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Geriatric trauma

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https://www.readbyqxmd.com/read/29183520/the-effect-of-sarcopenia-on-outcomes-in-geriatric-blunt-trauma
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/29125861/identification-of-hospitalized-elderly-patients-at-risk-for-adverse-in-hospital-outcomes-in-a-university-orthopedics-and-trauma-surgery-environment
#7
Janine Gronewold, Christian Dahlmann, Marcus Jäger, Dirk M Hermann
BACKGROUND: As a consequence of demographic changes, hospitals are confronted with increasing numbers of elderly patients, who are at high risk of adverse events during hospitalization. Geriatric risk screening followed by comprehensive geriatric assessment (CGA) and treatment has been requested by geriatric societies and task forces to identify patients at risk. Since empirical evidence on factors predisposing to adverse hospital events is scarce, we now prospectively evaluated implications of geriatric risk screening followed by CGA in a university hospital department of orthopedics and trauma surgery...
2017: PloS One
https://www.readbyqxmd.com/read/29117058/the-effect-of-time-to-international-normalized-ratio-reversal-on-intracranial-hemorrhage-evolution-in-patients-with-traumatic-brain-injury
#8
Hans Andrews, Katelyn Rittenhouse, Brian Gross, Frederick B Rogers
The incidence of geriatric traumatic brain injury (TBI) is increasing throughout the United States, with many of these patients taking anticoagulation (AC) medication. The purpose of this investigation was to determine the effect of time to international normalized ratio (INR) reversal on intracranial hemorrhage evolution in TBI patients taking prehospital AC medication. We hypothesized that rapid reversal of INR improves outcomes of head-injured patients taking AC medication. Admissions to a Level II trauma center between February 2011 and December 2013 were reviewed...
November 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29100833/isolated-orbital-fractures-are-severe-among-geriatric-patients
#9
Miika Toivari, Anna Liisa Suominen, Satu Apajalahti, Christian Lindqvist, Johanna Snäll, Hanna Thorén
PURPOSE: The purpose of the present study was to clarify the reasons for, types of, and degree of involvement of the orbital wall and the severity of orbital fractures in geriatric patients and to compare the differences between geriatric and younger adult patients. MATERIALS AND METHODS: A retrospective case-control study of geriatric patients aged at least 65 years (n = 72) and younger controls aged 20 to 50 years (n = 58) with a diagnosis of a unilateral isolated orbital fracture was designed and implemented...
October 9, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29084051/ten-year-incidence-of-high-energy-geriatric-trauma-at-a-level-1-trauma-center
#10
Jason A Lowe, Jeffrey Pearson, Michael Leslie, Russell Griffin
OBJECTIVES: To examine the characteristics of high-energy geriatric trauma over time. DESIGN: Retrospective chart review SETTING:: Level 1 trauma Center PATIENTS:: Demographic, injury, and clinical characteristics were compared between 34,017 geriatric and non-geriatric high energy trauma patients from 2005-2014 using t-test, chi-square analysis and negative binomial regression for annual trend in injuries. RESULTS: High-energy geriatric trauma comprised 11...
October 14, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29079066/anticoagulated-trauma-patients-a-level-i-trauma-center-s-response-to-a-growing-geriatric-population
#11
Mark D Mason, Sarah K Spilman, Elizabeth A Fuchsen, Sherry D Olson, Richard A Sidwell, James R Swegle, Sheryl M Sahr
BACKGROUND: Injured older adults often receive delayed care in the emergency department (ED) because they do not meet criteria for trauma team activation (TTA). This is particularly dangerous for the increasing number of patients taking anticoagulant or antiplatelet (AC/AP) medication at the time of injury. OBJECTIVES: The present study examined improvements in processes of care and triage accuracy when TTA criteria include an escalated response for older anticoagulated patients...
October 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29078902/admission-of-elderly-blunt-thoracic-trauma-patients-directly-to-the-intensive-care-unit-improves-outcomes
#12
Owen J Pyke, Jerry A Rubano, James A Vosswinkel, Jane E McCormack, Emily C Huang, Randeep S Jawa
INTRODUCTION: Blunt thoracic trauma in the elderly has been associated with adverse outcomes. As an internal quality improvement initiative, direct intensive care unit (ICU) admission of nonmechanically ventilated elderly patients with clinically important thoracic trauma (primarily multiple rib fractures) was recommended. METHODS: A retrospective review of the trauma registry at a level 1 trauma center was performed for patients aged ≥65 y with blunt thoracic trauma, admitted between the 2 y before (2010-2012) and after (2013-2015) the recommendation...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29077678/is-it-safe-nonoperative-management-of-blunt-splenic-injuries-in-geriatric-trauma-patients
#13
Marc D Trust, Pedro Teixeira, Lawrence Brown, Sadia Ali, Ben Coopwood, Jayson Aydelotte, Carlos V R Brown
BACKGROUND: Due to increased failure rates of non-operative management (NOM) of blunt splenic injuries (BSI) in the geriatric population, dogma dictated that this management was unacceptable. Recently, there has been an increased use of this treatment strategy in the geriatric population. However, published data assessing the safety of NOM of BSI in this population is conflicting and well-powered multicenter data is lacking. METHODS: We performed a retrospective analysis of data from the National Trauma Data Bank (NTDB) from 2014 and identified young (age < 65) and geriatric (age ≥ 65) patients with a BSI...
October 25, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29058020/-changes-in-the-patient-population-with-proximal-femur-fractures-over-the-last-decade-incidence-age-comorbidities-and-length-of-stay
#14
Markus Muhm, Matthias Amann, Alexander Hofmann, Thomas Ruffing
BACKGROUND: Over the last decade, the percentage of people >65 years has increased from 16.6% to 20.7%. In industrialized countries, the annual incidence in people >65 years with a proximal femur fracture is about 600-900 per 100,000 population. The incidence will increase by 3-5% per year. Guidelines advocate early surgery as soon as possible but within 24 h. External quality control requires surgical treatment within 48 h. In this study, the changes in the patient population with proximal femur fractures and their treatment during the last decade were investigated...
October 20, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/29017731/impact-of-geriatric-consultations-on-clinical-outcomes-of-elderly-trauma-patients-a-retrospective-analysis
#15
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...
December 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28985882/economic-evaluations-of-comprehensive-geriatric-assessment-in-surgical-patients-a-systematic-review
#16
REVIEW
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
#17
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
#18
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
#19
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
#20
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
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