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Geriatric surgery

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https://www.readbyqxmd.com/read/28534471/management-of-acetabular-fractures-in-the-geriatric-patient
#1
Marc Hanschen, Sebastian Pesch, Stefan Huber-Wagner, Peter Biberthaler
INTRODUCTION: Open reduction and internal fixation (ORIF) is standard care for most acetabular fractures. With increasing numbers of acetabular fractures in the elderly, the risk of revision surgery and conversion to total hip replacement (THR) is increasing. Alarmingly, about 20-25% of acetabular fractures in the elderly following ORIF needed revision and conversion to delayed THR. METHODS: Recently, prognostic factors have been identified, which correlate with an increased risk of worse outcomes following ORIF of acetabular fractures in the elderly patient...
2017: SICOT-J
https://www.readbyqxmd.com/read/28528805/acute-response-of-non-motor-symptoms-to-subthalamic-deep-brain-stimulation-in-parkinson-s-disease
#2
Margherita Fabbri, Miguel Coelho, Leonor Correia Guedes, Mario M Rosa, Daisy Abreu, Nilza Gonçalves, Angelo Antonini, Joaquim J Ferreira
BACKGROUND: Subthalamic deep brain stimulation (STN-DBS) is an established treatment for the motor complications of Parkinson's disease (PD) and may have beneficial effects on non-motor symptoms (NMS). However, the acute effect of STN stimulation on NMS has only been explored in small PD cohorts with short post-surgical follow-up. OBJECTIVE: To study NMS response to an acute stimulation challenge in an STN-DBS PD population with a medium/long-term post-surgical follow-up...
May 8, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28500499/-anesthesiological-care-of-trauma-patients-in-orthogeriatric-co-management
#3
Markus F Luger, Thomas J Luger
Elderly patients increasingly need to undergo surgery under anesthesia, especially following trauma. A timely interdisciplinary approach to the perioperative management of these patients is decisive for the long-term outcome. Orthogeriatric co-management, which includes geriatricians and anesthesiologists from an early stage, is of great benefit for geriatric patients. Patient age, comorbidities and self-sufficiency in activities of daily life are decisive for an anesthesiological assessment of the state of health and preoperative risk stratification...
May 12, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28497218/to-evaluate-the-efficacy-of-an-acellular-flowable-matrix-in-comparison-with-a-wet-dressing-for-the-treatment-of-patients-with-diabetic-foot-ulcers-a-randomized-clinical-trial
#4
F Campitiello, M Mancone, A Della Corte, R Guerniero, S Canonico
The authors aimed to evaluate the efficacy of an advanced wound matrix (Integra Flowable Wound Matrix, Integra LifeScience Corp, Plainsboro, NJ, USA) for treating wounds with irregular geometries versus a wet dressing in patients with diabetic foot ulcers. Sixty patients with diabetic foot ulcers (Grades 3 Wagner) were included in this randomized clinical trial. The study was conducted in the General Surgery Unit and Geriatric of the Second University of Naples, Italy, in the last 12 months. Forty-six cases of diabetic foot ulcers were equally and randomly divided into control and test groups...
May 11, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28497099/acetabular-fractures-in-the-senior-population-epidemiology-mortality-and-treatments
#5
Reza Firoozabadi, William W Cross, James C Krieg, Milton L Chip Routt
BACKGROUND: Management of acetabular fractures in the senior population can be one of the most challenging injuries to manage. Furthermore, treating surgeons have a paucity of information to guide the treatment in this patient population. THE PURPOSE OF THIS STUDY WAS TO DETERMINE: (1) demographic and epidemiologic data, (2) mortality rates for nonoperative compared to operative management at different time points, (3) common fracture configurations, and (4) fracture fixation strategies in senior patients treated with acetabular fractures...
March 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28488991/geriatric-hip-fracture-care-fixing-a-fragmented-system
#6
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/28483663/e-r-a-s-pathway-in-colorectal-surgery-in-elderly-our-experience
#7
Basilio Pirrera, Andrea Lucchi, Carlo Gabbianelli, Vincenzo Alagna, Giacomo Martorelli, Pierluigi Berti, Ilaria Panzini, Elisabetta Fabbri, Gianluca Garulli
AIM: Numerous geriatric patients develop colorectal disease. Elderly patients are often considered high-risk surgical candidates. Enhanced recovery after surgery (E.R.A.S.) has been proven to be beneficial for patients. The aim of the study was to evaluate the results of an ERAS protocol in older patients that underwent colorectal surgery compared to younger patients. METHOD: In the period between January 2010 to December 2015 a total of 589 patients underwent elective colorectal surgical interventions treated within the E...
May 5, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28467578/approach-to-inguinal-hernia-in-high-risk-geriatric-patients-should-it-be-elective-or-emergent
#8
Rıza Gürhan Işıl, Pınar Yazıcı, Uygar Demir, Cemal Kaya, Özgür Bostancı, Ufuk Oğuz İdiz, Canan Tülay Işıl, Mahmut Kaan Demircioğlu, Mehmet Mihmanlı
BACKGROUND: Elderly patients are more prone to have inguinal hernia due to weakened abdominal musculature. However, surgical repair of inguinal hernia (SRIH) may not be performed or may be delayed due to greater risk in presence of comorbidities. Present study is investigation of outcome of elective and emergency SRIH in geriatric patients. METHODS: Records of total of 384 high-risk (American Society of Anesthesiology classification III-IV) patients aged >65 years who underwent SRIH between January 2010 and December 2014 were reviewed...
March 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28459734/a-systematic-review-and-meta-analysis-examining-the-impact-of-incident-postoperative-delirium-on-mortality
#9
Gavin M Hamilton, Kathleen Wheeler, Joseph Di Michele, Manoj M Lalu, Daniel I McIsaac
BACKGROUND: Delirium is an acute and reversible geriatric syndrome that represents a decompensation of cerebral function. Delirium is associated with adverse postoperative outcomes, but controversy exists regarding whether delirium is an independent predictor of mortality. Thus, we assessed the association between incident postoperative delirium and mortality in adult noncardiac surgery patients. METHODS: A systematic search was conducted using Cochrane, MEDLINE/PubMed, Cumulative Index to Nursing and Allied Health Literature, and Embase...
May 1, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28459508/effect-of-electric-acupoint-stimulation-on-gastrointestinal-hormones-and-motility-among-geriatric-postoperative-patients-with-gastrointestinal-tumors
#10
Lili Hou, Lei Xu, Yan Shi, Fen Gu
OBJECTIVE: To evaluate the effects of electric acupoint stimulation on gastrointestinal hormones and motility among geriatric postoperative patients with gastrointestinal tumors, and to explore an efficient and noninvasive method for postoperative recovery of bowel functions. METHODS: Forty patients were randomly and evenly assigned into a regular nursing care group (RNC) and an acupoint electric stimulation group (AES). Patients in the RNC group received regular nursing care and patients in the AES group received regular nursing care plus electric stimulation of acupoints...
August 2016: Journal of Traditional Chinese Medicine, Chung i Tsa Chih Ying Wen Pan
https://www.readbyqxmd.com/read/28450739/comparing-mortality-risk-of-patients-with-acute-hip-fractures-admitted-to-a-major-trauma-centre-on-a-weekday-or-weekend
#11
Rajpal Nandra, Jack Pullan, Jonathan Bishop, Khalid Baloch, Liam Grover, Keith Porter
Proximal femoral fractures are a major public health concern with estimated annual direct and social costs amounting to £2 billion and average 30-day mortality risk of 7.5%. In response to the recent debate over out-of-hours hospital provision we investigated the 'weekend effect' at a major trauma centre, caring for acute injuries. A single centre, multi-surgeon review of 2060 patients performed. The distribution of patient and treatment variables compared in patients admitted on a weekday or the weekend. Fewer patients met performance indicators during weekend admission, time to surgery (63 vs...
April 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28444038/difficulties-in-accessing-services-that-are-of-medium-complexity-in-small-municipalities-a-case-study
#12
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/28433450/a-retrospective-cohort-study-of-concomitant-ipsilateral-extra-capsular-and-intra-capsular-fractures-of-the-proximal-femur-are-they-casual-findings-or-an-undervalued-reality
#13
Miquel Videla-Cés, José-Miguel Sales-Pérez, Joan Girós-Torres, Rubén Sánchez-Navés, Sebastián Videla
BACKGROUND: Fractures of the proximal femur constitute a major public health problem, with an annual incidence in Spain of 7.6 cases per 1000 inhabitants over 65 years of age. Hip fractures are frequent in elderly patients, related to osteoporosis and with low energy trauma, which means that they can be considered a geriatric syndrome. Simultaneous ipsilateral extra- and intra-articular hip fractures are considered as very rare are, and generally speaking, classified as extra- or intra-capsular fractures...
April 13, 2017: Injury
https://www.readbyqxmd.com/read/28424131/postoperative-complications-predict-30-day-readmission-in-geriatric-general-surgery-patients
#14
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/28419035/clinical-practice-guidelines-decrease-unnecessary-echocardiograms-before-hip-fracture-surgery
#15
Chris Adair, Eric Swart, Rachel Seymour, Joshua Patt, Madhav A Karunakar
BACKGROUND: Preoperative assessment of geriatric patients with a hip fracture may include transthoracic echocardiography (TTE), which increases resource utilization and cost and may delay surgery. The purpose of this study was to evaluate preoperative TTE utilization at a single institution in order to determine (1) how often TTE is ordered in accordance with clinical practice guidelines (CPGs), (2) how frequently TTE reveals cardiac disease that may alter medical or anesthesia management, and (3) whether following CPGs reduces unnecessary TTE utilization without potentially missing important disease...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28392431/-urinary-catheters-prevalence-study-in-a-university-hospital
#16
J Carrouget, C Legeay, A Poirier, A-R Azzouzi, J-R Zahar, P Bigot
INTRODUCTION: Urinary tract infection is the most common healthcare-association infection, especially because of urinary catheter. We evaluated our practices concerning catheter insertion and management in our institution. MATERIALS AND METHODS: We conducted a single-centre descriptive cross-sectional study during 1 week in September 2014 in all adult departments. We noted prevalence, indications, length, management of urinary catheter (UC) and symptomatic catheter-associated urinary tract infections (SCAUTI)...
April 6, 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/28388348/geriatric-patients-are-predisposed-to-strabismus-following-thyroid-related-orbital-decompression-surgery-a-multivariate-analysis
#17
Chris Y Wu, Alon Kahana
Geriatric patients (age ≥ 65) are prone to complications after surgery and are at risk for severe thyroid eye disease (TED). In this study, we aim to identify preoperative demographic and TED patterns associated with geriatric patients who underwent decompression surgery, to examine the effect of age on postoperative strabismus rates, and to identify factors that may contribute to postoperative strabismus in the geriatric subgroup. We retrospectively reviewed patients who underwent thyroid-related orbital decompression surgery at the Kellogg Eye Center, University of Michigan, between 1999 and 2014...
April 2017: Orbit
https://www.readbyqxmd.com/read/28387102/-how-i-treat-delirium-in-the-aged
#18
S Christelbach, J Petermans, S Allepaerts
Delirium is an acute psycho-organic disorder, most of the time reversible, that happens in various situations (acute disease, drugs ... ). It can also result from an acute or long term stress when the patient is already in an unstable homeostatic balance. Delirium is common in the geriatric population and can have serious consequences in terms of morbidity and mortality. Unfortunately, it is often not well known by hospital doctors. It is the consequence of predisposing factors (age, polypharmacy, multiple illnesses, neurodegenerative diseases, ...
November 2016: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28385519/complications-and-readmission-after-lumbar-spine-surgery-in-elderly-patients-an-analysis-of-2-320-patients
#19
Ahmed Saleh, Caroline Thirukumaran, Addisu Mesfin, Robert W Molinari
BACKGROUND CONTEXT: There is a paucity of literature describing risk factors for adverse outcomes after geriatric lumbar spinal surgery. As the geriatric population increases, so does the number of lumbar spinal surgeries in this cohort. PURPOSE: The purpose of the study was to determine how safe lumbar surgery is in elderly patients. Does patient selection, type of surgery, length of surgery, and other comorbidities in the elderly patient affect complication and readmission rates after surgery? STUDY DESIGN/SETTING: This is a retrospective cohort study...
April 3, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28383453/predictors-of-anastomotic-leak-in-elderly-patients-after-colectomy-nomogram-based-assessment-from-the-american-college-of-surgeons-national-surgical-quality-program-procedure-targeted-cohort
#20
Ahmet Rencuzogullari, Cigdem Benlice, Michael Valente, Maher A Abbas, Feza H Remzi, Emre Gorgun
BACKGROUND: Elderly patients undergoing colorectal surgery have increasingly become under scrutiny by accounting for the largest fraction of geriatric postoperative deaths and a significant proportion of all postoperative complications, including anastomotic leak. OBJECTIVE: This study aimed to determine predictors of anastomotic leak in elderly patients undergoing colectomy by creating a novel nomogram for simplistic prediction of anastomotic leak risk in a given patient...
May 2017: Diseases of the Colon and Rectum
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