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https://www.readbyqxmd.com/read/29683237/establishing-a-proactive-geriatrician-led-comprehensive-geriatric-assessment-in-older-emergency-surgery-patients-outcomes-of-a-pilot-study
#1
Matthew C Mason, Amy L Crees, Matthew R Dean, Nahida Bashir
INTRODUCTION: Increasing numbers of older adults are presenting with acute surgical disease to the unselected general surgical take. General surgeons have little training to manage these patients. We developed a pilot service of proactive geriatrician input into older emergency general surgical patients in a single institution. We wanted to demonstrate if geriatricians improve the management of these patients. METHODS: Patients aged 70 years or older admitted acutely under the general surgeons were assessed proactively by a geriatrician using comprehensive geriatric assessment (CGA)...
April 23, 2018: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/29679434/key-issues-to-consider-and-innovative-ideas-on-fall-prevention-in-the-geriatric-department-of-a-teaching-hospital
#2
Daniel Ky Chan, Cathie Sherrington, Vasi Naganathan, Ying Hua Xu, Jack Chen, Anita Ko, Ian Kneebone, Robert Cumming
Falls in hospital are common and up to 70% result in injury, leading to increased length of stay and accounting for 10% of patient safety-related deaths. Yet, high-quality evidence guiding best practice is lacking. Fall prevention strategies have worked in some trials but not in others. Differences in study setting (acute, subacute, rehabilitation) and sampling of patients (cognitively intact or impaired) may explain the difference in results. This article discusses these important issues and describes the strategies to prevent falls in the acute hospital setting we have studied, which engage the cognitively impaired who are more likely to fall...
April 20, 2018: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/29676780/retrospective-evaluation-of-a-restrictive-transfusion-strategy-in-older-adults-with-hip-fracture
#3
Lorene Zerah, Lucile Dourthe, Judith Cohen-Bittan, Marc Verny, Mathieu Raux, Anthony Mézière, Frédéric Khiami, Cendrine Tourette, Christian Neri, Yannick Le Manach, Bruno Riou, Hélène Vallet, Jacques Boddaert
OBJECTIVES: To compare the association between a restrictive transfusion strategy and cardiovascular complications during hospitalization for hip fracture with the association between a liberal transfusion strategy and cardiovascular complications, accounting for all transfusions from the emergency department to postacute rehabilitation settings. DESIGN: Retrospective study. SETTING: Perioperative geriatric care unit. PARTICIPANTS: All individuals aged 70 and older admitted to the emergency department for hip fracture and hospitalized in our perioperative geriatric care unit (N=667; n=193 in the liberal transfusion group, n=474 in the restrictive transfusion group) from July 2009 to April 2016...
April 20, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29671085/-gerontopsychosomatic-consultation-liaison-service-in-inpatient-acute-geriatrics-effects-of-trust-and-support-on-patient-nurse-interaction
#4
REVIEW
Reinhard Lindner
BACKGROUND: Geriatric and psychosomatic medicine follow a biopsychosocial paradigm. Despite this similar "Menschenbild" in general, collaboration between geriatrics and psychosomatics is still rare. OBJECTIVES: This comparative interventional study aims to find possible effects of psychosomatic work in geriatrics on the interaction between patients and nursing staff and contentment of patients with treatment in general. MATERIAL AND METHODS: In the period of one year 238 geriatric patients (return rate 22...
April 18, 2018: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/29669268/frailty-and-cognitive-status-evaluation-can-better-predict-mortality-in-older-adults
#5
Ivan Aprahamian, Claudia Kimie Suemoto, Márlon Juliano Romero Aliberti, Sileno de Queiroz Fortes Filho, Juliana de Araújo Melo, Sumika Mori Lin, Wilson Jacob Filho
OBJECTIVES: to evaluate the improvement in one-year mortality prediction after adding a 2-min cognitive screening to a simple 1-min frailty detection instrument. Secondary outcomes were new activities of daily living (ADL) disability and falls. DESIGN: Prospective cohort study. SETTING: A geriatric day-hospital for intermediate care. PARTICIPANTS: A total of 701 older adults with an acute or decompensated disease (79...
April 11, 2018: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29644803/prevalence-risk-factors-and-adverse-outcomes-of-anticholinergic-burden-in-patients-with-advanced-chronic-conditions-at-hospital-admission
#6
Daniel Sevilla-Sánchez, Núria Molist-Brunet, Javier González-Bueno, Núria Solà-Bonada, Joan Espaulella-Panicot, Carles Codina-Jané
AIM: To evaluate the anticholinergic burden (ACB), the risk factors associated with its onset and the clinical consequences for patients with advanced chronic conditions. METHODS: A 10-month cross-sectional study was carried out in an acute hospital care geriatric unit. Patients with advanced chronic conditions were identified by the NECessity of PALliative care (NECPAL) test. The ACB was established using the Anticholinergic Drug Scale and Drug Burden Index (DBI) tools...
April 11, 2018: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29628416/can-we-incorporate-geriatric-assessment-in-the-management-of-acute-lymphoblastic-leukemia-in-older-adults
#7
Kah Poh Loh, Jane L Liesveld, Kristen M O'Dwyer
Acute lymphoblastic leukemia (ALL) is an uncommon disease. Approximately 14% of new ALL cases occur in adults aged 60 and over, and the three-year overall survival in this population is poor at 12.8%. Older adults with ALL are heterogeneous in terms of their underlying health status, which can make treatment selection challenging given the disease rarity and limited inclusion of older patients in clinical trials. A comprehensive geriatric assessment (CGA) is a compilation of tools to assess multiple domains such as physical function and cognition, and may assist in guiding treatment selection and supportive care interventions...
April 5, 2018: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/29626386/effectiveness-of-weekend-physical-rehabilitation-for-functional-recovery-in-geriatric-patients-with-hip-fracture
#8
Kiyotaka Hasebe, Ryo Momosaki, Masashi Sawabe, Masayuki Chono, Akira Sawaguchi, Seiji Kasuga, Daichi Asanuma, Shoya Suzuki, Narimi Miyauchi, Masahiro Abo
AIM: To test the hypothesis that the functional outcome of hip fracture patients who receive weekend rehabilitation is better than that of similar patients who undergo non-weekend rehabilitation. METHODS: The present retrospective observational study used data from the Japan Rehabilitation Database spanning 2005-2015. We identified in-hospital hip fracture patients admitted to acute hospitals. After applying exclusion criteria, 469 patients were eligible. The primary outcome was motor Functional Independence Measure (FIM) efficiency...
April 6, 2018: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29616624/invasive-strategy-and-frailty-in-very-elderly-patients-with-acute-coronary-syndromes
#9
Isaac Llaó, Albert Ariza-Solé, Juan Sanchis, Oriol Alegre, Ramon López-Palop, Francesc Formiga, Francisco Marín, María T Vidán, Manuel Martínez-Sellés, Alessandro Sionis, Miguel Vives-Borrás, Joan Antoni Gómez-Hospital, Josep Gómez-Lara, Gerard Roura, Pablo Díez-Villanueva, Iván Núñez-Gil, Jaume Maristany, Lluis Asmarats, Héctor Bueno, Emad Abu-Assi, Àngel Cequier
AIMS: Current guidelines recommend an early invasive strategy in patients with non-ST segment elevation acute coronary syndromes (NSTEACS). The role of an invasive strategy in frail elderly patients remains controversial. METHODS AND RESULTS: The LONGEVO-SCA registry included unselected NSTEACS patients aged ≥80 years. A geriatric assessment was performed during hospitalization, including frailty. We evaluated the impact of an invasive strategy during the admission on the incidence of cardiac death, reinfarction or new revascularisation at 6-months...
April 3, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29610916/should-this-patient-receive-prophylactic-medication-to-prevent-delirium-grand-rounds-discussion-from-beth-israel-deaconess-medical-center
#10
Anjala V Tess, Melissa L P Mattison, Joshua R Leo, Eileen E Reynolds
In 2015, the American Geriatrics Society released recommendations for prevention and management of postoperative delirium, based on a systematic literature review and evaluation of nonpharmacologic and pharmacologic approaches by an expert panel. The guidelines recommend an interdisciplinary focus on nonpharmacologic measures (reorientation, medication management, early mobility, nutrition, and gastointestinal motility) for prevention and consideration of this strategy for acute management. They also recommend optimizing nonopioid medication as a means to manage pain and avoiding benzodiazepines other than to treat substance withdrawal...
April 3, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29608779/interdisciplinary-home-visits-for-individuals-with-advanced-parkinson-s-disease-and-related-disorders
#11
Jori Fleisher, William Barbosa, Meghan M Sweeney, Sarah E Oyler, Amy C Lemen, Arash Fazl, Mia Ko, Talia Meisel, Naomi Friede, Geraldine Dacpano, Rebecca M Gilbert, Alessandro Di Rocco, Joshua Chodosh
Parkinson's disease (PD) is a complex, multisymptom, neurodegenerative disease affecting primarily older adults. With progression, many individuals become homebound and removed from coordinated, expert care, resulting in excess morbidity, mortality, and healthcare expenditures in acute care settings and institutions. Home visit care models have achieved the triple aim of improving individual and population health while reducing costs in many frail, community-dwelling geriatric cohorts. This study details a novel, interdisciplinary home visit program specifically designed for individuals with PD and related disorders and their family caregivers built upon best practice principles in the care of multimorbid older adults...
April 2, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29600740/sensitivity-and-specificity-analysis-use-of-emoticon-for-screening-of-depression-in-elderly-in-singapore
#12
Laurence Tan, Hui Jin Toh, Lai Kiow Sim, James Alvin Low
BACKGROUND: The current screening tools for depression can be tedious to administer, especially in the elderly population with hearing impairment and/or limited proficiency in English language. OBJECTIVES: To look at the feasibility of using emoticon as a screening and assessment tool for depression in the elderly. DESIGN: Cross-sectional study. METHOD: A total of 77 elderly patients completed the study from June 2014 to August 2015 in a general geriatric outpatient clinic of an acute care hospital in Singapore...
March 1, 2018: Journal of the American Psychiatric Nurses Association
https://www.readbyqxmd.com/read/29600687/psychometric-properties-of-the-cumulated-ambulation-score-a-systematic-review
#13
Giorgio Ferriero, Morten T Kristensen, Marco Invernizzi, Ludovit Salgovic, Elisabetta Bravini, Francesco Sartorio, Stefano Vercelli
INTRODUCTION: In the geriatric population, independent mobility is a key factor in determining readiness for discharge following acute hospitalization. The Cumulated Ambulation Score (CAS) is a potentially valuable score that allows day-to-day measurements of basic mobility. The CAS was developed and validated in older patients with hip fracture as an early postoperative predictor of short-term outcome, but it is also used to assess geriatric in-patients with acute medical illness. Despite the fast- accumulating literature on the CAS, to date no systematic review synthesizing its psychometric properties has been published...
March 29, 2018: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/29593022/hospital-at-home-care-for-older-patients-with-cognitive-impairment-a-protocol-for-a-randomised-controlled-feasibility-trial
#14
Maaike A Pouw, Agneta H Calf, Barbara C van Munster, Jan C Ter Maaten, Nynke Smidt, Sophia E de Rooij
INTRODUCTION: An acute hospital admission is a stressful life event for older people, particularly for those with cognitive impairment. The hospitalisation is often complicated by hospital-associated geriatric syndromes, including delirium and functional loss, leading to functional decline and nursing home admission. Hospital at Home care aims to avoid hospitalisation-associated adverse outcomes in older patients with cognitive impairment by providing hospital care in the patient's own environment...
March 27, 2018: BMJ Open
https://www.readbyqxmd.com/read/29580885/prophylaxis-of-venous-thromboembolism-in-geriatric-settings-a-cluster-randomized-multicomponent-interventional-trial
#15
Jean Paul Rwabihama, Etienne Audureau, Marie Laurent, Lalaina Rakotoarisoa, Marc Jegou, Sofiane Saddedine, Sébastien Krypciak, Stéphane Herbaud, Hind Benzengli, Lauriane Segaux, Esther Guery, Gabin Ambime, Marie-Thérèse Rabus, Jean-Guy Perilliat, Jean-Philippe David, Elena Paillaud
OBJECTIVES: To evaluate the efficacy of an intervention on the practice of venous thromboembolism prevention. DESIGN: A multicenter, prospective, controlled, cluster-randomized, multifaceted intervention trial consisting of educational lectures, posters, and pocket cards reminding physicians of the guidelines for thromboprophylaxis use. SETTINGS: Twelve geriatric departments with 1861 beds total, of which 202, 803, and 856 in acute care, postacute care, and long-term care wards, respectively...
March 23, 2018: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29576622/predicting-cumulative-incidence-of-adverse-events-in-older-patients-with-cancer-undergoing-first-line-palliative-chemotherapy-korean-cancer-study-group-kcsg-multicentre-prospective-study
#16
Jin Won Kim, Yun-Gyoo Lee, In Gyu Hwang, Hong Suk Song, Su Jin Koh, Yoon Ho Ko, Seong Hoon Shin, In Sook Woo, Soojung Hong, Tae-Yong Kim, Sun Young Kim, Byung-Ho Nam, Hyun Jung Kim, Hyo Jung Kim, Myung Ah Lee, Jung Hye Kwon, Yong Sang Hong, Sung Hwa Bae, Dong-Hoe Koo, Kwang-Il Kim, Jee Hyun Kim
BACKGROUND: Older patients have increased risk of toxicity from chemotherapy. Current prediction tools do not provide information on cumulative risk. METHODS: Patients aged ≥ 70 years with solid cancer were prospectively enrolled. A prediction model was developed for adverse events (AEs) ≥ Grade 3 (G3), based on geriatric assessment (GA), laboratory, and clinical variables. RESULTS: 301 patients were enrolled (median age, 75 years). Median number of chemotherapy cycles was 4...
March 26, 2018: British Journal of Cancer
https://www.readbyqxmd.com/read/29573769/-delirium-the-7th-vital-sign
#17
REVIEW
Rita Prayce, Filipa Quaresma, Isabel Galriça Neto
INTRODUCTION: Delirium is an acute, transient and fluctuating neuropsychiatric syndrome that is common in medical wards, particularly in the geriatric and palliative care population. MATERIAL AND METHODS: We present a brief literature review of the definition, pathophysiology, aetiology, diagnosis, prevention and treatment of delirium and its social and economic impact. RESULTS AND DISCUSSION: Delirium is under-recognized, especially by health professionals, and is associated with higher morbidity, mortality and economic burden...
January 31, 2018: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/29569564/pilot-study-effectiveness-of-a-training-program-about-autonomy-in-elderly-patients-hospitalized-after-an-acute-episode
#18
Antoine Vignoles, Sophie Watelet, Thomas Gilbert, Mahdi Harchaoui, Marine Haution-Bitker, Joanna Jacoud, Claire Falandry, Marc Bonnefoy
Patients hospitalized in rehabilitation after an acute episode is at high risk of functional impairment and require active measures to prevent loss of autonomy. Resistance training has been proved beneficial to improve physical performances of aged subjects in the community. However, the feasibility and effects of training programs has never been assessed among hospitalized patients after an acute medical episode. In this pilot study, we aimed to evaluate a personalized training program of adapted physical education teacher combining muscular reinforcement and endurance training among patients over 65 year-old hospitalized in a geriatric rehabilitation care setting...
March 1, 2018: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/29569563/the-decision-making-capacity-of-elderly-hospitalized-patients-validation-of-a-test-on-their-choice-of-return-home
#19
Mouna Romdhani, Rachid Abbas, Cécile Peyneau, Pierre Koskas, Nadège Houenou Quenum, Sandrine Galleron, Olivier Drunat
Elderly hospitalized patients have uncertain or questionable capacity to make decisions about their care. Determining whether an elderly patient possesses decision-making capacity to return at home is a major concern for geriatricians in everyday practice. To construct and internally validate a new tool, the dream of home test (DROM-test), as support for decision making hospitalization discharge destination for the elderly in the acute or sub-acute care setting. The DROM-test consists of 10 questions and 4 vignettes based upon the 4 relevant criteria for decision-making: capacity to understand information, to appreciate and reason about medical risks and to communicate a choice...
March 1, 2018: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/29563036/prediction-of-in-hospital-mortality-with-the-6-item-brief-geriatric-assessment-tool-an-observational-prospective-cohort-study
#20
Cyrille Patrice Launay, Hélène Rivière, Julia Chabot, Olivier Beauchet
BACKGROUND: The 6-item Brief Geriatric Assessment (BGA) is a screening tool to identify frail inpatients who are at risk of adverse health events. Its predictive value for in-hospital mortality has not been examined yet. OBJECTIVE: This study examined whether the BGA is able to predict in-hospital mortality in older patients. METHODS: A total of 1082 participants were included in this observational prospective cohort study. At their admission to the medical wards of Angers University Hospital (France), all inpatients aged ≥65 years were screened with the BGA...
April 2018: Maturitas
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