the-elderly
#8
F Burget, O Foltán, J Kraus, K Kudrna, M Novák, J Ulrych
PURPOSE OF THE STUDY The incidence of geriatric fractures (proximal femur, distal radius, proximal humerus and thoracolumbar spine injuries) in the population increases with ageing. However, the role of weather conditions, such as icy and slippery winter, should not be overlooked. A deeper insight into this relationship may bring about a better understanding of the fracture aetiology and thus allow for improvement in the prevention of fractures in elderly people. MATERIAL AND METHODS This prospective study included 676 patients (469 women and 207 men) aged 65 and over...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28018094/a-rare-case-of-idiopathic-thumb-cmc-joint-neuropathic-arthropathy-complicated-by-blunt-trauma
#9
Manavdeep Singh, R R Butala, R G Khedekar, Manish Tripati
Neuropathic arthropathy (Charcot joints), which most frequently affects the weight-bearing joints of the body, is commonly associated with a variety of medical and neurological conditions, and is notoriously difficult to treat due to the nature of the underlying pathology. We present a case of idiopathic neuropathic arthropathy of the thumb CMC joint of an elderly female complicated by blunt trauma to the thumb. To our knowledge, this is the first reported case in the literature of this rare association.
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28017806/predicting-in-hospital-and-1-year-mortality-in-geriatric-trauma-patients-using-geriatric-trauma-outcome-score
#10
Rebecka Ahl, Herb A Phelan, Sinan Dogan, Yang Cao, Allyson C Cook, Shahin Mohseni
BACKGROUND: The Geriatric Trauma Outcome Score, GTOS (= [age] + [Injury Severity Score (ISS)x2.5] + 22 [if packed red blood cells (PRBC) transfused ≤24hrs of admission]), was developed and validated as a prognostic indicator for in-hospital mortality in elderly trauma patients. However, GTOS neither provides information regarding post-discharge outcomes, nor discriminates between patients dying with and without care restrictions. Isolating the latter, GTOS prediction performance was examined during admission and 1-year post-discharge in a mature European trauma registry...
December 22, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27999766/cerebral-hemorrhage-following-chiropractic-activator-treatment-case-report-and-review-of-literature
#11
Fred L Cohen
Background Despite widespread utilization of chiropractic treatment for various ailments, there is a paucity of documentation regarding intracerebral hemorrhage related to chiropractic trauma. Stroke has been reported from cervical manipulation, although with a suggested low incidence. Activator treatment, an instrument that produces a high-velocity, low-amplitude impact to the spine, is considered especially safe. There are no prior reports of intracerebral hemorrhage resulting from a chiropractic activator treatment...
October 2016: Journal of Neurological Surgery Reports
https://www.readbyqxmd.com/read/27992236/creating-new-opportunities-to-educate-families-on-the-impact-of-frailty-and-cognitive-impairment-in-a-trauma-intensive-care-unit-results-of-a-quality-improvement-project
#12
Mohana B Karlekar, Cathy A Maxwell, Mary S Dietrich, Richard S Miller
BACKGROUND: Older adults comprise a rapidly growing proportion of admissions to acute care hospitals and trauma centers. Older adults admitted to a trauma intensive care unit (TICU) often have a more complicated inpatient and posthospital course. This is the most pronounced in frail elders with cognitive dysfunction. We aimed at integrating validated screening instruments for physical frailty and cognitive impairment into the standard nursing assessment of all older trauma patients admitted to our TICU and stepdown unit...
February 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27984444/advanced-imaging-lacks-clinical-utility-in-treating-geriatric-pelvic-ring-injuries-caused-by-low-energy-trauma
#13
Roman M Natoli, Harold A Fogel, Daniel Holt, Adam Schiff, Mitchell Bernstein, Hobie D Summers, William Lack
OBJECTIVES: Is advanced imaging necessary in evaluation of pelvic fractures caused by low energy trauma in elderly patients? DESIGN: Retrospective review SETTING:: Single institution, Level 1 Trauma Center PATIENTS:: Age ≥ 60 years old treated for low energy traumatic pelvic ring injuries INTERVENTION:: None MAIN OUTCOMES:: Posterior pelvic ring injuries diagnosed on advanced imaging, radiographic displacement, admission status, hospital length of stay, change in weight-bearing status recommendations, and whether operative treatment was pursued RESULTS:: Eighty-seven patients met the inclusion criteria of which 42 had advanced imaging to evaluate the posterior pelvic ring (10 MRIs, 32 CTs)...
November 24, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27974304/improving-hip-fracture-outcomes-with-integrated-orthogeriatric-care-a-comparison-between-two-accepted-orthogeriatric-models
#14
Mark Middleton, Bettina Wan, Ruy da Assunçāo
BACKGROUND: our orthopaedic trauma unit serves a large elderly population, admitting 400-500 hip fractures annually. A higher than expected mortality was detected amongst these patients, prompting a change in the hip fracture pathway. The aim of this study was to assess the impact of a change in orthogeriatric provision on hip fracture outcomes and care quality indicators. PATIENTS AND METHODS: the hip fracture pathway was changed from a geriatric consultation service to a completely integrated service on a dedicated orthogeriatric ward...
December 14, 2016: Age and Ageing
https://www.readbyqxmd.com/read/27957380/palpable-mass-on-the-head-after-minor-trauma
#15
K M Nikolakopoulos, C P Papageorgopoulou, I G Ntouvas, S Kakkos, I Tsolakis
Temporal artery is superficially exhibited and easily traumatized. Rarely, a minor and blunt trauma, especially in elderly who are under anticoagulants, can cause a pseudoaneurysm. Diagnosis should be based, primarily, on history and physical examination and secondarily on duplex ultrasound scanning which will lead to confirmation and preoperative planning. The therapeutical plan consists of surgical ligation and excision of the aneurysm. Surgery can be performed under local anesthesia with no postoperative major or minor complications...
2016: Case Reports in Vascular Medicine
https://www.readbyqxmd.com/read/27943127/prescription-of-anti-osteoporosis-medications-after-hospitalization-for-hip-fracture-a-multicentre-italian-survey
#16
Stefano Gonnelli, Carla Caffarelli, Giovanni Iolascon, Francesco Bertoldo, Giulia Letizia Mauro, Aurora Patti, Ranuccio Nuti
PURPOSE: Literature data indicate that the proportion of patients with recent hip fracture who receive a prescription for anti-osteoporotic drugs is low and does not seem to increase over time. This study aimed to obtain data on the prescription for anti-osteoporotic drugs in Italian patients discharged after a recent hip fracture and to assess which variables could have influenced the decision for prescribing osteoporosis medication. METHODS: A total of four Italian centres located in four different geographical areas (Siena, Verona, Naples and Palermo) participated in this retrospective study...
December 9, 2016: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/27942737/prothrombin-complex-concentrates-an-alternative-to-fresh-frozen-plasma
#17
David R Burk, Jordan L Smith, Jason R Wild
Insufficiency fractures are a common cause of morbidity among geriatric patients worldwide. Improved outcomes are known to result from decreased delay to definitive operative fixation and mobilization. Use of warfarin is an important potential cause of delay. The ideal mode of warfarin reversal is currently unknown. Prothrombin complex concentrates (PCCs) offer rapid correction with small infusion volume, both of which are important for elderly patients with multiple comorbidities. The authors present 2 cases of insufficiency fractures occurring in geriatric patients receiving warfarin therapy reversed with a 3-factor PCC...
December 8, 2016: Orthopedics
https://www.readbyqxmd.com/read/27941328/upper-extremity-function-predicts-adverse-health-outcomes-among-older-adults-hospitalized-for-ground-level-falls
#18
Bellal Joseph, Nima Toosizadeh, Tahereh Orouji Jokar, Michelle R Heusser, Jane Mohler, Bijan Najafi
BACKGROUND: Despite National Surgical Quality Improvement guidelines to integrate frailty into surgical elder assessments, a quick, accurate, and simple frailty assessment tool suitable for busy clinical settings is still not available. Recently, we have demonstrated that a simple upper-extremity function (UEF) test based on wearable sensors could identify frailty with high agreement with conventional assessments by testing 20-s repetitive elbow flexion and extension. OBJECTIVE: We examined whether UEF parameters are sensitive for predicting adverse health outcomes in bedbound older adults admitted to hospital due to ground-level fall injuries...
December 10, 2016: Gerontology
https://www.readbyqxmd.com/read/27932078/the-utility-of-vacuum-assisted-closure-therapy-for-skin-necrosis-secondary-to-cervical-abscess-in-the-elderly
#19
Tadataka Tsuji, Koichi Satoh, Emi Okuno, Akiko Sobue, Yoshiya Nishide, Susumu Tanaka, Mikihiko Kogo
Vacuum-assisted closure (VAC) systems have been used as negative-pressure dressings in various fields, including decubitus ulcer, trauma, and wound dehiscence. To the best of our knowledge, few reports have examined the utility of VAC therapy for neck abscess in an oldest-old patient. We present here a rare case of neck abscess secondary to parotid abscess, resulting in extensive skin necrosis. Successful management included emergency drainage following epithelial induction through a VAC system without using skin grafting...
December 5, 2016: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/27927732/trauma-informed-hospice-and-palliative-care
#20
Barbara L Ganzel
This review highlights the need to integrate trauma-informed practices into hospice and palliative care. The pervasiveness of psychological trauma exposure has been established in the general population and among the elderly adults. Moreover, there is emerging evidence for multiple additional opportunities for exposure to psychological trauma at or near the end of life. For example, many people experience intensive medical interventions prior to their admission to hospice and/or palliative care, and there is increasing recognition that these interventions may be traumatic...
December 7, 2016: Gerontologist
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