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Geriatric surgery

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https://www.readbyqxmd.com/read/29340736/risk-factors-for-early-infection-following-hemiarthroplasty-in-elderly-patients-with-a-femoral-neck-fracture
#1
Dirk Zajonz, Alexander Brand, Christian Lycke, Orkun Özkurtul, Jan Theopold, Ulrich J A Spiegl, Andreas Roth, Christoph Josten, Johannes K M Fakler
PURPOSE: Periprosthetic joint infections (PJI) after hemiarthroplasty for geriatric femoral neck fractures are a devastating complication that results in serious morbidity and increased mortality. Identifying risk factors associated with early infection after HA for hip fractures may offer an opportunity to address and prevent this complication in many patients. The aim of this study was to evaluate preoperative risk factors for early PJI after HA in hip fracture patients. METHODS: From January 2010 to December 2015, 312 femoral neck fractures (AO/OTA 31-B) in 305 patients were included in this single-center, retrospective study...
January 16, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29337447/-geriatric-medicine
#2
Gabriel Gold, Christophe Büla, Pierre Olivier Lang, Philippe Chassagne
2017 highlights benefits of prevention. Better control of cardiovascular risk reduces the incidence of dementia and monthly high-dose vitamin D the incidence of respiratory infections in nursing home. Pre-operative geriatric assessment lowers by 20% the rate of delirium after hip-fracture surgery and complications in vascular surgery. Deleterious effects are also reported. High-dose vitamin D triples the rate of falls in supplemented residents and doesn't improve gait speed in sedentary men. Widely used in cardiovascular prevention, antithrombotic therapy is associated with an astonishing risk of subdural bleeding that further increases with the number of drugs combined together...
January 10, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29336006/the-place-of-frailty-and-vulnerability-in-the-surgical-risk-assessment-should-we-move-from-complexity-to-simplicity
#3
Mario Barbagallo, Ligia J Dominguez, Domenico Cucinotta
Due to aging of the world population, older patients accessing health services are becoming continuously more frequent. This has increased the interest in assessing frailty and vulnerability in all specialties and general medicine. Although the term frailty has been recognized for over 30 years, there is not yet a universally recognized definition, and different care providers assess frailty and vulnerability with dissimilar tools, from very complex to very simple validated scales. Being treated with respect and dignity at the right time and place is the key message, as well as after undergoing a global evaluation both in urgency/emergency and in programmed surgery for all older surgical patients...
January 15, 2018: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29334273/the-barthel-index-and-the-cumulated-ambulation-score-are-superior-to-the-de-morton-mobility-index-for-the-early-assessment-of-outcome-in-patients-with-a-hip-fracture-admitted-to-an-acute-geriatric-ward
#4
Signe Hulsbæk, Rikke Faebo Larsen, Susanne Rosthøj, Morten Tange Kristensen
PURPOSE: To examine clinimetric properties of the de Morton Mobility Index (DEMMI) in patients with hip fracture in comparison with the modified Barthel Index (BI), Cumulated Ambulation Score (CAS), and 30-s Chair Stand Test (30-s CST). MATERIALS AND METHODS: Two hundred and twenty two patients with a hip fracture admitted to a geriatric ward following surgery were assessed on day 1 and at discharge (mean of 9 [SD 5.1] post-surgery days). RESULTS: Ninety eight percent and 89% of patients were not able to perform the 30-s CST at baseline and at discharge (large floor effect), respectively...
January 15, 2018: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29332302/preoperative-cognitive-impairment-as-a-predictor-of-postoperative-outcomes-in-a-collaborative-care-model
#5
Kahli Zietlow, Shelley R McDonald, Richard Sloane, Jeffrey Browndyke, Sandhya Lagoo-Deenadayalan, Mitchell T Heflin
OBJECTIVES: To compare postoperative outcomes of individuals with and without cognitive impairment enrolled in the Perioperative Optimization of Senior Health (POSH) program at Duke University, a comanagement model involving surgery, anesthesia, and geriatrics. DESIGN: Retrospective analysis of individuals enrolled in a quality improvement program. SETTING: Tertiary academic center. PARTICIPANTS: Older adults undergoing surgery and referred to POSH (N = 157)...
January 13, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29325567/identifying-older-adults-at-risk-of-harm-following-elective-surgery-a-systematic-review-and-meta-analysis
#6
Jennifer Watt, Andrea C Tricco, Catherine Talbot-Hamon, Ba' Pham, Patricia Rios, Agnes Grudniewicz, Camilla Wong, Douglas Sinclair, Sharon E Straus
BACKGROUND: Elective surgeries can be associated with significant harm to older adults. The present study aimed to identify the prognostic factors associated with the development of postoperative complications among older adults undergoing elective surgery. METHODS: Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and AgeLine were searched for articles published between inception and April 21, 2016. Prospective studies reporting prognostic factors associated with postoperative complications (composite outcome of medical and surgical complications), functional decline, mortality, post-hospitalization discharge destination, and prolonged hospitalization among older adults undergoing elective surgery were included...
January 12, 2018: BMC Medicine
https://www.readbyqxmd.com/read/29325184/-distal-humerus-fracture-in-the-elderly
#7
Johannes E Plath, Stefan Förch, Thomas Haufe, Edgar Johann Mayr
Distal humerus fractures show increasing incidence with age. Due to preexisting osteoporosis, the surgeon is regularly confronted with complex comminuted intraarticular fractures. The maintenance of autonomy in daily life and avoidance of permanent care dependency is a dogma in the care of geriatric patients. Accordingly, a stable post-operative situation that allows early functional post-operative treatment is mandatory, especially in the elderly patient. Open reduction and stable internal fixation using double plate osteosynthesis are the current osteosynthetic standard of treatment...
January 11, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29318082/a-review-of-a-workers-compensation-database-2003-to-2013-patient-factors-influencing-return-to-work-and-cumulative-financial-claims-after-rotator-cuff-repair-in-geriatric-workers-compensation-cases
#8
Edward Shields, Caroline Thirukumaran, Katia Noyes, Ilya Voloshin
Background: Workers' compensation status is associated with poor outcomes after rotator cuff repair surgery. The purpose of this study was to analyze a database of geriatric workers' compensation patients after surgical repair of the rotator cuff and identify both medical and nonmedical patient factors that influence the time it takes for them to return to work at full duty, including a comparison of arthroscopic and open techniques. Methods: An all workers' compensation database was queried for rotator cuff claims that were surgically managed using arthroscopic, open, or both approaches from 2003 to 2013 in patients aged ≥60...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29317368/interdisciplinary-care-model-independently-decreases-use-of-critical-care-services-after-corrective-surgery-for-adult-degenerative-scoliosis
#9
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 is to determine whether an interdisciplinary team approach mitigates use of intensive care unit (ICU) resources. METHODS: A unique co-management 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...
January 6, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29315181/cochlear-implant-surgery-and-the-risk-of-falls-in-an-adult-population
#10
Julia Louza, Caspar Leon Klappert, Georg Ledderose, Robert Gürkov, Eike Krause
OBJECTIVE: To determine the effect of cochlear implant surgery on the balance and risk of falls in an adult patient population using a mobile posturograph. DESIGN: Prospective clinical pilot study. SETTING: Cochlear implant center at a tertiary referral hospital. SUBJECTS AND METHODS: Twenty adult patients undergoing cochlear implant surgery were tested using a mobile posturograph (VertiGuard). The standard balancing deficit test, or the geriatric standard balancing deficit test protocol (for patients older than 60 yr), was performed both 1 day before and 3 to 5 days after surgery...
February 2018: Otology & Neurotology
https://www.readbyqxmd.com/read/29313883/simple-method-of-screening-for-frailty-in-older-adults-using-a-chronometer-and-tape-measure-in-clinic
#11
Hee-Won Jung, Min-Gu Kang, Jung-Yeon Choi, Sol-Ji Yoon, Sun-Wook Kim, Kwang-Il Kim, Cheol-Ho Kim
OBJECTIVES: Detecting frailty in older adults scheduled for surgery is important to predict the occurrence of adverse outcomes, but because of its complexity, frailty screening is not commonly performed. The objective of the current study was to assess whether frailty can be screened for using automatically measured usual gait speed (UGS) and mid-arm circumference (MAC) in the outpatient clinic. DESIGN: Prospective, cross-sectional study. SETTING: Geriatric center of a tertiary hospital...
January 4, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29302797/proactive-care-of-older-people-undergoing-surgery
#12
Judith Partridge, Magda Sbai, Jugdeep Dhesi
The number of older patients undergoing surgery is increasing due to changing demographics, surgical and anaesthetic advances and shifts in patient expectations of healthcare. The benefits of surgery in older people are well documented and include symptom control and increased life expectancy. However, older surgical patients present not only with the index pathology requiring surgery but with concurrent age related physiological decline, multimorbidity and geriatric syndromes. These additional issues increase the risk of adverse postoperative outcome, in particular of postoperative medical and functional complications...
January 4, 2018: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29299599/association-of-integrated-care-coordination-with-postsurgical-outcomes-in-high-risk-older-adults-the-perioperative-optimization-of-senior-health-posh-initiative
#13
Shelley R McDonald, Mitchell T Heflin, Heather E Whitson, Thomas O Dalton, Michael E Lidsky, Phillip Liu, Cornelia M Poer, Richard Sloane, Julie K Thacker, Heidi K White, Mamata Yanamadala, Sandhya A Lagoo-Deenadayalan
Importance: Older adults undergoing elective surgery experience higher rates of preventable postoperative complications than younger patients. Objective: To assess clinical outcomes for older adults undergoing elective abdominal surgery via a collaborative intervention by surgery, geriatrics, and anesthesia focused on perioperative health optimization. Design, Setting, and Participants: Perioperative Optimization of Senior Health (POSH) is a quality improvement initiative with prospective data collection...
January 3, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29298301/mapping-of-global-scientific-research-in-comorbidity-and-multimorbidity-a-cross-sectional-analysis
#14
Ferrán Catalá-López, Adolfo Alonso-Arroyo, Matthew J Page, Brian Hutton, Rafael Tabarés-Seisdedos, Rafael Aleixandre-Benavent
BACKGROUND: The management of comorbidity and multimorbidity poses major challenges to health services around the world. Analysis of scientific research in comorbidity and multimorbidity is limited in the biomedical literature. This study aimed to map global scientific research in comorbidity and multimorbidity to understand the maturity and growth of the area during the past decades. METHODS AND FINDINGS: This was a cross-sectional analysis of the Web of Science...
2018: PloS One
https://www.readbyqxmd.com/read/29289445/incidence-risk-factors-and-clinical-implications-of-pneumonia-after-surgery-for-geriatric-hip-fracture
#15
Daniel D Bohl, Robert A Sershon, Bryan M Saltzman, Brian Darrith, Craig J Della Valle
BACKGROUND: Little is known regarding the occurrence of pneumonia after hip fracture surgery. The purpose of this study is to determine the incidence, risk factors, and clinical implications of pneumonia after surgery for geriatric hip fracture. METHODS: The American College of Surgeons National Surgical Quality Improvement Program was used to retrospectively study geriatric patients undergoing surgery for hip fracture during 2006-2014. Independent risk factors for developing pneumonia within 30 days of surgery were identified using multivariate regression...
December 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29287123/interventions-to-improve-the-outcomes-of-frail-people-having-surgery-a-systematic-review
#16
Daniel I McIsaac, Tim Jen, Nikhile Mookerji, Abhilasha Patel, Manoj M Lalu
BACKGROUND: Frailty is an important prognostic factor for adverse outcomes and increased resource use in the growing population of older surgical patients. We identified and appraised studies that tested interventions in populations of frail surgical patients to improve perioperative outcomes. METHODS: We systematically searched Cochrane, CINAHL, EMBASE and Medline to identify studies that tested interventions in populations of frail patients having surgery. All phases of study selection, data extraction, and risk of bias assessment were done in duplicate...
2017: PloS One
https://www.readbyqxmd.com/read/29279055/chronic-rhinosinusitis-with-nasal-polyps-in-the-elderly-assessing-current-evidence
#17
Gino Marioni, Claudia Zanotti, Giuseppe Brescia
BACKGROUND: The recently reported prevalence of chronic rhinosinusitis (CRS) among people >60 years old was 4.7%, with CRS emerging as the sixth most common chronic condition in the elderly. There is still a dearth of studies that focused on older patients, however, regarding the characteristics of CRS with nasal polyps (CRSwNP). OBJECTIVE: The emerging role of CRSwNP endotyping to enable a tailored medical approach (for elderly patients also) was investigated...
January 1, 2018: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/29275990/octogenarians-post-acute-care-use-after-cardiac-valve-surgery-and-recovery-clinical-implications
#18
Elizabeth Edmiston, Mary A Dolansky, Melissa Zullo, Daniel E Forman
Octogenarians receiving cardiac valve surgery is increasing and recovery is challenging. Post-acute care (PAC) services assist with recovery, yet services provided in facilities do not provide adequate cardiac-focused care or long-term self-management support. The purpose of the paper was to report post-acute care discharge rates in octogenarians and propose clinical implications to improve PAC services. Using a 2003 Medicare Part A database, we studied post-acute care service use in octogenarians after cardiac valve surgery...
December 21, 2017: Geriatric Nursing
https://www.readbyqxmd.com/read/29274640/effectiveness-of-the-malnutrition-quality-improvement-initiative-on-practitioner-malnutrition-knowledge-and-screening-diagnosis-and-timeliness-of-malnutrition-related-care-provided-to-older-adults-admitted-to-a-tertiary-care-facility-a-pilot-study
#19
Heidi J Silver, Kelsey Jones Pratt, Michelle Bruno, Joe Lynch, Kristi Mitchell, Sharon M McCauley
BACKGROUND: Malnutrition is present in 30% to 50% of hospitalized patients aged 60 years or older. As few as 3.2% of patients identified as high risk have a malnutrition diagnosis documented by medical providers. The Malnutrition Quality Improvement Initiative (MQii) aims to reduce the burden of hospital malnutrition by improving the process and delivery of care. OBJECTIVE: To evaluate implementing the MQii toolkit of best practice resources for screening, diagnosis, documentation, and timeliness of malnutrition care...
January 2018: Journal of the Academy of Nutrition and Dietetics
https://www.readbyqxmd.com/read/29259553/indication-of-cognitive-change-and-associated-risk-factor-after-thoracic-surgery-in-the-elderly-a-pilot-study
#20
Kay Kulason, Rui Nouchi, Yasushi Hoshikawa, Masafumi Noda, Yoshinori Okada, Ryuta Kawashima
Background: This pilot study investigated the effects of partial pulmonary lobectomy lung surgery on cognitive functions of elderly Japanese patients. It is recognized that elderly patients undergoing surgery have increased risk of Postoperative Cognitive Decline (POCD), a condition in which learning, memory, and processing speed is greatly reduced after surgery. Since elderly patients are more likely to exhibit symptoms of POCD, the incidence is increasing as the population receiving surgery is aging. Methods: Cognitive function was measured for all subjects (n = 12) before and after surgery using three different cognitive tests: Mini-Mental Status Exam-Japanese (MMSE-J), Frontal Assessment Battery (FAB), and a computerized Cogstate Brief Battery (CBB)...
2017: Frontiers in Aging Neuroscience
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