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Geriatric emergencies

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https://www.readbyqxmd.com/read/28515905/colonization-of-long-term-care-facility-patients-with-mdr-gram-negatives-during-an-acinetobacter-baumannii-outbreak
#1
Ines Zollner-Schwetz, Elisabeth Zechner, Elisabeth Ullrich, Josefa Luxner, Christian Pux, Gerald Pichler, Walter Schippinger, Robert Krause, Eva Leitner
BACKGROUND: We aimed to determine the prevalence of colonization by multidrug-resistant Gram-negative bacteria including ESBL-producing enterobacteriaceae, carbapenem-resistant enterobacteriaceae, Pseudomonas aeruginosa and Acinetobacter baumannii at two wards caring long term for patients with disorder of consciousness at the Geriatric Health Centers Graz, Austria. During our study we detected two A. baumannii outbreaks. METHODS: In August 2015, we conducted a point-prevalence study...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28513843/meeting-the-need-for-training-in-geriatrics-the-geriatrics-education-for-specialty-residents-program
#2
Myron Miller, Ronnie A Rosenthal
The imperative created by increasing numbers of aging Americans coupled with increasing longevity has generated recognition and acceptance within american medicine that education, from medical school through postgraduate training through continuing medical education, must include appropriate knowledge and skills in aging and geriatrics to provide for effective care of older adults. Such education and training is necessary not only for traditional primary care providers, but also for specialty physicians, including those in most surgical specialties and in related fields such as anesthesiology, emergency medicine and physical medicine and rehabilitation...
May 17, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28499745/distress-in-caregivers-accompanying-patients-to-an-emergency-department-a-scoping-review
#3
Thom Ringer, Daniel Moller, Adam Mutsaers
BACKGROUND: Despite substantial research interest in caregiver distress in the emergency department (ED), no recent review of the literature exists. OBJECTIVE: Our aims were to map primary research on caregiver distress in the ED, synthesize key concepts underpinning the literature, identify gaps, and provide guidance for future work. METHODS: We used a five-stage scoping review with tandem screening and data extraction. RESULTS: Of 2121 records, 29 studies were included...
May 9, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28499358/can-we-predict-functional-decline-in-hospitalized-older-people-admitted-through-the-emergency-department-reanalysis-of-a-predictive-tool-ten-years-after-its-conception
#4
Isabelle De Brauwer, Pascale Cornette, Benoît Boland, Franck Verschuren, William D'Hoore
BACKGROUND: In the Emergency Department (ED), early and rapid identification of older people at risk of adverse outcomes, who could best benefit from complex geriatric intervention, would avoid wasting time, especially in terms of prevention of adverse outcomes, and ensure optimal orientation of vulnerable patients. We wanted to test the predictive ability of a screening tool assessing risk of functional decline (FD), named SHERPA, 10 years after its conception, and to assess the added value of other clinical or biological factors associated with FD...
May 12, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28487242/oxidative-stress-genomic-features-and-dna-repair-in-frail-elderly-a-systematic-review
#5
REVIEW
María Sánchez-Flores, Diego Marcos-Pérez, Solange Costa, João Paulo Teixeira, Stefano Bonassi, Eduardo Pásaro, Blanca Laffon, Vanessa Valdiglesias
Frailty is an emerging geriatric syndrome characterized by higher vulnerability to stressors, with an increased risk of adverse health outcomes such as mortality, morbidity, disability, hospitalization, and institutionalization. Although it is generally recognized to have a biological basis, no particular biological trait has been consistently associated to frailty status so far. In this work, epidemiological studies evaluating association of frailty status with alterations at cellular level - namely oxidative stress, genomic instability and DNA damage and repair biomarkers -were revised and compared...
May 6, 2017: Ageing Research Reviews
https://www.readbyqxmd.com/read/28471238/clinician-perceptions-about-inpatient-occupational-therapy-groups-in-traumatic-brain-injury-rehabilitation
#6
Freyr Patterson, Jennifer Fleming, Emmah Doig
PRIMARY OBJECTIVE: The aim of the study was to explore the experiences and perceptions of clinicians about the benefits, challenges and processes of facilitating inpatient occupational therapy groups in traumatic brain injury (TBI) rehabilitation including peer-to-peer interactions and use of goals. DESIGN AND METHOD: A qualitative methodology, guided by a phenomenological approach was utilized with data collected from focus groups comprising 26 clinicians working in occupational therapy in three inpatient rehabilitation settings: brain injury, spinal injury and geriatric rehabilitation in order to identify aspects unique to brain injury rehabilitation...
May 4, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28467578/approach-to-inguinal-hernia-in-high-risk-geriatric-patients-should-it-be-elective-or-emergent
#7
Rıza Gürhan Işıl, Pınar Yazıcı, Uygar Demir, Cemal Kaya, Özgür Bostancı, Ufuk Oğuz İdiz, Canan Tülay Işıl, Mahmut Kaan Demircioğlu, Mehmet Mihmanlı
BACKGROUND: Elderly patients are more prone to have inguinal hernia due to weakened abdominal musculature. However, surgical repair of inguinal hernia (SRIH) may not be performed or may be delayed due to greater risk in presence of comorbidities. Present study is investigation of outcome of elective and emergency SRIH in geriatric patients. METHODS: Records of total of 384 high-risk (American Society of Anesthesiology classification III-IV) patients aged >65 years who underwent SRIH between January 2010 and December 2014 were reviewed...
March 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28453582/-frailty-in-patients-admitted-to-hospital-with-acute-decompensated-heart-failure
#8
Felipe Díaz-Toro, Carolina Nazzal Nazal, Hugo Verdejo, VÍctor Rossel, Pablo Castro, Ricardo Larrea, Roberto Concepción, Luis Sepúlveda
BACKGROUND: Frailty is a geriatric syndrome characterized by a progressive impairment in the subjects’ ability to respond to environmental stress. Frailty is more commonly found in heart failure (HF) patients than in general population and it is an independent predictor of rehospitalization, emergency room visits and death. AIM: To estimate the prevalence of frailty in patients with decompensated HF admitted to four hospitals in Santiago, Chile. MATERIAL AND METHODS: Cross-sectional study...
February 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28444116/effectiveness-of-in-hospital-geriatric-co-management-a-systematic-review-and-meta-analysis
#9
Bastiaan Van Grootven, Johan Flamaing, Bernadette Dierckx de Casterlé, Christophe Dubois, Katleen Fagard, Marie-Christine Herregods, Miek Hornikx, Annouschka Laenen, Bart Meuris, Steffen Rex, Jos Tournoy, Koen Milisen, Mieke Deschodt
Background: geriatric consultation teams have failed to impact clinical outcomes prompting geriatric co-management programmes to emerge as a promising strategy to manage frail patients on non-geriatric wards. Objective: to conduct a systematic review of the effectiveness of in-hospital geriatric co-management. Data sources: MEDLINE, EMBASE, CINAHL and CENTRAL were searched from inception to 6 May 2016. Reference lists, trial registers and PubMed Central Citations were additionally searched...
April 24, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28433490/evaluating-health-of-emerging-economies-through-the-eyes-of-heart-valve-disease-in%C3%A2-the%C3%A2-transcatheter-era
#10
REVIEW
Sameer Arora, Cassandra J Ramm, Amol A Bahekar, John P Vavalle
China and India are the 2 fastest growing major world economies. However, they suffer from great differences in health policies, demographics, and rates of population growth. Whereas China has seen a steep decline in rheumatic heart disease (RHD) and a rise in life expectancy, India continues to suffer from a significant burden of RHD due to insufficient distribution of economic prosperity to health care, denser population, and ineffective application of World Health Organization RHD prevention guidelines. As China faces the burden of the world's largest geriatric population, focus has shifted to calcific aortic stenosis for which it prepares by expansions in the field of transcatheter aortic valve replacement...
April 19, 2017: Global Heart
https://www.readbyqxmd.com/read/28422904/a-comparison-of-prognosis-calculators-for-geriatric-trauma-a-p-a-l-li-a-t-e-consortium-study
#11
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/28422415/impact-of-hospitalization-in-an-acute-geriatric-unit-on-polypharmacy-and-potentially-inappropriate-prescriptions-a-retrospective-study
#12
Marta Gutiérrez-Valencia, Mikel Izquierdo, Vincenzo Malafarina, Javier Alonso-Renedo, Belén González-Glaría, Beatriz Larrayoz-Sola, María Pilar Monforte-Gasque, Pello Latasa-Zamalloa, Nicolás Martínez-Velilla
AIM: Polypharmacy is a highly prevalent geriatric syndrome, and hospitalizations can worsen it. The aim of the present study was to analyze the influence of hospitalization on polypharmacy and indicators of quality of prescribing, and their possible association with health outcomes. METHODS: A retrospective study of 200 patients discharged from an acute geriatric unit was carried out. Indicators of quality of prescription were registered at admission and discharge: polypharmacy defined as ≥5 medications, hyperpolypharmacy (≥10), potentially inappropriate prescribing by Beers and Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria, potentially prescribing omissions by Screening Tool to Alert doctors to the Right Treatment (START) criteria, drug interactions and anticholinergic burden measured with the Anticholinergic Risk Scale...
April 19, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28399219/a-multidisciplinary-intervention-to-prevent-subsequent-falls-and-health-service-use-following-fall-related-paramedic-care-a-randomised-controlled-trial
#13
A Stefanie Mikolaizak, Stephen R Lord, Anne Tiedemann, Paul Simpson, Gideon A Caplan, Jason Bendall, Kirsten Howard, Lyndell Webster, Narelle Payne, Sarah Hamilton, Joanne Lo, Elisabeth Ramsay, Sandra O'Rourke, Linda Roylance, J C Close
Background: approximately 25% of older people who fall and receive paramedic care are not subsequently transported to an emergency department (ED). These people are at high risk of future falls, unplanned healthcare use and poor health outcomes. Objective: to evaluate the impact of a fall-risk assessment and tailored fall prevention interventions among older community-dwellers not transported to ED following a fall on subsequent falls and health service use. Design, setting, participants: Randomised controlled trial involving 221 non-transported older fallers from Sydney, Australia...
March 1, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28398987/predicting-risk-and-outcomes-for-frail-older-adults-an-umbrella-review-of-frailty-screening-tools
#14
João Apóstolo, Richard Cooke, Elzbieta Bobrowicz-Campos, Silvina Santana, Maura Marcucci, Antonio Cano, Miriam Vollenbroek-Hutten, Federico Germini, Carol Holland
BACKGROUND: A scoping search identified systematic reviews on diagnostic accuracy and predictive ability of frailty measures in older adults. In most cases, research was confined to specific assessment measures related to a specific clinical model. OBJECTIVES: To summarize the best available evidence from systematic reviews in relation to reliability, validity, diagnostic accuracy and predictive ability of frailty measures in older adults. INCLUSION CRITERIA POPULATION: Older adults aged 60 years or older recruited from community, primary care, long-term residential care and hospitals...
April 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28390405/fam-face-sg-a-score-for-risk-stratification-of-frequent-hospital-admitters
#15
Lian Leng Low, Nan Liu, Kheng Hock Lee, Marcus Eng Hock Ong, Sijia Wang, Xuan Jing, Julian Thumboo
BACKGROUND: An accurate risk stratification tool is critical in identifying patients who are at high risk of frequent hospital readmissions. While 30-day hospital readmissions have been widely studied, there is increasing interest in identifying potential high-cost users or frequent hospital admitters. In this study, we aimed to derive and validate a risk stratification tool to predict frequent hospital admitters. METHODS: We conducted a retrospective cohort study using the readily available clinical and administrative data from the electronic health records of a tertiary hospital in Singapore...
April 8, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28388818/enhancing-quality-of-provider-practices-for-older-adults-in-the-emergency-department-equipped
#16
Melissa Stevens, Susan N Hastings, Alayne D Markland, Ula Hwang, William Hung, Ann E Vandenberg, William Bryan, Dewayne Cross, James Powers, Gerald McGwin, Noor Fattouh, William Ho, Carolyn Clevenger, Camille P Vaughan
EQUiPPED is a multicomponent quality improvement initiative combining education, electronic clinical decision support, and individual provider feedback to influence prescribing and improve medication safety for older adults. The objective here was to evaluate the effectiveness and sustainability of EQUiPPED to reduce the use of potentially inappropriate medications (PIMs), as defined by the American Geriatrics Society 2012 Beers Criteria, prescribed to older Veterans at the time of emergency department (ED) discharge...
April 7, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28367005/a-multidisciplinary-approach-to-improve-the-quality-of-care-for-patients-with-fragility-fractures
#17
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
https://www.readbyqxmd.com/read/28360515/a-review-of-general-pain-measurement-tools-and-instruments-for-consideration-of-use-in-copd-clinical-practice
#18
REVIEW
Alisha Maree Johnson, Sheree Ms Smith
BACKGROUND: The experience of pain can have a significant impact on the everyday life of individuals including those with COPD. Recently, pain has emerged as an area in COPD research. When considering pain measurement in COPD studies, it is important to consider the validity, reliability, responsiveness and interpretability of instruments and tools. This review sought to assess these domains of general pain instruments and tools using the consensus-based standards for the selection of health measurement instruments (COSMIN)...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28358972/nurse-patient-and-care-partner-perceptions-of-a-personalized-safety-plan-screensaver
#19
Megan Duckworth, Emily Leung, Theresa Fuller, Jenzel Espares, Brittany Couture, Frank Chang, Alexandra C Businger, Sarah Collins, Anuj Dalal, Anne Fladger, Jeffrey L Schnipper, Kumiko O Schnock, David W Bates, Patricia C Dykes
A patient safety plan dashboard was developed that captures disparate data from the electronic health record that is then displayed as a personalized bedside screensaver. The dashboard aligns all care team members, including patients and families, in the safety plan. The screensaver content includes icons that pertain to common geriatric syndromes. In two phases, interviews were conducted with nurses, nursing assistants, patients, and informal caregivers in a large, tertiary care center. End user perceptions of the content and interface of the personalized safety plan screensavers were identified and strategies to overcome the barriers to use for future iterations were defined...
April 1, 2017: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/28358232/medical-parole-and-aging-prisoners
#20
George Pro, Miesha Marzell
The population of geriatric prisoners in the United States will reach unprecedented levels in the coming decades. Geriatric prisoners are at increased risk for deteriorating health and experience the onset of disease earlier than the aging population at large. Medical parole is an underutilized program that allows aging prisoners to transition to community-based health care. This article presents original key informant interview data and analysis of the perceptions of medical parole. Three dominant themes emerged: (1) drugs and nonviolent crimes; (2) politics, costs, and consequences; and (3) quality of health care and sense of security in prison...
January 1, 2017: Journal of Correctional Health Care
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