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Benjamin Bücking, Erich Hartwig, Ulrike Nienaber, Ulla Krause, Thomas Friess, Ulrich Liener, Maria Hevia, Christopher Bliemel, Matthias Knobe
BACKGROUND: Since 2014, hospitals with ortho-geriatric fracture centres could be certified as AltersTraumaZentrum DGU® in Germany. To measure the quality of treatment in these centres, a geriatric trauma registry (AltersTraumaRegister DGU®) was established. OBJECTIVES: The aim of this work was to report the results of the pilot phase of the AltersTraumaRegister DGU® from the year 2015. MATERIALS AND METHODS: Included were 118 patients >70 years with hip fracture or implant-related femoral fractures...
July 2017: Der Unfallchirurg
Shuang Quan Chan, Marianne Wadsley, Sue Ferriere
OBJECTIVE: To assess whether a novel bedside trolley table set-up decreased inpatient falls (IF) postintervention. METHODS: From December 2012 to December 2014, geriatric patients admitted to our orthopaedic ward with extreme falls risk had a bedside trolley placed between them and a floor sensor mat to give responders more time to prevent IF. Pre- and postintervention falls data was reviewed for falls reduction using falls per month as comparison standard. IF were classified as high or low/medium risk using St Thomas's Risk Assessment Tool In Falling Elderly inpatients (STRATIFY) scoring...
December 2017: Australasian Journal on Ageing
Rafael Bielza Galindo, Jesús Llorente Gutiérrez, José Luis Pérez González, Asunción Mora Casado, David Blanco Díaz, Javier Escalera Alonso, Adoración Morales Fernández, Cristina Molano Ortiz, Beredys Esmirla García López, Nazaret Del Amo Del Arco, Juan Pablo Barro Ordovas, Estefanía Arias Muñana, Marta Neira Álvarez, David Sanz Rosa, Jorge Fco Gómez Cerezo
INTRODUCTION: There are no previous studies evaluating the effect of intravenous iron therapy on functional and cognitive status of patients with hip fracture (HF). MATERIAL AND METHODS: A single-centre randomised, placebo-controlled, double-blind and parallel treatment, clinical trial has been designed to assess the efficacy of intravenous iron therapy during the peri-operative period in elderly patients suffering from a HF. Blinding will be ensured by the packaging of the drug infusion system...
January 2018: Revista Española de Geriatría y Gerontología
Ross Coomber, Matthew Porteous, Matthew J W Hubble, Martyn J Parker
When treating a hip fracture with a total hip replacement (THR) the surgical technique may differ in a number of aspects in comparison to elective arthroplasty. The hip fracture patient is more likely to have poor bone stock secondary to osteoporosis, be older, have a greater number of co-morbidities, and have had limited peri-operative work-up. These factors lead to a higher risk of complications, morbidity and perioperative mortality. Consideration should be made to performing the THR in a laminar flow theatre, by a surgeon experienced in total hip arthroplasty, using an anterolateral approach, cementing the implant in place, using a large head size and with repair of the joint capsule...
October 2016: Injury
Bodhi Wimalasena, Roger Harris
AIMS: The aims of this audit were to collect the Minimum Data Set outlined by the Australia New Zealand Hip Fracture Registry (ANZHFR), assess patient characteristics, analyse process of care, and evaluate how this compares to NICE guidelines for hip fracture care, as well as to Auckland Hospital data from 2007. METHOD: Retrospective case record audit of patients with fractured neck of femur aged 65 years and over admitted under Orthopaedics over a 4-month period in 2013...
July 1, 2016: New Zealand Medical Journal
Genni Lynch, Kate Bell, Debra Long, Liz Burmeister
INTRODUCTION: Patients presenting to hospital with a fragility hip fracture are routinely catheterized in the emergency department. Studies have found that the duration of catheterization is the greatest and most important risk factor for developing a urinary tract infection. Whilst there is a considerable body of evidence around correct techniques for insertion of urinary catheters, there appears to be little evidence as to the timing of their removal. AIM OF THE STUDY: To describe the current practice of indwelling catheter (IDC) removal post operatively in the fragility hip fracture patient and to identify factors associated with the successful removal of IDCs post operatively in the same cohort of patients...
November 2016: International Journal of Orthopaedic and Trauma Nursing
Stephen T Isbel, Maggie I Jamieson
The literature reports that rehabilitation for elderly patients with mild-to-moderate dementia who have a hip fracture improves functional outcomes. However, access to rehabilitation may be difficult due to misconceptions about the ability of these patients to engage in and benefit from rehabilitation. Additionally, people who are admitted from residential care may not have the same options for rehabilitation as those admitted from home. This study sought to understand from expert clinicians how and why decisions are made to accept a person with dementia post-fracture for rehabilitation...
February 2, 2016: Dementia
Juliana Hack, Christopher Bliemel, Steffen Ruchholtz, Benjamin Bücking
Hip fractures are among the most common fractures in elderly people. The annual number of femoral fractures is even expected to increase because of an aging society. Due to the high number of comorbidities, there are special challenges in treating geriatric hip fracture patients, which require a multidisciplinary management. This includes surgical treatment allowing full weight bearing in the immediate postoperative period, osteoporosis treatment and falls prevention as well as an early ortho-geriatric rehabilitation program...
April 2015: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
B Subramanian, H Parsons, P Finner, R Townsend
Following a cluster of two patients with identical strains of Clostridium perfringens prosthetic joint infections on an ortho-geriatric ward in a teaching hospital in England, investigations were conducted into infection control practices. It emerged that empathy dolls were being used to help alleviate agitation in dementia patients; this had been introduced without consultation with the infection prevention and control team. Environmental testing of the doll pre and post laundry at different temperatures helped to establish the types and numbers of organisms present...
May 2014: Journal of Hospital Infection
Gary Ginsberg, Abraham Adunsky, Iris Rasooly
BACKGROUND: The economic burden associated with hip fractures calls for the investigation of innovative new cost-utility forms of organisation and integration of services for these patients. OBJECTIVE: To carry out a cost-utility analysis integrating epidemiological and economic aspects for hip fracture patients treated within a comprehensive orthogeriatric model (COGM) of care, as compared with standard of care model (SOCM). DESIGN: A demonstration study conducted in a major tertiary medical centre, operating both a COGM ward and standard orthopaedic and rehabilitation wards...
November 2013: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Lucy Fergus, Greer Cutfield, Roger Harris
BACKGROUND: The process of care of older patients with fractured neck of femur at Auckland City Hospital has recently changed with selected patients "fast-tracked" as soon as possible postoperatively to a specialised Older People's Health (OPH) ward. AIMS: The aims of this study were: to evaluate patient characteristics; to analyse process of care; to compare outcomes in those "fast-tracked" patients with those receiving usual care; and to compare this information with previous data from Auckland City Hospital and other centres in New Zealand...
June 24, 2011: New Zealand Medical Journal
C Kammerlander, T Roth, S M Friedman, N Suhm, T J Luger, U Kammerlander-Knauer, D Krappinger, M Blauth
In the fast-growing geriatric population, we are confronted with both osteoporosis, which makes fixation of fractures more and more challenging, and several comorbidities, which are most likely to cause postoperative complications. Several models of shared care for these patients are described, and the goal of our systematic literature research was to point out the differences of the individual models. A systematic electronic database search was performed, identifying articles that evaluate in a multidisciplinary approach the elderly hip fracture patients, including at least a geriatrician and an orthopedic surgeon focused on in-hospital treatment...
December 2010: Osteoporosis International
Antonella Barone, Andrea Giusti, Monica Pizzonia, Monica Razzano, Mauro Oliveri, Ernesto Palummeri, Giulio Pioli
OBJECTIVE: To evaluate baseline characteristics and in-hospital factors associated with nonadherence with an immediate weight-bearing and early ambulation (IWB-EA) program after hip fracture (HF) surgery. DESIGN: Prospective inception cohort study. SETTING: Ortho-geriatric unit in an acute care hospital. PARTICIPANTS: Older adults (N=469) admitted with an osteoporotic HF who underwent surgery. INTERVENTIONS: Immediate weight-bearing and assisted ambulation training on the first postoperative day (all patients)...
September 2009: Archives of Physical Medicine and Rehabilitation
R Wakeman, P D Sheard, G H Jenner
No abstract text is available yet for this article.
July 2004: Journal of Bone and Joint Surgery. British Volume
A Edlund, M Lundström, G Lundström, B Hedqvist, Y Gustafson
The incidence of delirium, its predisposing factors, clinical profile, associated symptoms and consequences were investigated in 54 consecutive patients, 19 men and 35 women, mean age 77.1 years, admitted to an 'ortho-geriatric unit' with femoral neck fractures. The incidence of postoperative delirium was 15/54 (27.8%) and a logistic regression model found that dementia and a prolonged waiting time for the operation increased the risk of postoperative delirium. Delirium during the night was most common but in 5 patients the delirium was worst in the morning...
September 1999: Dementia and Geriatric Cognitive Disorders
P R Street, T Hill, L C Gray
An ortho-geriatric service operated by Bundoora Extended Care Centre and Preston and Northcote Community Hospital was established in 1991 to improve rehabilitative care and discharge planning of elderly hip fracture patients. 123 patients were treated during the first year of the service's operation. There was a 25 per cent reduction in the acute hospital length of stay, an increased proportion of patients discharged home and a decreased need for post-acute rehabilitation in comparison to figures for 1989, leading to a substantial reduction in the total number of bed-days occupied in the hospital system as a whole by hip fracture patients...
1994: Australian Health Review: a Publication of the Australian Hospital Association
J C Brocklehurst, K Andrews
The three main styles of geriatric practice in the UK at present are: combined acute and rehabilitation with separate long-stay wards (37.5%), separate acute, rehabilitation and long-stay wards (24.4%) and combined acute, rehabilitation and long-stay wards (21.1%). The first of these has the highest bed/population ratio, the second the highest discharge rate per bed and per population and the third has the highest consultant/bed ratio. There is some relationship between style of practice and geographical characteristics of the area...
January 1985: Age and Ageing
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