Archives of gerontology and geriatrics
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Arch Gerontol Geriatr · Jan 2010
Comparative StudyRisk factors for postoperative infections in patients with hip fracture treated by means of Thompson arthroplasty.
Specific conditions associated with surgery may predispose elderly people to septic complications after hip fracture surgery. This study investigated the risk factors predisposing infection in aged patients with subcapital hip fracture. We performed a prospective study of 290 patients with displaced subcapital hip fracture, operated by means of Thompson hip hemi-arthroplasty (83.5% fractures in women). ⋯ Transfusion appeared to be correlated with superficial wound infection (OR=1.96), urinary infection (OR=1.76) and pneumonia (OR=2.85). Higher number of days waiting for surgery were related significantly with pneumonia (9.8+/-7.44 days vs. 6.39+/-3.75), or urinary tract infection (7.76+/-4.39 days vs. 6.17+/-4.14). We concluded that the transfusion and longer waiting time for surgery have been associated with the septic complications in elderly patients treated surgically for hip fracture.
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Arch Gerontol Geriatr · Jan 2010
Comparative StudyUrinary incontinence and behavioral symptoms are independent risk factors for recurrent and injurious falls, respectively, among residents in long-term care facilities.
Numerous risk factors of falls, including urinary incontinence and behavioral symptoms have been identified among elderly people in long-term care settings. However, it remains uncertain whether incontinence or behavioral symptoms are associated with recurrent falls and injurious falls. The purpose of this research was to examine the association between various types of falls and urinary incontinence or behavioral symptoms among the residents of long-term care facilities using the Cox proportional hazards models. ⋯ However, urinary incontinence was a risk factor for recurrent falls but not for injurious falls. In contrast, behavioral symptoms were an independent risk factor for injurious but not for recurrent falls. The results suggested that treatment or management of urinary incontinence and behavioral symptoms should be considered to prevent falls in long-term care settings.
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Arch Gerontol Geriatr · Jan 2010
Comparative StudyGender differences influence the outcome of geriatric rehabilitation following hip fracture.
Hip fracture represents the most dramatic expression of the disease, in terms of morbidity, medical cost and mortality. The incidence of hip fracture increases substantially with age. The purpose of this study was to evaluate the association between gender and geriatric rehabilitation outcome after traumatic hip fracture. ⋯ Recovery after hip fracture depends in large part on the pre-fracture health and functional ability of the patient. Gender differences in functional recovery may affect therapeutic and rehabilitative decision making. Functional recovery after traumatic hip fracture was better in men in comparison with women.
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Arch Gerontol Geriatr · Jan 2010
Comparative StudyThe effect of increasing age on nocturnal joint pain in patients about to undergo hip or knee joint arthroplasty.
Many hip and knee joint scores rate nocturnal symptoms as important in their scoring systems. The aim of this study was to determine if being woken up with pain disappears with advancing age in patients with arthritic hip or knee joints. Data was collected from 60 patients with an average of age of 69.0 years through a questionnaire conducted at the time of their pre-operative assessment, 36 of them were awaiting hip replacements, 24 knee replacement surgery. ⋯ The average ages of those patients reporting night pain was 65.7 years and of those who did not report night pain 75.5 years. This is almost certainly because of a change in sleep pattern and nociceptive inputs. Although elderly patients may score more highly on other areas of a joint score they may be under assessed if nocturnal symptoms are relied upon.
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Arch Gerontol Geriatr · Dec 2009
Emergency department (ED) utilization and outcome of oldest old men presenting with geriatric syndromes in a veterans care home in Taiwan.
The first presentation of elderly people in the emergency department (ED) is commonly nonspecific and atypical, often in the form of geriatric syndromes, i.e. falls, immobility, incontinence, or deteriorating mental function. The purpose of this study was to evaluate the management and outcomes of institutionalized elderly people who initially presented with geriatric syndrome (GS) in the ED. A retrospective chart review of Banciao Veterans Care Home residents who visited the ED of a tertiary medical center was done. ⋯ When GS subjects were admitted, they were more likely to be transferred to step-down community hospitals for post-acute care (OR = 2.63; 95% CI: 1.36-5.08, p = 0.004). GS was common in institutionalized elderly people calling for ED services, and GS subjects were more likely to be transferred to step-down community hospitals after hospitalization. Comprehensive geriatric assessments may be of value for institutionalized elderly patients visiting the ED.