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geriatric intensive care

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https://www.readbyqxmd.com/read/29771351/burn-surgeon-and-palliative-care-physician-attitudes-regarding-goals-of-care-delineation-for-burned-geriatric-patients
#1
Holly B Cunningham, Shannon A Scielzo, Paul A Nakonezny, Brandon R Bruns, Karen J Brasel, Kenji Inaba, Scott C Brakenridge, Jeffrey D Kerby, Bellal A Joseph, M J Mohler, Joseph Cuschieri, Mary E Paulk, Akpofure P Ekeh, Tarik D Madni, Luis R Taveras, Jonathan B Imran, Steven E Wolf, Herb A Phelan
Objective: Palliative care specialists and burn surgeons were surveyed regarding: 1) importance of goals of care conversations for burned seniors; 2) confidence in their own specialty's ability to conduct these conversations; and 3) confidence in the ability of the other specialty to do so. Methods: A 13-item survey was developed by the steering committee of a multi-center consortium dedicated to palliative care in the injured geriatric patient and beta-tested by burn surgeons and palliative care specialists unaffiliated with the consortium...
May 16, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29741200/the-utility-of-the-frailty-index-in-clinical-decision-making
#2
K Khatry, N M Peel, L C Gray, R E Hubbard
Using clinical vignettes, this study aimed to determine if a measure of patient frailty would impact management decisions made by geriatricians regarding commonly encountered clinical situations. Electronic surveys consisting of three vignettes derived from cases commonly seen in an acute inpatient ward were distributed to geriatricians. Vignettes included patients being considered for intensive care treatment, rehabilitation, or coronary artery bypass surgery. A frailty index was generated through Comprehensive electronic Geriatric Assessment...
2018: Journal of Frailty & Aging
https://www.readbyqxmd.com/read/29720298/addressing-the-shortage-of-geriatric-specialists
#3
Casandra A Holveck, Jeannette Y Wick
With a population that is increasingly "gray," our nation faces a shortage of primary care providers who specialize in geriatrics. The number of geriatricians per 10,000 adults older than 65 years of age has decreased steadily since 2000. Health care providers from all disciplines (medicine, nursing, and pharmacy) tend not to choose geriatrics as a specialty area. Some are intimidated by the complexity of caring for elderly patients with geriatric syndromes and multiple morbidities. Others, who have little exposure to geriatrics in their undergraduate and graduate programs, are simply unaware of the personal and professional rewards associated with practice in geriatrics...
March 1, 2018: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29714992/issues-in-geriatric-care-maintaining-health-and-vigor
#4
Richard J Ackermann
Medicare covers annual wellness visits that are scheduled separately from regular medical appointments. These visits focus on prevention and health maintenance to help patients achieve successful aging, which is defined as living to old age without disability while also maintaining high physical and psychological levels of functioning and social engagement. To achieve these goals, most adults should perform at least 150 min/week of moderate-intensity exercise and maintain an optimal body mass index (ie, 23 to 32 kg/m2 )...
May 2018: FP Essentials
https://www.readbyqxmd.com/read/29690684/-the-composition-and-antimicrobial-resistance-of-isolates-from-lower-respiratory-tract-and-blood-in-hospitalized-patients-in-respiratory-ward-a-multicenter-national-study-in-china
#5
X Tang, C Zhuo, Y C Xu, N S Zhong
Objective: To investigate the species and antimicrobial resistance of bacterial pathogens isolated from hospitalized patients in respiratory ward in China. Methods: This was a multicenter retrospective study based on a national epidemiological network called China Antimicrobial Resistance Surveillance System (CARSS). The non-repetitive strains isolated from lower respiratory tract and blood samples in 91 hospitals from seven geographic regions of CARSS were reviewed. The distribution of specimen type, hospital level (secondary and tertiary hospital), patient age group [geriatric (>65 years old), adult (15 to 65 years old), pediatric (28 days to 14 years old ) and newborn group (≤28 days)] and ward type (respiratory intensive care unit and general respiratory ward) were analyzed for MRSA, PRSP, CREC, CRKP, CRPA, CRAB, ESBL-EC and ESBL-KP...
April 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29675629/-geriatric-trauma-center-dgu%C3%A2-evaluation-of-clinical-and-economic-parameters-a-pilot-study-in-a-german-university-hospital
#6
M Knobe, B Böttcher, M Coburn, T Friess, L C Bollheimer, H J Heppner, C J Werner, J-P Bach, M Wollgarten, S Poßelt, C Bliemel, B Bücking
BACKGROUND: Previous studies on orthogeriatric models of care suggest that there is substantial variability in how geriatric care is integrated in the patient management and the necessary intensity of geriatric involvement is questionable. OBJECTIVE: The aim of the current prospective cohort study was the clinical and economic evaluation of fragility fracture treatment pathways before and after the implementation of a geriatric trauma center in conformity with the guidelines of the German Trauma Society (DGU)...
April 19, 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29671037/-geriatric-intensive-care-patients-perspectives-and-limits-of-geriatric-intensive-care-medicine
#7
REVIEW
U Müller-Werdan, H-J Heppner, G Michels
Critically ill geriatric patients are vitally endangered due to the aging processes of organs, the frequently existing multimorbidity with subsequent polypharmacy and the typical geriatric syndrome of functional impairments. Aging processes in organs lower the clinical threshold for organ dysfunction and organ failure. Physiological organ aging processes with practical consequences for intensive care medicine are atypical manifestion of sepsis in immunosenescence, altered pharmacokinetics, reduced tolerance to hypovolemia due to proportionally reduced water compartment of the body in old age, the frequently only apparently normal function of the kidneys and the continuous reduction in pulmonary function in old age...
April 18, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29625940/incidence-of-drug-interactions-in-intensive-care-units-in-tertiary-care-settings-classification-facts-and-measures
#8
Hina Hasnain, Huma Ali, Farya Zafar, Ali Akbar Sial, Shazia Alam, Anwar Ejaz Beg, Rabia Bushra, Mehwish Rizvi, Maqsood Ahmed Khan, Huma Shareef, Ghazala R Naqvi, Anum Tariq
Drug-drug interactions (DDIs) are extremely significant concern, particularly in sensitive population including pediatric and geriatric. Propensity for the development of DDIs is high in patients admitted at intensive care units (ICU). This study was conducted to evaluate the DDIs incidence, facts and measures in ICU. From a total of 150 cases studied for ICU patients, with the mean age of 56.37±12.45 years, 55.33% were male and the rest were female 44.66%. The demographic information like age, gender and main diagnosis details of study participants that were extracted from the patients' clinical record...
March 2018: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29574340/assessing-frailty-in-the-intensive-care-unit-a-reliability-and-validity-study
#9
Melissa Shears, Alyson Takaoka, Bram Rochwerg, Sean M Bagshaw, Jennie Johnstone, Amanda Holding, Surenthar Tharmalingam, Tina Millen, France Clarke, Kenneth Rockwood, Guowei Li, Lehana Thabane, John Muscedere, Henry T Stelfox, Deborah J Cook
PURPOSE: To describe pre-ICU frailty in critically ill patients using the Clinical Frailty Scale (CFS). METHODS: We included patients ≥18years admitted to 2 ICUs in Hamilton, Canada. The ICU Research Coordinator (RC) generated 3 CFS scores using: 1) chart review, 2) family interview, 3) patient interview. Subsequently, an overall impression was captured in a final score. Mean differences were calculated to assess the RC intra-rater reliability and inter-rater reliability of chart reviews by the RC, Occupational Therapist (OT), and Geriatrics Resident (GR)...
June 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29566968/whole-body-computed-tomography-as-a-factor-associated-with-lower-mortality-in-severe-geriatric-trauma-with-thoracic-abdominal-pelvic-injury
#10
Y Peñasco, M J Sánchez-Arguiano, A González-Castro, J C Rodríguez-Borregán, R Jáuregui, P Escudero, M Ortiz-Lasa
OBJECTIVE: To determine the relationship between the use of whole-body computed tomography (WB-CT) and hospital mortality in elderly patients with thoracic-abdominal-pelvic injury requiring admission to an intensive care unit. PATIENTS AND METHOD: An observational, descriptive and retrospective study was conducted on 140 patients aged 65 years and older admitted to the intensive care unit after a thoracic-abdominal-pelvic injury. Two groups were established, depending on whether a WB-CT was performed as a routine part of the study or the diagnosis was established by conventional radiography or ultrasound...
March 19, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29559054/outcomes-after-falls-continue-to-worsen-despite-trauma-and-geriatric-care-advancements
#11
Eric J Charles, Nicholas J Napoli, Lily E Johnston, Carrie A Foster, Deirdre A Goode, Trevor B Parker, Eleanor A Sharp, Laura Barnes, Jeffrey S Young
The most common mechanism of traumatic injury is ground-level fall. The objective of this study was to understand how patients sustaining falls and their outcomes have evolved. An institutional trauma database was used to identify adult patients who suffered a fall and were admitted to a Level I trauma center during two distinct time periods: 1998 to 2003 (past) and 2008 to 2013 (current). Data on anticoagulant use and comorbidities was gathered by retrospective chart review of patients treated during 2003 and 2013...
March 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29548635/predicting-survival-in-geriatric-trauma-patients-a-comparison-between-the-triss-methodology-and-the-geriatric-trauma-outcome-score
#12
Jesús Abelardo Barea-Mendoza, Mario Chico-Fernández, Marcelino Sánchez-Casado, Ismael Molina-Díaz, Manuel Quintana-Díaz, José Manuel Jiménez-Moragas, Jon Pérez-Bárcena, Juan Antonio Llompart-Pou
INTRODUCTION: We compared the Geriatric Trauma Outcome Score (GTOS) with the probability of survival using the TRISS methodology (PS-TRISS) in geriatric severe trauma patients admitted to Intensive Care Units (ICU) participating in the Spanish trauma ICU registry (RETRAUCI). METHODS: Retrospective analysis from the RETRAUCI. Quantitative data were reported as median (Interquartile Range (IQR)), and categorical data as number (percentage). We analyzed the validity of the GTOS and PS-TRISS to predict survival...
March 13, 2018: Cirugía Española
https://www.readbyqxmd.com/read/29548528/outcomes-after-rib-fractures-in-geriatric-blunt-trauma-patients
#13
Rahman Barry, Errington Thompson
INTRODUCTION: Rib fractures after blunt trauma contribute substantially to morbidity and mortality in the elderly. METHODS: Retrospective review of 255 patients ≥65 years old at a level 2 trauma center over 6 years, who sustained blunt trauma resulting in rib fractures. Outcomes measured include mortality, hospital length of stay(LOS), intensive care unit(ICU) admission, ICU LOS, need for MV, and MV days. RESULTS: There were 24 deaths (9...
March 9, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29541862/do-independent-geriatric-outpatients-with-nocturnal-polyuria-profit-from-desmopressin
#14
W Weinrebe, S Käbe-Frisch, I Füsgen, M Karaman, E Johannsdottir, S Rupp
OBJECTIVE: To compare the efficacy of desmopressin and placebo in independent geriatric outpatients with nocturnal polyuria (NP). METHODS: A prospective, randomized, single-center, national, double blind, placebo-controlled, fixed-dose, parallel group comparative trial was carried out. The study included 110 geriatric outpatients, 55 patients per treatment group using desmopressin acetate nasal spray (strength: 0.1 mg/ml) once daily of 10 μg/spray blast or placebo...
March 14, 2018: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/29500147/a-retrospective-study-of-double-hit-lymphomas-in-elderly-patients-aged-70-years-overall-outcomes
#15
Christie Hancock, Phillip Knouse, Imad Almanaseer, Jacob Bitran
BACKGROUND: Double-hit lymphomas (DHLs) are high-grade diffuse large B-cell lymphomas with concurrent translocations involving myc and bcl-2 and/or bcl-6. A patient with DHL often has advanced disease at presentation and typically responds poorly to standard therapy with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone). More intensive treatment regimens have been studied; however, few data are available on the outcomes in elderly patients (aged > 70 years) treated with these therapies...
April 2018: Clinical Lymphoma, Myeloma & Leukemia
https://www.readbyqxmd.com/read/29468615/acute-care-hospital-at-different-levels-of-intensity-the-role-of-geriatrician
#16
REVIEW
Ilaria Liguori, Gennaro Russo, Luisa Aran, Giulia Bulli, Francesco Curcio, David Della-Morte, Gaetano Gargiulo, Gianluca Testa, Andrea Ungar, Francesco Cacciatore, Domenico Bonaduce, Pasquale Abete
The traditional model of care is based on "disease-centered" management that requires the organization of the hospital in specialized wards, to which the patient is assigned for the main disease. The growing need to optimize economical and human resources and to promote a global approach to the patient has led to the setting up of the intensity of care model. It is a health system based on a "patient-centered" approach, where the hospital is organized in departments dedicated to patients with homogenous needs of care...
February 21, 2018: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29440481/prospective-evaluation-of-medication-related-clinical-decision-support-over-rides-in-the-intensive-care-unit
#17
Adrian Wong, Mary G Amato, Diane L Seger, Christine Rehr, Adam Wright, Sarah P Slight, Patrick E Beeler, E John Orav, David W Bates
BACKGROUND: Clinical decision support (CDS) displayed in electronic health records has been found to reduce the incidence of medication errors and adverse drug events (ADE). Recent data suggested that medication-related CDS alerts were frequently over-ridden, often inappropriately. Patients in the intensive care unit (ICU) are at an increased risk of ADEs; however, limited data exist on the benefits of CDS in the ICU. This study aims to evaluate potential harm associated with medication-related CDS over-rides in the ICU...
February 9, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29366336/end-of-life-decision-making-for-patients-with-geriatric-trauma-cared-for-in-a-trauma-intensive-care-unit
#18
Meghan Wooster, Alyssa Stassi, Joshua Hill, James Kurtz, Marco Bonta, M Chance Spalding
BACKGROUND: The geriatric trauma population is growing and fraught with poor physiological response to injury and high mortality rates. Our primary hypothesis analyzed how prehospital and in-hospital characteristics affect decision-making regarding continued life support (CLS) versus withdrawal of care (WOC). Our secondary hypothesis analyzed adherence to end-of-life decisions regarding code status, living wills, and advanced directives. MATERIALS AND METHODS: We performed a retrospective review of patients with geriatric trauma at a level I and level II trauma center from January 1, 2007, to December 31, 2014...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29358101/the-validity-and-reliability-of-the-arabic-version-of-the-confusion-assessment-method-for-the-intensive-care-unit-cam-icu-a-prospective-cohort-study
#19
Abeer Selim, Nahed Kandeel, Mohamed Elokl, Mohamed Shawky Khater, Ashraf Nabil Saleh, Rami Bustami, E Wesley Ely
BACKGROUND: Accurate diagnosis for Arabic speaking critically ill patients suffering from delirium is limited by the need for a valid/reliable translation of a standardized delirium instrument such as the Confusion Assessment Method for the ICU (CAM-ICU). OBJECTIVE: To determine the validity and reliability of the Arabic version of the CAM-ICU. DESIGN: A prospective cohort study design was used to conduct the current study. SETTINGS: Data collection took place in Geriatric, Emergency and Surgical intensive care units...
April 2018: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29317368/interdisciplinary-care-model-independently-decreases-use-of-critical-care-services-after-corrective-surgery-for-adult-degenerative-scoliosis
#20
Owoicho Adogwa, Aladine A Elsamadicy, Amanda R Sergesketter, Michael Ongele, Victoria Vuong, Syed Khalid, Jessica Moreno, Joseph Cheng, Isaac O Karikari, Carlos A Bagley
OBJECTIVE: Interdisciplinary management of elderly patients requiring spine surgery has been shown to improve short- and long-term outcomes. The aim of this study was to determine whether an interdisciplinary team approach mitigates use of intensive care unit (ICU) resources. METHODS: A unique comanagement model for elderly patients undergoing lumbar fusion surgery was implemented at a major academic medical center. The Peri-operative Optimization of Senior Health Program (POSH) was launched with the aim of improving outcomes in elderly patients (>65 years old) undergoing complex lumbar spine surgery...
March 2018: World Neurosurgery
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