scholarly journals Poor adherence to guidelines in treatment of fragile and cognitively impaired patients with hip fracture: a descriptive study of 2,804 patients

2021 ◽  
pp. 1-7
Author(s):  
Christina F Frandsen ◽  
Eva N Glassou ◽  
Maiken Stilling ◽  
Torben B Hansen
Keyword(s):  
Hip Fracture ◽  
Descriptive Study ◽  
Poor Adherence ◽  
Cognitively Impaired ◽  
Adherence To Guidelines

scholarly journals Management of ongoing direct anticoagulant treatment in patients with hip fracture

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Carlo Rostagno ◽  
Alessandro Cartei ◽  
Gianluca Polidori ◽  
Roberto Civinini ◽  
Alice Ceccofiglio ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Demographic Data ◽  
Drug Intake ◽  
Control Group ◽  
Complication Rates ◽  
Adherence To Guidelines ◽  
Time To Surgery ◽  
Clinical Records ◽  
Current Guidelines ◽  
Type Of Fracture

AbstractAim of the present study was to investigate the effects of ongoing treatment with DOACs on time from trauma to surgery and on in-hospital clinical outcomes (blood losses, need for transfusion, mortality) in patients with hip fracture. Moreover we evaluated the adherence to current guidelines regarding the time from last drug intake and surgery. In this observational retrospective study clinical records of patients admitted for hip fracture from January 2016 to January 2019 were reviewed. 74 patients were in treatment with DOACs at hospital admission. Demographic data, comorbidities and functional status before trauma were retrieved. As control group we evaluated 206 patients not on anticoagulants matched for age, gender, type of fracture and ASA score. Time to surgery was significantly longer in patients treated with DOACs (3.6 + 2.7 vs. 2.15 ± 1.07 days, p < 0.0001) and treatment within 48 h was 47% vs. 80% in control group (p < 0.0001). The adherence to guidelines’ suggested time from last drug intake to surgery was 46%. Neither anticipation nor delay in surgery did result in increased mortality, length of stay or complication rates with the exception of larger perioperative blood loss (Hb levels < 8 g/dl) in DOACs patients (34% vs 9% p < 0.0001). Present results suggest that time to surgery is significantly longer in DOAC patients in comparison to controls and adherence to guidelines still limited.

T1006 Poor Adherence to Guidelines for Prevention of Recurrent Variceal Bleeding Among Veterans

2010 ◽  
Vol 138 (5) ◽  
pp. S-835
Author(s):  
Emmanuelle Williams ◽  
Phalgoon Shah ◽  
Tara Dyson ◽  
Alex R. Seamon ◽  
Vidhya Kunnathur ◽  
...  
Keyword(s):  
Variceal Bleeding ◽  
Poor Adherence ◽  
Adherence To Guidelines

scholarly journals The impact of cognitive impairment at admission on short-term functional outcome of elderly hip fracture patients

2010 ◽  
Vol 138 (5-6) ◽  
pp. 319-322 ◽  
Author(s):  
Emilija Dubljanin-Raspopovic ◽  
Dragana Matanovic ◽  
Marko Bumbasirevic
Keyword(s):  
Cognitive Impairment ◽  
Hip Fracture ◽  
Elderly Patients ◽  
Functional Outcome ◽  
Cognitive Status ◽  
Cognitively Impaired ◽  
Short Term ◽  
Functional Gain ◽  
The Impact ◽  
Cognitively Intact

Introduction The number of patents with dementia increases among hip fracture patients. Cognitive dysfunction is defined as a premorbid state which is potentionally negatively related to short-term functional outcome. Objective To assess the relationship between cognitive status on admission and functional gain during an early rehabilitation period in elderly hip fracture patients. Methods Forty-five elderly patients with surgically treated hip fracture were examined. Cognitive status was assessed by the Mini Mental State Examination (MMSE) at admission; functional status was assessed by the motor subscale of Functional Independence Measure (FIM) at admission and before discharge, while absolute functional gain was determined by the motor FIM gain (FIM discharge - FIM admission). Absolute functional gain was analyzed in respect to cognitive status. Results Both cognitively impaired and cognitively intact hip fracture patients exhibited overall FIM motor improvements, as well as functional gains in specific FIM motor areas (p<0.01). Absolute functional gain, however, was higher in 1) cognitively intact compared to cognitively impaired patients (p<0.01), and 2) cognitively moderately impaired patients compared to severely cognitively impaired patients (p<0.01). No difference in functional gain was detected between the patients with moderately cognitively impaired compared to the cognitive intact patients (p>0.05). Conclusion The systematic use of MMSE identifies cognitively impaired hip fracture patients, and effectively predicts their short-term functional outcome. A higher admission cognitive status is related to a more favorable short term rehabilitation outcome. In spite of cognitive impairment, elderly patients with hip fracture can benefit from participation in rehabilitation programmes. The systematic identification of cognitively impaired hip fracture patients at admission facilitates optimal treatment and rehabilitation, and thus enables the best achievable outcome to be reached.

scholarly journals POOR ADHERENCE TO GUIDELINES FOR LONG-TERM OXYGEN THERAPY

CHEST Journal ◽  
2009 ◽  
Vol 136 (4) ◽  
pp. 96S ◽  
Author(s):  
Alessia Verduri ◽  
Licia Ballerin ◽  
Marzia Simoni ◽  
Leonardo Fabbri ◽  
Pietro Roversi ◽  
...  
Keyword(s):  
Oxygen Therapy ◽  
Poor Adherence ◽  
Adherence To Guidelines ◽  
Long Term Oxygen Therapy

Analgesia requirements following hip fracture in the cognitively impaired

Injury ◽  
2000 ◽  
Vol 31 (6) ◽  
pp. 435-436 ◽  
Author(s):  
M.C Forster ◽  
A Pardiwala ◽  
D Calthorpe
Keyword(s):  
Hip Fracture ◽  
Cognitively Impaired

Hip fracture pain management in a regional Australian emergency department: A retrospective descriptive study

2020 ◽  
Vol 23 (4) ◽  
pp. 221-224
Author(s):  
Bridget Honan ◽  
Michael Davoren ◽  
Jennifer Preddy ◽  
Simon Danieletto
Keyword(s):  
Emergency Department ◽  
Hip Fracture ◽  
Pain Management ◽  
Descriptive Study

scholarly journals Start-up of an orthogeriatric unit in a specialized general hospital

2014 ◽  
Vol 5 (1) ◽  
pp. 43-53
Author(s):  
Mª de los Ángeles Cruz ◽  
Manuel Lillo
Keyword(s):  
Hip Fracture ◽  
The Elderly ◽  
Descriptive Study ◽  
Early Start ◽  
Start Up ◽  
Number Of Patients ◽  
Professional Assessment ◽  
Spanish Healthcare System ◽  
Very High ◽  
Orthopedic Ward

The aging of the Spanish population has led to an increasingly greater number of hip fractures attended by the Spanish Healthcare System in the last years. Those patients, due to their fragility, need special professional attention and consequently, Orthogeriatric Units (UOG) have achieved the highest benefits.The main purpose of this research project is to evaluate the principle variables associated to the elderly affected of hip fracture staying in a new Orthogeriatric Unit created at the Hospital Nuestra Señora de Candelaria in Tenerife, Spain. A descriptive study of the elderly patients diagnosed of hip fracture staying in a conventional Orthopedic Ward was conducted, focusing specifically in those who were transferred to the UOG. The main items to describe were: total time of in-hospital staying, type of hip fracture and the kind of surgery selected, physiotherapist sessions in the conventional Orthopedic Ward, in the UOG and in Home Hospitalization Unit (HADO) as well as the total number of patients that needed to continue ambulatory physiotherapist sessions. As a conclusion, early start of physiotherapist sessions inside the hospital, completed in the UOG and/or in HADO, along with counseling and professional assessment to families and patients, reduced a very high percentage of their need for ambulatory ongoing rehabilitation.

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