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Geriatric orthopedics

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https://www.readbyqxmd.com/read/28927741/associations-of-the-step-up-test-and-lower-limb-dysfunction-a-post-hoc-analysis-of-a-prospective-cohort-study
#1
Kiyoshi Kita, Yoshihiro Fukumoto, Yukihide Nishimura, Akihiko Kasuya, Tsuyoshi Asai
BACKGROUND: Step-up ability is considered to be associated with lower limb dysfunction. The objective of this research was to assess the height of the tallest step that could be mounted and to investigate its association with lower limb dysfunction. METHODS: We previously conducted a two-year follow-up prospective cohort study. The study subjects were 119 patients receiving physiotherapy or exercise therapy at an orthopedic surgery clinic. The items evaluated were step-up ability (maximum step height), the timed up and go test, one-leg standing time and the 5-question Geriatric Locomotive Function Scale...
September 16, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28891828/poor-performance-on-a-preoperative-cognitive-screening-test-predicts-postoperative-complications-in-older-orthopedic-surgical-patients
#2
Deborah J Culley, Devon Flaherty, Margaret C Fahey, James L Rudolph, Houman Javedan, Chuan-Chin Huang, John Wright, Angela M Bader, Bradley T Hyman, Deborah Blacker, Gregory Crosby
BACKGROUND: The American College of Surgeons and the American Geriatrics Society have suggested that preoperative cognitive screening should be performed in older surgical patients. We hypothesized that unrecognized cognitive impairment in patients without a history of dementia is a risk factor for development of postoperative complications. METHODS: We enrolled 211 patients 65 yr of age or older without a diagnosis of dementia who were scheduled for an elective hip or knee replacement...
September 8, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28891345/comparison-of-the-sensitivity-to-change-of-the-functional-independence-measure-with-the-assessment-of-motor-and-process-skills-within-different-rehabilitation-populations
#3
Silvana X Choo, Paul Stratford, Julie Richardson, Jackie Bosch, Susan M Pettit, Barbara J Ansley, Jocelyn E Harris
PURPOSE: To determine whether there was a difference in the sensitivity to change of the subscales of the Functional Independence Measure and the Assessment of Motor and Process Skills within three different post-acute inpatient rehabilitation populations. MATERIAL AND METHODS: We conducted retrospective chart review of patients consecutively admitted to inpatient rehabilitation units, with both admission and discharge Functional Independence Measure and Assessment of Motor and Process Skills scores...
September 10, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28866353/frail-questionnaire-screening-tool-and-short-term-outcomes-in-geriatric-fracture-patients
#4
Lauren Jan Gleason, Emily A Benton, M Loreto Alvarez-Nebreda, Michael J Weaver, Mitchel B Harris, Houman Javedan
OBJECTIVES: There are limited screening tools to predict adverse postoperative outcomes for the geriatric surgical fracture population. Frailty is increasingly recognized as a risk assessment to capture complexity. The goal of this study was to use a short screening tool, the FRAIL scale, to categorize the level of frailty of older adults admitted with a fracture to determine the association of each frailty category with postoperative and 30-day outcomes. DESIGN: Retrospective cohort study...
August 30, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28747158/characteristics-of-disability-in-activity-of-daily-living-in-elderly-people-associated-with-locomotive-disorders
#5
Tsutomu Iwaya, Tokuhide Doi, Atsushi Seichi, Yuichi Hoshino, Toru Ogata, Masami Akai
BACKGROUND: Ageing is associated with a decline of motor function and ability to perform daily activities. Locomotive disorders are one of the major disorders resulting in adverse health condition in elderly people. Concept of Locomotive syndrome (LoS) was proposed to tackle the problems and prolong healthy life expectancy of people with locomotive disorders. To develop intervention strategy for LoS it is mandatory to investigate impairments, functional disabilities which people with locomotive disorder experience and to examine relationships among these parameters...
July 26, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28742701/postoperative-delirium-as-a-target-for-surgical-quality-improvement
#6
Julia R Berian, Lynn Zhou, Marcia M Russell, Melissa A Hornor, Mark E Cohen, Emily Finlayson, Clifford Y Ko, Ronnie A Rosenthal, Thomas N Robinson
OBJECTIVE: To explore hospital-level variation in postoperative delirium using a multi-institutional data source. BACKGROUND: Postoperative delirium is closely related to serious morbidity, disability, and death in older adults. Yet, surgeons and hospitals rarely measure delirium rates, which limits quality improvement efforts. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Geriatric Surgery Pilot (2014 to 2015) collects geriatric-specific variables, including postoperative delirium using a standardized definition...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28658156/comprehensive-geriatric-care-reduces-acute-perioperative-delirium-in-elderly-patients-with-hip-fractures-a-meta-analysis
#7
REVIEW
Yiyang Wang, Jun Tang, Feiya Zhou, Lei Yang, Jianbin Wu
BACKGROUND: The aim of the current meta-analysis was to assess the treatment effect of comprehensive geriatric care in reducing acute perioperative delirium in older patients with hip fractures, compared with the effect of a routine orthopedic treatment protocol. METHODS: We conducted a search of multiple databases to identify randomized controlled trials (RCTs) and quasi-RCTs comparing comprehensive geriatric care and routine orthopedic treatment regarding the following outcomes: incidence of delirium, assessment of cognitive status, and duration of delirium...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28615514/prognostic-value-of-the-c-reactive-protein-prognostic-nutritional-index-ratio-after-hip-fracture-surgery-in-the-elderly-population
#8
Hanru Ren, Lianghao Wu, Wankun Hu, Xiuzhang Ye, Baoqing Yu
BACKGROUND: More and more older patients receive the surgery after hip fracture. However, the mortality rate is high. Prognostic nutritional index (PNI) is associated with prognosis in hip fracture patients. In the current study, we proposed a novel prognostic score, named c-reactive protein/PNI ratio (CRP/PNI ratio), for predicting the prognosis for geriatric orthopedic population. METHODS: This is a prospective study. Eighty cases of hip fracture surgery in the elderly population were studied to reveal the relationship between the CRP/PNI ratio and the clinicopathological characteristics of the elderly patients...
May 24, 2017: Oncotarget
https://www.readbyqxmd.com/read/28598710/the-use-of-yoga-by-physical-therapists-in-the-united-states
#9
Mary E Wims, Shayla M McIntyre, Ann York, Laura G Covill
How physical therapists (PTs) in the United States currently use yoga in their clinical practices is unknown. The purpose of this study was to determine how PTs in the United States view yoga as a physical therapy (PT) tool and how PTs use yoga therapeutically. The authors conducted a 24-item survey via electronic communications of the Geriatric, Orthopedic, Pediatric, and Women's Health Sections of the American Physical Therapy Association. Participants (n = 333) from 47 states and the District of Columbia replied...
June 9, 2017: International Journal of Yoga Therapy
https://www.readbyqxmd.com/read/28585992/complex-lumbar-spine-fusion-for-an-elderly-patient-under-spinal-anesthesia
#10
Noah L Lessing, Charles C Edwards, Charles Lin, Charles H Brown
Spinal anesthesia for spine surgery is an emerging technique. Because of their lack of physiologic reserve, elderly patients are an appealing population for this technique. Unfortunately, the safe limits of spine surgery using spinal anesthesia for the geriatric population are not well defined. The authors describe an elderly patient with severe spine degeneration who elected for a 5-level lumbar spine fusion with spinal anesthesia. Adequate anesthesia was maintained throughout the procedure, which lasted 3 hours and 24 minutes...
June 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28581701/mini-nutritional-assessment-short-form-as-a-useful-method-of-predicting-poor-1-year-outcome-in-elderly-patients-undergoing-orthopedic-surgery
#11
Che-Sheng Chu, Chih-Kuang Liang, Ming-Yueh Chou, Ti Lu, Yu-Te Lin, Chin-Liang Chu
AIM: The present study aimed to determine whether the Mini-Nutritional Assessment Short-Form (MNA-SF) can predict the 1-year outcome of orthopedic fracture surgery in elderly patients. METHODS: This 1-year prospective study assessed nutrition using the MNA-SF at baseline, and postoperatively at 6 and 12 months. Repeated measures analysis of covariance was used to examine functional change over time for two MNA-SF categories. Multivariable logistic regression analysis with forward stepwise modeling was carried out to identify risk factors of functional decline, emergency department visit, hospital readmission and mortality at follow up...
June 5, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28540113/comparison-of-3-different-perioperative-care-models-for-patients-with-hip-fractures-within-1-health-service
#12
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/28488991/geriatric-hip-fracture-care-fixing-a-fragmented-system
#13
Mary E Anderson, Kelly Mcdevitt, Ethan Cumbler, Heather Bennett, Zachary Robison, Bryan Gomez, Jason W Stoneback
CONTEXT: Fragmentation in geriatric hip fracture care is a growing concern because of the aging population. Patients with hip fractures at our institution historically were admitted to multiple different services and units, leading to unnecessary variation in inpatient care. Such inconsistency contributed to delays in surgery, discharge, and functional recovery; hospital-acquired complications; failure to adhere to best practices in osteoporosis management; and poor coordination with outpatient practitioners...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28465007/a-comparison-of-treatment-setting-for-elderly-patients-with-hip-fracture-is-the-geriatric-ward-superior-to-conventional-orthopedic-hospitalization
#14
Tal Frenkel Rutenberg, Efrat Daglan, Snir Heller, Steven Velkes
INTRODUCTION: Hip fractures in the elderly are a major cause of morbidity and mortality. The treatment settings of these patients may change their outcomes. The aim of this study is to compare the outcomes of patients with displaced femoral neck fractures who were admitted to the orthopedic vs. geriatric wards. PATIENTS AND METHODS: A retrospective study was conducted on 217 consecutive older patients with 219 displaced femoral neck fractures admitted either to the orthopedic or the geriatric ward between Jan...
July 2017: Injury
https://www.readbyqxmd.com/read/28444038/difficulties-in-accessing-services-that-are-of-medium-complexity-in-small-municipalities-a-case-study
#15
Camila Ribeiro Silva, Brigida Gimenez Carvalho, Luiz Cordoni, Elisabete de Fátima Pólo de Almeida Nunes
The study aimed to describe the specialized health services and to identify areas of greater difficulty of access to specialized consultations offered by SUS in small cities in the 18th Regional Health Area of Paraná State, Brazil, using case study methodology. The data were collected between January and April 2015. Managers, management teams and the board of directors of the CIS (Consórcio Intermunicipal de Saúde) were interviewed. The 21 studied specialist areas were rated like Sufficient Quota, Insufficient Quota, Inexistent Supply, and Assistance Gap...
April 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28367005/a-multidisciplinary-approach-to-improve-the-quality-of-care-for-patients-with-fragility-fractures
#16
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/28359364/age-dependent-risk-factors-for-malnutrition-in-traumatology-and%C3%A2-orthopedic-patients
#17
Christine Lambert, Andreas Nüssler, Hans Konrad Biesalski, Thomas Freude, Christian Bahrs, Gunnar Ochs, Ingo Flesch, Ulrich Stöckle, Christoph Ihle
OBJECTIVE: The aim of this study was to investigate the prevalence of risk of malnutrition (RoM) in an orthopedic and traumatology patient cohort with a broad range of ages. In addition to the classical indicators for risk assessment (low body mass index, weight loss, and comorbidity), this study aimed to analyze the effects of lifestyle factors (eating pattern, smoking, physical activity) on RoM. METHODS: The prospective cohort study included 1053 patients in a level 1 trauma center in Germany...
May 2017: Nutrition
https://www.readbyqxmd.com/read/28255509/palliative-management-of-nonoperative-femoral-neck-fractures-with-continuous-peripheral-pain-catheters-20-patient-case-series
#18
Christopher H Rashidifard, Nicholas M Romeo, Paul Muccino, Mark Richardson, Thomas G DiPasquale
INTRODUCTION: To identify the success of pain catheters in the management of pain in nonoperatively treated femoral neck fractures (FNFs) in supplement to current multimodal protocols for end-of-life pain management. METHODS: Twenty patients aged older than 50 years with FNFs were selected in a retrospective fashion at a level 1 trauma center. These patients were treated nonoperatively with indwelling continuous peripheral pain catheters to palliate pain. Adjunctive pain control for patients undergoing nonoperative management of FNFs was provided with an indwelling continuous intra-articular/peripheral nerve ropivacaine pain catheters...
March 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28149067/wholistic-orthopedics-is-this-the-right-way-to-treat-geriatric-orthopedic-patients
#19
John Ebnezar, Yogita Bali, Rakesh John
Geriatric orthopedic problems poses different challenges in their management. Conventional treatment methods like drugs, physiotherapy and surgeries are inadequate. A Geriatric orthopedic patient suffers as a whole and not in isolation. This article highlights the importance of managing geriatric orthopedic patients as a whole and outlines the various steps of wholistic management.
January 2017: International Journal of Yoga
https://www.readbyqxmd.com/read/28087218/relationship-among-motor-function-adl-disability-and-psychological-concerns-in-elderly-people-with-locomotive-disorders
#20
Toshiyuki Miyawaki, Keigo Kumamoto, Kaori Shimoda, Fusae Tozato, Tsutomu Iwaya
BACKGROUND: Locomotive disorders are one of the main causative pathologies for the condition requiring assistance on activities of daily living (ADL). Although psychological concerns such as feeling of depression and anxiety are prevalent in elderly people, the causal relation among motor function, ADL disability, and psychological concerns is controversial. PURPOSE: Purpose of this study was to investigate causal relationship among motor function, ADL disability, and psychological concerns in elderly people with locomotive disorders...
January 10, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
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