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Geriatric orthopedics

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https://www.readbyqxmd.com/read/27858179/outcome-parameters-in-orthogeriatric-co%C3%A2-management%C3%A2-a%C3%A2-mini-review
#1
REVIEW
Radko Komadina, Klaus W Wendt, Gerold Holzer, Tomaž Kocjan
Recognizing hip and other fragility fractures as an adverse event of chronic geriatric conditions led to the concept of orthogeriatric co-management (OGC). OGC today represents various forms of structural cooperation between orthopedic trauma surgeons and multiprofessional geriatric teams taking care of frail elderly patients. The models are country specific. Despite several published models there are still no clear recommendations on how this service should be best organized. The 12 outcome parameters published by the Experts' Roundtable in 2013 were recommended to be used for the further assessment of different OCG models...
November 17, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27747924/results-of-screening-of-apparently-healthy-senior-and-geriatric-dogs
#2
A Willems, D Paepe, S Marynissen, P Smets, I Van de Maele, P Picavet, L Duchateau, S Daminet
BACKGROUND: There is a growing interest in health care of elderly dogs; however, scientific information about physical and laboratory examination findings in this age group is limited. OBJECTIVES: To describe systolic blood pressure (SBP), and results of physical examination and laboratory tests in senior and geriatric dogs that were judged by the owner to be healthy. ANIMALS: Hundred client-owned dogs. METHODS: Dogs were prospectively recruited...
October 17, 2016: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/27678211/frailty-and-resilience-in-an-older-population-the-role-of-resilience-during-rehabilitation-after-orthopedic-surgery-in-geriatric-patients-with-multiple-comorbidities
#3
G A A Rebagliati, L Sciumè, P Iannello, A Mottini, A Antonietti, V A Caserta, V Gattoronchieri, Lorenzo Panella, Camilla Callegari
Hip fracture is common in the elderly and it is usually associated with comorbidities and physiological changes which may have an impact on functioning and quality of life. The concept of resilience may explain why this impact varies among patients. The aim of this open, prospective cohort study was to explore the relationships between resilience, frailty and quality of life in orthopedic rehabilitation patients, and also to assess whether these factors might affect rehabilitation outcome. Eighty-one patients, older than 60 years, underwent a multidisciplinary assessment at the beginning and at the end of the rehabilitation period following orthopedic surgery to the lower limb...
July 2016: Functional Neurology
https://www.readbyqxmd.com/read/27546959/lower-limb-orthopedic-surgery-in-geriatric-patients-under-paravertebral-blocks-a-prospective-feasibility-study
#4
Rajesh Kumar Singh, J P Chaturvedi, H S Agrawal, Nitesh Agrawal
BACKGROUND: Aging causes progressive deterioration of all the organ systems. Physiological changes of aging and co-morbidities make regional anesthesia a preferred technique for this age group. Regional anesthesia with risk of hypotension and its consequences is fraught with dangers. Peripheral nerve blocks (PNBs) are much safer and give much superior post-op analgesia. The present study was undertaken to perform major lower limb orthopedic surgeries PNBs in geriatric settings. METHODS: A feasibility study was undertaken in patients above age of 60 years admitted for lower limb surgeries to undertake these surgeries under para-vertebral blocks for a period of one year from Mar 2011 to Feb 2012...
July 2016: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/27430902/-delirium-day-a-nationwide-point-prevalence-study-of-delirium-in-older-hospitalized-patients-using-an-easy-standardized-diagnostic-tool
#5
MULTICENTER STUDY
Giuseppe Bellelli, Alessandro Morandi, Simona G Di Santo, Andrea Mazzone, Antonio Cherubini, Enrico Mossello, Mario Bo, Angelo Bianchetti, Renzo Rozzini, Ermellina Zanetti, Massimo Musicco, Alberto Ferrari, Nicola Ferrara, Marco Trabucchi
BACKGROUND: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy...
July 18, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27409710/association-of-loss-of-independence-with-readmission-and-death-after-discharge-in-older-patients-after-surgical-procedures
#6
Julia R Berian, Sanjay Mohanty, Clifford Y Ko, Ronnie A Rosenthal, Thomas N Robinson
IMPORTANCE: Older adults are at increased risk for adverse events after surgical procedures. Loss of independence (LOI), defined as a decline in function or mobility, increased care needs at home, or discharge to a nonhome destination, is an important patient-centered outcome measure. OBJECTIVE: To evaluate LOI among older adult patients after surgical procedures and examine the association of LOI with readmission and death after discharge in this population. DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study examined 9972 patients 65 years and older with known baseline function, mobility, and living situation undergoing inpatient operations from January 2014 to December 2014 at 26 hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program Geriatric Surgery Pilot Project...
September 21, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27257439/assessment-of-recovery-in-older-patients-hospitalized-with-different-diagnoses-and-functional-levels-evaluated-with-and-without-geriatric-assessment
#7
Jenny Foss Abrahamsen, Cathrine Haugland, Anette Hylen Ranhoff
BACKGROUND: The objective of the present study was to investigate 1) the role of different admission diagnoses and 2) the degree of functional loss, on the rate of recovery of older patients after acute hospitalization. Furthermore, to compare the predictive value of simple assessments that can be carried out in a hospital lacking geriatric service, with assessments including geriatric screening tests. METHODS: Prospective, observational cohort study, including 961community dwelling patients aged ≥ 70 years, transferred from medical, cardiac, pulmonary and orthopedic acute hospital departments to intermediate care in nursing home...
2016: European Review of Aging and Physical Activity
https://www.readbyqxmd.com/read/27231388/prognostic-value-of-serum-procalcitonin-after-orthopedic-surgery-in-the-elderly-population
#8
Hélène Vallet, Camille Chenevier-Gobeaux, Cédric Villain, Judith Cohen-Bittan, Patrick Ray, Loïc Epelboin, Marc Verny, Bruno Riou, Frédéric Khiami, Jacques Boddaert
BACKGROUND: Orthopedic surgery is more and more frequent in the older patients and is associated with a high mortality rate. Although serum procalcitonin levels are associated with prognosis in young adults, data are still lacking in the elderly population, and especially after surgery. The main objective of this study was to determine the prognostic value of procalcitonin levels in a large geriatric orthopedic population, and we compared it with clinical variables and biomarkers. METHODS: This is a prospective study including patients admitted in our dedicated geriatric postoperative unit, after orthopedic surgery with immediate postoperative measured procalcitonin levels...
May 26, 2016: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/27125080/complex-management-of-frailty-fractures-case-report
#9
Elena Puin Costescu, Aliona Dronic, Loana Dana Alexa, O Alexa
Frailty fractures encompass pelvic ring fractures in the elderly--a condition more frequently encountered in women, usually with pre-existing osteoporosis. The incidence of these fractures is increasing, following the increase in average life expectancy. Most of the times, they are the result of a minor injury, of which the patient has little or no recollection; the clinical signs and symptoms, radiological changes and the degree of fracture stability vary greatly. As such, there is a wide range of therapeutic options and one of the most important decisions for the physician is choosing between surgery and conservative treatment...
January 2016: Revista Medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti Din Iaş̧i
https://www.readbyqxmd.com/read/26929852/do-orthogeriatric-inpatients-have-a-correct-medication-list-a-pharmacist-led-assessment-of-254-patients-in-a-swedish-university-hospital
#10
Olof Wolf, Henrik Åberg, Ulrika Tornberg, Kenneth B Jonsson
INTRODUCTION: Comorbidities and polypharmacy complicate the treatment of geriatric patients with acute orthopedic injuries. A correct medication history and an updated medication list are a prerequisite for safe treatment of these debilitated patients. Published evidence suggests favorable outcomes with comanaged care. The aim of this study was to assess the accuracy of the inpatient medication lists generated at admission and investigate the efficacy of a dedicated ward-based pharmacist to find and correct mistakes in these lists...
March 2016: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/26928617/-hip-fracture-experience-in-647-chilean-patients-aged-60-years-or-more
#11
José Luis Dinamarca-Montecinos, Gedeón Améstica-Lazcano, Ramona Rubio-Herrera, Alejandro Carrasco-Buvinic, Alejandra Vásquez
BACKGROUND: Hip fractures (HFx) are an important geriatric syndrome, with a high incidence in developing countries. AIM: To describe characteristics of a group of Chilean patients with HFx. PATIENTS AND METHODS: In a cross-sectional study we included patients aged 60 years or more with a HF admitted to an orthopedic service along three years. Age, incidence, location, seasonality, hospital stay, time between HFx and surgery, mortality, prior treatment for osteoporosis, anatomical location, etiology and type of surgery were evaluated...
December 2015: Revista Médica de Chile
https://www.readbyqxmd.com/read/26879927/validation-of-the-sour-seven-questionnaire-for-screening-delirium-in-hospitalized-seniors-by-informal-caregivers-and-untrained-nurses
#12
Richard W Shulman, Saurabh Kalra, Joanne Zhuan Jiang
BACKGROUND: Delirium is a common condition in hospitalized seniors that nonetheless often goes undetected by nurses or is delayed in being detected which negatively impacts quality of care and outcomes. We sought to develop a new screening tool for delirium, The Sour Seven Questionnaire, a 7-item questionnaire suitable to be completed from informal or untrained caregiver observation. The study aimed to develop the scoring criteria for a positive delirium screen and assess concurrent validity of the questionnaire against a geriatric psychiatrist's assessment...
2016: BMC Geriatrics
https://www.readbyqxmd.com/read/26676735/-multidrug-resistant-organisms-mdro-in-rehabilitation-clinics-in-the-rhine-main-district-germany-2014-risk-analysis-and-hygiene-procedures
#13
MULTICENTER STUDY
U Heudorf, D Färber, D Mischler, M Schade, C Zinn, D Nillius, M Herrmann
BACKGROUND: Many regional German MDRO-networks aim to improve the medical rehabilitation of patients with methicillin-resistant Staphylococcus aureus (MRSA) and other multidrug-resistant pathogens. In 2014, the German Commission for Hospital Hygiene and Infection Control (KRINKO) released revised recommendations for the care of patients with MRSA. In particular, for rehabilitation facilities, these recommendations stipulated a medical risk analysis to establish necessary hygiene measures, and provide specific recommendations...
December 2015: Die Rehabilitation
https://www.readbyqxmd.com/read/26676632/-fls-three-letters-alter-secondary-fracture-prevention
#14
N Suhm, C Meier, M Kraenzlin, E Kungler, B Savic, S Mueller, M Jakob, D Rikli
The increasing importance of preventive measures in the field of orthopedics and trauma surgery becomes apparent because of the demographic changes and the high risk for secondary fractures following osteoporotic fractures. Within the fracture treatment chain, orthopedics and trauma surgery are in the "pole position" to initiate these measures in geriatric patients. In the past orthopedists and trauma surgeons have constantly accused of neglecting secondary fracture prevention in fragility fracture patients...
January 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/26658903/-geriatric-fracture-centers-improved-patient-care-and-economic-benefits
#15
S L Kates
The world's population is aging resulting in changes in the way we manage geriatric care. Furthermore, this population has a considerable risk of fragility fractures, most notably hip fractures. Hip fractures are associated with significant morbidity and mortality and have large economic consequences. It is due to these factors that the concept of an elderly trauma center was developed. These trauma centers utilize the expertise in orthopedic and geriatric disciplines to provide coordinated care to the elderly hip fracture patient...
January 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/26637222/the-long-term-effect-of-being-treated-in-a-geriatric-ward-compared-to-an-orthopaedic-ward-on-six-measures-of-free-living-physical-behavior-4-and-12-months-after-a-hip-fracture-a-randomised-controlled-trial
#16
RANDOMIZED CONTROLLED TRIAL
Kristin Taraldsen, Pernille Thingstad, Olav Sletvold, Ingvild Saltvedt, Stian Lydersen, Malcolm H Granat, Sebastien Chastin, Jorunn L Helbostad
BACKGROUND: This study is part of the Trondheim Hip Fracture Trial, where we compared free-living physical behavior in daily life 4 and 12 months following hip surgery for patients managed with comprehensive geriatric care (CGC) in a geriatric ward with those managed with orthopedic care (OC) in an orthopedic ward. METHODS: This is a single centre, prospective, randomized controlled trial. 397 hip fracture patients were randomized to CGC (n = 199) or OC (n = 198) in the Emergency Department with follow-up assessments performed four and 12 months post-surgery...
December 4, 2015: BMC Geriatrics
https://www.readbyqxmd.com/read/26539441/geriatric-orthopedic-co-management-of-older-adults-with-hip-fracture-an-emerging-standard
#17
Pei Chen, William W Hung
Hip fracture, a common complication of fall injuries in older adults, often results in high rate of mortality, increased debility, functional loss, and worse quality of life. The value of geriatric teams and model of care for the hip fracture patients have been examined in a number of studies, and even though most studies have demonstrated potential impact in improving outcomes for the hip fracture patients, they are often observational or quasi-experimental designs that are prone to bias. In this editorial, we review the Lancet article by Prestmo and colleagues, a randomized controlled trial that demonstrated improved outcomes for hip fracture patients managed in a geriatric unit...
September 2015: Annals of Translational Medicine
https://www.readbyqxmd.com/read/26537967/geriatric-fracture-centers-improved-patient-care-and-economic-benefits-english-version
#18
M Kelly, S L Kates
The world's population is aging resulting in changes in the way we manage geriatric care. Furthermore, this population has a considerable risk of fragility fractures, most notably hip fractures. Hip fractures are associated with significant morbidity and mortality and have large economic consequences. It is due to these factors that the concept of an elderly trauma center was developed. These trauma centers utilize the expertise in orthopedic and geriatric disciplines to provide coordinated care to the elderly hip fracture patient...
November 4, 2015: Der Unfallchirurg
https://www.readbyqxmd.com/read/26474551/-future-of-orthogeriatrics-from-the-perspective-of-a-geriatrician
#19
A H Leischker
In the elderly, fractures and other severe injuries frequently lead to substantial restrictions in the activities of daily living (ADLs) resulting in dependency. Typical complications following a fracture include acute delirium, deep vein thrombosis, pneumonia and other infections. It has been demonstrated that early surgery (osteosynthesis) and early mobilization significantly decrease the risk of these complications. An interdisciplinary cooperation between orthopedic surgeons and geriatricians leads to a shorter length of hospitalization, better mobility and, most importantly, to an improvement in the quality of life...
January 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/26246953/early-results-of-a-geriatric-hip-fracture-program-in-india-for-femoral-neck-fracture
#20
Deepak Jain, Guraziz Singh Sidhu, Harpal Singh Selhi, Simon C Mears, Mohammad Yamin, Pankaj Mahindra, Harminder Singh Pannu
Geriatric hip fractures are a challenging clinical problem throughout the world. Hip fracture services have been shown to shorten time to surgery, decrease the cost of admissions, and improve the outcomes. We instituted a geriatric hip fracture program for comanagement of these injuries by orthopedic and internal medicine teams at our hospital in India. From January 2010 till December 2011, 119 patients with a femoral neck fracture were treated with cemented modular hemiarthroplasty under this program using a cost-effective Indian implant...
March 2015: Geriatric Orthopaedic Surgery & Rehabilitation
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