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Orthogeriatrics

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https://www.readbyqxmd.com/read/28578883/hospital-at-home-integrated-care-program-for-older-patients-with-orthopedic-processes-an-efficient-alternative-to-usual-hospital-based-care
#1
Conxita Closa, Miquel À Mas, Sebastià J Santaeugènia, Marco Inzitari, Aida Ribera, Miquel Gallofré
OBJECTIVE: To compare outcomes and costs for patients with orthogeriatric conditions in a home-based integrated care program versus conventional hospital-based care. DESIGN: Quasi-experimental longitudinal study. SETTING: An acute care hospital, an intermediate care hospital, and the community of an urban area in the North of Barcelona, in Southern Europe. PARTICIPANTS: In a 2-year period, we recruited 367 older patients attended at an orthopedic/traumatology unit in an acute hospital for fractures and/or arthroplasty...
May 31, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28567160/the-introduction-of-a-multidisciplinary-hip-fracture-pathway-to-optimise-patient-care-and-reduce-mortality-a-prospective-audit-of-161-patients
#2
Michael Shenouda, Zacharia Silk, Sarkhell Radha, Emer Bouanem, Warwick Radford
INTRODUCTION: Hip fractures are a major cause of morbidity and mortality in the elderly. A new patient pathway was introduced in our institution to facilitate rapid preoperative assessment, acute physician involvement and early surgery for patients with hip fractures. We sought to assess its impact on patient care and outcomes. MATERIALS AND METHODS: Prospective audit of 161 patients admitted with a proximal femoral fracture in the six months before (92 patients) and after (69 patients) implementation of the pathway...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28550459/patterns-of-drug-prescriptions-in-an-orthogeriatric-ward-as-compared-to-orthopaedic-ward-results-from-the-trondheim-hip-fracture-trial-a-randomised-clinical-trial
#3
Marianne Heltne, Ingvild Saltvedt, Stian Lydersen, Anders Prestmo, Olav Sletvold, Olav Spigset
PURPOSE: In the Trondheim Hip Fracture Trial, 397 home-dwelling patients with hip fractures were randomised to comprehensive geriatric care (CGC) in a geriatric ward or traditional orthopaedic care (OC). Patients in the CGC group had significantly better mobility and function 4 months after discharge. This study explores group differences in drug prescribing and possible associations with the outcomes in the main study. METHODS: Drugs prescribed at admission and discharge were registered from hospital records...
May 26, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28540117/orthogeriatric-combined-management-of-elderly-patients-with-proximal-femoral-fracture-results-of-a-1-year-follow-up
#4
Stefan Förch, Reiner Kretschmer, Thomas Haufe, Johannes Plath, Edgar Mayr
INTRODUCTION: According to the expected demographical changes, the number of elderly trauma patients will increase exponentially over the next decades. Different models of an interdisciplinary orthogeriatric care have been developed. But there is only limited evaluation of their benefit without clear and evidence-based results. In 2011, we monitored the results of our orthogeriatric combined management by conducting a 1-year follow-up. METHODS: We treated 231 patients presenting a proximal femoral fracture on our orthogeriatric ward...
June 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28540116/using-care-bundles-to-improve-surgical-outcomes-and-reduce-variation-in-care-for-fragility-hip-fracture-patients
#5
Stephanie Bandara, Genni Lynch, Cameron Cooke, Paul Varghese, Nicola Ward
INTRODUCTION: Fragility hip fractures constitute a large proportion of orthogeriatric admissions to orthopedic wards. This study looked at reducing variation in care in fragility hip fracture patients using a novel approach with care bundles. The care bundle comprises 5 elements targeted at providing adequate analgesia, early mobilization, improving recognition of delirium, and decreasing rates of urinary infections. METHODS: A total of 198 patients who sustained a fragility hip fracture during the intervention period were included in the study...
June 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28540113/comparison-of-3-different-perioperative-care-models-for-patients-with-hip-fractures-within-1-health-service
#6
Lillian Sarah Coventry, Austin Nguyen, Amalia Karahalios, Sasha Roshan-Zamir, Phong Tran
INTRODUCTION: Orthogeriatric care models have been introduced within many health-care facilities to improve outcomes for hip fracture patients. This study aims to evaluate differences in care between 3 models, an orthopedic model, a geriatric model, and a comanaged model. MATERIALS AND METHODS: A retrospective analysis was conducted for hip fracture patients treated at Western Health between November 2012 and March 2014. All patients aged 65 years or older were included in the analysis...
June 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28522074/-orthogeriatrics-the-first-multicentre-regional-register-of-hip-fractures-in-castilla-y-le%C3%A3-n-spain
#7
Angélica Muñoz-Pascual, Pilar Sáez-López, Sonia Jiménez-Mola, Natalia Sánchez-Hernández, Noelia Alonso-García, Ana Isabel Andrés-Sainz, M Cruz Macias-Montero, Carmen Vázquez-Pedrezuela, Nieves Pereira de Castro Juez, Pilar Del Pozo-Tagarro, Carmen Pablos-Hernández, Carmen Cervera-Díaz, Ana Cerón-Fernández, Esther Vuelta-Calzada, Javier Perez-Jara Carrera, Alfonso González-Ramírez, Teresa Collado-Díaz, Javier Idoate-Gil, M Teresa Guerrero-Díaz, Dayro Gutierrez-Bejarano, Encarnación Martín-Perez
OBJECTIVE: The objective of this study is to describe the characteristics of the patients with hip fracture admitted to the Public Hospitals of Castilla y León during three monthly periods (November 2014, and October and November 2015). MATERIAL AND METHOD: The Castilla y León orthogeriatrics work group created a common register to collect data on hip fractures. The study included patients 75 years-old and over hospitalised with hip fractures in the 13 public hospitals in the community during November 2014, and October and November 2015...
May 15, 2017: Revista Española de Geriatría y Gerontología
https://www.readbyqxmd.com/read/28500499/-anesthesiological-care-of-trauma-patients-in-orthogeriatric-co-management
#8
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/28497702/book-reviews-adverse-drug-interactions-a-handbook-for-prescribers-2nd-edn-edited-by-lakshman-delgoda-karalliedde-simon-fj-clarke-ursula-gotel-janaka-karalliedde-crc-press-2016-price-%C3%A2-44-99-pp-1089-isbn-9781482236217-orthogeriatrics-edited-by-paolo-falaschi
#9
https://www.readbyqxmd.com/read/28488559/-hip-fracture-in-elderly-patients-additional-value-of-a-multidisciplinary-approach-and-concentration-of-care
#10
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/28277764/book-reviews-adverse-drug-interactions-a-handbook-for-prescribers-2nd-edn-edited-by-lakshman-delgoda-karalliedde-simon-fj-clarke-ursula-gotel-janaka-karalliedde-crc-press-2016-price-%C3%A2-44-99-pp-1089-isbn-9781482236217-orthogeriatrics-edited-by-paolo-falaschi
#11
https://www.readbyqxmd.com/read/28263371/association-between-preoperative-malnutrition-and-postoperative-delirium-after-hip-fracture-surgery-in-older-adults
#12
Paolo Mazzola, Libby Ward, Sara Zazzetta, Valentina Broggini, Alessandra Anzuini, Breanna Valcarcel, Justin S Brathwaite, Giulio M Pasinetti, Giuseppe Bellelli, Giorgio Annoni
OBJECTIVES: To determine whether poor nutritional status can predict postoperative delirium in elderly adults undergoing hip fracture surgery. DESIGN: Prospective observational cohort study. SETTING: Italian orthogeriatric unit. PARTICIPANTS: Individuals aged 70 and older (mean age 84.0 ± 6.6, 74.5% female) consecutively admitted for surgical repair of a proximal femur fracture between September 2012 and April 2016 (N = 415)...
March 6, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28259736/health-care-professionals-readiness-for-an-interprofessional-orthogeriatric-unit-a-cross-sectional-survey
#13
Charlotte Abrahamsen, Birgitte Nørgaard, Eva Draborg
An assessment of readiness for change can set the stage for the implementation by providing information regarding staff members' beliefs and attitudes prior to an organizational change. We conducted a cross-sectional survey to assess readiness for change (N = 113 employees) in a hospital on the verge of implementing an interprofessional, co-managed orthogeriatric unit. Staff members from three departments with roles related to orthogeriatric patients were invited to answer a web-based questionnaire. Our survey demonstrates that health care professionals are confident that interprofessional collaboration will be promoted by the implementation of orthogeriatric care...
November 11, 2016: International Journal of Orthopaedic and Trauma Nursing
https://www.readbyqxmd.com/read/28214194/orthogeriatric-activity-in-a-general-hospital-of-castilla-la-mancha-spain
#14
J M Fernández-Ibáñez, M C Morales-Ballesteros, E Crespo-Romero, S Gómez-Gómez, M D Fraga-Fuentes, J Cruz-Tejado, P A Hernández-Zegarra, Á Arias-Arias, M M García-Baltasar
AIM: To describe the orthogeriatric activity in the elderly with hip fractures in the Hospital Mancha Centro, based on the recommendations of the main guidelines. MATERIAL AND METHOD: Observational prospective study, comprising all patients over 65 years of age admitted to the Traumatology Unit with a hip fracture between April 2015 and December 2015. Patients were admitted under the care of the Traumatology Unit with cross-consultation carried out with the Geriatrics Department, which then carried out a pre-operative geriatric assessment and the post-operative follow-ups...
February 14, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28049616/three-decades-of-comprehensive-geriatric-assessment-evidence-coming-from-different-healthcare-settings-and-specific-clinical-conditions
#15
REVIEW
Alberto Pilotto, Alberto Cella, Andrea Pilotto, Julia Daragjati, Nicola Veronese, Clarissa Musacchio, Anna Maria Mello, Giancarlo Logroscino, Alessandro Padovani, Camilla Prete, Francesco Panza
Comprehensive geriatric assessment (CGA) is a multidisciplinary diagnostic and treatment process that identifies medical, psychosocial, and functional capabilities of older adults to develop a coordinated plan to maximize overall health with aging. Specific criteria used by CGA programs to evaluate patients include age, medical comorbidities, psychosocial problems, previous or predicted high healthcare utilization, change in living situation, and specific geriatric conditions. However, no universal criteria have been agreed upon to readily identify patients who are likely to benefit from CGA...
February 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28007756/eular-efort-recommendations-for-management-of-patients-older-than-50%C3%A2-years-with-a-fragility-fracture-and-prevention-of-subsequent-fractures
#16
REVIEW
W F Lems, K E Dreinhöfer, H Bischoff-Ferrari, M Blauth, E Czerwinski, Jap da Silva, A Herrera, P Hoffmeyer, T Kvien, G Maalouf, D Marsh, J Puget, W Puhl, G Poor, L Rasch, C Roux, S Schüler, B Seriolo, U Tarantino, T van Geel, A Woolf, C Wyers, P Geusens
The European League Against Rheumatism (EULAR) and the European Federation of National Associations of Orthopaedics and Traumatology (EFORT) have recognised the importance of optimal acute care for the patients aged 50 years and over with a recent fragility fracture and the prevention of subsequent fractures in high-risk patients, which can be facilitated by close collaboration between orthopaedic surgeons and rheumatologists or other metabolic bone experts. Therefore, the aim was to establish for the first time collaborative recommendations for these patients...
May 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/27999879/-perioperative-patient-management-in-orthogeriatrics
#17
P Moldzio, J Peters
The management of major orthopedic surgery in the elderly prototypically reflects the perioperative risks of geriatric, often very frail patients reflecting an aging population. To improve outcome, the risks of anesthesia and surgery as well as of patient comorbidities must be thoroughly assessed and balanced using a multidisciplinary approach. Particular risks include cardiopulmonary morbidity, anemia, risk of hemorrhage and the management by anticoagulation, cerebral impairments as well as frailty and limited physiological reserves in general...
January 2017: Der Orthopäde
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/27913981/the-challenges-of-anaesthesia-and-pain-relief-in-hip-fracture-care
#19
Rachel Cowan, Jun Hao Lim, Terence Ong, Ashok Kumar, Opinder Sahota
The care of the older person with hip fracture is complicated by their comorbid condition, limited physiological reserve, cognitive impairment and frailty. Two aspects of hip fracture management that have received considerable attention are how best to manage the pain associated with it and the ideal mode of anaesthesia. Existing literature has reported on the suboptimal treatment of pain in this orthogeriatric cohort. With recent advancements in medical care, a number of options have emerged as alternatives to conservative systemic analgesia...
January 2017: Drugs & Aging
https://www.readbyqxmd.com/read/27911302/association-between-cognitive-status-before-surgery-and-outcomes-in-elderly-patients-with-hip-fracture-in-a-dedicated-orthogeriatric-care-pathway
#20
Lorene Zerah, Judith Cohen-Bittan, Mathieu Raux, Anthony Meziere, Cendrine Tourette, Christian Neri, Marc Verny, Bruno Riou, Frederic Khiami, Jacques Boddaert
BACKGROUND: Dementia is associated with a worse prognosis of hip fracture, but the impact of a dedicated geriatric care pathway on the prognosis of these patients has not been evaluated. OBJECTIVE: According to the cognitive status before surgery, our main objective was to compare mortality rate at 6 months; secondary outcomes were to compare in-hospital complications, the risk of new institutionalization, and the ability to walk at 6 months. METHODS: Between 2009 and 2015, all patients (>70 years) admitted after hip fracture surgery into a dedicated unit of peri-operative geriatric care were included: patients with dementia (DP), without dementia (NDP), and with cognitive status not determined (CSND)...
2017: Journal of Alzheimer's Disease: JAD
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