Geriatrics

Latest Issue of OR Manager
June 2018

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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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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