scholarly journals Who Is the Geriatric Trauma Patient? An Analysis of Patient Characteristics, Hospital Quality Measures, and Inpatient Cost

2020 ◽  
Vol 11 ◽  
pp. 215145932095508
Author(s):  
Sanjit R. Konda ◽  
Ariana Lott ◽  
Jessica Mandel ◽  
Thomas R. Lyon ◽  
Jonathan Robitsek ◽  
...  
Keyword(s):  
Age Groups ◽  
Quality Measures ◽  
High Energy ◽  
Cost Of Care ◽  
Hospital Quality ◽  
Geriatric Trauma ◽  
Inpatient Cost ◽  
Orthopedic Trauma ◽  
Age Related ◽  
Trauma Population

Purpose: The purpose of this study was 2-fold: 1) to investigate the age-related frequency, demographics and distribution of the middle-aged and geriatric orthopedic trauma population and 2) to describe the age-related frequency and distribution of hospital quality measure outcomes and inpatient cost. Methods: All patients > 55 years of age who required orthopedic, trauma, or neurosurgery consults at 3 hospitals within an academic medical center from 2014 to 2017 were prospectively followed. On initial evaluation, each patient’s demographics, injury severity, and functional status were collected. Patients were grouped into low and high-energy mechanism cohorts and divided into 5 groups based on age. Hospital quality measures including length of stay, complications, discharge location, and cost of care was compared between age groups. Data were analyzed using ANOVA and Chi-square tests. Results: A total of 3965 patients were included in this study of which 3268 (82%) sustained low-energy trauma and 697 (18%) sustained high-energy trauma. With increasing age, more patients had more comorbidities, were less likely to be community ambulators, and more likely to use assistive devices (p < 0.05). Patients in older age groups had longer lengths of stay, more complications, were more likely to need ICU level care, and were less likely to be discharged home (p < 0.05). Rates of mortality were also greater in patients of more advanced age in both low and high-energy cohorts, and the calculated risk triage tool (STTGMA) score increased with each age bracket (p < 0.05). Total cost of care differed between age groups in the low-energy cohort (p = 0.003). Conclusion: This epidemiological study provides a clear picture of the frequency and distribution of demographic, physiologic characteristics, outcomes, and cost of care in a middle-aged and geriatric orthopedic trauma population as evaluated by the STTGMA risk tool. Risk profiling of geriatric trauma patients allows for the establishment of baseline norms.

scholarly journals How Does Frailty Factor Into Mortality Risk Assessment of a Middle-Aged and Geriatric Trauma Population?

2017 ◽  
Vol 8 (4) ◽  
pp. 225-230 ◽  
Author(s):  
Sanjit R. Konda ◽  
Ariana Lott ◽  
Hesham Saleh ◽  
Sebastian Schubl ◽  
Jeffrey Chan ◽  
...  
Keyword(s):  
Mortality Risk ◽  
Functional Independence ◽  
High Energy ◽  
Low Energy ◽  
Geriatric Trauma ◽  
Inpatient Mortality ◽  
Middle Aged ◽  
Trauma Population ◽  
Increased Risk ◽  
Significant Difference

Introduction: Frailty in elderly trauma populations has been correlated with an increased risk of morbidity and mortality. The Score for Trauma Triage in the Geriatric and Middle-Aged (STTGMA) is a validated mortality risk score that evaluates 4 major physiologic criteria: age, comorbidities, vital signs, and anatomic injuries. The aim of this study was to investigate whether the addition of additional frailty variables to the STTGMA tool would improve risk stratification of a middle-aged and elderly trauma population. Methods: A total of 1486 patients aged 55 years and older who met the American College of Surgeons Tier 1 to 3 criteria and/or who had orthopedic or neurosurgical traumatic consultations in the emergency department between September 2014 and September 2016 were included. The STTGMAORIGINAL and STTGMAFRAILTY scores were calculated. Additional “frailty variables” included preinjury assistive device use (disability), independent ambulatory status (functional independence), and albumin level (nutrition). The ability of the STTGMAORIGINAL and the STTGMAFRAILTY models to predict inpatient mortality was compared using area under the receiver operating characteristic curves (AUROCs). Results: There were 23 high-energy inpatient mortalities (4.7%) and 20 low-energy inpatient mortalities (2.0%). When the STTGMAORIGINAL model was used, the AUROC in the high-energy and low-energy cohorts was 0.926 and 0.896, respectively. The AUROC for STTGMAFRAILTY for the high-energy and low-energy cohorts was 0.905 and 0.937, respectively. There was no significant difference in predictive capacity for inpatient mortality between STTGMAORIGINAL and STTGMAFRAILTY for both the high-energy and low-energy cohorts. Conclusion: The original STTGMA tool accounts for important frailty factors including cognition and general health status. These variables combined with other major physiologic variables such as age and anatomic injuries appear to be sufficient to adequately and accurately quantify inpatient mortality risk. The addition of other common frailty factors that account for does not enhance the STTGMA tool’s predictive capabilities.

Geriatric Trauma

2019 ◽  
Author(s):  
Sigrid Burruss ◽  
Lillian Min ◽  
Areti Tillou
Keyword(s):  
Risk Factors ◽  
Care Coordination ◽  
Unintentional Injury ◽  
The Elderly ◽  
Geriatric Trauma ◽  
Trauma Patients ◽  
Age Related ◽  
Trauma Population ◽  
Downward Spiral ◽  
Risk Factors For Falls

The geriatric trauma population continues to grow as life expectancy and unintentional injury increase. Age-related physiologic changes and complex comorbidities may not only lead to injury but also may precipitate a downward spiral. The injury patterns, presentation of life-threatening injury, and response to injury are unique in the elderly trauma population, and dedicated evaluation of elderly trauma patients at a trauma center may be beneficial. Aggressive, early intervention with a focus on geriatric-specific needs and care coordination are an integral part of the management to reduce morbidity and mortality. Much of the unintentional injuries may be preventable with identification of risk factors for falls and fall prevention programs. Frailty measurements may be used to predict morbidity and functional status. Surgeons must become familiar with geriatric-specific issues and how best to treat the geriatric trauma population.  This review contains 3 figures, 2 tables, and 133 references. Key Words: care coordination, elderly, frailty, geriatric, injury, prevention, risk factors, trauma, triage

scholarly journals Predicting Hospital Quality Measures Following High-Energy Orthopaedic Trauma

2019 ◽  
Author(s):  
Sanjit Konda ◽  
Erin A. Kelly MS ◽  
Joseph Johnson ◽  
R. Jonathan Robitsek PhD ◽  
Kenneth Egol
Keyword(s):  
Quality Measures ◽  
High Energy ◽  
Hospital Quality ◽  
Orthopaedic Trauma

Immigrant Youth in Germany

2013 ◽  
Vol 18 (3) ◽  
pp. 158-168 ◽  
Author(s):  
Emily Frankenberg ◽  
Katharina Kupper ◽  
Ruth Wagner ◽  
Stephan Bongard
Keyword(s):  
School System ◽  
Large Scale ◽  
Age Groups ◽  
Well Being ◽  
Ethnic Discrimination ◽  
Emotional And Behavioral Problems ◽  
Sociocultural Adaptation ◽  
Age Related ◽  
German School ◽  
Transcultural Adaptation

This paper reviews research on young migrants in Germany. Particular attention is given to the question of how Germany’s history of migration, immigration policies, and public attitude toward migrants influence the transcultural adaptation of children and adolescents from different ethnic backgrounds. We combine past research with the results of new empirical studies in order to shed light on migrants’ psychological and sociocultural adaptation. Studies comparing young migrants and their German peers in terms of psychological well-being, life satisfaction, and mental health outcome suggest higher rates of emotional and behavioral problems among migrants of most age groups. With regard to adolescent populations between the ages of 14 and 17 years, however, the existence of differences between migrants and natives appears to be less clear. Research has also yielded inconsistent findings regarding the time trajectory of transcultural adaptation among adolescents. The coincidence of acculturation and age-related change is discussed as a possible source of these inconsistencies. Further, we provide an overview of risk and protective factors such as conflicting role expectations and ethnic discrimination, which may cause heightened vulnerability to adverse adaptation outcomes in some groups. Large-scale studies have repeatedly shown migrants of all age groups to be less successful within the German school system, indicating poor sociocultural adaptation. Possible explanations, such as the idiosyncrasies of the German school system, are presented. Our own studies contribute to the understanding of young migrants’ adaptation process by showing that it is their orientation to German culture, rather than the acculturation strategy of integration, that leads to the most positive psychological and sociocultural outcomes. The paper concludes by discussing implications for future cross-cultural research on young migrants and by suggesting recommendations for multicultural policies.

The influence of osteopathic correction on the rate of various rhythms of the body

2019 ◽  
pp. 64-71 ◽  
Author(s):  
A. E. Chernikova ◽  
Yu. P. Potekhina
Keyword(s):  
Heart Rate ◽  
Respiratory Rate ◽  
Age Groups ◽  
Biomechanical Properties ◽  
Dispersion Analysis ◽  
The Body ◽  
Body Tissues ◽  
Age Related ◽  
Significant Difference ◽  
Before And After

Introduction. An osteopathic examination determines the rate, the amplitude and the strength of the main rhythms (cardiac, respiratory and cranial). However, there are relatively few studies in the available literature dedicated to the influence of osteopathic correction (OC) on the characteristics of these rhythms.Goal of research — to study the influence of OC on the rate characteristics of various rhythms of the human body.Materials and methods. 88 adult osteopathic patients aged from 18 to 81 years were examined, among them 30 men and 58 women. All patients received general osteopathic examination. The rate of the cranial rhythm (RCR), respiratory rate (RR) heart rate (HR), the mobility of the nervous processes (MNP) and the connective tissue mobility (CTM) were assessed before and after the OC session.Results. Since age varied greatly in the examined group, a correlation analysis of age-related changes of the assessed rhythms was carried out. Only the CTM correlated with age (r=–0,28; p<0,05) in a statistically significant way. The rank dispersion analysis of Kruskal–Wallis also showed statistically significant difference in this indicator in different age groups (p=0,043). With the increase of years, the CTM decreases gradually. After the OC, the CTM, increased in a statistically significant way (p<0,0001). The RCR varied from 5 to 12 cycles/min in the examined group, which corresponded to the norm. After the OC, the RCR has increased in a statistically significant way (p<0,0001), the MNP has also increased (p<0,0001). The initial heart rate in the subjects varied from 56 to 94 beats/min, and in 15 % it exceeded the norm. After the OC the heart rate corresponded to the norm in all patients. The heart rate and the respiratory rate significantly decreased after the OC (р<0,0001).Conclusion. The described biorhythm changes after the OC session may be indicative of the improvement of the nervous regulation, of the normalization of the autonomic balance, of the improvement of the biomechanical properties of body tissues and of the increase of their mobility. The assessed parameters can be measured quickly without any additional equipment and can be used in order to study the results of the OC.

Age related volume of cadaver-prostates in Bangladesh

1970 ◽  
Vol 4 (2) ◽  
pp. 74-77
Author(s):  
Rukshana Ahmed ◽  
Shamim Ara
Keyword(s):  
Prostate Gland ◽  
Age Groups ◽  
Clinical Settings ◽  
Cross Sectional ◽  
Medical College ◽  
Age Related ◽  
Group A ◽  
Key Words Prostate ◽  
The Mean ◽  
Group B

Pathological changes in the prostate gland occur commonly with advancing age including inflammation, atrophy, hyperplasia and carcinoma and a change in volume is also evident. Estimation of volume of prostate may be useful in a variety of clinical settings. A cross-sectional descriptive study was designed to see the changes in volume of the prostate with advancing age and done in the Department of Anatomy, Dhaka Medical College, Dhaka from August 2006 to June 2007. The study was performed on 70 post-mortem human prostates collected from the unclaimed dead bodies that were under examination in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. The samples were divided into three age groups; group A (10-20 years), group B (21-40 years) and group C (41-70 years). Volume of the sample was measured by using the ellipsoid formula. The mean ± SD volume of prostate was 7.68 ± 3.64 cm3 in group A, 10.61 ± 3.99 cm3 in group B and 15.40 ± 6.31 cm3 in group C. Mean difference in volume between group A and group C, group B and group C were statistically significant (p<0.001). Statistically significant positive correlation was found between age and volume of prostate (r = + 0.579, p < 0.001). Key Words: Prostate; volume; Bangladeshi. DOI: 10.3329/imcj.v4i2.6501Ibrahim Med. Coll. J. 2010; 4(2): 74-77

Age development of cortical rhythmics in the EEG depending on the formation of the child’s personal psychical characteristics

2019 ◽  
Vol 1 (8) ◽  
pp. 42-50
Author(s):  
A. V. Budkevich ◽  
L. B. Ivanov ◽  
G. R. Novikova ◽  
G. M. Dzhanumova
Keyword(s):  
Alpha Rhythm ◽  
Age Groups ◽  
Healthy Children ◽  
Brain Organization ◽  
Age Related ◽  
Mathematical Processing ◽  
Functional Brain Organization ◽  
Child's Brain ◽  
Attention Function ◽  
Apparently Healthy

According to the authors, rationing the age-related EEG parameters in children should be based on personal psychical characteristics. A comparative analysis of personal psychical characteristics and electroencephalographic data was carried out in 300 apparently healthy children aged 3-15 years. According to this principle, two subgroups of conditionally healthy children in each age group were singled out: 1) with an immature attention function and 2) with an increased anxious background that do not reach the pathological level. Registration and analysis of EEG was performed by the Neurokariograf computer complex (MBN, Moscow) using mathematical processing methods.The EEG interpretation was based on the principle of assessing the functional state of a child's brain using a three-component model according to: 1) wakefulness level and its dissociation, 2) severity of signs of the EEG neurotic pattern, 3) directionality of formation of traits of the system-functional brain organization (severity of signs functional hypofrontality).lt was found the presence of EEG signs was indicative of a lower level of wakefulness in children with an immature function of attention in all age groups, compared with the indicators of the average population of group and children with an increased background of anxiety. Children with an increased background of anxiety have a tendency to prevalence and excessive spatial synchronization of the alpha rhythm. ln healthy children, the fact of a decrease in wakefulness and the presence of signs of anxiety in the clinic and in EEG patterns indicates individual personalities and should not be considered as pathology.

Information Practices of Baby Boomers as Caregivers

2013 ◽  
Author(s):  
Khuan Seow ◽  
Nadia Caidi
Keyword(s):  
Social Policy ◽  
Baby Boomers ◽  
Information Needs ◽  
Family Members ◽  
Age Groups ◽  
Maladie D’Alzheimer ◽  
Policy Makers ◽  
Age Related ◽  
The Family ◽  
Growing Age

Canada has an aging population with the fastest growing age groups (80 and 45-64 years old) vulnerable to age-related diseases such as Alzheimer’s disease. Caregiving responsibilities often fall to the family members of the afflicted without much attention and consideration being placed on the information needs of these caregivers. We call for a better understanding of these caregivers' information needs and uses by social policy makers as well as information providers.La population du Canada a tendance à vieillir considérablement, avec la hausse la plus rapide dans les groupes d’âge (80 et 45 à 64 ans). Les personnes âges sont très vulnérables à toute sorte de maladies, telles que la maladie d’Alzheimer. La responsabilité revient souvent aux membres de la famille qui doivent prendre soin des personnes atteintes de cette maladie. Or, nous ne connaissons que peu de chose sur les besoins en information des personnes qui prennent soin de ces malades de l’Alzheimer : qui sont-ils ? Quelles sont leurs sources... 

Sources of cognitive conflict and their relevance to Theory of Mind proficiency in healthy ageing. A preregistered study.

2018 ◽  
Author(s):  
Foyzul Rahman ◽  
Sabrina Javed ◽  
Ian Apperly ◽  
Peter Hansen ◽  
Carol Holland ◽  
...  
Keyword(s):  
Theory Of Mind ◽  
Executive Control ◽  
Spatial Working Memory ◽  
Age Groups ◽  
Response Speed ◽  
Cognitive Conflict ◽  
Mental States ◽  
Younger Adults ◽  
Age Related ◽  
Outcome Knowledge

Age-related decline in Theory of Mind (ToM) may be due to waning executive control, which is necessary for resolving conflict when reasoning about others’ mental states. We assessed how older (OA; n=50) versus younger adults (YA; n=50) were affected by three theoretically relevant sources of conflict within ToM: competing Self-Other perspectives; competing cued locations and outcome knowledge. We examined which best accounted for age-related difficulty with ToM. Our data show unexpected similarity between age groups when representing a belief incongruent with one’s own. Individual differences in attention and motor response speed best explained the degree of conflict experienced through conflicting Self-Other perspectives. However, OAs were disproportionately affected by managing conflict between cued locations. Age and spatial working memory were most relevant for predicting the magnitude of conflict elicited by conflicting cued locations. We suggest that previous studies may have underestimated OA’s ToM proficiency by including unnecessary conflict in ToM tasks.

Study of functional state of microcirculatory channel system in periodontal tissues in persons of different age groups

2020 ◽  
Vol 20 (2) ◽  
pp. 88-94
Author(s):  
L. Yu. Orekhova ◽  
A. A. Petrov ◽  
E. S. Loboda ◽  
I. V. Berezkina ◽  
K. V. Shadrina
Keyword(s):  
Functional State ◽  
Age Groups ◽  
Peripheral Resistance ◽  
Circulatory System ◽  
Structural Features ◽  
Periodontal Tissues ◽  
Non Invasive ◽  
Age Related ◽  
Group 12 ◽  
Therapeutic Measures

Relevance. The study of age-related features of microcirculation in periodontal tissues, using non-invasive functional research methods, allows us to develop the optimal range of therapeutic measures, as well as form a “personalized therapeutic case”.Purpose. Study of the functional state of the microvasculature in the tissues of the parodont in individuals of various age groups.Materials and methods. A standard dental examination of 80 patients was carried out, the sample of participants was ranked in 4 groups by age: 1 group – 12 years old, 2 group – 15 years old, 3 group – from 16 to 18 years old, 4 group – from 22 to 24 years old. Hygiene and periodontal indices were determined for all patients, such as papillarymarginal-alveolar (PMA) in the Parma modification, the Mulleman bleeding index in the Cowell modification (SBI), and the simplified Green Vermillion index of oral hygiene (OHI–s), caries intensity indicators for a permanent bite (CPI), as well as ultrasound dopplerography of periodontal tissues using the apparatus "Minimax-Doppler-K".Results. When studying microcirculation in periodontal tissues, distinctive characteristics of linear (Vas) and volumetric (Qas) blood flow rates, as well as indicators of pulsation indices (PI) and peripheral resistance (RI) in people of different age groups were recorded.Conclusions. This study confirms the presence of various hemodynamic indicators of periodontal tissues in the studied groups, which is due to structural features of the circulatory system in age periods.

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