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https://www.readbyqxmd.com/read/28424131/postoperative-complications-predict-30-day-readmission-in-geriatric-general-surgery-patients
#1
James D Dieterich, Celia M Divino
The Affordable Care Act has placed unplanned patient readmissions under more scrutiny than ever. Geriatric patients, in particular, suffer a disproportionate amount of complications from any kind of hospitalization, including readmissions. This study seeks to identify risk factors in this population that predispose them to an unplanned readmission within 30 days after index surgery. The National Surgical Quality Improvement Program database was used to select patients 65 years and older, who underwent general surgery procedures in 2012...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28422280/integrating-frailty-research-into-the-medical-specialties-report-from-a-u13-conference
#2
Jeremy Walston, Thomas N Robinson, Susan Zieman, Frances McFarland, Christopher R Carpenter, Keri N Althoff, Melissa K Andrew, Caroline S Blaum, Patrick J Brown, Brian Buta, E Wesley Ely, Luigi Ferrucci, Kevin P High, Stephen B Kritchevsky, Kenneth Rockwood, Kenneth E Schmader, Felipe Sierra, Kaycee M Sink, Ravi Varadhan, Arti Hurria
Although the field of frailty research has expanded rapidly, it is still a nascent concept within the clinical specialties. Frailty, conceptualized as greater vulnerability to stressors because of significant depletion of physiological reserves, predicts poorer outcomes in several medical specialties, including cardiology, human immunodeficiency virus care, and nephrology, and in the behavioral and social sciences. Lack of a consensus definition, proliferation of measurement tools, inadequate understanding of the biology of frailty, and lack of validated clinical algorithms for frail individuals hinders incorporation of frailty assessment and frailty research into the specialties...
April 19, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28388818/enhancing-quality-of-provider-practices-for-older-adults-in-the-emergency-department-equipped
#3
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
#4
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/28364990/polypharmacy-reduction-strategies-tips-on-incorporating-american-geriatrics-society-beers-and-screening-tool-of-older-people-s-prescriptions-criteria
#5
REVIEW
Hedva Barenholtz Levy
There is no single definition of polypharmacy. Use of 5 or more medications commonly is used. An alternative, quantitative definition, such as use of more medications than clinically indicated or use of unnecessary or harmful prescribing, has been proposed. Protocols or algorithms to improve polypharmacy and prescribing in older adults have been developed. The American Geriatrics Society (AGS) Beers Criteria and Screening Tool of Older People's Prescriptions (STOPP) explicit criteria reflect elements that are common across protocols and algorithms...
May 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28342121/can-comprehensive-imaging-analysis-with-analytic-morphomics-and-geriatric-assessment-predict-serious-complications-in-patients-undergoing-pancreatic-surgery
#6
Andrew J Benjamin, Mary M Buschmann, Andrew Schneider, Brian A Derstine, Jeffrey F Friedman, Stewart C Wang, William Dale, Kevin K Roggin
We aimed to determine whether comprehensive imaging analysis with analytic morphomics (AM) enhances or replaces geriatric assessment (GA) in risk-stratifying pancreatic surgery patients. One hundred thirty-four pancreatic surgery patients were identified from a prospective cohort. Sixty-three patients in the cohort had preoperative CT scans in addition to comprehensive geriatric assessments. CT scans were processed using AM. Associations with National Surgical Quality Improvement Program (NSQIP) serious complications were evaluated using univariate analysis and robust elastic net modeling to obtain AUROC curves by adding AM and GA measures to our previously defined clinical base risk model (age, body mass index, American Society of Anesthesiologists classification, and Charlson comorbidity index)...
March 24, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28306149/medicare-access-and-chip-reauthorization-act-what-do-geriatrics-healthcare-professionals-need-to-know-about-the-quality-payment-program
#7
Kathleen T Unroe, Peter A Hollmann, Alanna C Goldstein, Michael L Malone
Commencing in 2017, the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 will change how Medicare pays health professionals. By enacting MACRA, Congress brought an end to the (un)sustainable growth rate formula while also setting forth a vision for how to transform the U.S. healthcare system so that clinicians deliver higher-quality care with smarter spending by the Centers for Medicare and Medicaid Services (CMS). In October 2016, CMS released the first of what stakeholders anticipate will be a number of (annual) rules related to implementation of MACRA...
March 17, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28297828/-treatment-of-geriatric-ankle-osteoarthritis-by-arthrodesis-with-screw-fixation-through-lateral-malleolus-osteotomy
#8
W Q Qu, Z H Wang, J Y Zhang, S J Dong, D Wang
Objective: To evaluate the Treatment effect of geriatric ankle osteoarthritis by arthrodesis with screw fixation through lateral malleolus osteotomy. Methods: Thirty-three patients with severe osteoarthritis according to the classification of Takakura-Tanakawere treated by ankle arthrodesis through lateral malleolus osteotomy with screw fixation from January 2010 to June 2015. Twenty-five patients were combined with more than 1 internal diseases. Twenty-six patients owned ankle injury history. Clinical and radiologic evaluations were performed before surgery and at the most recent follow-up...
March 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28263371/association-between-preoperative-malnutrition-and-postoperative-delirium-after-hip-fracture-surgery-in-older-adults
#9
Paolo Mazzola, Libby Ward, Sara Zazzetta, Valentina Broggini, Alessandra Anzuini, Breanna Valcarcel, Justin S Brathwaite, Giulio M Pasinetti, Giuseppe Bellelli, Giorgio Annoni
OBJECTIVES: To determine whether poor nutritional status can predict postoperative delirium in elderly adults undergoing hip fracture surgery. DESIGN: Prospective observational cohort study. SETTING: Italian orthogeriatric unit. PARTICIPANTS: Individuals aged 70 and older (mean age 84.0 ± 6.6, 74.5% female) consecutively admitted for surgical repair of a proximal femur fracture between September 2012 and April 2016 (N = 415)...
March 6, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28198559/list-of-referees-reviewers-for-the-journal-of-the-american-geriatrics-society-jags-from-january-to-december-2016
#10
(no author information available yet)
No abstract text is available yet for this article.
February 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28188187/electronic-rapid-fitness-assessment-a-novel-tool-for-preoperative-evaluation-of-the-geriatric-oncology-patient
#11
Armin Shahrokni, Amy Tin, Robert J Downey, Vivian Strong, Sanam Mahmoudzadeh, Manpreet K Boparai, Sincere McMillan, Andrew Vickers, Beatriz Korc-Grodzicki
Background: The American College of Surgeons and American Geriatrics Society recommend performing a geriatric assessment (GA) in the preoperative evaluation of older patients. To address this, we developed an electronic GA, the Electronic Rapid Fitness Assessment (eRFA). We reviewed the feasibility and clinical utility of the eRFA in the preoperative evaluation of geriatric patients. Methods: We performed a retrospective review of our experience using the eRFA in the preoperative assessment of geriatric patients...
February 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28164825/geriatric-care-issues-an-american-and-an-international-perspective
#12
REVIEW
Mohamad A Sidani, Brian C Reed, Jeffrey Steinbauer
As the global population ages, there is an opportunity to benefit from the increased longevity of a healthy older adult population. Healthy older individuals often contribute financially to younger generations by offering financial assistance, paying more in taxes than benefits received, and providing unpaid childcare and voluntary work. Governments must address the challenges of income insecurity, access to health care, social isolation, and neglect that currently face elderly adults in many countries. A reduction in disparities in these areas can lead to better health outcomes and allow societies to benefit from longer, healthier lives of their citizens...
March 2017: Primary Care
https://www.readbyqxmd.com/read/28124479/is-spinal-surgery-safe-in-octogenarians
#13
Harrison G Mihailidis, Simon Manners, Leonid Churilov, Gerald M Y Quan
BACKGROUND: An ageing population and advances in medical management often requires spinal surgeons to increasingly operate on patients older than 80 years. The ability to predict complications and mortality rates would allow discrimination of which octogenarians are able to safely undergo spinal surgery. Therefore, the aims of this study were to determine whether comorbidities and extent of surgery were associated with complications in this age group, in addition to which comorbidity and physical status assessment scales were best associated with the development of complications following spinal surgery...
January 26, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28102637/american-geriatrics-society-policy-priorities-for-new-administration-and-115th-congress
#14
Nancy E Lundebjerg, Peter Hollmann, Michael L Malone
This paper is a statement of the American Geriatrics Society's (AGS) core policy priorities and the Society's positions on federal programs and policies that support older Americans as articulated to the new administration. Among the AGS priorities discussed in this paper are health reform, Medicare, and Medicaid. The AGS is committed to leveraging its expertise to inform regulatory and legislative policy proposals.
January 19, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28092400/aging-the-medical-subspecialties-and-career-development-where-we-were-where-we-are-going
#15
Arti Hurria, Kevin P High, Lona Mody, Frances McFarland Horne, Marcus Escobedo, Jeffrey Halter, William Hazzard, Kenneth Schmader, Heidi Klepin, Sei Lee, Una E Makris, Michael W Rich, Stephanie Rogers, Jocelyn Wiggins, Rachael Watman, Jennifer Choi, Nancy Lundebjerg, Susan Zieman
Historically, the medical subspecialties have not focused on the needs of older adults. This has changed with the implementation of initiatives to integrate geriatrics and aging research into the medical and surgical subspecialties and with the establishment of a home for internal medicine specialists within the annual American Geriatrics Society (AGS) meeting. With the support of AGS, other professional societies, philanthropies, and federal agencies, efforts to integrate geriatrics into the medical and surgical subspecialties have focused largely on training the next generation of physicians and researchers...
January 16, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28074747/liraglutide-a-glucagon-like-peptide-1-agonist-for-chronic-weight-management
#16
Kendra R Manigault, Maria Miller Thurston
OBJECTIVE: To review the efficacy and safety of liraglutide 3.0 mg for weight loss. DATA SOURCE: A literature search was performed using PubMed and MEDLINE from 2000 to 2016. The following key terms were used alone or in combination: glucagon-like peptide-1 agonist, liraglutide, obesity, overweight, and weight loss. Additional supporting literature was identified utilizing the reference lists of the preceding articles. STUDY SELECTION: Analyzed studies were published in English and investigated use of liraglutide and its impact on weight loss...
December 1, 2016: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/27974304/improving-hip-fracture-outcomes-with-integrated-orthogeriatric-care-a-comparison-between-two-accepted-orthogeriatric-models
#17
Mark Middleton, Bettina Wan, Ruy da Assunçāo
BACKGROUND: our orthopaedic trauma unit serves a large elderly population, admitting 400-500 hip fractures annually. A higher than expected mortality was detected amongst these patients, prompting a change in the hip fracture pathway. The aim of this study was to assess the impact of a change in orthogeriatric provision on hip fracture outcomes and care quality indicators. PATIENTS AND METHODS: the hip fracture pathway was changed from a geriatric consultation service to a completely integrated service on a dedicated orthogeriatric ward...
December 14, 2016: Age and Ageing
https://www.readbyqxmd.com/read/27874181/ags-position-statement-making-medical-treatment-decisions-for-unbefriended-older-adults
#18
Timothy W Farrell, Eric Widera, Lisa Rosenberg, Craig D Rubin, Aanand D Naik, Ursula Braun, Alexia Torke, Ina Li, Caroline Vitale, Joseph Shega
In this position statement, we define unbefriended older adults as patients who: (1) lack decisional capacity to provide informed consent to the medical treatment at hand; (2) have not executed an advance directive that addresses the medical treatment at hand and lack capacity to do so; and (3) lack family, friends or a legally authorized surrogate to assist in the medical decision-making process. Given the vulnerable nature of this population, clinicians, health care teams, ethics committees and other stakeholders working with unbefriended older adults must be diligent when formulating treatment decisions on their behalf...
November 22, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27871540/comparison-of-the-effects-of-truview-pcd%C3%A2-video-laryngoscopy-and-macintosh-blade-direct-laryngoscopy-in-geriatric-patients
#19
Muhammed M Kurnaz, Aykut Sarıtaş
STUDY OBJECTIVE: To compare the effects of Truview PCD™ video laryngoscopy (TVL) and Macintosh blade direct laryngoscopy (MDL) on hemodynamic responses observed during laryngoscopy and orotracheal intubation conditions in geriatric patients. DESIGN: Randomized prospective study. SETTING: Operating room. PATIENTS: One hundred patients in the risk group American Society of Anesthesiologists I to III aged 65 years and older underwent elective surgery under general anesthesia...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27858974/report-and-research-agenda-of-the-american-geriatrics-society-and-national-institute-on-aging-bedside-to-bench-conference-on-sleep-circadian-rhythms-and-aging-new-avenues-for-improving-brain-health-physical-health-and-functioning
#20
Constance H Fung, Michael V Vitiello, Cathy A Alessi, George A Kuchel
The American Geriatrics Society, with support from the National Institute on Aging and other funders, held its eighth Bedside-to-Bench research conference, entitled "Sleep, Circadian Rhythms, and Aging: New Avenues for Improving Brain Health, Physical Health and Functioning," October 4 to 6, 2015, in Bethesda, Maryland. Part of a conference series addressing three common geriatric syndromes-delirium, sleep and circadian rhythm (SCR) disturbance, and voiding dysfunction-the series highlighted relationships and pertinent clinical and pathophysiological commonalities between these three geriatric syndromes...
December 2016: Journal of the American Geriatrics Society
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