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Geriatric preoperative assessment

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
Harrison G Weed
No abstract text is available yet for this article.
July 18, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28706089/evaluation-of-the-geriatric-co-management-for-patients-with-fragility-fractures-of-the-proximal-femur-geriatric-fracture-centre-gfc-concept-protocol-for-a-prospective-multicentre-cohort-study
#10
Alexander Joeris, Anahí Hurtado-Chong, Denise Hess, Vasiliki Kalampoki, Michael Blauth
INTRODUCTION: Treatment of fractures in the elderly population is a clinical challenge due partly to the presence of comorbidities. In a Geriatric Fracture Centre (GFC), patients are co-managed by a geriatrician in an attempt to improve clinical outcomes and reduce morbidity and mortality. Until now the beneficial effect of orthogeriatric co-management has not been definitively proven. The primary objective of this study is to determine the effect of GFC on predefined major adverse events related to a hip fracture compared to usual care centres (UCC)...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28654541/caring-for-older-surgical-patients-contemporary-attitudes-knowledge-practices-and-needs-of-general-surgeons-and-residents
#11
Tyler R Chesney, George Pang, Najma Ahmed
OBJECTIVE: To gain contemporary insights from residents and surgeons regarding the care of older surgical patients. BACKGROUND DATA: With worldwide aging, efforts over the past decade have attempted to increase surgeons' abilities to care for older adults, but a current understanding of attitudes, knowledge, practices, and needs is missing. METHODS: Between July 2016 and September 2016 we conducted a national Web-based survey sampling all general surgery residents and academic general surgeons using a questionnaire designed and tested for this purpose...
June 26, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28649755/preoperative-geriatric-assessment-and-tailored-interventions-in-frail-older-patients-with-colorectal-cancer-a-randomised-controlled-trial
#12
Nina Ommundsen, Torgeir B Wyller, Arild Nesbakken, Arne O Bakka, Marit S Jordhøy, Eva Skovlund, Siri Rostoft
BACKGROUND: Colorectal cancer (CRC) is prevalent in the older population, and surgery is the mainstay in curative treatment. A preoperative geriatric assessment (GA) can identify frail older patients at risk for developing postoperative complications. In this randomised controlled trial we wanted to investigate whether tailored interventions based on a preoperative GA could reduce the frequency of postoperative complications in frail patients operated for CRC. METHODS: Patients >65 years scheduled for elective CRC surgery and fulfilling predefined criteria for frailty were randomised to either a preoperative GA followed by a tailored intervention, or care as usual...
June 26, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28581701/mini-nutritional-assessment-short-form-as-a-useful-method-of-predicting-poor-1-year-outcome-in-elderly-patients-undergoing-orthopedic-surgery
#13
Che-Sheng Chu, Chih-Kuang Liang, Ming-Yueh Chou, Ti Lu, Yu-Te Lin, Chin-Liang Chu
AIM: The present study aimed to determine whether the Mini-Nutritional Assessment Short-Form (MNA-SF) can predict the 1-year outcome of orthopedic fracture surgery in elderly patients. METHODS: This 1-year prospective study assessed nutrition using the MNA-SF at baseline, and postoperatively at 6 and 12 months. Repeated measures analysis of covariance was used to examine functional change over time for two MNA-SF categories. Multivariable logistic regression analysis with forward stepwise modeling was carried out to identify risk factors of functional decline, emergency department visit, hospital readmission and mortality at follow up...
June 5, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28540113/comparison-of-3-different-perioperative-care-models-for-patients-with-hip-fractures-within-1-health-service
#14
Lillian Sarah Coventry, Austin Nguyen, Amalia Karahalios, Sasha Roshan-Zamir, Phong Tran
INTRODUCTION: Orthogeriatric care models have been introduced within many health-care facilities to improve outcomes for hip fracture patients. This study aims to evaluate differences in care between 3 models, an orthopedic model, a geriatric model, and a comanaged model. MATERIALS AND METHODS: A retrospective analysis was conducted for hip fracture patients treated at Western Health between November 2012 and March 2014. All patients aged 65 years or older were included in the analysis...
June 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28530213/-the-model-of-perioperative-risk-assessment-in-elderly-patients-interim-analysis
#15
Izabela Grabowska, Lucyna Ścisło, Szymon Pietruszka, Elzbieta Walewska, Agata Paszko, Benita Siarkiewicz, Piotr Richter, Andrzej Budzyński, Antoni M Szczepanik
Demographic changes in contemporary society require implementation of proper perioperative care of elderly patients due to an increased risk of perioperative complications in this group. Preoperative assessment of health status identifies risks and enables preventive interventions, improving outcomes of surgical treatment. The Comprehensive Geriatric Assessment contains numerous diagnostic tests and consultations, which is expensive and difficult to use in everyday practice. The development of a simplified model of perioperative assessment of elderly patients will help identifying the group of patients who require further diagnostic workup...
April 21, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28500499/-anesthesiological-care-of-trauma-patients-in-orthogeriatric-co-management
#16
Markus F Luger, Thomas J Luger
Elderly patients increasingly need to undergo surgery under anesthesia, especially following trauma. A timely interdisciplinary approach to the perioperative management of these patients is decisive for the long-term outcome. Orthogeriatric co-management, which includes geriatricians and anesthesiologists from an early stage, is of great benefit for geriatric patients. Patient age, comorbidities and self-sufficiency in activities of daily life are decisive for an anesthesiological assessment of the state of health and preoperative risk stratification...
May 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28419035/clinical-practice-guidelines-decrease-unnecessary-echocardiograms-before-hip-fracture-surgery
#17
Chris Adair, Eric Swart, Rachel Seymour, Joshua Patt, Madhav A Karunakar
BACKGROUND: Preoperative assessment of geriatric patients with a hip fracture may include transthoracic echocardiography (TTE), which increases resource utilization and cost and may delay surgery. The purpose of this study was to evaluate preoperative TTE utilization at a single institution in order to determine (1) how often TTE is ordered in accordance with clinical practice guidelines (CPGs), (2) how frequently TTE reveals cardiac disease that may alter medical or anesthesia management, and (3) whether following CPGs reduces unnecessary TTE utilization without potentially missing important disease...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28391428/do-clinical-outcomes-correlate-with-bone-density-after-open-reduction-and-internal-fixation-of-tibial-plateau-fractures
#18
Elizabeth Gausden, Matthew R Garner, Peter D Fabricant, Stephen J Warner, Andre D Shaffer, Dean G Lorich
INTRODUCTION: The operative management of tibial plateau fractures in elderly patients has historically led to inconsistent results, and these clinical outcomes were thought to be associated with poor bone quality often in elderly patients. The goal of this study was to investigate the relationship between bone density and subjective clinical outcome scores after open reduction and internal fixation of tibial plateau fractures. MATERIALS AND METHODS: This is a retrospective cohort study from a single-surgeon conducted at an Academic, Level 1 Trauma Center...
April 8, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28383453/predictors-of-anastomotic-leak-in-elderly-patients-after-colectomy-nomogram-based-assessment-from-the-american-college-of-surgeons-national-surgical-quality-program-procedure-targeted-cohort
#19
Ahmet Rencuzogullari, Cigdem Benlice, Michael Valente, Maher A Abbas, Feza H Remzi, Emre Gorgun
BACKGROUND: Elderly patients undergoing colorectal surgery have increasingly become under scrutiny by accounting for the largest fraction of geriatric postoperative deaths and a significant proportion of all postoperative complications, including anastomotic leak. OBJECTIVE: This study aimed to determine predictors of anastomotic leak in elderly patients undergoing colectomy by creating a novel nomogram for simplistic prediction of anastomotic leak risk in a given patient...
May 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28366577/use-of-geriatric-assessment-tools-in-selecting-therapies-in-women-aged-%C3%A2-70%C3%A2-years-with-hormone-receptor-positive-early-stage-breast-cancer-preliminary-experience-with-a-quality-improvement-initiative
#20
Jean L Wright, Arti Parekh, Yao Yao Pollock, Nancy Schoenborn, Karen L Smith, Colette Magnant, Vered Stearns
PURPOSE: To develop a multidisciplinary algorithmic approach to management of women aged ≥70 years with clinically staged T1N0 hormone receptor-positive breast cancer, including geriatric assessments predicting life expectancy and the likelihood of functional decline in the near future, in the context of a program-wide quality improvement initiative, to better select patients for therapeutic interventions. METHODS AND MATERIALS: Two geriatric assessment tools, the Combined Lee-Schonberg Index and the Vulnerable Elderly Scale, were introduced into our clinical workflow to predict long-term mortality and likelihood of functional decline...
July 15, 2017: International Journal of Radiation Oncology, Biology, Physics
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