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Delirium in orthopaedic

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https://www.readbyqxmd.com/read/29735284/music-intervention-to-prevent-delirium-among-older-patients-admitted-to-a-trauma-intensive-care-unit-and-a-trauma-orthopaedic-unit
#1
Kari Johnson, Julie Fleury, Darya McClain
PURPOSE: Evaluate music listening for delirium prevention among patients admitted to a Trauma Intensive Care and Trauma Orthopaedic Unit. The Roy Adaptation Model provided the theoretical framework focusing on modifying contextual stimuli. METHODS: Randomised controlled trial, 40 patients aged 55 and older. INTERVENTION: Participants randomly assigned to receive music listening or usual care for 60 minutes, twice a day, over three days. Pre-recorded self-selected music using an iPod and headsets, with slow tempo, low pitch and simple repetitive rhythms to alter physiologic responses...
May 4, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29651743/polypharmacy-in-palliative-care-copd-and-multimorbidity-a-case-report
#2
Marcel Rowhani, Bernhard Iglseder
This is the case report of an 80-year-old woman with advanced chronic obstructive pulmonary disease (COPD), multimorbidity and frailty. Despite regular critical re-evaluation of on-going medication, a significant reduction of prescribed medication was not achieved up until the patient's terminal phase, and this may have contributed to several episodes of delirium. It was particularly difficult to reduce the number of prescribed drugs due to cardiovascular, endocrinologic, orthopaedic, neurologic, psychiatric and pulmonary comorbidities...
April 12, 2018: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29486947/-assessment-of-clinical-complications-and-their-associated-factors-in-hip-fracture-patients-in-an-acute-geriatric-orthopaedic-unit
#3
Rafael Bielza, Paola Fuentes, David Blanco Díaz, Ricardo Vicente Moreno, Estefanía Arias, Marta Neira, Ana M Birghilescu, Jorge Sanjurjo, Javier Escalera, David Sanz-Rosa, Israel J Thuissard, Jorge F Gómez Cerezo
INTRODUCTION: The incidence of clinical complications in hip fracture (HF) patients is high and variable due to their heterogeneous nature. The aim of the study was to assess the clinical complications and their associated factors in HF patients admitted to the Orthopaedic Geriatric Unit of a 283 bed University Hospital. An average of 200 HF patients is attended yearly. MATERIAL AND METHODS: A prospective, observational and analytical study was conducted on 383 consecutive patients admitted to the unit during the years 2013 and 2014...
May 2018: Revista Española de Geriatría y Gerontología
https://www.readbyqxmd.com/read/29341066/cerebral-near-infrared-spectroscopy-nirs-for-perioperative-monitoring-of-brain-oxygenation-in-children-and-adults
#4
REVIEW
Yun Yu, Kaiying Zhang, Ling Zhang, Huantao Zong, Lingzhong Meng, Ruquan Han
BACKGROUND: Various techniques have been employed for the early detection of perioperative cerebral ischaemia and hypoxia. Cerebral near-infrared spectroscopy (NIRS) is increasingly used in this clinical scenario to monitor brain oxygenation. However, it is unknown whether perioperative cerebral NIRS monitoring and the subsequent treatment strategies are of benefit to patients. OBJECTIVES: To assess the effects of perioperative cerebral NIRS monitoring and corresponding treatment strategies in adults and children, compared with blinded or no cerebral oxygenation monitoring, or cerebral oxygenation monitoring based on non-NIRS technologies, on the detection of cerebral oxygen desaturation events (CDEs), neurological outcomes, non-neurological outcomes and socioeconomic impact (including cost of hospitalization and length of hospital stay)...
January 17, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29189623/preoperative-risk-factors-for-subsyndromal-delirium-in-older-adults-who-undergo-joint-replacement-surgery
#5
Dawn L Denny, Glenda Lindseth
BACKGROUND: Older adults with subsyndromal delirium have similar risks for adverse outcomes following joint replacement surgery as those who suffer from delirium. PURPOSE: This study examined relationships among subsyndromal delirium and select preoperative risk factors in older adults following major orthopaedic surgery. METHODS: Delirium assessments of a sample of 62 adults 65 years of age or older were completed on postoperative Days 1, 2, and 3 following joint replacement surgery...
November 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/29054389/optimizing-surgical-quality-datasets-to-care-for-older-adults-lessons-from-the-american-college-of-surgeons-nsqip-geriatric-surgery-pilot
#6
Julia R Berian, Lynn Zhou, Melissa A Hornor, Marcia M Russell, Mark E Cohen, Emily Finlayson, Clifford Y Ko, Thomas N Robinson, Ronnie A Rosenthal
BACKGROUND: Surgical quality datasets can be better tailored toward older adults. The American College of Surgeons (ACS) NSQIP Geriatric Surgery Pilot collected risk factors and outcomes in 4 geriatric-specific domains: cognition, decision-making, function, and mobility. This study evaluated the contributions of geriatric-specific factors to risk adjustment in modeling 30-day outcomes and geriatric-specific outcomes (postoperative delirium, new mobility aid use, functional decline, and pressure ulcers)...
December 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28475261/impact-of-the-orthopaedic-nurse-practitioner-role-on-acute-hospital-length-of-stay-and-cost-savings-for-patients-with-hip-fracture-a-retrospective-cohort-study
#7
Linda L Coventry, Sharon Pickles, Michelle Sin, Amanda Towell, Margaret Giles, Kevin Murray, Diane E Twigg
AIMS: To compare acute hospital length of stay and cost-savings for patients with hip fracture before and after commencement of the Orthopaedic Nurse Practitioner and identify variables that increase length of stay in hospital. BACKGROUND: Globally, hip fractures are associated with significant morbidity and mortality. Whilst the practical benefits of the Orthopaedic Nurse Practitioner have been anecdotally shown, an analysis showing the cost-saving benefits has yet to be published...
November 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28466701/care-of-patients-with-dementia-in-an-acute-trauma-and-orthopaedics-unit
#8
Gillian McCorkell, Deirdre Harkin, Victoria McCrory, Mary Lafferty, Vivien Coates
Aim To increase awareness of the needs of patients with dementia in the trauma and orthopaedics unit of one acute hospital, and to collaborate with staff on the unit to identify ways of improving the care experienced by these patients and their families. Method An action research approach was used and three action research cycles were completed. Data were obtained retrospectively for 20 patients with dementia who were admitted to the unit for treatment. Deficiencies in the care of these patients were identified and related to communication, pain management and the recognition of delirium...
May 3, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28421731/intraoperative-dexmedetomidine-sedation-reduces-the-postoperative-agitated-behavior-in-elderly-patients-undergoing-orthopedic-surgery-compared-to-the-propofol-sedation
#9
Hyun-Jung Shin, Bon-Wook Koo, Seung-Uk Bang, Jin-Hee Kim, Jung-Won Hwang, Sang-Hwan DO, Hyo-Seok Na
BACKGROUND: Postoperative agitation or confusion is one of the symptoms of hyperactive delirium in elderly patients. We retrospectively evaluated the incidence of postoperative abnormal psychomotor behavior in elderly surgical patients according to the use of different intraoperative sedative agents: dexmedetomidine vs. propofol. METHODS: The medical records of 855 elderly patients, who underwent orthopedic surgery with regional anesthesia between July 2012 and September 2015, were divided into two groups, the dexmedetomidine group (N...
October 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28407199/comprehensive-geriatric-assessment-for-prevention-of-delirium-after-hip-fracture-a-systematic-review-of-randomized-controlled-trials
#10
REVIEW
Lynn Shields, Victoria Henderson, Robert Caslake
OBJECTIVES: To assess the efficacy of comprehensive geriatric assessment (CGA) in prevention of delirium after hip fracture. DESIGN: Systematic review and metaanalysis. SETTING: Ward based models on geriatrics wards and visiting team based models on orthopaedics wards were included. PARTICIPANTS: Four trials (three European, one U.S.; 973 participants) were identified. Two assessed ward-based, and two assessed team-based interventions...
July 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28349412/evaluating-outcomes-for-older-patients-with-parkinson-s-disease-or-dementia-with-lewy-bodies-who-have-been-hospitalised-for-hip-fracture-surgery-potential-impact-of-drug-administration
#11
Marie Enemark, Mette Midttun, Kristian Winge
INTRODUCTION: People with Parkinson's disease (PD) are at risk of falling and have an increased risk of complications and prolonged recovery during hospitalisation. OBJECTIVE: The aim of this study was to investigate the rate of complications and recovery related to a hip fracture in patients with PD. METHODS: All patients with PD or dementia with Lewy bodies (DLB) and a hip fracture who were admitted from January 2013 through June 2014 (18 months) to the Department of Orthopaedics, Copenhagen University Hospital, Herlev, Denmark were evaluated...
May 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28128699/surgical-results-and-complications-of-anterior-decompression-and-fusion-as-a-revision-surgery-after-initial-posterior-surgery-for-cervical-myelopathy-due-to-ossification-of-the-posterior-longitudinal-ligament
#12
Seiichi Odate, Jitsuhiko Shikata, Tsunemitsu Soeda, Satoru Yamamura, Shinji Kawaguchi
OBJECTIVE Ossification of the posterior longitudinal ligament (OPLL) is a progressive disease. An anterior cervical decompression and fusion (ACDF) procedure for cervical OPLL is theoretically feasible, as the lesion exists anteriorly; however, such a procedure is considered technically demanding and is associated with serious complications. Cervical laminoplasty is reportedly an effective alternative procedure with few complications; it is recognized as a comparatively safe procedure, and has been widely used as an initial surgery for cervical OPLL...
April 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27554319/baseline-vulnerability-and-inpatient-frailty-status-in-relation-to-adverse-outcomes-in-a-surgical-cohort
#13
H-S Lin, N M Peel, R E Hubbard
This study aimed to derive measures of baseline vulnerability and inpatient frailty in elderly surgical patients and to study their association with adverse post-operative outcomes. Data from comprehensive geriatric assessment of 208 general surgical and orthopaedic patients aged 70 and over admitted to four acute hospitals in Queensland, Australia, were analysed to derive a baseline and inpatient Frailty Index (FI). The association of these indices with adverse outcomes was examined in logistic regression...
2016: Journal of Frailty & Aging
https://www.readbyqxmd.com/read/27235526/the-influence-of-a-history-of-clinical-depression-on-peri-operative-outcomes-in-elective-total-shoulder-arthroplasty-a-ten-year-national-analysis
#14
B Mollon, S A Mahure, D Y Ding, J D Zuckerman, Y W Kwon
AIMS: Depression can significantly affect quality of life and is associated with higher rates of medical comorbidities and increased mortality following surgery. Although depression has been linked to poorer outcomes following orthopaedic trauma, total joint arthroplasty and spinal surgery, we wished to examine the impact of depression in elective total shoulder arthroplasty (TSA) as this has not been previously explored. PATIENTS AND METHODS: The United States Nationwide Inpatient Sample (NIS) was used to identify patients undergoing elective TSA over a ten-year period...
June 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27147696/rethinking-orthopaedic-decision-making-for-frail-patients-with-hip-fracture-commentary-on-an-article-by-marilyn-heng-md-frcsc-et-al-abnormal-mini-cog-is-associated-with-higher-risk-of-complications-and-delirium-in-geriatric-patients-with-fracture
#15
COMMENT
https://www.readbyqxmd.com/read/27147687/abnormal-mini-cog-is-associated-with-higher-risk-of-complications-and-delirium-in-geriatric-patients-with-fracture
#16
COMMENT
Marilyn Heng, Caitlin E Eagen, Houman Javedan, Jennifer Kodela, Michael J Weaver, Mitchel B Harris
BACKGROUND: The Mini-Cog test is a validated and simple tool to screen for dementia. The purpose of this study was to investigate the relationship of cognitive impairment as measured by Mini-Cog testing as a predictor for in-hospital complications and mortality in geriatric patients with fracture. METHODS: From 2011 to 2014, patients who were seventy years of age or older, had a fracture, and were admitted to co-managed orthopaedic trauma and geriatrics services embedded at two Level-I trauma centers were enrolled in our study...
May 4, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/26999246/three-different-outcomes-in-older-community-dwelling-patients-receiving-intermediate-care-in-nursing-home-after-acute-hospitalization
#17
J F Abrahamsen, C Haugland, R M Nilsen, A H Ranhoff
OBJECTIVES: To evaluate the recovery and outcome of older communitydwelling patients admitted to intermediate care (IC) in nursing homes after acute hospitalization, and to compare patients who were able and unable to return directly to their own homes. DESIGN: Prospective, observational, cohort study conducted between June 2011 and 2014. SETTING: A 19- bed IC unit in a nursing home with increased multidisciplinary staffing. PARTICIPANTS: A total of 961 community-dwelling patients, ≥70 years of age, considered to have a rehabilitation potential and no major cognitive impairment or delirium, transferred from internal medicine, cardiac, pulmonary and orthopaedic hospital departments...
April 2016: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/26967259/interventions-for-preventing-delirium-in-hospitalised-non-icu-patients
#18
REVIEW
Najma Siddiqi, Jennifer K Harrison, Andrew Clegg, Elizabeth A Teale, John Young, James Taylor, Samantha A Simpkins
BACKGROUND: Delirium is a common mental disorder, which is distressing and has serious adverse outcomes in hospitalised patients. Prevention of delirium is desirable from the perspective of patients and carers, and healthcare providers. It is currently unclear, however, whether interventions for preventing delirium are effective. OBJECTIVES: To assess the effectiveness of interventions for preventing delirium in hospitalised non-Intensive Care Unit (ICU) patients...
March 11, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26253332/prevention-of-delirium-pod-for-older-people-in-hospital-study-protocol-for-a-randomised-controlled-feasibility-trial
#19
RANDOMIZED CONTROLLED TRIAL
John Young, Francine Cheater, Michelle Collinson, Marie Fletcher, Anne Forster, Mary Godfrey, John Green, Shamaila Anwar, Suzanne Hartley, Claire Hulme, Sharon K Inouye, David Meads, Gillian Santorelli, Najma Siddiqi, Jane Smith, Elizabeth Teale, Amanda J Farrin
BACKGROUND: Delirium is the most frequent complication among older people following hospitalisation. Delirium may be prevented in about one-third of patients using a multicomponent intervention. However, in the United Kingdom, the National Health Service has no routine delirium prevention care systems. We have developed the Prevention of Delirium Programme, a multicomponent delirium prevention intervention and implementation process. We have successfully carried out a pilot study to test the feasibility and acceptability of implementation of the programme...
August 8, 2015: Trials
https://www.readbyqxmd.com/read/26074478/enhanced-rehabilitation-and-care-models-for-adults-with-dementia-following-hip-fracture-surgery
#20
REVIEW
Toby O Smith, Yasir A Hameed, Jane L Cross, Catherine Henderson, Opinder Sahota, Chris Fox
BACKGROUND: Hip fracture is a major fall-related injury which causes significant problems for individuals, their family and carers. Over 40% of people with hip fracture have dementia or cognitive impairment, and their outcomes after surgery are poorer than those without dementia. It is not clear which care and rehabilitation interventions achieve the best outcomes for these people. OBJECTIVES: (a) To assess the effectiveness of models of care including enhanced rehabilitation strategies designed specifically for people with dementia following hip fracture surgery compared to usual care...
June 15, 2015: Cochrane Database of Systematic Reviews
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