Annals of the Royal College of Surgeons of England
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Ann R Coll Surg Engl · Feb 2016
Review Meta AnalysisSystematic review and meta-analysis of the association between frailty and outcome in surgical patients.
Frailty is becoming increasingly prevalent in the elderly population although a lack of consensus regarding a clinical definition hampers comparison of clinical studies. More elderly patients are being assessed for surgical intervention but the effect of frailty on surgical related outcomes is still not clear. ⋯ The presence of frailty in patients undergoing surgical intervention is associated with poorer outcomes with regard to mortality and return to independence. Further in-depth studies are required to identify factors that can be optimised to reduce the burden of frailty in surgical patients.
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Ann R Coll Surg Engl · Feb 2016
Best practices for scholarly authors in the age of predatory journals.
'Continuous effort, not strength or intelligence, is the key to understanding our potential.' Margaret J Wheatley. The focus of any academic or research author is to share his or her findings, and to gain respect and reward for publishing. The ideal journal is one that not only publishes an article quickly but also helps the author to improve the article before publication through peer review, selects only the best research so that the author's article lies alongside other high quality articles, and provides maximum (and long-term) visibility and access to the article. ⋯ Check. Submit. (http://thinkchecksubmit.org/), was launched in the latter half of 2015 and hopes to raise awareness of disreputable journals while clearly separating them from valid, high quality, open access journals (of which there are many). PIPPA SMART Guest Editor.
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Ann R Coll Surg Engl · Feb 2016
Decision making on timing of surgery for hip fracture patients on clopidogrel.
Patients taking clopidogrel who sustain a fractured neck of femur pose a challenge to orthopaedic surgeons. The aim of this study was to determine whether delay to theatre for these patients affects drop in haemoglobin levels, need for blood transfusion, length of hospital stay and 30-day mortality. A retrospective review of all neck of femur patients admitted at two centres in the North East of England over 3 years revealed 85 patients. ⋯ There were no significant differences in mortality or wound complications. Hip fracture patients on clopidogrel can be safely operated on early provided they are medically stable. Bleeding risk should be borne in mind in those patients on dual therapy with aspirin.
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Ann R Coll Surg Engl · Feb 2016
The provision of total hip replacement for displaced intracapsular hip fractures.
The National Institute for Health and Care Excellence (NICE) currently recommends the use of total hip replacement (THR) for displaced intracapsular hip fractures in patients who meet certain mobility, cognitive and health criteria. ⋯ There is significant variation in the provision of THR for eligible hip fracture patients, which is influenced by both patient demographics and the unit to which a patient is admitted.