The Correlation Between Timing of Surgery and the Need for RBC Transfusions in the Geriatric Intertrochanteric Fracture Population

Objective: To identify whether the timing of surgery affects red blood cell (RBC) transfusion requirements in the elderly with intertrochanteric fractures. Methods: We retrospectively studied all patients undergoing surgical fixation of their intertrochanteric fractures in our hospital between January 2009 and December 2018 and analyzed the relationship between the timing of surgery and RBC transfusion. Results: A total of 679 patients were included in this study. The need for RBC transfusion was lower in the patients who underwent surgery within 12 h after admission (timing of surgery <12 h, <12 h group) than those who underwent surgery over 12 h after admission (timing of surgery >12 h, >12 h group) (P = 0.046); lower in the the patients who underwent surgery within 24 h after admission (timing of surgery <24 h, <24 h group) than in those who underwent surgery over 24 h after admission (timing of surgery >24 h, >24 h group) (P = 0.008), and lower in the <24 h group compared to the patients who underwent surgery within 48 h after admission (timing of surgery <48 h, <48 h group) (P = 0.035). Moreover, the need for RBC transfusion was lower in the <24 h group (in the first 24 h from admission to surgery) than in the 24-48 h group (in the second 24 h from admission to surgery) (P = 0.016), and also lower in the <24 h group compared to the 48-72 h group (in the third 24 h from admission to surgery) (P = 0.047). However, there were no differences between the <12 h group and 12-24 h group, between the <12 h group and <24 h group, and between the 12-24 h group and <24 h group, respectively. Conclusion: Timing of surgery within 24 h contributes to the reduction of RBC transfusion in the elderly with intertrochanteric fractures.

Download Full-text

Admission deep venous thrombosis of lower extremity after intertrochanteric fracture in the elderly: a retrospective cohort study

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-02092-9 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Jinzeng Zuo ◽

Yongcheng Hu

Keyword(s):

Risk Factors ◽

Elderly Patients ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Intertrochanteric Fracture ◽

Lower Extremities ◽

The Elderly ◽

Intertrochanteric Fractures ◽

Targeted Interventions ◽

Laboratory Test Results

Abstract Objective The purpose of this study was to investigate the incidence, location, and related factors of deep venous thrombosis (DVT) of the bilateral lower extremities after intertrochanteric fractures in the elderly. Methods Retrospective analysis was performed on the elderly patients with intertrochanteric fracture who were admitted from January 2017 to December 2019. At admission, patients receive routine ultrasound Doppler scanning of bilateral lower extremities to detect DVT; those with DVT were assigned to the case group and those without DVT to the control group. Patient data on demographics, comorbidities, injury-related data, and laboratory test results at admission were extracted. Logistic regression analyses were conducted to identify the independent risk factors associated with DVT. Results Five hundred seventy-eight patients were included, among whom 116 (20.1%) had DVT. Among those with DV, 70.7% (82/116) had DVT of the distal type, 24 (29.6%) had DVT of the proximal type, and 10 (10.4%) had mixed DVT. In 76.7% (89/116) of patients, DVT occurred in the fractured extremity, 9.5% (11/116) in the bilateral and 13.8% (16/116) in the non-fractured extremity. Multivariate analyses identified obesity, delay to admission, increased D-dimer level (> 1.44 mg/L) and reduced albumin (< 31.7 g/L) as independent factors. Conclusions Admission incidence of DVT was high in elderly patients with intertrochanteric fractures, especially the proximal DVT. Identification of associated risk factors is useful for individualized assessment risk of DVT and early targeted interventions.

Download Full-text

VIOLÊNCIA CONTRA O IDOSO: O TERCEIRO COMO REGULADOR PSÍQUICO

International Journal of Developmental and Educational Psychology Revista INFAD de psicología ◽

10.17060/ijodaep.2014.n1.v2.426 ◽

2016 ◽

Vol 2 (1) ◽

pp. 135

Author(s):

Olga Perazzolo ◽

Siloe Pereira ◽

Marcia María Cappellano dos Santos

Keyword(s):

Social Learning ◽

The Elderly ◽

Contemporary Society ◽

Social Conventions ◽

The Third ◽

Moral Space ◽

The Social ◽

The Family ◽

Systemic Model ◽

The Relationship

Abstract:VIOLENCE AGAINST THE ELDERLY: THE THIRD PART AS A PSYCHIC REGULATORThe paper proposes reflections on the idea that the ingress of a third part in the relationship marked by violence, especially against the elderly, contributes to alter the dysfunctional model and to stabilize the guiding moral behaviors boundaries. It is not to consider that the aggressor hesitates in front of a third part to avoid the social disapproval or the punishment, but it is to observe that the psyche loosens the bounds with the social conventions in the absence of an element which sustains the constitutive triangulation of the moral space especially in stressful situations. The theoretical readings related to the proposition are made from the psychoanalysis contributions mainly in which it refers to the updating of the paternal role; the systemic model, particularly due the changes that occur in the system when there are alterations in its composition; and the social learning regarding the exposure to models to be adopted as source of vicarious schooling. It still proposes reflections over the aging context in the contemporary society, considering the increase on the number of elderly people, the demands of work which take to the deflation of the inner space in the family and thelongevity as a collective reality that the mankind is not aware of and which requires to be signified, invented and appraised.Keywords: Violence. Elderly. Family. Society.Resumo:O trabalho propõe reflexões sobre a ideia de que o ingresso de um terceiro na relação marcada pela violência, em especial contra o idoso, contribui para alterar o modelo disfuncional, estabilizar os marcos morais norteadores do comportamento. Não se trata de considerar que o agressor contenha-se frente a um terceiro para evitar o rechaço social ou a punição, mas de observar que o psiquismo afrouxa os laços com as regras sociais na ausência de um elemento que sustente a triangulação constitutiva do espaço moral, especialmente, em situações de estresse. As leituras teóricas acerca da proposição são feiras a partir de contributos da psicanálise, sobretudo no que se refere à atualização da função paterna; do modelo sistêmico, particularmente no que tange à mudança do sistema quando de alterações em sua composição; e da aprendizagem social, relativamente à exposição à modelos a serem adotados como fonte de aprendizagem vicária. Propõe, ainda, reflexões sobre o contexto do envelhecimento na sociedade contemporânea, considerando o aumento do numero de pessoas idosas, as demandas de trabalho, esvaziando o interior do espaço familiar, e a longevidade como realidade coletiva que a humanidade não conhece e que precisa ser significada, inventada, valorada.Palavras-chave: Violência. Idoso. Família. Sociedade

Download Full-text

Anthropometric measurements associated with intertrochanteric fractures in the elderly: a case-control study

Medical Journal of Indonesia ◽

10.13181/mji.v28i4.2680 ◽

2019 ◽

Vol 28 (4) ◽

pp. 365-9

Author(s):

Andy Ardiansyah ◽

Sugeng Yuwana

Keyword(s):

Intertrochanteric Fracture ◽

Case Control Study ◽

The Elderly ◽

Case Control ◽

Lower Limbs ◽

Control Group ◽

Case Group ◽

Intertrochanteric Fractures ◽

Steroid Use ◽

Control Study

BACKGROUND Femoral intertrochanteric fracture is an important cause of disability in the elderly. Low muscle mass, especially those of the lower limbs, has been associated with osteoporosis and higher fall incidents. This study was aimed to assess the association between the anthropometric indices and intertrochanteric fractures. METHODS This case-control study was performed from September 2013 to July 2015. The criteria of case group were elderly patients with intertrochanteric fractures admitted in Dr. Sardjito Hospital within 72 hours after a low energy injury without multiple fractures or pathological fracture. For control group, the subjects were matched according to age and gender without any fracture. Thigh and calf circumferences were done on healthy limbs. Body mass index (BMI) was calculated. History of steroid use was obtained. Adjusted odds ratio (OR) was calculated using logistic regression after analyzed with student's t-test or chi-square test. RESULTS There were 82 subjects on each group. Smaller thigh and calf circumferences and also lower BMI were risk factors of intertrochanteric fractures. Thigh circumference <39 cm (aOR 5.12; 95% CI 2.30–11.43; p < 0.001) and calf circumference <29 cm (aOR 9.42; 95% CI 4.14–21.40; p < 0.001) were independently associated with intertrochanteric fracture after adjustment of BMI and steroid use. CONCLUSIONS Calf and thigh circumferences were independently associated with femoral intertrochanteric fractures in Indonesian elderly.

Download Full-text

Proximal femoral nail anti-rotation versus cementless bipolar hemiarthroplasty for unstable femoral intertrochanteric fracture in the elderly: a retrospective study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-019-2793-8 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 4

Author(s):

Shenghu Zhou ◽

Jun Liu ◽

Ping Zhen ◽

Weiwei Shen ◽

Yanfeng Chang ◽

...

Keyword(s):

Postoperative Complications ◽

Elderly Patients ◽

Intertrochanteric Fracture ◽

Operation Time ◽

The Elderly ◽

Proximal Femoral Nail ◽

Bipolar Hemiarthroplasty ◽

Intertrochanteric Fractures ◽

Intraoperative Bleeding ◽

Femoral Intertrochanteric Fracture

Abstract Background The treatment for unstable intertrochanteric fractures in the elderly has always been a controversial issue. The aim in this study was to compare the curative effects of proximal femoral nail anti-rotation (PFNA) and cementless bipolar hemiarthroplasty (CPH) on femoral intertrochanteric fracture in the elderly. Methods From March 2008 to December 2012, 108 elderly patients with femoral intertrochanteric fractures were treated by PFNA or CPH. There were 63 males and 45 females, aged 75.3–99.1 years [(83.7 ± 5.6) years]. The patients’ bone mineral density was routinely measured, and the fractures were classified according to Evans-Jensen. The patients were divided into CPH group and PFNA group. The differences in operation time, intraoperative bleeding, immobilization duration, hospitalization time, Harris scores and postoperative complications including deep venous thrombosis, lung and urinary infection were analyzed. Results All patients were followed for 12.5–36.2 months [(28.0 ± 6.3) months)]. The operation time was (53.7 ± 15.2) min and (77.5 ± 16.8) min in PFNA group and CPH group, respectively (P < 0.05); intraoperative bleeding was (132.5 ± 33.2) mL and (286.3 ± 43.2) mL, respectively (P < 0.05); immobilization duration was (28.2 ± 3.7) days and (3.1 ± 1.2) days, respectively (P < 0.05); hospitalization time was (7.6 ± 1.8) days and (6.9 ± 2.2) days, respectively (P > 0.05); and the Harris scores after 1 year were (87.7 ± 7.9) points and (88.3 ± 9.2) points, respectively (P > 0.05). There was no significant difference in postoperative complications between the two groups (P > 0.05). Conclusion Both PFNA and CPH are safe and effective treatments for femoral intertrochanteric fracture in elderly patients. Nonetheless, CPH allows faster mobilization and recovery. Trial registration Registration Number: ChiCTR1900022846. Reg Date:2019-04-26 00:27:33 Retrospective registration

Download Full-text

Functional analysis of cemented bipolar hemiarthroplasty with medial calcar augmentation for unstable intertrochanteric fractures in elderly

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20175662 ◽

2017 ◽

Vol 4 (1) ◽

pp. 141

Author(s):

Sivabalan T. ◽

Thirunarayanan V. ◽

Senthil Kumar S. ◽

Ramprasath D. R. ◽

Basheer Ahmed S.

Keyword(s):

Functional Outcome ◽

Intertrochanteric Fracture ◽

The Elderly ◽

Fracture Pattern ◽

Harris Hip Score ◽

Bipolar Hemiarthroplasty ◽

Intertrochanteric Fractures ◽

Excellent Outcome ◽

Unstable Intertrochanteric Fracture ◽

Cemented Bipolar Hemiarthroplasty

Background: Intertrochanteric fracture is one of the most common fractures among the elderly osteoporotic population, constituting about 50% of hip fractures. These fractures are managed either by fixation using dynamic hip screw (DHS), proximal femur nail (PFN) or by replacement, based on the stability of fracture pattern, age of the patient, quality of bone and associated co-morbid conditions. Prosthetic replacement which is routinely done for femoral neck fractures requires modification when done for trochanteric fractures to improve stability. This study aims to analyse the short term functional outcome of cemented bipolar hemiarthroplasty with medial calcar augmentation for unstable intertrochanteric fractures in elderly.Methods: Our study includes 60 patients of age more than 70 years admitted in our institution during June 2012 to September 2016 with unstable intertrochanteric fractures. All patients operated through posterior approach to hip and cemented hemiarthroplasty with medial calcar augmentation with bone graft was done. Patients were followed up for an average of period of 2 years. Functional outcome was evaluated with Harris Hip score.Results: 28% of cases had excellent outcome. 43% of cases had good and 23% of cases had fair outcome. 2% of cases ended with poor outcome. The in-hospital mortality rate was 3.3%. The survival rate of the patients in this study at the end of one year is 85%. Conclusions: Cemented bipolar hemiarthroplasty with medial calcar augumentation can be considered as a good primary option for elderly unstable intertrochanteric fracture patients with osteoporotic bones and associated co-morbidities.

Download Full-text

Primary modular straight stem cemented prosthetic replacement for unstable, comminuted intertrochanteric fracture in the elderly with severe osteoporosis

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20193590 ◽

2019 ◽

Vol 5 (5) ◽

pp. 777

Author(s):

Manju G. Pillai

Keyword(s):

Functional Outcome ◽

Hip Fractures ◽

Intertrochanteric Fracture ◽

The Elderly ◽

Research Centre ◽

Complication Rates ◽

Intertrochanteric Fractures ◽

Prosthetic Replacement ◽

Straight Stem ◽

Walking Capacity

Background: The increasing number of hip fractures in the elderly, with the subset of unstable, comminuted intertrochanteric hip fractures is extremely relevant as the treatment is hampered by unsuccessful fixations and high complication rates. Osteoporosis and fracture geometry are two factors responsible for the failure of fixation in such fractures, upon which the surgeon has no control. Hence newer methods of fixation or treatment have to be opted for. The objective of the study was to evaluate the functional outcome of primary modular cemented prosthetic replacement for unstable, osteoporotic intertrochanteric fractures in a selected group of patients.Methods: A total of 34 patients with type II and type III unstable intertrochanteric fractures were treated with primary modular cemented bipolar prosthesis and followed up in Pushpagiri Institute of Medical Sciences and Research Centre, Tiruvalla.Results: After surgery 94.12% patients regained walking capacity. The functional outcome at the time of discharge was fair to excellent in 88.24% of cases. The complications were few and the major benefit was early ambulation of patients and return to pre-fracture level of activity.Conclusions: Primary modular bipolar straight stem cemented prosthetic replacement is probably the best option for treatment in previously independently ambulant, elderly osteoporotic patients with unstable, comminuted intertrochanteric fracture of femur.

Download Full-text

The relationship between alexithymia, cognitive deterioration and chronic illness in the elderly

PsycEXTRA Dataset ◽

10.1037/e573122012-020 ◽

2012 ◽

Author(s):

Antonia Gomez-Conesa ◽

Maria Virgilia Anton Anton ◽

Daniel Jesus Catalan Matamoros

Keyword(s):

Chronic Illness ◽

The Elderly ◽

Cognitive Deterioration ◽

The Relationship

Download Full-text

The Mediating Effects of Self-Efficacy and Social Support on the Relationship between Interactive SNS Usage of Smart Devices and Depression in the Elderly

The Korean Journal of Clinical Psychology ◽

10.15842/kjcp.2018.37.2.004 ◽

2018 ◽

Vol 37 (2) ◽

pp. 166-177 ◽

Cited By ~ 1

Author(s):

Yunhui Chey ◽

Jungkyu Kim

Keyword(s):

Social Support ◽

Self Efficacy ◽

The Elderly ◽

Smart Devices ◽

Mediating Effects ◽

The Relationship

Download Full-text

Verification of the Relationship between Stepping Ability for Avoiding Falls and the Ten-Step Test in the Elderly

Rigakuryoho Kagaku ◽

10.1589/rika.35.545 ◽

2020 ◽

Vol 35 (4) ◽

pp. 545-549

Author(s):

Kengo OKAWARA ◽

Yoshinobu YOSHIMOTO ◽

Ryota ASHIZAWA ◽

Kazuma YAMASHITA ◽

Koki TAKE ◽

...

Keyword(s):

The Elderly ◽

Step Test ◽

The Relationship

Download Full-text

In our society, the proportion of youth is higher than any other society. They are important in this regard. But the real question is whether his views, trends and likes and dislikes are different from other generations of society in political terms. What

Think India ◽

10.26643/think-india.v22i3.8367 ◽

2019 ◽

Vol 22 (3) ◽

pp. 680-686

Author(s):

Azad Pratap Singh

Keyword(s):

The Elderly ◽

Fundamental Difference ◽

The West ◽

Green Party ◽

The Real ◽

The Third ◽

English Speaking ◽

Education And Employment ◽

Political Understanding ◽

Separate Class

In our society, the proportion of youth is higher than any other society. They are important in this regard. But the real question is whether his views, trends and likes and dislikes are different from other generations of society in political terms. What is the reason for the tendency to see youth as a separate class. That we borrow the principles of politics from the West, where the distinction of generations is more important factor in politics than the distinction of community or class. At one time, parties like the Labor Party and the Green Party have been standing mainly on the vote of the youth for some time. The second reason is that the image of the youth is based on the English-speaking youths living somewhere in the metros. We often consider him to be a symbol of youth. While in reality they are a very small part of our youth. And the third reason is that the part of change, revolution and the politics of change that had set the hopes of the youth are still there in our political understanding. The fact is that the youth class is not very different from the elderly or any other generation in terms of participation in politics, if different then it means that its participation is less than the other class because it is more concerned about education and employment. There is no fundamental difference between the vote of the youth and other generations in terms of voting or political choice. If there is a difference, then only in the sense that the parties who have come in the last 25-30 years have heard more about the youth, hence their choice is more. Older parties usually get little support from the youth. However, it is not related to its youth, because the information about that party is limited to certain people.

Download Full-text