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Frailty and surgery

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https://www.readbyqxmd.com/read/29773431/preoperative-frailty-assessment-predicts-loss-of-independence-after-vascular-surgery
#1
Graham W Donald, Amir A Ghaffarian, Farid Isaac, Larry W Kraiss, Claire L Griffin, Brigitte K Smith, Mark R Sarfati, Julie L Beckstrom, Benjamin S Brooke
OBJECTIVE: Frailty, a clinical syndrome associated with loss of metabolic reserves, is prevalent among patients who present to vascular surgery clinics for evaluation. The Clinical Frailty Scale (CFS) is a rapid assessment method shown to be highly specific for identifying frail patients. In this study, we sought to evaluate whether the preoperative CFS score could be used to predict loss of independence after major vascular procedures. METHODS: We identified all patients living independently at home who were prospectively assessed using the CFS before undergoing an elective major vascular surgery procedure (admitted for >24 hours) at an academic medical center between December 2015 and December 2017...
May 14, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29772594/-upper-age-limit-in-outpatient-anesthesia-opportunities-and-risks
#2
Tobias Hüppe, Nicole Kneller, Alexander Raddatz
Ambulatory surgery in elderly patients continues to increase - avoiding hospitalization and thus postoperative cognitive dysfunction in older patients being its major objectives. An upper age limit in outpatient anesthesia does not exist to date. However, functional rather than chronological age is crucial in patient selection. In consensus discussion, baseline functional status should be evaluated regularly - defined as everyday behaviors necessary to maintain daily life and encompassing areas of physical, cognitive, and social functioning...
May 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29770549/importance-of-frailty-evaluation-in-the-prediction-of-the-prognosis-of-patients-with-chronic-subdural-hematoma
#3
Kiyoharu Shimizu, Takashi Sadatomo, Takeshi Hara, Shumpei Onishi, Kiyoshi Yuki, Kaoru Kurisu
AIM: The present study aimed to clarify the relationship between frailty and prognosis of patients with chronic subdural hematoma. METHODS: This retrospective study involved 211 patients aged ≥65 years with chronic subdural hematoma, who underwent surgery at Higashihiroshima Medical Center, Hiroshima, Japan, between July 2011 and May 2017. The study outcome was the patient's modified Rankin Scale score at 3 months after surgery. A logistic regression analysis was carried out to analyze factors that influenced the outcome...
May 17, 2018: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29762340/external-validation-of-the-adult-spinal-deformity-asd-frailty-index-asd-fi-in-the-scoli-risk-1-patient-database
#4
Emily K Miller, Lawrence G Lenke, Brian J Neuman, Daniel M Sciubba, Khaled M Kebaish, Justin S Smith, Yong Qiu, Benny T Dahl, Ferran Pellisé, Yukihiro Matsuyama, Leah Y Carreon, Michael G Fehlings, Kenneth M Cheung, Stephen Lewis, Mark B Dekutoski, Frank J Schwab, Oheneba Boachie-Adjei, Hossein Mehdian, Shay Bess, Christopher I Shaffrey, Christopher P Ames
STUDY DESIGN: Analysis of a prospective multicenter database. OBJECTIVE: To assess the ability of the recently created Adult Spinal Deformity (ASD) Frailty Index (ASD-FI) to predict odds of major complications and length of hospital stay for patients who had more severe preoperative deformity and underwent more invasive ASD surgery compared with patients in the database used to create the index. SUMMARY OF BACKGROUND DATA: Accurate preoperative estimates of risk are necessary given the high complication rates currently associated with ASD surgery...
May 14, 2018: Spine
https://www.readbyqxmd.com/read/29741200/the-utility-of-the-frailty-index-in-clinical-decision-making
#5
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/29733701/the-impact-of-sedentary-and-physical-activity-behaviour-on-frailty-in-middle-aged-and-older-adults
#6
Dustin Scott Kehler
Physical activity and sedentary behaviours are associated with frailty. However, it is unknown if different accumulation patterns of these behaviours are linked with frailty. Four studies were conducted: the first 3 determined if bouts of moderate-vigorous physical activity (MVPA) and patterns of sedentary behaviours were associated with frailty (study 1), and if sex (study 2) and cardiovascular disease (CVD) status (study 3) affected these associations. Study 4 systematically reviewed the evidence to determine if preoperative physical activity and sedentary behaviours were linked to postcardiac surgical outcomes...
May 7, 2018: Applied Physiology, Nutrition, and Metabolism, Physiologie Appliquée, Nutrition et Métabolisme
https://www.readbyqxmd.com/read/29718365/high-and-low-estimated-glomerular-filtration-rates-are-associated-with-adverse-outcomes-in-patients-undergoing-surgery-for-gastrointestinal-malignancies
#7
Takashi Ui, Yoshitsugu Obi, Akihiro Shimomura, Alan K Lefor, Reza Fazl Alizadeh, Hyder Said, Ninh T Nguyen, Michael J Stamos, Kamyar Kalantar-Zadeh, Naohiro Sata, Hirohito Ichii
Background: Abnormally high estimated glomerular filtration rates (eGFRs) are associated with endothelial dysfunction and frailty. Previous studies have shown that low eGFR is associated with increased morbidity, but few reports address high eGFR. The purpose of this study is to evaluate the association of high eGFR with surgical outcomes in patients undergoing surgery for gastrointestinal malignancies. Methods: We identified patients who underwent elective surgery for gastrointestinal malignancies from 2005 to 2015 in the American College of Surgeons National Surgical Quality Improvement Program database...
April 27, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29712598/association-of-increasing-frailty-with-detrimental-outcomes-after-pancreatic-resection
#8
Rodney Lane Guyton, Catalina Mosquera, Konstantinos Spaniolas, Timothy L Fitzgerald
An association between detrimental outcomes and frailty has been documented; however, the impact specific to pancreatic surgery is unknown. Using NSQIP data, patients were classified as non-, mildly, moderately, or severely frail. A total of 16,028 patients were included in the study; most of the patients were white (78.5%) and underwent pancreaticoduodenectomy (PD) (67%). Complications occurred in 17.6 per cent cases, and the median length of stay (LOS) was 11.89 days. Prolonged LOS and mortality occurred in 9...
April 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29708603/evidence-appraisal-of-sandini-m-pinotti-e-persico-i-picone-d-bellelli-g-gianotti-l-systematic-review-and-meta-analysis-of-frailty-as-a-predictor-of-morbidity-and-mortality-after-major-abdominal-surgery-bjs-open-2017-1-5-128-137
#9
https://www.readbyqxmd.com/read/29702425/impact-of-frailty-on-complications-in-patients-with-thoracic-and-thoracolumbar-spinal-fracture
#10
Remi A Kessler, Rafael De la Garza Ramos, Taylor E Purvis, A Karim Ahmed, C Rory Goodwin, Daniel M Sciubba, Muhammad M Abd-El-Barr
OBJECTIVES: It is well-documented that geriatric patients are at risk for serious injuries after fracture due to pre-existing medical conditions, physical changes of aging, and medication effects. Frailty has been demonstrated to be a predictor of morbidity and mortality in inpatient head and neck surgery, and for surgical intervention for adult spinal deformity and degenerative spine disease. However, the impact of frailty on complications following thoracolumbar/thoracic fractures are unknown and has not been previously assessed in the literature, particularly in a nationwide setting...
April 9, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29701364/clinical-utility-of-frailty-scales-for-the-prediction-of-postoperative-complications-systematic-review-and-meta-analysis
#11
Vânia Rocha, Filipe Marmelo, Adelino Leite-Moreira, Daniel Moreira-Gonçalves
INTRODUCTION: Frailty can be defined as a biological syndrome of reduced reserve and resistance to stressful events. Evidence suggests that this syndrome is linked to adverse outcomes in various surgical populations. Several instruments have been developed to measure frailty, however there is no consensus about which one is the most useful in the surgical population. Therefore, this study aims to evaluate the utility of different frailty scales in the prediction of postoperative complications in older surgical population...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29699709/endocrine-surgery-in-the-geriatric-population
#12
REVIEW
John Benjamin McIntire, Susan McCammon, Eric R Mong
Age must be a factor when considering endocrine surgery. Age itself is a risk factor for complications after thyroidectomy, specifically pulmonary, infectious, and cardiac complications. For this reason, in patients with nodular thyroid disease or thyroid microcarcinoma, length of observation must be measured against age and surgical risk. Outcomes of thyroid surgery in geriatric patients can be improved with several measures, including careful preoperative risk stratification based on comorbidities and frailty...
April 23, 2018: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/29683237/establishing-a-proactive-geriatrician-led-comprehensive-geriatric-assessment-in-older-emergency-surgery-patients-outcomes-of-a-pilot-study
#13
Matthew C Mason, Amy L Crees, Matthew R Dean, Nahida Bashir
INTRODUCTION: Increasing numbers of older adults are presenting with acute surgical disease to the unselected general surgical take. General surgeons have little training to manage these patients. We developed a pilot service of proactive geriatrician input into older emergency general surgical patients in a single institution. We wanted to demonstrate if geriatricians improve the management of these patients. METHODS: Patients aged 70 years or older admitted acutely under the general surgeons were assessed proactively by a geriatrician using comprehensive geriatric assessment (CGA)...
April 23, 2018: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/29681636/parkinsonism-as-presenting-symptom-of-primary-hyperparathyroidism-improvement-after-surgery
#14
Delia Luján-Martínez, Ángela Sánchez-Cifuentes, Emilio Peña-Ros, Antonio Albarracín-Marín-Blázquez, Mari Fe Candel-Arenas
Introduction: Hypercalcemia can cause different neurological disorders, depending on the calcium level. We report an exceptional case of primary hyperparathyroidism presenting as neurological alteration and it has favourable outcome after parathyroidectomy. Case report: A 74-year-old woman presented with progressive cognitive deterioration and impaired motor function. The complementary tests showed hypercalcemia due to a parathyroid adenoma. Parathyroidectomy was performed with symptomatic improvement...
2018: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/29672410/derivation-and-validation-of-a-generalizable-preoperative-frailty-index-using-population-based-health-administrative-data
#15
Daniel I McIsaac, Coralie A Wong, Allen Huang, Husein Moloo, Carl van Walraven
OBJECTIVE: To develop and validate a preoperative frailty index (pFI) for use in population-based health administrative (HA) data. SUMMARY BACKGROUND DATA: Frailty is a robust predictor of adverse postoperative outcomes. Population-level frailty measures used in surgical studies have significant methodological limitations. Frailty indices (FIs) are a well-defined approach to measuring frailty with well-described methods for development and evaluation. An appropriate preoperative FI in HA data has not been derived or evaluated...
April 18, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29668839/prognostic-factors-of-functional-outcome-after-hip-fracture-surgery-a-systematic-review
#16
K J Sheehan, L Williamson, J Alexander, C Filliter, B Sobolev, P Guy, L M Bearne, C Sackley
Objective: this systematic review aimed to identify immutable and modifiable prognostic factors of functional outcomes and their proposed mechanism after hip fracture surgery. Design: systematic search of MEDLINE, Embase, CINAHL, PEDRO, OpenGrey and ClinicalTrials.gov for observational studies of prognostic factors of functional outcome after hip fracture among surgically treated adults with mean age of 65 years and older. Study selection, quality assessment, and data extraction were completed independently by two reviewers...
April 12, 2018: Age and Ageing
https://www.readbyqxmd.com/read/29660011/craniotomy-and-survival-for-primary-central-nervous-system-lymphoma
#17
Ali I Rae, Amol Mehta, Michael Cloney, Connor J Kinslow, Tony J C Wang, Govind Bhagat, Peter D Canoll, George J Zanazzi, Michael B Sisti, Sameer A Sheth, E Sander Connolly, Guy M McKhann, Jeffrey N Bruce, Fabio M Iwamoto, Adam M Sonabend
BACKGROUND: Cytoreductive surgery is considered controversial for primary central nervous system lymphoma (PCNSL). OBJECTIVE: To investigate survival following craniotomy or biopsy for PCNSL. METHODS: The National Cancer Database-Participant User File (NCDB, n = 8936), Surveillance, Epidemiology, and End Results Program (SEER, n = 4636), and an institutional series (IS, n = 132) were used. We retrospectively investigated the relationship between craniotomy, prognostic factors, and survival for PCNSL using case-control design...
April 4, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29659475/frailty-screening-and-a-frailty-pathway-decrease-length-of-stay-loss-of-independence-and-30-day-readmission-rates-in-frail-geriatric-trauma-and-emergency-general-surgery-patients
#18
Kathryn E Engelhardt, Quentin Reuter, Jessica Liu, Jonathan F Bean, Joliette Barnum, Michael B Shapiro, Allison Ambre, Amanda Dunbar, Mara Markzon, Tara Reddy, Christine Schilling, Joseph Posluszny
BACKGROUND: Frail geriatric trauma and emergency general surgery (TEGS) patients have longer lengths of stay (LOS), more readmissions, and higher rates of post-discharge institutionalization than their non-frail counterparts. Despite calls to action by national trauma coalitions, there are few published reports of prospective interventions. The objective of this quality improvement (QI) project was to first develop a frailty screening program, and, then, if frail, implement a novel Frailty Pathway to reduce LOS, 30-day readmissions, and loss of independence (LOI)...
April 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29649609/surgical-treatment-improves-survival-of-elderly-with-axis-fracture-a-national-population-based-multi-registry-cohort-study
#19
Anna-Lena Robinson, Claes Olerud, Yohan Robinson
Background Context Fractures of the axis (C2) are the most common cervical spinal injuries in the elderly population. Several authors have reported improved survival among elderly patients with C2 fractures when treated surgically. Purpose To analyze whether surgery improves survival of elderly with C2 fractures. Study Design/ Setting Observational population-based longitudinal multi-registry study Patient Sample Swedish Patient Registry 1997 to 2014, and Swedish Cause of Death Registry 1997 to 2014 Outcome measures Survival after C2 fracture according to non-surgical and surgical treatment...
April 9, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29649027/pain-and-its-long-term-interference-of-daily-life-after-critical-illness
#20
Christina J Hayhurst, Jim C Jackson, Kristin R Archer, Jennifer L Thompson, Rameela Chandrasekhar, Christopher G Hughes
BACKGROUND: Persistent pain likely interferes with quality of life in survivors of critical illness, but data are limited on its prevalence and risk factors. We sought to determine the prevalence of persistent pain after critical illness and its interference with daily life. Additionally, we sought to determine if intensive care unit (ICU) opioid exposure is a risk factor for its development. METHODS: In a cohort of adult medical and surgical ICU survivors, we used the brief pain inventory (BPI) to assess pain intensity and pain interference of daily life at 3 and 12 months after hospital discharge...
April 11, 2018: Anesthesia and Analgesia
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