Geriatrics

Latest Issue of OR Manager
December 2017

Preop cognitive screening predicts postop complications in older total joint patients

Editor's Note Poor preoperative cognition, as assessed by preoperative Mini-Cog screening, is prevalent among older total joint patients and predictive of adverse outcomes, including postoperative delirium, longer hospital stay, and greater likelihood of discharge to a place other than home, this study finds. Of 211 patients 65 years of age…

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By: Judy Mathias
November 7, 2017
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PSH model reduces deaths, ED visits in elderly hip fracture patients

Editor's Note Elderly hip fracture patients were less likely to die or return to the emergency department (ED) after discharge if they received care under the Perioperative Surgical Home (PSH) model of care, finds this study presented October 21 at the Anesthesiology 2017 annual meeting in Boston. PSH patients also…

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By: Judy Mathias
October 30, 2017
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Most hip fractures occur in warm months, indoors

Editor's Note Most elderly hip fractures occur during warm months, and a greater number happen indoors rather than out, finds this study presented October 23 at the Anesthesiology 2017 annual meeting in Boston. In this analysis of 544 hip fracture patients treated at The Hospital of Central Connecticut from 2013…

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By: Judy Mathias
October 25, 2017
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ACS NSQIP pilot identifies geriatric–specific risk factors that affect surgical outcomes

Editor's Note A new pilot study from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) finds that adding geriatric-specific risk factors to traditional risk factors could significantly improve the ability of surgeons to predict poor surgical outcomes in older patients. The study involved 36,399 older surgical…

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By: Judy Mathias
October 18, 2017
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Frailty linked to increased morbidity after ambulatory general surgery

Editor's Note Frailty was associated with postoperative morbidity in patients having ambulatory general surgery procedures, independent of age, type of anesthesia, and other comorbidities, this study finds. In this study of 140,828 patients older than 40 years of age, frailty was associated with increased adjusted odds of 30-day morbidity after…

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By: Judy Mathias
October 16, 2017
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Preop conditions that predict postop outcomes, mortality in elderly

Editor's Note In patients 85 years of age and older, surgical complexity and certain geriatric variables (malnutrition, frailty), which are overlooked in American Society of Anesthesiologists and most other scores, were relevant in predicting postoperative outcomes and mortality, finds this study. Of 127 patients who completed follow-up, 30-day mortality was…

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By: Judy Mathias
September 27, 2017
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Preadmission frailty predicts adverse outcomes in geriatric trauma patients

Editor's Note In this study, preadmission clinical frailty independently predicted adverse discharge destination (ie, death or discharge to a long-term, chronic or acute care facility) in geriatric trauma patients. The analysis of 266 trauma patients 65 years and older using the Clinical Frailty Scale (CFS) and the laboratory Frailty Index…

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By: Judy Mathias
September 11, 2017
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Cognitive assessment helps predict survival in frail surgical patients

Editor's Note Adding cognitive assessment to frailty assessment predicted poor postoperative outcomes and survival in frail patients better than either measurement alone, this study finds. The study included 330 patients having major surgery who were assessed with a four-level composite frailty scoring system, which was created by combining the Fried…

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By: Judy Mathias
August 10, 2017
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Preop elderly assessment tool identifies postop complication risks

Editor's Note Screening elderly patients preoperatively using the Vulnerable Elders Surgical Pathways and Outcomes Assessment (VESPA) tool helped identify patients at higher risk of postoperative complications in this study. A total of 736 patients 70 years of age or older were assessed in a preoperative clinic from July 9, 2008,…

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By: Judy Mathias
August 4, 2017
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Ketamine doesn’t affect postop delirium, pain

Editor's Note Ketamine does not decrease delirium or lower levels of pain in older adults after major surgery and might cause harm by inducing hallucinations and nightmares, this study finds. A total of 672 patients were randomly assigned to a placebo group (222 patients), a 0.5 mg/kg ketamine group (227),…

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By: Judy Mathias
June 2, 2017
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