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Geriatric trauma

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https://www.readbyqxmd.com/read/29017731/impact-of-geriatric-consultations-on-clinical-outcomes-of-elderly-trauma-patients-a-retrospective-analysis
#1
James P Dugan, Keith M Burns, Mustafa Baldawi, David G Heidt
INTRODUCTION: The elderly account for a large proportion of morbidity and mortality secondary to trauma, despite lower-energy mechanisms of injury and fewer trauma admissions. The benefit of geriatric trauma consultation services (GTCS) to this population remains unclear. METHODS: We performed a retrospective cohort analysis of a GTCS, which was established in January 2015. Patients over 60 admitted to the trauma service from January of 2014 to February 2016 were eligible...
September 19, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28985882/economic-evaluations-of-comprehensive-geriatric-assessment-in-surgical-patients-a-systematic-review
#2
Gilgamesh Eamer, Bianka Saravana-Bawan, Brenden van der Westhuizen, Thane Chambers, Arto Ohinmaa, Rachel G Khadaroo
BACKGROUND: Seniors presenting with surgical disease face increased risk of postoperative morbidity and mortality and have increased treatment costs. Comprehensive Geriatric Assessment (CGA) is proposed to reduce morbidity, mortality, and the cost after surgery. METHODS: A systematic review of CGA in emergency surgical patients was conducted. The primary outcome was cost-effectiveness; secondary outcomes were length of stay, return of function, and mortality. Inclusion and exclusion criteria were predefined...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28974313/disparate-effects-of-catecholamines-under-stress-conditions-on-endothelial-glycocalyx-injury-an-in%C3%A2-vitro-model
#3
Jonathan V Martin, David M Liberati, Lawrence N Diebel
BACKGROUND: Geriatric trauma patients have high circulating norepinephrine (NE) levels but attenuated release of epinephrine (Epi) in response to increasing severity of injury. We hypothesized that NE and Epi have different effects on the endothelial and glycocalyx components of the vascular barrier following shock. METHODS: Human umbilical vein endothelial cells (HUVEC) were treated with varying concentrations of NE or Epi and exposed to simulated shock conditions (HR)...
September 22, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28958650/is-routine-head-ct-indicated-in-awake-stable-older-patients-after-a-ground-level-fall
#4
Rebecca Sartin, Christine Kim, Sharmila Dissanaike
BACKGROUND: Despite the development of several prediction rules to guide head CT imaging, determining whom to screen for head trauma in the geriatric population after a ground level fall remains controversial. The purpose of this study was to assess the impact of head CT on the management of older adult patients who present with a normal GCS after a ground level fall, and to identify factors that could predict the need for neurosurgical intervention. METHODS: A retrospective study was conducted on hemodynamically stable patients >55 years of age with GCS of 15, who presented to a level 1 trauma center after a ground level fall...
September 18, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28958648/mortality-is-predicted-by-comorbidity-polypharmacy-score-but-not-charlson-comorbidity-index-in-geriatric-trauma-patients
#5
Vaughn E Nossaman, Brett E Larsen, Jody C DiGiacomo, Zara Manuelyan, Renee Afram, Sally Shukry, Amiee Luan Kang, Swapna Munnangi, L D George Angus
BACKGROUND: Increased life expectancy has resulted in more older patients at trauma centers. Traditional assessments of injuries alone may not be sufficient; age, comorbidities, and medications should be considered. METHODS: 446 older trauma patients were analyzed in two groups, 45-65 years and <65, using Injury Severity Score (ISS), the Charlson Comorbidity Index (CCI), and Comorbidity-Polypharmacy Score (CPS). RESULTS: CCI and CPS were associated with HLOS in patients <65...
September 19, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28958363/evidence-based-care-of-geriatric-trauma-patients
#6
REVIEW
Steven E Brooks, Allan B Peetz
The doubling of the geriatric population over the next 20 years will challenge the existing health care system. Optimal care of geriatric trauma patients will be of paramount importance to the health care discussion in America. These patients warrant special consideration because of altered anatomy, physiology, and the resultant decreased ability to tolerate the stresses imposed by traumatic insult. Despite increased risk for worsened outcomes, nearly half of all geriatric trauma patients will be cared for at nondesignated trauma centers...
October 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28953670/poor-prognosis-after-surgery-for-intertrochanteric-fracture-in-elderly-patients-with-clopidogrel-treatment-a-cohort-study
#7
Jianzheng Zhang, Xiaobin Chen, Juan Wang, Zhi Liu, Xiaowei Wang, Jixin Ren, Tiansheng Sun
Choice of surgical approach in patients under clopidogrel treatment is controversial. Intertrochanteric fractures are common in the elderly, who also suffer from a number of comorbidities.The aim of this study is to assess the prognosis of elderly patients with clopidogrel treatment after surgery for intertrochanteric fracture.This was a cohort study of 238 elderly patients who underwent proximal femur intramedullary nailing for intertrochanteric fracture between January 2012 and December 2013 at the Geriatric Trauma Center of the Beijing Army General Hospital...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28947693/-oral-healthcare-for-the-persons-with-special-needs
#8
Ichijiro Morisaki
The field of special care dentistry is rapidly gaining recognition as a service that should be provided to the persons with physical, mental or intellectual disabilities by general practitioner, pediatric or geriatric dentists as well as dental hygienists. Because the oral healthcare and dental treatments are given in the narrow space of oral cavity and also accompanying technical difficulties with high risk of injury, the special needs patients are treated under being controlled their behavior or body motion by applying psychological, physical or pharmacological techniques...
2017: Clinical Calcium
https://www.readbyqxmd.com/read/28930900/retrospective-evaluation-of-the-impact-of-a-geriatric-trauma-institute-on-fragility-hip-fracture-patient-outcomes
#9
Elizabeth D Katrancha, Jami Zipf, Nancy Abrahams, Richard Schroeder
BACKGROUND: Fragility hip fractures occur in the older than 65-year population at an alarming rate. It is estimated that 260,000 hip fractures occur annually. Patient outcomes following hip fractures are devastating. One of every 5 patients dies within 1 year of injury, and 1 of 3 remains in a nursing home for years after the injury. Published literature recommends an interdisciplinary approach to caring for hip-fractured patients and expediting surgery to improve outcomes. PURPOSE: The purpose of this study was to retrospectively evaluate the impact of the Geriatric Trauma Institute (GTI) on fragility hip fracture patient outcomes...
September 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28926873/-to-enhance-clinical-application-of-comprehensive-geriatric-assessment-in-elderly-inpatients-with-non-cardiac-surgical-operation
#10
X M Wang, Y Liu
In this commentary article, we introduce the definition, evaluative contents and methods of comprehensive geriatric assessment (CGA), as well as its successful application in Western countries. CGA is a multidisciplinary diagnosis and treatment process that identifies medical, psychosocial, and functional capabilities of elderly adults to develop plans including overall treatment, nursing, and follow-up to maximize overall health with aging. How to change this situation has become an important challenge due to the significant increase in postoperative complications, mortality, and treatment costs for elderly patients with surgical diseases...
September 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28926821/autopsies-in-the-elderly-erzurum-study
#11
Ozge Timur, Pinar Tosun Tasar, Merve Gulsah Ulusoy, Azem Irez, Filiz Yildirim, Dogan Nasir Binici, Sevnaz Sahin, Ahmet Nezih Kok
INTRODUCTION: Clinical and forensic autopsies are the best methods for determining cause of death. The aim of this study was to determine demographic and etiologic characteristics in geriatric forensic cases analyzed in Erzurum, Turkey. MATERIALS AND METHODS: Autopsy reports and prosecution documents of decedents aged 65 and older autopsied in the Morgue Specialization Department of the Forensic Medicine Institute, Erzurum Division between January 1, 2010 and December 31, 2015 were screened retrospectively...
September 12, 2017: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/28921003/mortality-and-cardiorespiratory-complications-in-trochanteric-femoral-fractures-a-ten-year-retrospective-analysis
#12
Juliane Carow, John Bennet Carow, Mark Coburn, Bong-Sung Kim, Benjamin Bücking, Christopher Bliemel, Leo Cornelius Bollheimer, Cornelius Johannes Werner, Jan Philipp Bach, Matthias Knobe
PURPOSE: Despite intense research and innovations in peri-operative management, a high mortality rate and frequent systemic complications in trochanteric femoral fractures persist. The aim of the present study was to identify predictive factors for mortality and cardio-respiratory complications after different treatment methods in a ten year period at a level I trauma centre. METHODS: Retrospectively, all patients above 60 years of age with trochanteric femoral fracture between January 2000 and May 2011 were analyzed at a level I trauma centre...
September 18, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28888692/canadian-study-of-health-and-aging-clinical-frailty-scale-does-it-predict-adverse-outcomes-among-geriatric-trauma-patients
#13
Annie Cheung, Barbara Haas, Thom J Ringer, Amanda McFarlan, Camilla L Wong
BACKGROUND: The Canadian Study of Health and Aging Clinical Frailty Scale (CFS) and the laboratory Frailty Index (FI-lab) are validated tools based on clinical and laboratory data, respectively. Their utility as predictors of geriatric trauma outcomes is unknown. Our primary objective was to determine whether pre-admission CFS is associated with adverse discharge destination. Secondary objectives were to evaluate the relationships between CFS and in-hospital complications and between admission FI-lab and discharge destination...
September 6, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28887864/oral-maxillofacial-trauma-of-a-geriatric-population-in-a-super-ageing-country
#14
Ryohei Ito, Kosei Kubota, Akinari Inui, Hiroshi Nakagawa, Takao Kon, Norihiko Narita, Yoshihiro Tamura, Toshiaki Oyama, Anna Satake, Ken Furudate, Wataru Kobayashi
BACKGROUND/AIM: World population has been aging and oral-maxillofacial trauma of geriatric population is expected to increase. The aim of this study was to analyze the characteristic features of oral-maxillofacial trauma in the geriatric population. MATERIALS AND METHODS: Data from 127 patients aged 65 years old or older, who were treated for oral-maxillofacial trauma at the Department of Oral and Maxillofacial Surgery, Hirosaki University, from 2000 to 2014, were retrospectively analyzed...
September 8, 2017: Dental Traumatology: Official Publication of International Association for Dental Traumatology
https://www.readbyqxmd.com/read/28877802/a-comprehensive-investigation-of-comorbidities-mechanisms-injury-patterns-and-outcomes-in-geriatric-blunt-trauma-patients
#15
COMPARATIVE STUDY
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/28866353/frail-questionnaire-screening-tool-and-short-term-outcomes-in-geriatric-fracture-patients
#16
Lauren Jan Gleason, Emily A Benton, M Loreto Alvarez-Nebreda, Michael J Weaver, Mitchel B Harris, Houman Javedan
OBJECTIVES: There are limited screening tools to predict adverse postoperative outcomes for the geriatric surgical fracture population. Frailty is increasingly recognized as a risk assessment to capture complexity. The goal of this study was to use a short screening tool, the FRAIL scale, to categorize the level of frailty of older adults admitted with a fracture to determine the association of each frailty category with postoperative and 30-day outcomes. DESIGN: Retrospective cohort study...
August 30, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28857647/ems-dispatches-during-hurricanes-irene-and-sandy-in-new-jersey
#17
Joshua Bucher, Jonathan McCoy, Colleen Donovan, Snehal Patel, Pamela Ohman-Strickland, Asa Dewan
BACKGROUND: Hurricanes Irene and Sandy heavily impacted New Jersey. Investigating EMS dispatch trends during these storms may allow us to prepare for future disasters. OBJECTIVES: Our objectives to characterize the types of EMS dispatches immediately before, during, and after landfall compared to a control period. METHODS: This retrospective study was conducted at a large EMS dispatch center that provides first responders, Basic Life Support (BLS), Advanced Life Support (ALS), and critical care transport services to an area with approximately 20 receiving hospitals including a Level I Trauma Center...
August 31, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28855767/whats-new-in-emergencies-trauma-and-shock-age-and-trauma-geriatric-trauma-patients-and-geriatric-trauma-ward-services
#18
EDITORIAL
Christian Zeckey, Christian Kammerlander
No abstract text is available yet for this article.
July 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28807214/early-geriatric-consultation-increases-adherence-to-tqip-geriatric-trauma-management-guidelines
#19
Lauren T Southerland, Tanya R Gure, Daniel I Ruter, Michael M Li, David C Evans
BACKGROUND: The American College of Surgeons' Trauma Quality Improvement Program (TQIP) Geriatric Trauma Management Guidelines recommend geriatric consultation for injured older adults. However it is not known how or whether geriatric consultation improves compliance to these quality measures. METHODS: This study is a retrospective chart review of our institutional trauma databank. Adherence to quality measures was compared before and after implementation of specific triggers for geriatric consultation...
August 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28807194/the-impact-of-glasgow-coma-scale-age-prognosis-score-on-geriatric-traumatic-brain-injury-outcomes
#20
Muhammad Khan, Terence O'Keeffe, Faisal Jehan, Narong Kulvatunyou, Abdullah Kattaa, Lynn Gries, Andrew Tang, Bellal Joseph
BACKGROUND: As the population ages, increasing number of geriatric patients sustain traumatic brain injury (TBI). Communication of accurate prognostic information is crucial for making informed decisions on behalf of such patients. Therefore, the aim of our study was to develop a simple and clinically applicable tool that accurately predicts the prognosis in geriatric TBI patients. METHODS: We performed a 1-y (2011) retrospective analysis of isolated geriatric TBI patients (age ≥65 y, head abbreviated injury score [AIS] ≥ 3, and other body AIS < 3) in the National Trauma Data Bank...
August 2017: Journal of Surgical Research
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