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Geriatric preoperative assessment

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https://www.readbyqxmd.com/read/29162957/geriatric-pelvic-organ-prolapse-surgery-going-the-extra-mile
#1
Seethalakshmi Krishnan
Background: To assess the quality of life in geriatric patients after reconstructive and obliterative vaginal surgery for advanced pelvic organ prolapse (POP). Methods: Prospective observational study was conducted between January 2009 and December 2014 at the department of Urogynaecology, Government Kasturbha Gandhi Hospital. A total of 424 women (between the age group of 60 and 94 years) with advanced pelvic organ prolapse underwent vaginal hysterectomy along with vaginal apical suspension procedures which were McCalls culdoplasty (35...
December 2017: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/29137576/perioperative-assessment-of-older-surgical-patients-using-a-frailty-index-feasibility-and-association-with-adverse-post-operative-outcomes
#2
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/29129220/preoperative-screening
#3
REVIEW
Julianna G Marwell, Mitchell T Heflin, Shelley R McDonald
Older adults undergoing elective surgical procedures suffer higher rates of morbidity and mortality than younger patients. A geriatric-focused preoperative evaluation can identify risk factors for complications and opportunities for health optimization and care coordination. Key components of a geriatric preoperative evaluation include (1) assessments of function, mobility, cognition, and mental health; (2) reviews of medical conditions and medications; and (3) discussion of risks, preferences, and goals of care...
February 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29125432/association-between-baseline-cognitive-impairment-and-postoperative-delirium-in-elderly-patients-undergoing-surgery-for-adult-spinal-deformity
#4
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/29081391/independent-association-between-pre-operative-cognitive-status-and-discharge-location-after-surgery-a-strategy-to-reduce-resource-use-after-surgery-for-deformity
#5
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/29069040/predictive-validity-of-the-acs-nsqip-surgical-risk-calculator-in-geriatric-patients-undergoing-lumbar-surgery
#6
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/29034078/recent-advances-in-cancer-surgery-in-older-patients
#7
REVIEW
Siri Rostoft, Riccardo A Audisio
Age is the most important risk factor for the occurrence of cancer, and a declining mortality from heart disease and other non-cancer causes leaves an older population that is at high risk of developing cancer. Choosing the optimal treatment for older cancer patients may be a challenge. Firstly, older age and associated factors such as comorbidities, functional limitations, and cognitive impairment are risk factors for adverse effects of cancer treatment. Secondly, older patients are often excluded from clinical trials, and current clinical guidelines rarely address how to manage cancer in patients who have comorbidities or functional limitations...
2017: F1000Research
https://www.readbyqxmd.com/read/28971482/effect-of-preoperative-geriatric-evaluation-on-outcomes-after-elective-surgery-a-population-based-study
#8
Daniel I McIsaac, Allen Huang, Coralie A Wong, Duminda N Wijeysundera, Gregory L Bryson, Carl van Walraven
BACKGROUND/OBJECTIVES: Randomized and nonrandomized single-center studies suggest that preoperative geriatric evaluation improves postoperative outcomes in older adults. The generalizability and population-level effect of preoperative geriatric evaluation has not been determined. Our objective was to measure the adjusted association between preoperative geriatric evaluation and postoperative outcomes. DESIGN: Multilevel multivariable regression model analysis of a population-based historical cohort...
October 3, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28967093/advances-in-geriatric-oncology-a-multidisciplinary-perspective
#9
Ponnandai Somasundar, Loïc Mourey, Laura Lozza, Stefania Maggi, Rob Stepney
A growing majority of people with cancer is composed of older patients. For many such patients, independence and quality of life are as important as prolongation of survival, emphasizing the need for treatments that are not only effective but also well-tolerated. Given age-related decline in organ function and the prevalence of comorbidities and polypharmacy, optimum management is complex and requires collaboration between oncologists and geriatricians. Advances in surgery now include preoperative assessment and, when indicated, prehabilitation of the patient, as well as the enhanced recovery after surgery approach...
September 27, 2017: Tumori
https://www.readbyqxmd.com/read/28960161/geriatric-comanagement-reduces-perioperative-complications-and-shortens-duration-of-hospital-stay-after-lumbar-spine-surgery-a-prospective-single-institution-experience
#10
Owoicho Adogwa, Aladine A Elsamadicy, Victoria D Vuong, Jessica Moreno, Joseph Cheng, Isaac O Karikari, Carlos A Bagley
OBJECTIVE Geriatric patients undergoing lumbar spine surgery have unique needs due to the physiological changes of aging. They are at risk for adverse outcomes such as delirium, infection, and iatrogenic complications, and these complications, in turn, contribute to the risk of functional decline, nursing home admission, and death. Whether preoperative and perioperative comanagement by a geriatrician reduces the incidence of in-hospital complications and length of in-hospital stay after elective lumbar spine surgery remains unknown...
September 29, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28953670/poor-prognosis-after-surgery-for-intertrochanteric-fracture-in-elderly-patients-with-clopidogrel-treatment-a-cohort-study
#11
Jianzheng Zhang, Xiaobin Chen, Juan Wang, Zhi Liu, Xiaowei Wang, Jixin Ren, Tiansheng Sun
Choice of surgical approach in patients under clopidogrel treatment is controversial. Intertrochanteric fractures are common in the elderly, who also suffer from a number of comorbidities.The aim of this study is to assess the prognosis of elderly patients with clopidogrel treatment after surgery for intertrochanteric fracture.This was a cohort study of 238 elderly patients who underwent proximal femur intramedullary nailing for intertrochanteric fracture between January 2012 and December 2013 at the Geriatric Trauma Center of the Beijing Army General Hospital...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28888555/functional-impairment-prior-to-major-non-cardiac-surgery-is-associated-with-mortality-within-one-year-in-elderly-patients-with-gastrointestinal-gynaecological-and-urogenital-cancer-a-prospective-observational-cohort-study
#12
Maren Schmidt, Rahel Eckardt, Sarah Altmeppen, Klaus-Dieter Wernecke, Claudia Spies
OBJECTIVE: To investigate the prognostic value of elements of the Geriatric Assessment, in particular the Timed Up and Go (TUG) Test and the Barthel Index of Activities of Daily Living (ADL) for one-year post-operative mortality in elderly patients with cancer. MATERIALS AND METHODS: This prospective cohort study included patients 65years of age or older undergoing elective major surgery for cancer between June 2008 and June 2010. Preoperative functional status was measured by the TUG Test and the Barthel Index of ADL Cognitive state was assessed by the Mini Mental State Examination (MMSE)...
September 6, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28882527/successful-lumbar-surgery-results-in-improved-psychological-well-being-a-longitudinal-assessment-of-depressive-and-anxiety-symptoms
#13
Carol A Mancuso, Roland Duculan, Frank P Cammisa, Andrew A Sama, Alexander P Hughes, Darren R Lebl, Federico P Girardi
BACKGROUND CONTEXT: Preoperative psychological symptoms predict surgical outcomes. The impact of surgical outcomes on psychological well-being, however, has not been delineated. PURPOSE: To compare pre- to postoperative depressive and anxiety symptoms based on success of surgery, defined as fulfilled expectations and improvement in disability and pain. STUDY DESIGN/SETTING: Prospective two-year longitudinal study in a tertiary care center PATIENT SAMPLE: 276 lumbar surgery patients OUTCOME MEASURES: the Geriatric Depression Scale (GDS) and the Spielberger State Anxiety Inventory (STAI) METHODS: Patients completed the following validated surveys several days before and again two years after surgery: the GDS with a set threshold for a positive screen for depression; the STAI with population norms used as threshold values; the Oswestry Disability Index (ODI); a numerical pain rating; and the Expectations Survey measuring amount of improvement expected...
September 4, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28866353/frail-questionnaire-screening-tool-and-short-term-outcomes-in-geriatric-fracture-patients
#14
Lauren Jan Gleason, Emily A Benton, M Loreto Alvarez-Nebreda, Michael J Weaver, Mitchel B Harris, Houman Javedan
OBJECTIVES: There are limited screening tools to predict adverse postoperative outcomes for the geriatric surgical fracture population. Frailty is increasingly recognized as a risk assessment to capture complexity. The goal of this study was to use a short screening tool, the FRAIL scale, to categorize the level of frailty of older adults admitted with a fracture to determine the association of each frailty category with postoperative and 30-day outcomes. DESIGN: Retrospective cohort study...
August 30, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28851486/geriatric-rescue-after-surgery-gras-score-to-predict-failure-to-rescue-in-geriatric-emergency-general-surgery-patients
#15
Muhammad Khan, Asad Azim, Terence O'Keeffe, Faisal Jehan, Narong Kulvatunyou, Chelsey Santino, Andrew Tang, Gary Vercruysse, Lynn Gries, Bellal Joseph
BACKGROUND: Geriatric-patients(GP) undergoing emergency-general-surgery(EGS) are vulnerable to develop adverse-outcomes. Impact of patient-level-factors on Failure-to-Rescue(FTR) in EGS-GP remains unclear. Aim of our study was to determine factors associated with FTR(death from major-complication) and devise simple-bedside-score that predicts FTR in EGS-GP. METHODS: 3-year(2013-15) analysis of patients, age≥65y on acute-care-surgery-service and underwent EGS. Regression analysis used to analyze factors associated with FTR and natural-logarithm of significant odds-ratio used to calculate estimated-weights for each factor...
August 15, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28776893/preoperative-medication-use-and-its-association-with-postoperative-length-of-hospital-stay-in-surgical-oncology-patients-receiving-comprehensive-geriatric-assessment
#16
Young Mi Jeong, Kyung Eun Lee, Eun Sook Lee, Kwang Ill Kim, Jee Eun Chung, Byung Koo Lee, Hye Sun Gwak
AIM: The present study aimed to investigate whether preoperative medication use is associated with postoperative length of hospital stay in older adults undergoing cancer surgery. METHODS: Patients aged ≥65 years who were scheduled for cancer surgery and presented for preoperative comprehensive geriatric assessment were included in the present study. Cognitive function evaluation and preoperative medication review were carried out, as well as baseline characteristics of participants collected from electronic medical records...
August 4, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28768325/estimating-risk-of-postsurgical-general-and-geriatric-complications-using-the-vespa-preoperative-tool
#17
Lillian Min, Karen Hall, Emily Finlayson, Michael Englesbe, William Palazzolo, Chiao-Li Chan, Hechuan Hou, Ashley Miller, Kathleen M Diehl
Importance: As greater numbers of older patients seek elective surgery, one approach to preventing postoperative complications is enhanced assessment of risks during preoperative evaluation. Objective: To determine whether a geriatric assessment tool can be implemented in a preoperative clinic and can estimate risk of postoperative complications. Design, Setting, and Participants: In this prospective cohort study, patients 70 years of age or older were assessed in a preoperative clinic for elective surgery from July 9, 2008, to January 5, 2011...
August 2, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28765416/the-physician-s-role-in-perioperative-management-of-older-patients-undergoing-surgery
#18
Adam L Gordon, Barry J Evans, Jugdeep Dhesi
Life-sustaining and life-improving surgical interventions are increasingly available to older, frailer patients, many of whom have multimorbidity. Physicians can help support perioperative multidisciplinary teams with assessment and preoperative optimisation of physiological reserve, comorbidities and associated geriatric syndromes. Similar structured support can be useful in the postoperative period where older patients are at increased risk of delirium, medical complications, increased functional dependency and where discharge planning can prove more difficult than in younger cohorts...
July 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28742701/postoperative-delirium-as-a-target-for-surgical-quality-improvement
#19
Julia R Berian, Lynn Zhou, Marcia M Russell, Melissa A Hornor, Mark E Cohen, Emily Finlayson, Clifford Y Ko, Ronnie A Rosenthal, Thomas N Robinson
OBJECTIVE: To explore hospital-level variation in postoperative delirium using a multi-institutional data source. BACKGROUND: Postoperative delirium is closely related to serious morbidity, disability, and death in older adults. Yet, surgeons and hospitals rarely measure delirium rates, which limits quality improvement efforts. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Geriatric Surgery Pilot (2014 to 2015) collects geriatric-specific variables, including postoperative delirium using a standardized definition...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28715824/preoperative-geriatric-assessment-reduced-hospital-stay-and-complications-in-patients-%C3%A2-%C3%A2-65-y-having-vascular-surgery
#20
Harrison G Weed
No abstract text is available yet for this article.
July 18, 2017: Annals of Internal Medicine
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