Geriatrics

Latest Issue of OR Manager
March 2018

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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Postop program reduces delirium risk, LOS for elderly

Editor's Note Older patients who had major abdominal surgery and received interventions that included daily orienting communication, oral and nutritional assistance, and early mobilization were less likely to experience delirium and had a shorter hospital length of stay (LOS), this study finds. A total of 377 patients were included in…

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By: Judy Mathias
May 31, 2017
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Association of frailty with postop outcomes, resource use

Editor's Note After emergency general surgery, frailty is associated with increased rates of mortality, discharge to an institution, and resource use, this Canadian study finds. Of 77,184 patients analyzed, 19,779 were frail. Death within 1 year of surgery occurred in 33.5% of frail patients, compared with 19.8% of nonfrail patients. Risk…

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By: Judy Mathias
May 9, 2017
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Standards developed to improve surgical care in elderly

Editor's Note The Coalition for Quality in Geriatric Surgery (CQGS) developed high-quality, valid standards to improve surgical care in the older adult, this study finds. A total of 306 of 308 standards developed were rated as valid to improve quality of geriatric surgery, 290 were rated as feasible, and 18…

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By: Judy Mathias
March 10, 2017
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New tool predicts outcomes in elderly traumatic brain injury patients

Editor's Note Researchers at Wake Forest University, Winston-Salem, North Carolina, have developed a tool that helps predict the possibility of survival and independence at discharge for elderly patients with traumatic brain injury. The tool, which accounts for variables such as age, gender, and severity of brain injury, was evaluated in…

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By: Judy Mathias
March 6, 2017
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Hospital volume of frail patients linked to outcomes

Editor's Note In hospitals that care for a lower volume of frail patients, frail surgical patients have increased postoperative mortality and failure to rescue, finds this study. Of 63,381 frail patients analyzed, 30-day mortality in the lowest volume quintile was 1.1%, compared to 0.9% in the highest. Adjusted analysis found…

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By: Judy Mathias
February 15, 2017
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Frailty screening tied to improved postop outcomes

Editor's Note Implementation of a frailty screening initiative for preoperative patients was associated with reduced mortality, this study finds. In 9,153 patients screened, postoperative mortality decreased significantly at 30, 180, and 365 days, and improvements were noted in both frail and nonfrail patients. Multivariate analysis showed a three-fold survival benefit…

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By: Judy Mathias
November 30, 2016
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Risk Analysis Index measures frailty in surgical patients

Editor's Note In this study, a Risk Analysis Index was found to measure frailty in surgical patients with predictive ability equal to other frailty tools, with an additional advantage of rapid, real-time, preoperative assessment feasible for guiding surgical decision making. The Index measures frailty prospectively using a questionnaire or retrospectively…

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By: Judy Mathias
November 28, 2016
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Effect of acute, postacute care on hip fracture outcomes

Editor's Note For older hip fracture patients, the care they received at a postacute care facility had a three to eight times greater impact on their long-term recovery than the care they received at the hospital, this study finds. Nursing home factors explained three times more variation in the odds…

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By: Judy Mathias
November 7, 2016
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Screening for frailty in older surgery patients

Editor's Note Identifying frailty in older patients could increase their chances of surviving surgery and improve their overall outcomes, this study finds. Researchers conducted frailty screening using five characteristics: weight loss, weakness (grip strength), exhaustion, low activity level, and slow gait. Of 125 patients screened in a thoracic surgery clinic,…

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By: Judy Mathias
October 6, 2016
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