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Geriatric trauma

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https://www.readbyqxmd.com/read/28338866/the-growing-challenge-of-major-trauma-in-older-people-a-role-for-comprehensive-geriatric-assessment
#1
James Michael Fisher, Charlotte Bates, Jay Banerjee
In this commentary article, we describe the impact that an ageing population is having on the nature of major trauma seen in emergency departments. The proportion of major trauma victims who are older people is rapidly increasing and a fall from standing is now the most common mechanism of injury in major trauma. Potential barriers to effective care of this patient group are highlighted, including: a lack of consensus regarding triage criteria; potentially misleading physiological parameters within triage criteria; non-linear patient presentations and diagnostic nihilism...
March 10, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28327565/impaired-nutritional-status-in-geriatric-trauma-patients
#2
F S Müller, O W Meyer, P Chocano-Bedoya, S Schietzel, M L Gagesch, G Freystaetter, V Neuhaus, H-P Simmen, W Langhans, H A Bischoff-Ferrari
BACKGROUND/OBJECTIVES: Malnutrition is an established risk factor for adverse clinical outcomes. Our aim was to assess nutritional status among geriatric trauma patients. SUBJECTS/METHODS: We enrolled 169 consecutive patients (⩾70 years) admitted to the Geriatric Traumatology Centre (University Hospital Zurich, Switzerland). On admission to acute care, nutritional status was assessed with the mini nutritional assessment (score<17=malnourished (M), ⩽23.5=at risk of malnutrition (ARM), >23...
March 22, 2017: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28289356/management-of-burns-in-the-elderly
#3
G S Abu-Sittah, F M Chahine, H Janom
Burns are one of the most devastating forms of trauma worldwide. While geriatric burns are uncommon in the developing world - accounting for less than 5% of burns in South Asian and Middle Eastern countries - they account for almost 20% of burns in economically developed countries such as the USA. The elderly population in general is at higher risk for burn injury, moreover mortality rate, as well as severity of complications, is more pronounced in this group of patients. A review of the literature was conducted to evaluate risk factors as well as pathophysiological and immunological conditions that affect response to burn injury in the elderly population...
December 31, 2016: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/28255509/palliative-management-of-nonoperative-femoral-neck-fractures-with-continuous-peripheral-pain-catheters-20-patient-case-series
#4
Christopher H Rashidifard, Nicholas M Romeo, Paul Muccino, Mark Richardson, Thomas G DiPasquale
INTRODUCTION: To identify the success of pain catheters in the management of pain in nonoperatively treated femoral neck fractures (FNFs) in supplement to current multimodal protocols for end-of-life pain management. METHODS: Twenty patients aged older than 50 years with FNFs were selected in a retrospective fashion at a level 1 trauma center. These patients were treated nonoperatively with indwelling continuous peripheral pain catheters to palliate pain. Adjunctive pain control for patients undergoing nonoperative management of FNFs was provided with an indwelling continuous intra-articular/peripheral nerve ropivacaine pain catheters...
March 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28225741/redefining-the-association-between-old-age-and-poor-outcomes-after-trauma-the-impact-of-frailty-syndrome
#5
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/28206931/a-comprehensive-investigation-of-comorbidities-mechanisms-injury-patterns-and-outcomes-in-geriatric-blunt-trauma-patients
#6
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/28188510/medication-use-and-risk-of-falls-among-nursing-home-residents-a-retrospective-cohort-study
#7
Andrea Bor, Mária Matuz, Márta Csatordai, Gábor Szalai, András Bálint, Ria Benkő, Gyöngyvér Soós, Péter Doró
Background Geriatric falls are leading causes of hospital trauma admissions and injury-related deaths. Medication use is a crucial element among extrinsic risk factors for falls. To reduce fall risk and the prevalence of adverse drug reactions, potentially inappropriate medication (PIM) lists are widely used. Objective Our aim was to investigate the possible predictors of geriatric falls annualized over a 5-year-long period, as well as to evaluate the medication use of nursing home residents. Setting Nursing home residents were recruited from the same institution between 2010 and 2015 in Szeged, Hungary...
February 10, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28162786/base-excess-a-useful-marker-in-the-prognosis-of-chest-trauma-in-the-geriatric-population
#8
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/28107485/better-visual-outcome-by-intraocular-lens-ejection-in-geriatric-patients-with-ruptured-ocular-injuries
#9
Hiroki Kaneko, Tetsu Asami, Tadasu Sugita, Taichi Tsunekawa, Toshiyuki Matsuura, Kei Takayama, Kentaro Yamamoto, Shu Kachi, Yasuki Ito, Shinji Ueno, Norie Nonobe, Keiko Kataoka, Ayana Suzumura, Takeshi Iwase, Hiroko Terasaki
Ocular trauma is one of the leading causes of visual impairment worldwide. Because of the popularity of cataract surgeries, aged individuals with ocular trauma commonly have a surgical wound in their eyes. The purpose of this study was to evaluate the visual outcome of cases that were coincident with intraocular lens (IOL) ejection in the eyes with ruptured open-globe ocular injuries. Consecutive patients with open-globe ocular injuries were first reviewed. Patients' characteristics, corrected distance visual acuities (CDVAs) over 3 years after the trauma, causes of injuries, traumatic wound patterns, and coexistence of retinal detachment were examined...
2017: PloS One
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
#10
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/28032058/epidemiology-of-geriatric-trauma-in-an-urban-kazakhstani-setting
#11
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/28030715/future-directions-of-geriatric-trauma-care-function-and-quality-of-life-beyond-survival
#12
Erika L Rangel
No abstract text is available yet for this article.
February 15, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28026728/-influence-of-the-weather-on-the-incidence-of-fractures-in-the-elderly
#13
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/28017806/predicting-in-hospital-and-1-year-mortality-in-geriatric-trauma-patients-using-geriatric-trauma-outcome-score
#14
Rebecka Ahl, Herb A Phelan, Sinan Dogan, Yang Cao, Allyson C Cook, Shahin Mohseni
BACKGROUND: The Geriatric Trauma Outcome Score (GTOS; [age] + [2.5 × Injury Severity Score] + 22 [if packed RBC transfused within ≤24 hours of admission]), was developed and validated as a prognostic indicator for in-hospital mortality in elderly trauma patients. However, GTOS neither provides information about 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...
March 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27997467/functional-outcomes-of-operative-management-of-scapula-fractures-in-a-geriatric-cohort
#15
Peter A Cole, Jeffrey A Gilbertson, Peter A Cole
OBJECTIVES: To analyze functional outcomes, motion, and strength in patients 65 years of age and older who underwent operative management of a scapula fracture. DESIGN: Retrospective review of prospective database. SETTING: A single level-1 teaching trauma center. PATIENTS/PARTICIPANTS: Two hundred fifty patients with scapula fractures were operated between January 2002 and March 2014. A review identified 16 geriatric patients 65 years of age and older...
January 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27994985/mortality-in-tongue-cancer-patients-treated-by-curative-surgery-a-retrospective-cohort-study-from-cgrd
#16
Ming-Shao Tsai, Chia-Hsuan Lai, Chuan-Pin Lee, Yao-Hsu Yang, Pau-Chung Chen, Chung-Jan Kang, Geng-He Chang, Yao-Te Tsai, Chang-Hsien Lu, Chih-Yen Chien, Chi-Kuang Young, Ku-Hao Fang, Chin-Jui Liu, Re-Ming A Yeh, Wen-Cheng Chen
BACKGROUND: Our study aimed to compare the outcomes of surgical treatment of tongue cancer patients in three different age groups. METHODS: From 2004 to 2013, we retrospectively analyzed the clinical data of 1,712 patients who were treated in the four institutions constituting the Chang Gung Memorial Hospitals (CGMH). We divided and studied the patients in three age groups: Group 1, younger (<65 years); Group 2, young old (65 to <75); and Group 3, older old patients (≥75 years)...
2016: PeerJ
https://www.readbyqxmd.com/read/27984444/advanced-imaging-lacks-clinical-utility-in-treating-geriatric-pelvic-ring-injuries-caused-by-low-energy-trauma
#17
Roman M Natoli, Harold A Fogel, Daniel Holt, Adam Schiff, Mitchell Bernstein, Hobie D Summers, William Lack
OBJECTIVES: Is advanced imaging necessary in the 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...
April 2017: 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
#18
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/27942737/prothrombin-complex-concentrates-an-alternative-to-fresh-frozen-plasma
#19
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
#20
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
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