keyword
MENU ▼
Read by QxMD icon Read
search

Acute care for elders

keyword
https://www.readbyqxmd.com/read/28817444/strategies-for-reducing-population-surgical-costs-in-medicare-local-referrals-to-low-cost-hospitals
#1
Hari Nathan, Jyothi R Thumma, Edward C Norton, Justin B Dimick
OBJECTIVE: We sought to assess hospital cost variation for elective inpatient surgical procedures within small geographic areas. SUMMARY BACKGROUND DATA: Previous studies have documented cost variation for inpatient surgical procedures on a national basis, suggesting opportunities for savings. Cost variation within small geographic areas is more relevant to policymakers, providers, and patients, but it has not been studied. METHODS: Using Medicare payment data, we identified elderly patients undergoing 1 of 7 elective inpatient surgical procedures during 2010-2012...
August 16, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28815461/drug-induced-kidney-injury-in-the-elderly
#2
REVIEW
Sana Khan, Valentina Loi, Mitchell H Rosner
The incidence of acute kidney injury in the elderly has grown over the past decade. One of the primary drivers is drug-induced nephrotoxicity, which is the result of a combination of the unique susceptibilities to kidney injury and the increased use of medications in the elderly population. Specific drug classes are associated with increased rates of kidney injury including agents that block the renin angiotensin system, antimicrobials, and chemotherapeutic agents. Mechanistically, injury may be due to hemodynamic effects, tubular or glomerular toxicity, and interstitial nephritis...
August 16, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28807263/the-growth-of-aki-half-empty-or-half-full-it-s-the-size-of-the-glass-that-matters
#3
Raymond K Hsu, Edward D Siew
Previous data suggest rapid growth in the population incidence of acute kidney injury (AKI). In this study, Kashani et al. report data from the Mayo Clinic Hospital indicating slowing to stabilization of AKI rates in Olmsted County, Minnesota, from 2006 through 2014. More studies are needed to confirm this trend, and if this trend exists, reasons behind it. Further, strategies to optimally care for vulnerable populations in which AKI rates remain high, including the elderly, are warranted.
September 2017: Kidney International
https://www.readbyqxmd.com/read/28804877/validation-of-a-geriatric-trauma-prognosis-calculator-a-p-a-l-li-a-t-e-consortium-study
#4
Allyson C Cook, Bellal Joseph, M Jane Mohler, Kenji Inaba, Brandon R Bruns, Paul A Nakonezny, Jeff D Kerby, Karen J Brasel, Steven E Wolf, Joseph Cuschieri, M Elizabeth Paulk, Ramona L Rhodes, Scott C Brakenridge, A Peter Ekeh, Herb A Phelan
BACKGROUND/OBJECTIVES: The P.A.L.Li.A.T.E. (prognostic assessment of life and limitations after trauma in the elderly) consortium has previously created a prognosis calculator for mortality after geriatric injury based on age, injury severity, and transfusion requirement called the geriatric trauma outcome score (GTOS). Here, we sought to create and validate a prognosis calculator called the geriatric trauma outcome score ii (GTOS II) estimating probability of unfavorable discharge. DESIGN: Retrospective cohort...
August 14, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28802907/the-who-how-and-why-allogeneic-transplant-for-acute-myeloid-leukemia-in-patients-older-than-60years
#5
REVIEW
Sarah A Wall, Steven Devine, Sumithira Vasu
Acute myelogenous leukemia (AML) is primarily a disease of the elderly, and as such, our approach to treatment needs to be tailored to address an aging population. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains the only potentially curative treatment for intermediate and high risk AML, and until recently, its use had been limited to a younger population and dependent on availability of a donor. Advances in conditioning regimens, supportive care, and the use of alternative donor sources have greatly expanded access to this therapy...
July 15, 2017: Blood Reviews
https://www.readbyqxmd.com/read/28799226/educational-intervention-on-medication-reviews-aiming-to-reduce-acute-healthcare-consumption-in-elderly-patients-with-potentially-inappropriate-medicines-a-pragmatic-open-label-cluster-randomized-controlled-trial-in-primary-care
#6
K Schmidt-Mende, M Andersen, B Wettermark, J Hasselström
PURPOSE: Potentially inappropriate medicines (PIMs) may cause 10% of unplanned admissions in elderly people. We performed an educational intervention in primary care to reduce acute health care consumption and PIMs through the promotion of medication reviews (MRs) in elderly patients. METHODS: This cluster-randomized controlled trial was conducted in the context of an official campaign promoting rational drug use in elderly people. Sixty-nine primary health care practices with 119,910 patients aged older than or equal to 65 were randomized, with 1 dropout in the intervention group...
August 11, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28795663/-evaluation-function-of-intermedin-on-prognosis-of-elderly-patients-with-sepsis
#7
Yi Zhang, Fengxue Zhu, Weihuan Du, Yongmei He, Li Guo, Zhihong Yan, Hong Ji
OBJECTIVE: To investigate the predicting value of intermedin (IMD) for the prognosis of elderly sepsis patients. METHODS: A retrospective analysis was conducted. Forty-one patients with sepsis, aged ≥65 years, and admitted to geriatrics intensive care unit of Aerospace Center Hospital from April 2015 to December 2016 were enrolled. Thirty healthy patients were studied as control during the same time. The expression of C-reactive protein (CRP), procalcitonin (PCT) and IMD were tested within 24 hours during hospitalization, and the acute physiology and chronic health evaluation II (APACHE II) score and prognosis was evaluated...
August 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28795662/-evaluation-value-of-the-levels-of-peripheral-blood-cd20-cd24-hi-cd38-hi-regulatory-b-cells-on-the-prognosis-of-elderly-patients-with-sepsis
#8
Chunmei Wang, Lunxian Tang, Huihui Xu, Xiaoming Zhang, Jianwen Bai
OBJECTIVE: To explore the predicting value of peripheral blood CD20(+) CD24(hi) CD38(hi) regulatory B cells (Bregs) on the prognosis of elderly patients with sepsis. METHODS: A prospective study was conducted. Septic patients aged > 65 years old, compliance with diagnostic criteria for Sepsis-3, admitted to emergency and emergency intensive care unit (ICU) of Shanghai East Hospital of Tongji University from April 2016 to February 2017 were enrolled. Procalcitonin (PCT), C-reaction protein (CRP) and lactate (Lac) were routinely measured...
August 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28795216/the-impact-of-pre-existing-conditions-on-functional-outcome-and-mortality-in-geriatric-hip-fracture-patients
#9
Christopher Bliemel, Benjamin Buecking, Ludwig Oberkircher, Matthias Knobe, Steffen Ruchholtz, Daphne Eschbach
PURPOSE: Due to pre-existing illnesses, elderly hip fracture patients represent a vulnerable patient population. The present study was conducted to investigate the effects of various pre-existing conditions on the outcomes of hip fracture patients. METHODS: A total of 402 surgically treated geriatric hip fracture patients were included in this prospective, single-centre study. Upon admission, patient age, gender and fracture type were documented, among other information...
August 9, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28791772/functional-trajectories-of-older-patients-admitted-to-an-acute-care-unit-for-elders
#10
Andreina D'Onofrio, Christophe Büla, Eve Rubli, Fabiana Butrogno, Diane Morin
AIMS AND OBJECTIVES: To describe the functional trajectories of older medical inpatients and to identify factors associated with overall and in-hospital functional decline. BACKGROUND: Functional decline during a hospital stay is an important clinical outcome because independence remains a major determinant of older persons' quality of life and health care demands. DESIGN AND METHODS: Participants (n = 189) were admitted to the Acute Care Unit for Elders of a Swiss academic hospital and were aged 65 years and older...
August 9, 2017: International Journal of Older People Nursing
https://www.readbyqxmd.com/read/28791424/-to-stent-or-not-to-stent-immediate-emergency-surgery-with-laparoscopic-radical-colectomy-with-cme-and-primary-anastomosis-is-feasible-for-obstructing-left-colon-carcinoma
#11
Salomone Di Saverio, Arianna Birindelli, Edoardo Segalini, Matteo Novello, Anna Larocca, Francesco Ferrara, Gian Andrea Binda, Marco Bassi
Great debate exists in the initial acute management of large bowel obstruction from obstructing left colon carcinoma. While endoscopic stenting is well established as the first approach in the setting of palliative care of patients with advanced metastatic disease as well as a bridge to elective surgery in elderly patients who have an increased risk of postoperative mortality (age >70 years and/or ASA status ≥3), controversies exist regarding oncological safety and long-term outcomes of endoscopic colonic stenting in younger patients and ESGE Guidelines do not recommend SEMS placement in patients <70 and fit for curative surgery...
August 8, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28789804/all-cause-hospital-admissions-among-older-adults-after-a-natural-disaster
#12
Sue Anne Bell, Mahshid Abir, HwaJung Choi, Colin Cooke, Theodore Iwashyna
STUDY OBJECTIVE: We characterize hospital admissions among older adults for any cause in the 30 days after a significant natural disaster in the United States. The main outcome was all-cause hospital admissions in the 30 days after natural disaster. Separate analyses were conducted to examine all-cause hospital admissions excluding the 72 hours after the disaster, ICU admissions, all-cause inhospital mortality, and admissions by state. METHODS: A self-controlled case series analysis using the 2011 Medicare Provider and Analysis Review was conducted to examine exposure to natural disaster by elderly adults located in zip codes affected by tornadoes during the 2011 southeastern superstorm...
August 5, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28781317/impact-of-aging-on-high-sensitivity-cardiac-troponin-t-in-patients-suspected-of-acute-myocardial-infarction
#13
Taro Ichise, Hayato Tada, Kenji Sakata, Masa-Aki Kawashiri, Masakazu Yamagishi, Kenshi Hayashi
Objective High-sensitivity cardiac troponin T (hs-cTnT) is widely used for the diagnosis of acute myocardial infarction (AMI). The current cut-off value of 0.014 ng/mL was determined based on the 99th percentile of a normal reference population; however, little data exist regarding the appropriate cut-off value in the elderly (≥75 years). Accordingly, we aimed to investigate the accuracy of the current cut-off value in an elderly population. Methods We assessed 355 consecutive patients (mean age =66.7±16...
August 1, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28779820/pain-assessment-in-older-adults
#14
REVIEW
Ann L Horgas
Pain is a common experience for many older adults. Significant efforts have been undertaken to address and improve the assessment of pain in older adults over the past 2 decades. There have been many empirical studies and several expert panel statements to guide health care providers in the best practices for assessing pain in this population. This article provides a conceptual model that summarizes causes and consequences of pain and highlights the relationship between acute and persistent pain. Recommendations for pain assessment tools, including those developed for use in cognitively impaired elders, are presented...
September 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28775217/end-of-life-services-for-older-people-in-residential-care-homes-in-hong-kong
#15
REVIEW
J K Luk
Good end-of-life care is needed for older people living in residential care homes with advanced irreversible chronic medical illnesses and cancers. At present, the usual practice of residential care homes is to send older residents to acute hospitals when they are unwell, and some residents will die in hospital. Dying in hospital without choice for older people may not be in alignment with the principle of 'good death'. There are many barriers for older people to die in the place of their choice, particularly in a residential care home...
August 4, 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28767209/preventive-effects-of-suvorexant-on-delirium-a-randomized-placebo-controlled-trial
#16
Kotaro Hatta, Yasuhiro Kishi, Ken Wada, Takashi Takeuchi, Shigeo Ito, Akiko Kurata, Kazunori Murakami, Manabu Sugita, Chie Usui, Hiroyuki Nakamura
OBJECTIVE: No highly effective pharmacologic interventions to prevent delirium have been identified. We examined whether suvorexant, a potent and selective orexin receptor antagonist, is effective for the prevention of delirium. METHODS: We conducted a multicenter, rater-blinded, randomized, placebo-controlled clinical trial in intensive care units and regular acute wards between April 2015 and March 2016. Eligible patients were 65 to 89 years old, newly admitted due to emergency, and able to take medicine orally and had an expected stay or life expectancy of 48 hours or more...
August 1, 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28766100/anticholinergic-burden-and-health-outcomes-among-older-adults-discharged-from-hospital-results-from-the-crime-study
#17
Marta Gutiérrez-Valencia, Nicolás Martínez-Velilla, Davide Liborio Vetrano, Andrea Corsonello, Fabrizia Lattanzio, Sergio Ladrón-Arana, Graziano Onder
PURPOSE: The purpose of this study is to investigate whether there is an association between anticholinergic burden and mortality or rehospitalization in older adults discharged from hospital. METHODS: Prospective multicenter cohort study carried out with patients aged 65 and older discharged from seven acute care hospitals. The primary outcomes of the study were rehospitalization and mortality within 1 year after discharge. The study population was classified in three groups according to the anticholinergic exposure measured by the Anticholinergic Risk Scale (ARS) and Durán's list at the time of hospital discharge: without risk (ARS/Durán = 0), low risk (ARS/Durán = 1), and high risk (ARS/Durán ≥ 2)...
August 1, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28764696/healthcare-quality-improvement-and-work-engagement-concluding-results-from-a-national-longitudinal-cross-sectional-study-of-the-productive-ward-releasing-time-to-care-programme
#18
Mark White, Tony Butterworth, John Sg Wells
BACKGROUND: Concerns about patient safety and reducing harm have led to a particular focus on initiatives that improve healthcare quality. However Quality Improvement (QI) initiatives have in the past typically faltered because they fail to fully engage healthcare professionals, resulting in apathy and resistance amongst this group of key stakeholders. Productive Ward: Releasing Time to Care (PW) is a ward-based QI programme created to help ward-based teams redesign and streamline the way that they work; leaving more time to care for patients...
August 1, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28757465/mini-encyclopaedia-of-the-wound-healing-opportunities-for-integrating-multi-omic-approaches-into-medical-practice
#19
Lara Stolzenburg-Veeser, Olga Golubnitschaja
Wound healing is a highly complex life-important repair process triggered by plenty of local and/or systemic organ and tissue damaging events, such as an acute surgical invasion, accidental organ and tissue damages, acute and chronic diseases, aggressive local and systemic therapeutic approaches (e.g. irradiation and systemic chemotherapy). Individual health condition determines over the quality of wound healing. Impaired wound healing, in turn, may lead, for example, to post-surgical complications frequently observed in elderly, chronic ulcers in diabetic patients, hindered and ineffective pain management, etc...
July 28, 2017: Journal of Proteomics
https://www.readbyqxmd.com/read/28748892/clinical-profile-of-geriatric-acute-kidney-injury-in-a-tertiary-care-center-from-south-india
#20
Eshwarappa Mahesh, Praveen Nallamuthu, Mahesh Kumar, Parampalli Rakesh Madhyastha, Gurudev Konanna
The incidence of acute kidney injury (AKI) is high in the elderly, who comprise an ever-growing segment of the population. Elderly patients pose a different set of diagnostic and therapeutic challenge owing to their associated comorbidities. AKI in the elderly is associated with an increased risk of mortality, morbidity, prolonged length of stay, and progression to chronic kidney disease. Data regarding the clinical profile of AKI in the elderly from the South Indian population are limited. Hence, we present this analysis of the etiological and prognostic factors associated with AKI in elderly population from South India...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
keyword
keyword
4376
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"