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Geriatric surgery

Olubode A Olufajo, Gally Reznor, Stuart R Lipsitz, Zara R Cooper, Adil H Haider, Ali Salim, Erika L Rangel
BACKGROUND: The risk of mortality after emergency general surgery (EGS) in elderly patients is prolonged beyond initial hospitalization. Our objective was to develop a preoperative scoring tool to quantify risk of 1-year mortality. METHODS: Three hundred ninety EGS patients aged 70 years or more were analyzed. Risk factors for 1-year mortality were identified using stepwise-forward logistic multivariate regression and weights assigned using natural logarithm of odds ratios...
September 3, 2016: American Journal of Surgery
V Giantin, C Falci, E De Luca, E Valentini, M Iasevoli, P Siviero, S Maggi, B Martella, G Crepaldi, S Monfardini, E Manzato
: The Multidimensional Geriatric Assessment (MGA) is currently used for assessing geriatric oncological patients, but a new prognostic index - the Multidimensional Prognostic Index (MPI) - has a demonstrated prognostic value in cancer patients too. The present work was designed to compare the MPI and MGA as predictors of 12-month mortality. 160 patients ≥70 years old with locally-advanced or metastatic solid cancers consecutively joining our Geriatric Oncology Program were administered a Comprehensive Geriatric Assessment to calculate their MGA and MPI scores...
October 10, 2016: European Journal of Cancer Care
YaoYao G Pollock, Amanda L Blackford, Stacie C Jeter, Jean Wright, Ashley Cimino-Mathews, Melissa Camp, Susan Harvey, Fariba Asrari, Nancy L Schoenborn, Vered Stearns
PURPOSE: In 2004, The National Comprehensive Cancer Network (NCCN) Guidelines incorporated omission of radiation therapy after breast-conservation surgery in women ≥70 years old with stage I, estrogen receptor-positive breast cancer who plan to receive endocrine therapy. One study demonstrated wide variation in implementing this change across 13 NCCN institutions. We evaluated the practice pattern at our institution. METHODS: We identified women ≥70 years old treated at our institution from 2009 to 2014...
November 2016: Breast Cancer Research and Treatment
Megan E Gornet, Michael P Kelly
Fractures of the second cervical vertebra (C2, axis) are common in adult spine surgery. Those fractures occurring in younger adult patients are often associated with high-energy mechanism trauma, resulting in a "Hangman's Fracture." Management of these fractures is often successful with nonoperative means, though surgery may be needed in those fractures with greater displacement and injury to the C2-C3 disc. Older patients are more likely to sustain fractures of the odontoid process. The evidence supporting surgical management of these fractures is evolving, as there may be a mortality benefit to surgery...
September 29, 2016: Current Reviews in Musculoskeletal Medicine
C Ihle, C Bahrs, T Freude, M Bickel, I Spielhaupter, E Wintermeyer, L Stollhof, L Grünwald, P Ziegler, S Pscherer, U Stöckle, A Nussler
Background: The prevalence of malnutrition in hospitalised patients is reported to be between 16 and 55 % across disciplines. Within hospital care, screening for malnutrition is required. However, in orthopaedics and trauma surgery, there is still no generally accepted recommendation for the methods for such a data survey. In the present study, the following aspects are to be investigated with the help of two established scores: (1) the prevalence of malnutrition in the patient population of geriatric trauma care, and (2) the correlation between methods of data survey...
September 29, 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
G A A Rebagliati, L Sciumè, P Iannello, A Mottini, A Antonietti, V A Caserta, V Gattoronchieri, Lorenzo Panella, Camilla Callegari
Hip fracture is common in the elderly and it is usually associated with comorbidities and physiological changes which may have an impact on functioning and quality of life. The concept of resilience may explain why this impact varies among patients. The aim of this open, prospective cohort study was to explore the relationships between resilience, frailty and quality of life in orthopedic rehabilitation patients, and also to assess whether these factors might affect rehabilitation outcome. Eighty-one patients, older than 60 years, underwent a multidisciplinary assessment at the beginning and at the end of the rehabilitation period following orthopedic surgery to the lower limb...
July 2016: Functional Neurology
René Aigner, Constantin Salomia, Philipp Lechler, Roman Pahl, Michael Frink
BACKGROUND: The incidence of geriatric ankle fractures has increased during the last few decades. In contrast to younger patients, increased complication rates have been observed. Thus, the goal of the present study was to identify risk factors for perioperative complications following open reduction and internal fixation of geriatric ankle fractures. METHODS: Two hundred thirty-seven patients over the age of 65 years (mean, 72.5 ± 6.1 years) treated for ankle fractures in our institution between 2004 and 2014 were included...
September 23, 2016: Foot & Ankle International
Antonia Rizzuto, Raffaele Serra, Chiara Mignogna, Ilaria Palaia, Franz Ulrich Zittel, Rosario Sacco
BACKGROUND: Laparoscopy is a surgical approach recommended for the treatment of gall bladder disease. It is recommended also in geriatric patients. Recently Single Incision Laparoscopic Cholecystectomy (SILC) has been proposed to minimize surgical trauma, recovery and hospitalization time. However, the results and advantages of SILC in the geriatric population have received minimal attention. This case series review is focused on the results of SILC in the geriatric population. METHODS: The records of 355 patients who had undergone SILC were reviewed...
September 20, 2016: International Journal of Surgery
Antonio Graham, Charles H Brown
Older adults make up an ever-increasing number of patients presenting for surgery, and a significant percentage of these patients will be frail. Frailty is a geriatric syndrome that has been conceptualized as decreased reserve when confronted with stressors, although the precise definition of frailty has not been easy to standardize. The 2 most popular approaches to define frailty are the phenotypic approach and the deficit accumulation approach, although at least 20 tools have been developed, which has made comparison across studies difficult...
September 12, 2016: Anesthesia and Analgesia
Kui Hu, Jun Li, Yun Wan, Tao Hong, Shu-Yang Lu, Chang-Fa Guo, Chun-Sheng Wang
BACKGROUND: A considerable proportion of elderly patients with symptomatic severe heart valve disease are treated conservatively despite clear indications for surgical intervention. However, little is known about how advanced age and comorbidities affect treatment decision-making and therapeutic outcomes. METHODS: Patients (n = 234, mean age: 78.5 ± 3.7 years) with symptomatic severe heart valve disease hospitalized in our center were included. One hundred and fifty-one patients (65%) were treated surgically (surgical group) and 83 (35%) were treated conservatively (conservative group)...
July 2016: Journal of Geriatric Cardiology: JGC
Giulio Mari, Andrea Costanzi, Elisa Galfrascoli, Andrea Rosato, Jacopo Crippa, Dario Maggioni
Laparoscopic anterior rectal resection with total mesorectal excision is related to sexual and urinary disorders. Anastomotic leak and neo-adjuvant radiation therapy are effective factors in worsening pelvic function. We report a series of 50 elderly (age 70) patients who underwent laparoscopic total mesorectal excision inquired about pre and post-operative genito-urinary function. Patients were interviewed preoperatively, 1 and 9 months post-operatively with validated questionnaires about sexual and urinary function and quality of life...
July 2016: Chirurgia
A R Mothes, T Lehmann, A Kwetkat, M P Radosa, I B Runnebaum
BACKGROUND: The aim of this study is to compare very elderly female patients with a younger control group after prolapse surgery with regard to co-morbidity and complications. METHOD: In a case-control design, the consecutive data of patients after prolapse surgery at the age of over 80 years and those of a control group were analysed by means of the Clavien-Dindo (CD) classification of surgical complications, the Charlson Comorbidity Index and the Cumulative Illness Rating Scale Geriatrics (CIRS-G)...
August 2016: Geburtshilfe und Frauenheilkunde
Lee Eric Rubin, Travis D Blood, Julio C Defillo-Draiby
A rapidly aging population is currently reshaping the demographic profile of the United States. Among older patients, the cohort aged >80 years is not only living longer but also is electing to undergo more total hip and knee arthroplasties. To improve perioperative safety, orthopaedic surgeons should understand the risks and clinical outcomes of arthroplasty in patients of advanced age. Although morbidity and mortality rates are higher for patients aged >80 years than for younger patients undergoing total hip and knee arthroplasties and revision surgeries, functional outcomes, pain relief, and patient satisfaction are consistent between groups...
October 2016: Journal of the American Academy of Orthopaedic Surgeons
Ersin Ercin, M Gokhan Bilgili, Cihangir Sari, S Hakan Basaran, Bulent Tanriverdi, Erdem Edipoglu, K Mumtaz Celen, Halil Cetingok, Cemal Kural
BACKGROUND: Only a little is known about whether type of surgical intervention has an effect on mortality of these patients. Our primary objective was to assess whether different type of surgical procedures has an effect on mortality among elderly patients with hip fracture. A secondary objective was to examine factors that are related to mortality in our patient population. Our hypothesis is that type of surgical procedure, especially external fixation, should have an influence on mortality outcomes...
August 31, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
C Stadler, M Gosch, T Roth, C Neuerburg, C Kammerlander
BACKGROUND: The treatment of geriatric patients in the field of trauma surgery is increasingly gaining importance. To provide optimized treatment to these mostly multimorbid patients, interdisciplinary treatment concepts between trauma surgeons and geriatricians have been designed and implemented successfully. OBJECTIVES: The aim of this survey was to evaluate the current state of interdisciplinary management in the treatment of geriatric patients on trauma surgery wards throughout Austria...
August 30, 2016: Der Unfallchirurg
C Gatot, A Cc Chou, T S Howe, W Yeo, H C Chong, J Sb Koh
PURPOSE: To identify predictors for rehabilitation outcome in Asian geriatric hip fracture patients. METHODS: Records of 153 consecutive Asian patients aged 61 to 99 years who underwent surgery for hip fracture and were followed up for at least one year were reviewed. They were stratified into 4 agegroups: 60-69 years (n=27), 70-79 years (n=70), 80-89 years (n=50), and ≥90 years (n=6). Any comorbidity, regardless of severity, was recorded. Pre-injury and postoperative functional status was evaluated using the 36-item Short Form Health Survey...
August 2016: Journal of Orthopaedic Surgery
Nicolas Mottet, Joaquim Bellmunt, Michel Bolla, Erik Briers, Marcus G Cumberbatch, Maria De Santis, Nicola Fossati, Tobias Gross, Ann M Henry, Steven Joniau, Thomas B Lam, Malcolm D Mason, Vsevolod B Matveev, Paul C Moldovan, Roderick C N van den Bergh, Thomas Van den Broeck, Henk G van der Poel, Theo H van der Kwast, Olivier Rouvière, Ivo G Schoots, Thomas Wiegel, Philip Cornford
OBJECTIVE: To present a summary of the 2016 version of the European Association of Urology (EAU) - European Society for Radiotherapy & Oncology (ESTRO) - International Society of Geriatric Oncology (SIOG) Guidelines on screening, diagnosis, and local treatment with curative intent of clinically localised prostate cancer (PCa). EVIDENCE ACQUISITION: The working panel performed a literature review of the new data (2013-2015). The guidelines were updated and the levels of evidence and/or grades of recommendation were added based on a systematic review of the evidence...
August 25, 2016: European Urology
B Méry, A Vallard, S Espenel, N Badie, M Thiermant, V Lambert, V Soulier, S Piqueres, K Del Santo, M Ben Mrad, G Wang, P Diao, J Langrand-Escure, R Rivoirard, J-B Guy, A Guillot, A-F Chanelière, R Gonthier, E Achour, P Fournel, N Magné
INTRODUCTION: The aim of this study was to appreciate the place and role of geriatric assessment in elderly patients with prostate cancer. MATERIALS AND METHODS: We performed a retrospective analysis of prostate cancer patients who underwent geriatric assessment during the therapeutic management from 2008 to 2014. Patient, tumor, treatment characteristics and their associated toxicity as well as the parameters of geriatric assessment were studied. The occurrence of geriatric assessment within the 3 months preceding a therapeutic decision was reviewed...
September 2016: Progrès en Urologie
M Thaeter, M Knobe, M Vande Kerckhove, F Böhle, J Herold, E Verhaven, H-C Pape
PURPOSE: Interleukin-6 is a mainly proinflammatory interleukin and an indicator for the magnitude of surgery. The IL-6 serum concentration correlates with injury severity, the extent of tissue trauma and has negative impact on prognosis. To date it is unclear whether the immunologic changes assessed are age dependent. The aim of this study is to compare the surgical inflammatory response in different age groups. METHODS: Data were collected at a level-1 university trauma center in a prospective, consecutive cohort study...
October 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Alexandre Villeneuve, Caroline Hommet, Charles Aussedat, Emmanuel Lescanne, Kevin Reffet, David Bakhos
The objective of this study is to assess the validity of ASSR as a complementary diagnostic test for peripheral hearing loss by proving a significant correlation between behavioral thresholds and ASSR. The design used in this study is monocentric prospective study from November 2014 to April 2015. The setting used in this study is the ENT-Head and Neck Surgery Department and Geriatrics Department in a French Regional and University Hospital. The participants are patients over 75 years with cognitive impairment (Alzheimer's disease or mild-cognitive impairment) with a Mini-Mental State Examination score under 27/30 and without hearing aids...
August 23, 2016: European Archives of Oto-rhino-laryngology
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