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Geriatric trauma

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https://www.readbyqxmd.com/read/29462121/patient-mortality-in-geriatric-distal-femur-fractures
#1
Philip Myers, Patrick Laboe, Kory J Johnson, Peter D Fredericks, Renn J Crichlow, Dean C Maar, Timothy G Weber
OBJECTIVES: To estimate 1-year mortality rates in elderly patients who undergo operative treatment for distal femur fractures and identify potential risk factors for mortality. DESIGN: Retrospective chart review. SETTING: Level 1 and Level 2 trauma centers. PATIENTS/PARTICIPANTS: Two hundred eighty-three elderly patients (average age 76.0 years ± 9.8) who sustained distal femur fractures between 2002 and 2012. INTERVENTION: Fracture fixation of the distal femur...
March 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29432317/the-outcomes-of-early-surgical-intervention-in-geriatric-proximal-femur-fractures-among-patients-receiving-direct-oral-anticoagulation
#2
Nathan A Franklin, Ashley Ali, Richard K Hurley, Hassan R Mir, Michael J Beltran
OBJECTIVE: Evaluate the pre-hospital use of Direct Oral Anticoagulant (DOAC) agents on the outcomes of early surgical fixation of a geriatric hip fracture. DESIGN: Case-Control. SETTING: Two academic level 1 trauma centers. INTERVENTION: Early (<48h) surgical fixation of a geriatric proximal femur fracture. PATIENTS: 19 patients receiving Pradaxa (Dabigatran), Eliquis (Apixaban), or Xarelto (Rivaroxaban) who underwent surgery between 2010 and 2015 and 74 control patients...
February 9, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29423769/repeat-computed-tomography-scans-among-inter-facility-transferred-major-trauma-patients-in-oklahoma-2009-2015
#3
Yang Wan, Kenneth E Stewart, Martin Q Lansdale
PURPOSE: Computed tomography (CT) scans play a vital role in the diagnosis and evaluation of trauma patients. Repeat CT scans occurred often among transferred trauma patients. The objective was to describe CT use and identify patient- and hospital-level factors associated with repeat CT scans among inter-facility transferred major trauma patients. METHODS: A retrospective cohort study was conducted using data extracted from the Oklahoma State Trauma Registry between 2009 and 2015...
February 8, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29396590/-evaluation-of-a%C3%A2-simple-screening-tool-for-ambulant-fall-prevention
#4
M Knobe, P Rasche, L Rentemeister, C Bliemel, B Bücking, L C Bollheimer, H-C Pape
BACKGROUND: An individual's risk of falling is generally difficult to detect and it is likely to be underestimated. Thus, preventive measures are challenging and they demand sufficient integration and implementation into aftercare and outpatient management. The Aachen Falls Prevention Scale (AFPS) is a quick and easy tool for patient-driven fall risk assessment. Older adults' risk of falling is identified in a suitable manner and they then have the opportunity to independently assess and monitor their risk of falling...
February 2, 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29391108/application-of-a-geriatric-injury-protocol-demonstrates-high-survival-rates-for-geriatric-trauma-patients-with-high-injury-acuity
#5
Tigran Karamanukyan, Andrea Pakula, Maureen Martin, Ashwitha Francis, Ruby Skinner
Geriatric trauma has historically been associated with poor outcomes, particularly in the setting of severe polytrauma. Although geriatric trauma protocols are common, there are limited data on their impact in patients with high injury severity. In this study, we sought to investigate the impact of a geriatric injury protocol on outcomes in patients with severe trauma acuity. Ninety-eight geriatric patients (age ≥65) admitted to our trauma center with injury severity scores (ISS) ≥15 comprised the study cohort...
October 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29389841/emergency-general-surgery-in-geriatric-patients-a-statewide-analysis-of-surgeon-and-hospital-volume-with-outcomes
#6
Ambar Mehta, Linda A Dultz, Bellal Joseph, Joseph K Canner, Kent Stevens, Christian Jones, Elliot R Haut, David T Efron, Joseph V Sakran
INTRODUCTION: Geriatric patients undergoing emergency general surgery (EGS) face significant morbidity and mortality. We assessed how surgeon and hospital volumes affected these outcomes. METHODS: We identified patients at least 65 years old in Maryland's Health Services Cost Review Commission database from 2012-2014 who underwent one of 12 EGS procedures, as defined by the American Association for the Surgery of Trauma, and then calculated four outcomes: mortality rate, the incidence of at least one of eight common in-hospital EGS complications, failure-to-rescue (death after experiencing a postoperative complication), and the 30-day readmission rate...
January 31, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29389749/trauma-and-transfusion-in-the-geriatric-patient
#7
Corey Scott Scher
PURPOSE OF REVIEW: The percentage of people over the age of 65 is growing rapidly and anesthesiologists must develop a medical understanding that is comprehensive to meet the unique medical needs of this population. The changing physiology of an elderly population makes them extremely vulnerable to trauma and the administration of blood products. Although most of these cases involve orthopedic attention, it is not less dangerous as a blunt trauma case. RECENT FINDINGS: This article addresses some of the main concerns for the anesthesiologists of providing a hemostatic resuscitation in the geriatric population...
January 30, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29373451/does-total-hip-arthroplasty-reduce-the-risk-of-secondary-surgery-following-the-treatment-of-displaced-acetabular-fractures-in-the-elderly-compared-to-open-reduction-internal-fixation-a-pilot-study
#8
Michael J Weaver, Raymond Malcolm Smith, David W Lhowe, Mark S Vrahas
OBJECTIVES: The goal of open reduction and internal fixation (ORIF) is to anatomically reduce the facture and maintain a congruent hip joint. However, ORIF in the elderly is technically challenging. Therefore, there are advocates for acute total hip arthroplasty (THA) in this patient population. The primary purpose of this study was to evaluate the rate of revision surgery in elderly patients with acetabular fractures treated with ORIF or THA. The secondary purpose was to compare patient's self-reported functional outcomes...
February 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29366336/end-of-life-decision-making-for-patients-with-geriatric-trauma-cared-for-in-a-trauma-intensive-care-unit
#9
Meghan Wooster, Alyssa Stassi, Joshua Hill, James Kurtz, Marco Bonta, M Chance Spalding
BACKGROUND: The geriatric trauma population is growing and fraught with poor physiological response to injury and high mortality rates. Our primary hypothesis analyzed how prehospital and in-hospital characteristics affect decision-making regarding continued life support (CLS) versus withdrawal of care (WOC). Our secondary hypothesis analyzed adherence to end-of-life decisions regarding code status, living wills, and advanced directives. MATERIALS AND METHODS: We performed a retrospective review of patients with geriatric trauma at a level I and level II trauma center from January 1, 2007, to December 31, 2014...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29351768/overweight-in-adult-cats-a-cross-sectional-study
#10
Malin Öhlund, Malin Palmgren, Bodil Ström Holst
BACKGROUND: Overweight in cats is a major risk factor for diabetes mellitus and has also been associated with other disorders. Overweight and obesity are believed to be increasing problems in cats, as is currently seen in people, with important health consequences. The objectives of the present study were to determine the prevalence of overweight in cats from two different cohorts in a cross-sectional study design and to assess associations between overweight and diagnoses, and between overweight and demographic and environmental factors...
January 19, 2018: Acta Veterinaria Scandinavica
https://www.readbyqxmd.com/read/29318088/hoffa-fragments-in-the-geriatric-distal-femur-fracture-myth-or-reality
#11
Brian W Hill, Lisa K Cannada
Background: Previous research reported the frequency of coronal plane (Hoffa) fractures in high-energy supracondylar femur fractures in a relatively young population. It is the purpose of this study to identify the frequency of coronal plane fractures seen in elderly patients. Methods: All patients over the age of 18 years treated for supracondylar femur fractures at 2 level I trauma centers were reviewed over a 4-year period. The patients were stratified (≥60 years and <60 years) and compared to determine differences in injury characteristics and fracture patterns with special attention to the prevalence of coronal plane fractures...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29318084/how-does-frailty-factor-into-mortality-risk-assessment-of-a-middle-aged-and-geriatric-trauma-population
#12
Sanjit R Konda, Ariana Lott, Hesham Saleh, Sebastian Schubl, Jeffrey Chan, Kenneth A Egol
Introduction: Frailty in elderly trauma populations has been correlated with an increased risk of morbidity and mortality. The Score for Trauma Triage in the Geriatric and Middle-Aged (STTGMA) is a validated mortality risk score that evaluates 4 major physiologic criteria: age, comorbidities, vital signs, and anatomic injuries. The aim of this study was to investigate whether the addition of additional frailty variables to the STTGMA tool would improve risk stratification of a middle-aged and elderly trauma population...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29251704/improved-outcomes-in-elderly-trauma-patients-with-the-implementation-of-two-innovative-geriatric-specific-protocols-final-report
#13
Eric H Bradburn, Brian W Gross, Shreya Jammula, William H Adams, Jo Ann Miller
INTRODUCTION: Elderly trauma care is challenging due to the unique physiology and comorbidities prevalent in this population. To improve the care of these patients, two practice management guidelines (PMG) were implemented: High Risk Geriatric Protocol (HRGP), which triages patients based on injury patterns and comorbid conditions for occult hypotension, and the Anticoagulation and Trauma Alert (ACT), which is designed to streamline the care of geriatric trauma patients on anticoagulants...
December 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29249533/is-prescribed-lower-extremity-weight-bearing-status-after-geriatric-lower-extremity-trauma-associated-with-increased-mortality
#14
Ida Leah Gitajn, Daniel Connelly, Daniel Mascarenhas, Stephen Breazeale, Peter Berger, Carrie Schoonover, Brook Martin, Robert V O'Toole, Raymond Pensy, Marcus Sciadini
OBJECTIVES: Evaluate whether mortality after discharge is elevated in geriatric fracture patients whose lower extremity weight-bearing is restricted. DESIGN: Retrospective cohort study SETTING: Urban Level 1 trauma center PATIENTS/PARTICIPANTS: 1746 patients >65 years of age INTERVENTION: Post-operative lower extremity weight-bearing status MAIN OUTCOME MEASURE: Mortality, as determined by the Social Security Death Index RESULTS: Univariate analysis demonstrated that patients who were weight-bearing as tolerated on bilateral lower extremities (BLE) had significantly higher 5-year mortality compared to patients with restricted weight-bearing on one lower extremity and restricted weight-bearing on BLE (30%, 21% and 22% respectively, p < 0...
December 14, 2017: Injury
https://www.readbyqxmd.com/read/29183520/the-effect-of-sarcopenia-on-outcomes-in-geriatric-blunt-trauma
#15
Mahdi Malekpour, Kelly Bridgham, Kathryn Jaap, Ryan Erwin, Kenneth Widom, Megan Rapp, Diane Leonard, Susan Baro, James Dove, Marie Hunsinger, Joseph Blansfield, Mohsen Shabahang, Denise Torres, Jeffrey Wild
Elderly patients are at a higher risk of morbidity and mortality after trauma, which is reflected through higher frailty indices. Data collection using existing frailty indices is often not possible because of brain injury, dementia, or inability to communicate with the patient. Sarcopenia is a reliable objective measure for frailty that can be readily assessed in CT imaging. In this study, we aimed to evaluate the effect of sarcopenia on the outcomes of geriatric blunt trauma patients. Left psoas area (LPA) was measured at the level of the third lumbar vertebra on the axial CT images...
November 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29157892/is-it-safe-to-discharge-geriatric-trauma-patients-with-anemia
#16
Adrian W Ong, Nick R Jaisingh, Susan Butler, Adam Sigal, Forrest B Fernandez
INTRODUCTION: The consequences of discharging anemic geriatric trauma patients are not well studied. We hypothesize that anemia at discharge is associated with adverse outcomes. METHODS: A 1-year retrospective review of patients ≥65 years was performed. Hemoglobin levels at admission (HbA), discharge (HbD) and the lowest inpatient level (HbL) were recorded. Severity of anemia was categorized as mild (Hb ≥ 10.0 g/dl), moderate (Hb < 10.0 and ≥ 8.5 g/dl) and severe (Hb < 8...
November 11, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29154774/recommendations-for-care-of-geriatric-maxillofacial-trauma-patients-following-a-retrospective-10-year-multicenter-review
#17
Robert Shumate, Jason Portnof, Melissa Amundson, Eric Dierks, Robert Batdorf, Patrick Hardigan
PURPOSE: The purpose of this study was to analyze maxillofacial trauma sustained by patients at least 75 years old. With the injury patterns identified, treatment recommendations for the contemporary oral and maxillofacial surgeon are made. PATIENTS AND METHODS: This study was a retrospective case series using data from 2 level 1 trauma centers. The variables of interest included age at traumatic event, gender, mechanism of trauma, concomitant injuries, radiographic studies performed, management of maxillofacial injuries, and disposition...
October 26, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29145998/discussion-of-impact-of-geriatric-consultations-on-clinical-outcomes-of-elderly-trauma-patients-a-retrospective-analysis
#18
James P Dugan, Keith M Burns, Mustafa Baldawi, David G Heidt
No abstract text is available yet for this article.
December 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29139194/advantages-of-care-for-patients-with-hip-fractures-in-the-acute-geriatric-unit-hip-study-anoia
#19
Enric Duaso, Francesc Formiga, Patrícia Marimón, Montserrat Sandiumenge, Maria Teresa Salgado, Victor Murga, Andrés Gamboa, Carlos Rodriguez, Jaume Castellà, Enrique Escalante, Célia Lumbreras, Anna Tarrida, Ramón Sellarès
AIM: Hip fracture as a result of bone fragility is characterized by poor health outcomes in the medium and long term. Our goal was to compare a new orthogeriatric model with the old trauma model and evaluate improvements in clinical management. METHODS: We carried out a comparative unicentric study, a historical sample (trauma model) collected from 1 June 2007 to 31 May 2010, versus a prospective sample (orthogeriatric model) collected from 1 June 2010 until 31 May 2013...
November 15, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29132579/the-tragically-hip-trauma-in-elderly-patients
#20
REVIEW
Katrin Hruska, Toralph Ruge
Old age is a risk factor for poor outcome in trauma patients, as a result of undertriage and the presence of occult life-threatening injuries. The mechanisms of injury for geriatric trauma differ from those in younger patients, with a much higher incidence of low-impact trauma, especially falls from a low height. Frailty is a risk factor for severe injury after minor trauma, and caring for these patients require a multidisciplinary team with both trauma and geriatric expertise. With early recognition and aggressive management, severe injuries can still be associated with good outcomes, even in very elderly patients...
February 2018: Emergency Medicine Clinics of North America
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