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Geriatric surgery

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https://www.readbyqxmd.com/read/29142852/thyroidectomy-in-elderly-patients-aged-%C3%A2-70-years
#1
REVIEW
Davide Inversini, Andrea Morlacchi, Giuseppinella Melita, Simona Del Ferraro, Carlo Boeri, Mattia Portinari, Antonino Cancellieri, Francesco Frattini, Antonio Giacomo Rizzo, Gianlorenzo Dionigi
Worldwide, the indications for thyroid surgery have been continuously extended among elderly patients in the last 20 years. The balance between treatment indication and surgical risk is certainly an interesting topic for every thyroid surgeon. This paper is a review of recent literature from January 2005 up to April 2017. We analyzed three principal subjects: indications for surgical treatment, medical complications and surgical complications. We can summarize the conclusions of our analysis, stating that age could not be considered as an absolute factor, but in relation to the comorbidities and the general clinical condition of the patient...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29142628/perioperative-results-and-complications-after-posterior-lumbar-interbody-fusion-for-spinal-stenosis-in-geriatric-patients-over-than-70-years-old
#2
Jong Min Choi, Man Kyu Choi, Sung Bum Kim
Objective: As increasing the size of the geriatric population, the number of elderly patients, who need the surgery for painful degenerative spinal stenosis has been increasing. The geriatric population may be relatively high complications, because of age and age-associated medical conditions. However, there is a lack of studies addressing the perioperative complications and outcomes in elderly patients with posterior lumbar inter body fusion with screw augmentation (PLIF). Methods: We retrospectively reviewed the medical records and radiographic studies of geriatric patients who had spine surgery of PLIF due to spinal stenosis for 11 years...
November 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29139189/clostridium-difficile-infection-in-hospitalized-octogenarian-patients
#3
Anca Trifan, Irina Girleanu, Carol Stanciu, Egidia Miftode, Camelia Cojocariu, Ana-Maria Singeap, Catalin Sfarti, Stefan Chiriac, Tudor Cuciureanu, Oana Stoica
AIM: To evaluate the risk factors and outcome of Clostridium difficile infection in hospitalized octogenarian patients. METHODS: A retrospective analysis of risk factors and outcome of C. difficile infection in hospitalized octogenarians was carried out at two academic centers in Romania from January 2014 to September 2016. Demographic, clinical and laboratory characteristics; antibiotics and proton pump inhibitors use in-hospital and 2 months before admission; comorbidities; length of hospital stay; treatment; and outcome were carefully collected from the patients' medical charts and compared with those from octogenarians hospitalized during the same period...
November 15, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29137628/hypertonic-saline-for-prevention-of-delirium-in-geriatric-patients-who-underwent-hip-surgery
#4
Xi Xin, Fei Xin, Xuguang Chen, Qi Zhang, Yanan Li, Shuping Huo, Chongfu Chang, Qiujun Wang
BACKGROUND: Postoperative delirium (POD) is a common disorder in the elderly patients, and neuroinflammation is the possible underlying mechanism. This study is designed to determine whether or not hypertonic saline (HS) pre-injection can alleviate POD in aged patients. METHODS: This prospective study recruited 120 geriatric patients who underwent hip surgery. The patients were randomly divided into two groups: control group (NS group) and HS group. Patients in the NS group were pre-injected with 4 mL/kg isotonic saline, and those in the HS group were pre-injected with 4 mL/kg 7...
November 14, 2017: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/29137576/perioperative-assessment-of-older-surgical-patients-using-a-frailty-index-feasibility-and-association-with-adverse-post-operative-outcomes
#5
H Lin, N M Peel, I A Scott, D L Vardesh, P Sivalingam, R L McBride, J J Morong, M J Nelson, R E Hubbard
This study aimed to examine the feasibility of using a frailty index (FI) based on comprehensive geriatric assessment (CGA), to assess the level of frailty in older surgical patients preoperatively and to evaluate the association of FI-CGA with poorer postoperative outcomes. Two hundred and forty-six patients aged ≥70 years undergoing intermediate- to high-risk surgery in a tertiary hospital were recruited. Frailty was assessed using a 57-item FI-CGA form, with fit, intermediate frail, and frail patients defined as FI ≤0...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29132430/hospital-choice-in-germany-from-the-patient-s-perspective-a-cross-sectional-study
#6
Werner de Cruppé, Max Geraedts
BACKGROUND: In many countries health policy encourages patients to choose their hospital, preferably by considering information of performance reports. Previous studies on hospital choice mainly have focused on patients undergoing elective surgery. This study examined a representative sample of hospital inpatients across disciplines and treatment interventions in Germany. Its research questions were: How many patients decide where to go for hospital treatment? How much time do patients have before admission? Which sources of information do they use, and which criteria are relevant to their decision? METHODS: Cross-sectional observational study covering 1925 inpatients of 46 departments at 17 hospitals in 2012...
November 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29129470/risk-stratification-for-surgical-outcomes-in-older-colorectal-cancer-patients-using-isar-hp-and-g8-screening-tools
#7
Esteban T D Souwer, Norbert M Verweij, Frederiek van den Bos, Esther Bastiaannet, Rob M E Slangen, Willem H Steup, Marije E Hamaker, Johanna E A Portielje
BACKGROUND: Older patients are at risk for adverse outcomes after surgical treatment of cancer. Identifying patients at risk could affect treatment decisions and prevent functional decline. Screening tools are available to select patients for Geriatric Assessment. Until now their predictive value for adverse outcomes in older colorectal cancer patients has not been investigated. OBJECTIVE: To study the predictive value of the Geriatric 8 (G8) and Identification of Seniors at Risk for Hospitalized Patients (ISAR-HP) screening tools for adverse outcomes after elective colorectal surgery in patients older than 70years...
November 9, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/29125861/identification-of-hospitalized-elderly-patients-at-risk-for-adverse-in-hospital-outcomes-in-a-university-orthopedics-and-trauma-surgery-environment
#8
Janine Gronewold, Christian Dahlmann, Marcus Jäger, Dirk M Hermann
BACKGROUND: As a consequence of demographic changes, hospitals are confronted with increasing numbers of elderly patients, who are at high risk of adverse events during hospitalization. Geriatric risk screening followed by comprehensive geriatric assessment (CGA) and treatment has been requested by geriatric societies and task forces to identify patients at risk. Since empirical evidence on factors predisposing to adverse hospital events is scarce, we now prospectively evaluated implications of geriatric risk screening followed by CGA in a university hospital department of orthopedics and trauma surgery...
2017: PloS One
https://www.readbyqxmd.com/read/29125432/association-between-baseline-cognitive-impairment-and-postoperative-delirium-in-elderly-patients-undergoing-surgery-for-adult-spinal-deformity
#9
Owoicho Adogwa, Aladine A Elsamadicy, Victoria D Vuong, Jared Fialkoff, Joseph Cheng, Isaac O Karikari, Carlos A Bagley
OBJECTIVE Postoperative delirium is common in elderly patients undergoing spine surgery and is associated with a longer and more costly hospital course, functional decline, postoperative institutionalization, and higher likelihood of death within 6 months of discharge. Preoperative cognitive impairment may be a risk factor for the development of postoperative delirium. The aim of this study was to investigate the relationship between baseline cognitive impairment and postoperative delirium in geriatric patients undergoing surgery for degenerative scoliosis...
November 10, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29120933/an-overview-of-perioperative-considerations-in-elderly-patients-for-thoracic-surgery-demographics-risk-benefit-and-resource-planning
#10
Maria Castillo
PURPOSE OF REVIEW: Increasing numbers of geriatric patients will present for thoracic surgery as the population ages. The changes in physiologic reserve as well as the increase in comorbid conditions among this population must be considered in order to optimize patient care in the perioperative period. RECENT FINDINGS: For elderly patients with cancer, the risk-benefit relationship for thoracic surgery remains favorable. Consideration of comorbidities, especially chronic obstructive pulmonary disease and congestive heart failure, is important in the setting of surgical treatment, as they have implications for perioperative care as well as postoperative morbidity and mortality...
November 7, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29115653/bridge-treatment-for-early-cholecystectomy-in-geriatric-patients-with-acute-cholecystitis-percutaneous-cholecystostomy
#11
Sezgin Zeren, Zülfü Bayhan, Cengiz Koçak, Uğur Kesici, Mehmet Korkmaz, Mehmet Fatih Ekici, Mustafa Cem Algın, Faik Yaylak
BACKGROUND: The main cause of acute cholecystitis (AC) is gallstones, and the incidence of gallstones in elderly patients is high. METHODS: In this study, we aimed to investigate the efficacy of percutaneous cholecystostomy (PC) before early cholecystectomy in geriatric patients with AC. This retrospective study included 85 patients undergoing laparoscopic or conventional cholecystectomy during early stage of calculous AC. RESULTS: All patients were over 65 years old and were divided into two groups: Group I, PC plus early cholecystectomy and Group II, only cholecystectomy without PC...
November 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29100824/the-25-question-geriatric-locomotive-function-scale-predicts-the-risk-of-recurrent-falls-in-postoperative-patients-with-cervical-myelopathy
#12
Atsushi Kimura, Katsushi Takeshita, Hirokazu Inoue, Atsushi Seichi, Yosuke Kawasaki, Toshitaka Yoshii, Hiroyuki Inose, Takeo Furuya, Kazuhiro Takeuchi, Shunji Matsunaga, Shoji Seki, Mikito Tsushima, Shiro Imagama, Masao Koda, Masashi Yamazaki, Kanji Mori, Hirosuke Nishimura, Kenji Endo, Kei Yamada, Kimiaki Sato, Atsushi Okawa
BACKGROUND: Fall-induced injuries represent a major public health concern for older individuals. The relationship between risk of falling and the severity of locomotive syndrome (LS) remains largely unknown. METHODS: We conducted a retrospective analysis of patients who had undergone surgery from January 2012 to December 2013 and completed at least 1 year of follow-up at 12 participating institutes. Patients completed a questionnaire survey regarding their fall experience during a routine postoperative follow-up...
October 31, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/29100194/cognitive-decline-after-major-oncological-surgery-in-the-elderly
#13
M Plas, E Rotteveel, G J Izaks, J M Spikman, H van der Wal-Huisman, B van Etten, A R Absalom, M J E Mourits, G H de Bock, B L van Leeuwen
BACKGROUND: Elderly patients undergoing oncological surgery experience postoperative cognitive decline. The aims of this study were to examine the incidence of cognitive decline 3 months after surgery and identify potential patient-, disease- and surgery-related risk factors for postoperative cognitive decline in onco-geriatric patients. METHODS: A consecutive series of elderly patients (≥65 years) undergoing surgery for the removal of a solid tumour were included (n = 307)...
October 31, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/29081391/independent-association-between-pre-operative-cognitive-status-and-discharge-location-after-surgery-a-strategy-to-reduce-resource-use-after-surgery-for-deformity
#14
Owoicho Adogwa, Aladine A Elsamadicy, Amanda Sergesketter, Victoria D Vuong, Jessica Moreno, Joseph Cheng, Isaac O Karikari, Carlos A Bagley
BACKGROUND: The aim of this study is to determine if preoperative scores on a screening measure for cognitive status(the Saint Louis Mental Status), were associated with discharge to a location other than home in elderly patients undergoing surgery for deformity. METHODS: Elderly subjects (≥65 years) undergoing a planned elective spinal surgery for correction of adult degenerative scoliosis were enrolled in this study. Pre-operative baseline cognition was assessed using the validated Saint Louis Mental Status (SLUMS) test...
October 25, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29075972/clinical-benefits-of-single-incision-laparoscopic-surgery-for-postoperative-delirium-in-elderly-colon-cancer-patients
#15
Yujiro Nishizawa, Taishi Hata, Ichiro Takemasa, Makoto Yamasaki, Hiroshi Akasaka, Ken Sugimoto, Koki Tamai, Hidekazu Takahashi, Naotsugu Haraguchi, Junichi Nishimura, Chu Matsuda, Tsunekazu Mizushima, Masakazu Ikenaga, Hirofumi Yamamoto, Kohei Murata, Hiromi Rakugi, Yuichiro Doki, Masaki Mori
BACKGROUND: The number of elderly patients with colon cancer is increasing in Japan. Postoperative delirium (POD) is a major complication for elderly patients who undergo surgery, and postoperative pain is a common inducer of POD. We reported previously that single-incision laparoscopic surgery (SLS) significantly reduces postoperative pain compared to conventional laparoscopic surgery (CLS). Data are lacking about the effect of SLS on POD. This retrospective study evaluated the clinical benefits of SLS for POD in elderly patients with colon cancer...
October 26, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29071370/determination-of-the-median-effective-dose-ed50-of-bupivacaine-and-ropivacaine-unilateral-spinal-anesthesia-prospective-double-blinded-randomized-dose-response-trial
#16
WeiBing Wang, YuanHai Li, AiJiao Sun, HongPing Yu, JingChun Dong, Huang Xu
BACKGROUND: Unilateral spinal anesthesia (USpA) has been reported to potentiate spinal anaesthesia and is used in geriatric patients. The purpose of this study was to determine the median effective dose (ED50) of 0.5% hypobaric bupivacaine and 0.5% hypobaric ropivacaine USpA for geriatric patients (age ≥ 70 years) undergoing elective hip replacement surgery. METHODS: A total of 60 geriatric patients (age ≥ 70 years) undergoing elective hip replacement surgery were enrolled in this study...
October 25, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29069040/predictive-validity-of-the-acs-nsqip-surgical-risk-calculator-in-geriatric-patients-undergoing-lumbar-surgery
#17
Xiao Wang, Yanting Hu, Binjiang Zhao, Yue Su
The risk calculator of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) has been shown to be useful in predicting postoperative complications. In this study, we aimed to evaluate the predictive value of the ACS-NSQIP calculator in geriatric patients undergoing lumbar surgery.A total of 242 geriatric patients who underwent lumbar surgery between January 2014 and December 2016 were included. Preoperative clinical information was retrospectively reviewed and entered into the ACS-NSQIP calculator...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29065869/leading-comorbidity-associated-with-30-day-post-anesthetic-mortality-in-geriatric-surgical-patients-in-taiwan-a-retrospective-study-from-the-health-insurance-data
#18
Chun-Lin Chu, Hung-Yi Chiou, Wei-Han Chou, Po-Ya Chang, Yi-You Huang, Huei-Ming Yeh
BACKGROUND: Elderly patients with aged physical status and increased underlying disease suffered from more postoperative complication and mortality. We design this retrospective cohort study to investigate the relationship between existing comorbidity of elder patients and 30 day post-anesthetic mortality by using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) from Health Insurance Database. METHODS: Patients aged above 65 years old who received anesthesia between 2000 and 2010 were included from 1 million Longitudinal Health Insurance Database in (LHID) 2005 in Taiwan...
October 24, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29059734/re-evaluation-and-establishment-of-a-ward-based-geriatric-liaison-service-for-older-urological-surgical-patients-proactive-care-of-older-people-undergoing-surgery-pops-urology
#19
https://www.readbyqxmd.com/read/29058020/-changes-in-the-patient-population-with-proximal-femur-fractures-over-the-last-decade-incidence-age-comorbidities-and-length-of-stay
#20
Markus Muhm, Matthias Amann, Alexander Hofmann, Thomas Ruffing
BACKGROUND: Over the last decade, the percentage of people >65 years has increased from 16.6% to 20.7%. In industrialized countries, the annual incidence in people >65 years with a proximal femur fracture is about 600-900 per 100,000 population. The incidence will increase by 3-5% per year. Guidelines advocate early surgery as soon as possible but within 24 h. External quality control requires surgical treatment within 48 h. In this study, the changes in the patient population with proximal femur fractures and their treatment during the last decade were investigated...
October 20, 2017: Der Unfallchirurg
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