Geriatrics

Latest Issue of OR Manager
March 2018

Association between frailty and delirium after cardiac surgery

Editor's Note In this study, preoperative frailty was associated with a high risk for delirium after cardiac surgery. Of 55 patients included in the analysis, the prevalence of frailty was 30.9%. Frail patient had a higher incidence of delirium (47.1%) compared with nonfrail patients (2.6%). Frailty may be used to…

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By: Judy Mathias
August 12, 2016
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Loss of independence linked to postop readmission, mortality in older adults

Editor's Note Loss of independence in surgical patients 65 years and older was associated with readmission and mortality after discharge, this study finds. The study of more than 5,000 patients found that loss of independence occurred frequently and increased with age. After risk adjustment, loss of independence was significantly associated…

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By: Judy Mathias
July 19, 2016
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Effect of frailty on surgical outcomes

Editor's Note Frailty has a significant impact on postoperative outcomes that varies with procedure, this study finds. Using data on 232,352 patients in the American College of Surgeons National Surgical Quality Improvement Program who had elective, high-risk surgical procedures, multivariate analysis found that frailty was associated with complications, prolonged duration…

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By: Judy Mathias
July 13, 2016
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Improving preop decision making for older patients

Editor's Note In this study, researchers developed a question prompt list for older adults considering high-risk surgery. Three decision-making needs were addressed, including clarification of treatment options, setting postoperative expectations, and advance care planning. The list included 11 questions within 3 domains: Should I have surgery? What should I expect…

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By: Judy Mathias
June 29, 2016
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Communication training for orthopedic residents pays off

Editor's Note A program at the Hospital for Special Surgery, New York City, to improve orthopedic surgery residents’ communication skills with older adults is paying off, according to a new study presented at the Council of Orthopaedic Residency Directors meeting on June 24 in Seattle. A total of 64 residents…

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By: Judy Mathias
June 28, 2016
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Feasibility of preop cognitive stratification of older surgical patients

Editor's Note Preoperative cognitive screening is feasible in most older elective surgical patients, and results show a substantial prevalence of probable cognitive impairment in this population, this study finds. Because preexisting cognitive impairment is emerging as a predictor of poor postoperative outcomes in seniors, researchers examined whether preoperative cognitive screening…

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By: Judy Mathias
June 22, 2016
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Predictors for developing multiple postop complications

Editor's Note Nearly half of general surgery patients with postoperative complications have multiple complications, finds this study. Of more than 470,000 patients in the analysis, the overall complication rate was 15%, with multiple complications in 27,032. Strongest predictors for developing multiple complications were admission from chronic care facility or nursing…

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By: Judy Mathias
May 31, 2016
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Postop morbidity, discharge in elderly fast-track total joint patients

Editor's Note Fast-track total hip and knee arthroplasties with a median length of stay of 3 days and discharge to home are feasible in most patients 85 years of age or older, this study finds. Of 13,775 procedures included in the analysis: median age was 87 years and median length…

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By: Judy Mathias
May 24, 2016
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Simple arm test identifies frailty

Editor's Note A simple arm test that uses a wearable technology can rapidly and accurately identify physiological frailty in older adults facing surgery, finds this study. Researchers developed a 20-second upper arm extension test (ie, upper extremity frailty [UEF] system) to assess biomarkers of frailty, such as slowness of motion,…

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By: Judy Mathias
May 5, 2016
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Mobility predicts postop outcomes in older patients

Editor's Note A quick, reliable, and cost-effective mobility assessment tool helped to identify older patients at risk for adverse postoperative outcomes in this study. Mobility was assessed with 10 animated video clips of activities. Patients were asked to watch each clip and respond to a series of questions about their…

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By: Judy Mathias
April 25, 2016
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