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Maximizing rehabilitation outcomes in geriatric hip fracture patients: the impact of surgical variables.

BACKGROUND AND AIM: Hip fracture is a major traumatic event with high mortality and disability rate. Its management in the acute setting and in the rehabilitation process is highly debated. This study evaluates the possible determinants of hip fracture rehabilitation outcome, among which surgical intervention type, weight-bearing status and hospitalization length Methods: The data of 738 hip fracture patients, who completed rehabilitation process in our centre, were collected and patients' functional abilities at the time of admission and discharge were analysed. RESULTS: It has been observed

Association between admission hyperglycemia and postoperative pneumonia in geriatric patients with hip fractures.

BACKGROUND: Admission hyperglycemia is a common phenomenon in the early stages of injury. This study aimed to determine the relationship between admission hyperglycemia and postoperative pneumonia in geriatric patients with hip fractures. METHODS: A total of 600 geriatric patients admitted to Dandong Central Hospital with hip fractures were included. Patients were divided into four groups based on quartiles of admission blood glucose levels: Q1- Q4. Multivariable logistic regression and propensity score-matched analyses were conducted to calculate adjusted odds ratios (ORs) and 95% confidence

The role of geriatric nutritional risk index as a predictor for postoperative outcomes in gastrointestinal emergencies.

BACKGROUND: The geriatric nutritional risk index (GNRI) is a simple nutritional and inflammatory marker for older adults. The aim of the present study was to investigate the usefulness of the GNRI in older adults who underwent emergency gastrointestinal surgery. METHODS: This study included 206 older adults who had undergone emergency gastrointestinal surgery. We retrospectively investigated the relationship between the GNRI and postoperative complications. Univariate and multivariate analyses were performed to evaluate risk factors for postoperative complications. We then evaluated the assoc

Mapping knowledge structure and themes trends in geriatric spine surgery: A bibliometric analysis.

To analyze the status, hotspots, and frontiers of spine surgery in the geriatric using bibliometric method, the Web of Science Core Collection was searched for all papers concerning the use of spine surgery in the elderly from January 1, 1982 to August 3, 2022. VOSviewer and R software were used to perform the bibliometric analysis, which included retrieving the country, institution, author, journal, and keyword. A total of 663 articles were identified. The investigation revealed a growing number of publications over the past 20 years. The country with the highest number of publications was th

[Current problems of polypharmacy in geriatric patients when taking drugs with a risk of photosensitivity.].

The article presents an overview of the current problems of polypharmacy in geriatric patients when taking drugs with a risk of photosensitivity. The article contains information about emerging adverse drug reactions, as well as methods for diagnosing, correcting and preventing phototoxic and photoallergic reactions in patients of older age groups. The main aspects of dermatological support in the system of long-term care for geriatric patients when taking drugs with a risk of photosensitivity are outlined. Clinical signs of senile xerosis and skin manifestations of adverse drug reactions were

Is the 5-factor modified Frailty Index a prognostic marker in geriatric ankle fractures?

BACKGROUND: The 5-factor modified Frailty Index (mFI-5), which is the latest version of the Frailty Index, is a tool that calculates the risk of complications after treatment by scoring the comorbidity status of the patient. The aim of this study was to evaluate the efficacy of the mFI-5 in predicting complications in geriatric patients with an ankle fracture. METHODS: A retrospective examination was made of a total of 94 patients aged >65 years who were treated for an ankle fracture in our hospital between 2015 and 2020. Weber type A, B, and C fractures were included in the study. For each p

Geriatric assessment tool application in treatment recommendations for older women with breast cancer.

INTRODUCTION: Treatment of early breast cancer in older women is usually not guideline concordant owing to lack of routine evaluation of their potential frailty. We assessed the feasibility and impact of a self-administered geriatric assessment on the decision-making process in women aged 65 and above treated in a UK District General Hospital. METHODS: One hundred and one patients, aged 65 and above, with early stage, non-metastatic breast cancer were prospectively recruited between Dec-2018 and March-2021. Patients with metastatic breast cancer, a previous history of cancer and dementia were

Comprehensive Geriatric Assessment for community-dwelling, high-risk, frail, older people.

BACKGROUND: Comprehensive Geriatric Assessment (CGA) is a multidimensional interdisciplinary diagnostic process focused on determining an older person's medical, psychological and functional capability in order to develop a co-ordinated and integrated care plan. CGA is not limited simply to assessment, but also directs a holistic management plan for older people, which leads to tangible interventions. While there is established evidence that CGA reduces the likelihood of death and disability in acutely unwell older people, the effectiveness of CGA for community-dwelling, frail, older people at

Assessing frailty using comprehensive geriatric assessment in older patients with hematologic malignancy.

The incidence of hematologic malignancy increases with age; thus, the number of older patients who require intensive chemotherapy is expected to increase with the aging population. In Korea, 61.8%, 59.3%, 47.0%, and 46.7% of newly diagnosed cases of multiple myeloma, myelodysplastic syndrome, myeloproliferative disorder, and non-Hodgkin lymphoma, respectively, occurred in patients aged >65 years in 2018. Health status among older patients, defined by frailty, age-related syndrome of physiological decline and increased vulnerability, is associated with adverse health outcomes. Health status is

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… REFERENCES 1 Baek JY Lee E Jung HW Jang IY 2021 Geriatrics fact sheet in Korea 2021 Ann Geriatr Med Res 25 65 71 10.4235/agmr.21.0063 a96b154a77dc4335a5ebd4aab3fd28dc https://www.scopus.com/inward/record.uri? … partnerID=HzOxMe3b&scp=0036000276&origin=inward 12061133 16 By the 2019 American Geriatrics Society Beers Criteria® Update Expert Panel 2019 American Geriatrics Society 2019 updated AGS Beers Criteria Ⓡ for potentially inappropriate medication use in older adults J Am Geriatr Soc 67 674 94 10.1111/jgs …

Changing Hospital Care For Older Adults: The Case for Geriatric Hospitals in the United States.

Hospital care of frail older adults is far from optimal. Although some geriatric models of care have been shown to improve outcomes, the effect size is small and models are difficult to fully implement, sustain and replicate. The two root causes for these shortcomings are competing interests (high revenue generating diseases, procedures and surgeries) and current hospital cultures (for example a culture of safety that emphasizes bed alarms and immobility rather than frequent ambulation). Geriatric hospitals would be hospitals completely dedicated to the care of frail older patients, a group wh

Clinical outcomes of tranexamic acid in acute hip hemiarthroplasties in frail geriatric patients.

BACKGROUND: Tranexamic acid (TXA) has shown to significantly reduce perioperative blood loss in elective orthopedic joint replacement surgery but is yet not implemented in acute hip fracture surgery for elderly patients who are particularly vulnerable to perioperative blood loss and postoperative anemia. Aim of this study is to answer the following questions: 1. Does TXA reduce bleeding associated complications in elderly patients? 2. Does TXA induce thromboembolic complications in elderly patients? HYPOTHESIS: TXA reduces perioperative blood loss and associated complications in acute hip fra

Predictive factors associated with thirty-day mortality in geriatric patients with hip fractures.

OBJECTIVE: This study aimed to determine the predictive factors affecting the 30-day mortality in geriatric hip fractures, investigate the effect of the timing of surgery, and thus determine the optimum cut-off time in delaying the surgery. METHODS: A total of 596 patients(205 men, 391 women; mean age = 78.3 years) were included in this retrospective study. All possible predictive factors encountered in the literature review, including age, sex, fracture type, comorbidities, American Society of Anesthesiologists (ASA) score, surgical delay time, anaesthesia type, surgery type, need for erythr

[A geriatric case of hyperosmolar hyperglycemic state with osmotic demyelination syndrome that manifested with dysphagia].

The patient was an 84-year-old man who had been on insulin therapy for type 2 diabetes mellitus for 55 years. He had undergone bile duct stenting to avoid obstruction due to adenocarcinoma of the bile duct. The patient had suffered from fever and anorexia for two weeks, and had subsequently stopped insulin therapy. Since he showed signs of impaired consciousness, he was taken to the emergency room, and was diagnosed with a hyperosmotic hyperglycemic state (HHS) based on the following laboratory findings: blood glucose, 632 mg/dL; plasma osmolality, 391 mOsm/kg·H2O; and serum Na, 163 mEq/L, wit

Comprehensive geriatric assessment (CGA) in perioperative care: a systematic review of a complex intervention.

OBJECTIVES: Comprehensive geriatric assessment (CGA) is a complex intervention applied to older people with evidence of benefit in medical populations. The aim of this systematic review was to describe how CGA is applied to surgical populations in randomised controlled trials. This will provide a basis for design of future studies focused on optimising CGA as a complex intervention. SETTING: A systematic review of randomised controlled trials. PARTICIPANTS: A systematic search was performed for studies of CGA in the perioperative period across Ovid MEDLINE, Ovid EMBASE, CINAHL and Cochrane C

A bone-conserving revision stem for unstable intertrochanteric fractures of the geriatric osteoporotic population.

PURPOSE: Primary hemiarthroplasty is gaining popularity for the treatment of unstable intertrochanteric fractures in geriatric patients with severe osteoporosis. This study evaluated early clinical and radiographic outcomes by using a bone-conserving revision stem for unstable intertrochanteric fractures in the geriatric osteoporotic population. METHODS: A retrospective study involving 31 patients with unstable intertrochanteric fractures was conducted. The patients were aged 82.1 years on average. All patients underwent primary hemiarthroplasty using bone-conserving, fully porous-coated revi

Application effect of thoracoscopic tricuspid valvuloplasty in geriatric patients with tricuspid valve disease.

BACKGROUND: Thoracoscopic-assisted technology can ensure that doctors can implement minimally invasive treatment through the right intercostal incision or small incision of the lower sternum. This approach not only can achieve a cardiac correction effect equivalent to that of a thoracotomy but also has the benefit of a clear surgical field ensuring the safety of surgical treatment. AIM: To investigate the effect of thoracoscopic tricuspid valvuloplasty in patients with tricuspid valve disease. METHODS: A total of 41 patients with tricuspid valve disease underwent traditional thoracotomy trea

Cardiac complications in a geriatric population hospitalized with COVID-19: The OCTA-COVID cohort.

PURPOSE: The geriatric population is especially vulnerable to coronavirus disease (COVID-19) and its potential complications. We sought to analyze the incidence of cardiological complications in an elderly population hospitalized for COVID-19. METHODS: A prospective observational longitudinal that included patients ≥75 years of age with diagnosis of COVID-19 admitted to the Geriatric Department from March to May 2020. Epidemiological, geriatric, clinical and laboratory test variables were collected. Cardiovascular events, including de novo atrial fibrillation (AF), acute coronary syndrome (AC

Length of hospital stay among oldest-old patients in acute geriatric ward.

PURPOSE: To examine risk factors for prolonged hospital length of stay (LOS) in the oldest-old inpatients aged ≥ 90. METHODS: This retrospective cross-sectional study was performed in acute Geriatrics Department at Kaplan Medical Center. The target population was the oldest-old inpatients aged ≥ 90 hospitalized with acute illness. In total 1536 admissions of 987 patients admitted between January 2007 and December 2010 from the emergency room were included in the study. We retrieved from the electronic hospital records the following data: demographics, admission diagnosis, comorbidities, labor…