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Geriatric trauma

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https://www.readbyqxmd.com/read/28538458/continuous-femoral-nerve-catheters-decrease-opioid-related-side-effects-and-increase-home-disposition-rates-among-geriatric-hip-fracture-patients
#1
Diren Arsoy, Michael J Gardner, Derek F Amanatullah, James I Huddleston, Stuart B Goodman, William J Maloney, Julius A Bishop
OBJECTIVE: To evaluate the effect of continuous femoral nerve catheter (CFNC) for postoperative pain control in geriatric proximal femur fractures compared with standard analgesia (SA) treatment. DESIGN: Retrospective comparative study. SETTING: Academic Level 1 trauma center. PATIENTS/PARTICIPANTS: We retrospectively identified 265 consecutive geriatric hip fracture patients who underwent surgical treatment. INTERVENTION: One hundred forty-nine patients were treated with standard analgesia without nerve catheter whereas 116 patients received an indwelling CFNC...
June 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28534301/effects-of-acetyl-l-carnitine-in-diabetic-neuropathy-and-other-geriatric-disorders
#2
REVIEW
G Sergi, S Pizzato, F Piovesan, C Trevisan, N Veronese, E Manzato
A long history of diabetes mellitus and increasing age are associated with the onset of diabetic neuropathy, a painful and highly disabling complication with a prevalence peaking at 50% among elderly diabetic patients. Acetyl-L-carnitine (ALC) is a molecule derived from the acetylation of carnitine in the mitochondria that has an essential role in energy production. It has recently been proposed as a therapy to improve the symptoms of diabetic neuropathy. ALC is widely distributed in mammalian tissues, including the brain, blood-brain barrier, brain neurons, and astrocytes...
May 22, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28529911/severe-trauma-in-the-geriatric-population
#3
REVIEW
Juan Antonio Llompart-Pou, Jon Pérez-Bárcena, Mario Chico-Fernández, Marcelino Sánchez-Casado, Joan Maria Raurich
Geriatric trauma constitutes an increasingly recognized problem. Aging results in a progressive decline in cellular function which leads to a loose of their capacity to respond to injury. Some medications commonly used in this population can mask or blunt the response to injury. Falls constitute the most common cause of trauma and the leading cause of trauma-related deaths in this population. Falls are complicated by the widespread use of antiplatelets and anticoagulants, especially in patients with brain injury...
May 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28526897/the-impact-of-pre-injury-direct-oral-anticoagulants-compared-to-warfarin-in-geriatric-g-60-trauma-patients
#4
J F Barletta, S Hall, J F Sucher, J K Dzandu, M Haley, A J Mangram
PURPOSE: Pre-injury oral anticoagulants are associated with worse outcomes in geriatric (G-60) trauma patients, but there are limited data comparing warfarin with direct oral anticoagulants (DOAC). We sought to compare outcomes in G-60 trauma patients taking pre-injury DOACs vs. warfarin. METHODS: All trauma patients, age ≥60 who were admitted to the hospital and taking an oral anticoagulant pre-injury were retrospectively identified. Patients were excluded if their reason for admission was a suicide attempt or penetrating extremity injury...
May 19, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28503462/predictors-for-depressive-mood-in-geriatric-patients-after-traumatic-brain-injury-a-retrospective-cross-sectional-study
#5
Je Kyung Kim, Na Young Kim, Yong Wook Kim
OBJECTIVE: To identify predictors for depressive mood in geriatric patients after traumatic brain injury (TBI). METHODS: A retrospective review of patients' medical charts was performed in TBI patients who were older than 60 years and referred to the Department of Rehabilitation Medicine at Severance Hospital in 2002-2016. The patients were classified into two groups based on the Geriatric Depression Scale (GDS): non-depressive group (0≤GDS≤16) and depressive group (17≤GDS≤30)...
April 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28502379/external-validation-of-the-clinical-indications-of-computed-tomography-ct-of-the-head-in-patients-with-low-energy-geriatric-hip-fractures
#6
Amrut Borade, Harish Kempegowda, Hemil H Maniar, Anthony De Giacomo, Paul Tornetta, Kasey Bramlett, Andrew J Marcantonio, Lucas S Marchand, Erik N Kubiak, William H Ip, James F Kellam, Jay S Bender, Eric G Meinberg, James Kee, Regis Renard, Michael Suk, Daniel S Horwitz
INTRODUCTION: On evaluation of the clinical indications of computed tomography (CT) scan of head in the patients with low-energy geriatric hip fractures, Maniar et al. identified physical evidence of head injury, new onset confusion, and Glasgow Coma Scale (GCS)<15 as predictive risk factors for acute findings on CT scan. The goal of the present study was to validate these three criteria as predictive risk factors for a larger population in a wider geographical distribution. PATIENTS AND METHODS: Patients ≥65 years of age with low-energy hip fractures from 6 trauma centers in a wide geographical distribution in the United States were included in this study...
April 26, 2017: Injury
https://www.readbyqxmd.com/read/28500499/-anesthesiological-care-of-trauma-patients-in-orthogeriatric-co-management
#7
Markus F Luger, Thomas J Luger
Elderly patients increasingly need to undergo surgery under anesthesia, especially following trauma. A timely interdisciplinary approach to the perioperative management of these patients is decisive for the long-term outcome. Orthogeriatric co-management, which includes geriatricians and anesthesiologists from an early stage, is of great benefit for geriatric patients. Patient age, comorbidities and self-sufficiency in activities of daily life are decisive for an anesthesiological assessment of the state of health and preoperative risk stratification...
May 12, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28497099/acetabular-fractures-in-the-senior-population-epidemiology-mortality-and-treatments
#8
Reza Firoozabadi, William W Cross, James C Krieg, Milton L Chip Routt
BACKGROUND: Management of acetabular fractures in the senior population can be one of the most challenging injuries to manage. Furthermore, treating surgeons have a paucity of information to guide the treatment in this patient population. THE PURPOSE OF THIS STUDY WAS TO DETERMINE: (1) demographic and epidemiologic data, (2) mortality rates for nonoperative compared to operative management at different time points, (3) common fracture configurations, and (4) fracture fixation strategies in senior patients treated with acetabular fractures...
March 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28488559/-hip-fracture-in-elderly-patients-additional-value-of-a-multidisciplinary-approach-and-concentration-of-care
#9
P van der Vet, J Kussen, M van Dijk, R M Houwert, E J M M Verleisdonk, D van der Velde
Management of elderly patients with a proximal femoral fracture is an increasing challenge for the Dutch healthcare system. Proximal femoral fractures in the elderly have high morbidity and mortality rates. Furthermore, healthcare costs for this group of patients are rising. Referral, operation and postoperative care demand efficient collaboration between healthcare professionals. Every step in this chain of events is crucial for optimal treatment results. Multidisciplinary orthogeriatric trauma care shows promising results...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28467584/the-geriatric-polytrauma-risk-profile-and-prognostic-factors
#10
Holger Rupprecht, Hans Jürgen Heppner, Kristina Wohlfart, Alp Türkoglu
BACKGROUND: In the German population, the percentage of elderly patients is increasing, and consequently there are more elderly patients among trauma cases, and particularly cases of polytrauma. The aim of this study was to present clinical results and a risk profile for geriatric polytrauma patients. METHODS: Review of 140 geriatric (over 65 years of age) polytrauma patients who received prehospital treatment was performed. Severity of trauma was retrospectively assessed with Hannover Polytrauma Score (HPTS)...
March 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28467125/do-trauma-patients-aged-55-and-older-benefit-from-air-medical-transport
#11
Howard A Werman, Subrahmanyam Darbha, Michael Cudnik, Jeffrey Caterino
INTRODUCTION: A recent analysis of the National Sample Project demonstrated that the mortality benefits of air medical transport do not extend to patients age 55 or older. The purpose of the current investigation was to evaluate mortality benefits of air transport in adult trauma patients ≥ 55 years of age. METHODS: A retrospective analysis of all adult patients greater than age 55 years directly transported from a trauma scene to a Level I or II facility was conducted...
May 3, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28461962/anticoagulation-therapy-and-proximal-femoral-fracture-treatment-an-update
#12
Ioannis Ktistakis, Vasileios Giannoudis, Peter V Giannoudis
Hip fractures in the elderly population have become a 'disease' with increasing incidence.Most of the geriatric patients are affected by a number of comorbidities.Coagulopathies continue to be a special point of interest for the orthopaedic trauma surgeon, with the management of this high-risk group of patients a hot topic of debate among the orthopaedic community.While a universal consensus on how to manage thromboprophylaxis for this special cohort of patients has not been reached, multiple attempts to define a widely accepted protocol have been published...
August 2016: EFORT Open Rev
https://www.readbyqxmd.com/read/28450739/comparing-mortality-risk-of-patients-with-acute-hip-fractures-admitted-to-a-major-trauma-centre-on-a-weekday-or-weekend
#13
Rajpal Nandra, Jack Pullan, Jonathan Bishop, Khalid Baloch, Liam Grover, Keith Porter
Proximal femoral fractures are a major public health concern with estimated annual direct and social costs amounting to £2 billion and average 30-day mortality risk of 7.5%. In response to the recent debate over out-of-hours hospital provision we investigated the 'weekend effect' at a major trauma centre, caring for acute injuries. A single centre, multi-surgeon review of 2060 patients performed. The distribution of patient and treatment variables compared in patients admitted on a weekday or the weekend. Fewer patients met performance indicators during weekend admission, time to surgery (63 vs...
April 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28433450/a-retrospective-cohort-study-of-concomitant-ipsilateral-extra-capsular-and-intra-capsular-fractures-of-the-proximal-femur-are-they-casual-findings-or-an-undervalued-reality
#14
Miquel Videla-Cés, José-Miguel Sales-Pérez, Joan Girós-Torres, Rubén Sánchez-Navés, Sebastián Videla
BACKGROUND: Fractures of the proximal femur constitute a major public health problem, with an annual incidence in Spain of 7.6 cases per 1000 inhabitants over 65 years of age. Hip fractures are frequent in elderly patients, related to osteoporosis and with low energy trauma, which means that they can be considered a geriatric syndrome. Simultaneous ipsilateral extra- and intra-articular hip fractures are considered as very rare are, and generally speaking, classified as extra- or intra-capsular fractures...
April 13, 2017: Injury
https://www.readbyqxmd.com/read/28424132/outcomes-of-recreational-activity-associated-trauma-in-elderly-persons-on-blood-thinning-medications
#15
Zachary M DeBoard, Jonathan Grotts, Lisa Ferrigno
With increasing life expectancy, the elderly are participating in recreational activities traditionally pursued by younger persons. Elderly patients have many reasons for worse outcomes after trauma, one of which may be the rising use of anticoagulant and/or antiplatelet medications. This study aimed to determine whether preinjury use of these agents yielded worse outcomes in geriatric patients injured during high-impact recreational activities. The National Trauma Data Bank was reviewed from 2007 to 2010 for patients ≥65 years admitted to Level I or II trauma centers with ICD-9 E-codes for specific mechanisms of injury...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28422904/a-comparison-of-prognosis-calculators-for-geriatric-trauma-a-p-a-l-li-a-t-e-consortium-study
#16
Tarik D Madni, Akpofure Peter Ekeh, Scott C Brakenridge, Karen J Brasel, Bellal Joseph, Kenji Inaba, Brandon R Bruns, Jeffrey D Kerby, Joseph Cuschieri, M Jane Mohler, Paul A Nakonezny, Audra Clark, Jonathan Imran, Steven E Wolf, M Elizabeth Paulk, Ramona L Rhodes, Herb A Phelan
BACKGROUND: The nine-center PALLIATE consortium has validated the Geriatric Trauma Outcome Score (GTOS) as a prognosis calculator for injured elders. We compared GTOS' performance to that of the Trauma Injury Severity Score (TRISS) in a multicenter sample. METHODS: Three PALLIATE centers not submitting subjects to the GTOS validation study identified subjects aged 65 to 102 yrs admitted from 2000-2013. GTOS was specified using the formula [GTOS = age + (ISS x 2...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28406852/survivorship-after-high-energy-geriatric-trauma
#17
Ida Leah Gitajn, Renan Castillo, Stephen Breazeale, Carrie Schoonover, Peter Berger, Yanjie Huang, Nathan O'Hara, Robert V O'Toole, Marcus F Sciadini
OBJECTIVES: To evaluate in-hospital, 1-year, and 5-year survivorship of geriatric patients after high-energy trauma, to compare survivorship of geriatric patients who sustained high-energy trauma with that of those who sustained low-energy trauma, and to identify predictors for mortality. DESIGN: Retrospective. SETTING: Urban Level I trauma center. PATIENTS: Study group of 1849 patients with high-energy trauma and comparison group of 761 patients with low-energy trauma...
April 18, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28391428/do-clinical-outcomes-correlate-with-bone-density-after-open-reduction-and-internal-fixation-of-tibial-plateau-fractures
#18
Elizabeth Gausden, Matthew R Garner, Peter D Fabricant, Stephen J Warner, Andre D Shaffer, Dean G Lorich
INTRODUCTION: The operative management of tibial plateau fractures in elderly patients has historically led to inconsistent results, and these clinical outcomes were thought to be associated with poor bone quality often in elderly patients. The goal of this study was to investigate the relationship between bone density and subjective clinical outcome scores after open reduction and internal fixation of tibial plateau fractures. MATERIALS AND METHODS: This is a retrospective cohort study from a single-surgeon conducted at an Academic, Level 1 Trauma Center...
April 8, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28384504/pelvic-ring-fractures-in-the-elderly-now-and-then-a-pelvic-registry-study
#19
Mika F Rollmann, Steven C Herath, Florian Kirchhoff, Benedikt J Braun, Joerg H Holstein, Tim Pohlemann, Michael D Menger, Tina Histing
OBJECTIVES: To analyze the changes in demographic data stratified for age, sex and type of injury of elderly patients suffering from pelvic ring fractures over a 22-year observation period. DESIGN/SETTING: Data has been collected prospectively, multi-centrically in hospitals participating in the German Pelvic Trauma Registry. PATIENTS: We analyzed the data of 5665 patients with an age ≥60years included in the German Pelvic Trauma Registry from 1991 to 2013...
March 19, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28367005/a-multidisciplinary-approach-to-improve-the-quality-of-care-for-patients-with-fragility-fractures
#20
Laura C Lamb, Stephanie C Montgomery, Brian Wong Won, Siobhan Harder, Jeffrey Meter, James M Feeney
BACKGROUND: Fragility fractures have become a worldwide epidemic associated with significant morbidity and mortality. As the world population ages, the number of patients that experience these fractures is also expected to rise. A multidisciplinary team was assembled that was coordinated by the Acute Inpatient Medical Service and included orthopedic surgeons, geriatricians, anesthesiologists, cardiologists, nurses, trauma surgeons, emergency medicine physicians, physiatrists, and physical therapists...
June 2017: Journal of Orthopaedics
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