scholarly journals Preoperative fluid management of the older adult patient with hip fracture

2021 ◽  
Author(s):  
◽  
Victoria Carolyn Ward
Keyword(s):  
Hip Fracture ◽  
Older Adult ◽  
Fluid Management ◽  
Postoperative Outcomes ◽  
Fragility Hip Fracture ◽  
Significant Relationships ◽  
Postoperative Confusion ◽  
Limited Power ◽  
Predominantly Female ◽  
Preoperative Oral Fluids

<p>Background While recommendations about the preoperative fluid management of the older adult hip fracture patient have been produced the evidence relating to postoperative outcomes is scant.  Aim The aim of this study is, therefore, to explore the relationships between preoperative fluid management (PFM) - defined as timing to start of fluids (oral or intravenous) after admission, preoperative oral fluid rate, and timing of last preoperative oral fluids – and postoperative outcomes - defined as change in renal function (creatinine and GFR), new reported postoperative confusion, timing of discontinuation of postoperative intravenous fluids (IV), and length of stay (LOS).  Method This observational study looked at 100 consecutive older adult patients admitted to a tertiary New Zealand hospital with traumatic hip fracture between March and September, 2012. Data was gathered regarding cohort demographics and in hospital events, including surgical details, alongside PFM and postoperative outcomes. Descriptive statistics, linear regression, independent t-tests, tests of equality, and multiple logistic regression were utilised to ascertain relationships between variables.  Results Characteristics of the perioperative journey of 100 consecutive patients, with mean age of 85.2 yr (SD 6.6) and predominantly female (70%), presenting to CCDHB with a fragility hip fracture were itemised. High rates of co-morbidities were observed in this group, with 92% of patients having cardiac, pulmonary, vascular or renal co-morbidities, but with a mortality rate (2%) much lower than the literature would suggest might be expected. There was no substantiated statistically significant relationships observed between preoperative fluid management in this cohort and postoperative outcomes, but this may reflect limited power in this study.  Conclusion These results provide useful data for planning services with regards management of the older adult hip fracture patient at CCDHB. In addition, the study has highlighted a number of clinical guidelines that might be more effectively promoted.</p>

scholarly journals Preoperative fluid management of the older adult patient with hip fracture

2021 ◽  
Author(s):  
◽  
Victoria Carolyn Ward
Keyword(s):  
Hip Fracture ◽  
Older Adult ◽  
Fluid Management ◽  
Postoperative Outcomes ◽  
Fragility Hip Fracture ◽  
Significant Relationships ◽  
Postoperative Confusion ◽  
Limited Power ◽  
Predominantly Female ◽  
Preoperative Oral Fluids

<p>Background While recommendations about the preoperative fluid management of the older adult hip fracture patient have been produced the evidence relating to postoperative outcomes is scant.  Aim The aim of this study is, therefore, to explore the relationships between preoperative fluid management (PFM) - defined as timing to start of fluids (oral or intravenous) after admission, preoperative oral fluid rate, and timing of last preoperative oral fluids – and postoperative outcomes - defined as change in renal function (creatinine and GFR), new reported postoperative confusion, timing of discontinuation of postoperative intravenous fluids (IV), and length of stay (LOS).  Method This observational study looked at 100 consecutive older adult patients admitted to a tertiary New Zealand hospital with traumatic hip fracture between March and September, 2012. Data was gathered regarding cohort demographics and in hospital events, including surgical details, alongside PFM and postoperative outcomes. Descriptive statistics, linear regression, independent t-tests, tests of equality, and multiple logistic regression were utilised to ascertain relationships between variables.  Results Characteristics of the perioperative journey of 100 consecutive patients, with mean age of 85.2 yr (SD 6.6) and predominantly female (70%), presenting to CCDHB with a fragility hip fracture were itemised. High rates of co-morbidities were observed in this group, with 92% of patients having cardiac, pulmonary, vascular or renal co-morbidities, but with a mortality rate (2%) much lower than the literature would suggest might be expected. There was no substantiated statistically significant relationships observed between preoperative fluid management in this cohort and postoperative outcomes, but this may reflect limited power in this study.  Conclusion These results provide useful data for planning services with regards management of the older adult hip fracture patient at CCDHB. In addition, the study has highlighted a number of clinical guidelines that might be more effectively promoted.</p>

Acute nursing care of the older adult with fragility hip fracture: An international perspective (Part 1)

2012 ◽  
Vol 16 (4) ◽  
pp. 177-194 ◽  
Author(s):  
Ann Butler Maher ◽  
Anita J Meehan ◽  
Karen Hertz ◽  
Ami Hommel ◽  
Valerie MacDonald ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Older Adult ◽  
Nursing Care ◽  
International Perspective ◽  
Fragility Hip Fracture

Acute nursing care of the older adult with fragility hip fracture: An international perspective (Part 2)

2013 ◽  
Vol 17 (1) ◽  
pp. 4-18 ◽  
Author(s):  
Ann Butler Maher ◽  
Anita J Meehan ◽  
Karen Hertz ◽  
Ami Hommel ◽  
Valerie MacDonald ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Older Adult ◽  
Nursing Care ◽  
International Perspective ◽  
Fragility Hip Fracture

Care of the Older Adult With Fragility Hip Fracture

2020 ◽  
Author(s):  
Anita J. Meehan ◽  
Ann Butler Maher ◽  
Valerie MacDonald ◽  
Karen Hertz ◽  
Ami Hommel
Keyword(s):  
Hip Fracture ◽  
Older Adult ◽  
Fragility Hip Fracture

Care of the Older Adult With Fragility Hip Fracture

2018 ◽  
Author(s):  
Anita J. Meehan ◽  
Ami Hommel ◽  
Karen Hertz ◽  
Valerie MacDonald ◽  
Ann Butler Maher
Keyword(s):  
Hip Fracture ◽  
Older Adult ◽  
Fragility Hip Fracture

scholarly journals Outcomes of COVID-19 Negative Hip Fracture Patients During the Acute and Subacute Pandemic

2021 ◽  
Vol 12 ◽  
pp. 215145932110066
Author(s):  
Naoko Onizuka ◽  
Lauren N. Topor ◽  
Lisa K. Schroder ◽  
Julie A. Switzer
Keyword(s):  
Hip Fracture ◽  
Length Of Stay ◽  
Healthcare System ◽  
Perioperative Complications ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Surgical Care ◽  
Admission Rate ◽  
System Response ◽  
Fragility Hip Fracture

Objectives: To better elucidate how the COVID-19 pandemic has affected the operatively treated geriatric hip fracture population and how the health care system adapted to pandemic dictated procedures. Design: Retrospective cohort study. Setting: A community hospital. Participants: Individuals ≥65 years of age presented with a proximal femoral fracture from a low-energy mechanism undergoing operative treatment from January 17, 2020 to July 2, 2020 (N = 125). Measurements: We defined 3 phases of healthcare system response: pre-COVID-19, acute phase, and subacute phase. Thirty-day mortality, time to operating room (OR), length of stay, time to start physical therapy, perioperative complications, delirium rate, hospice admission rate, discharge dispositions, readmission rate, and the reason of surgery delay were assessed. Results: The number of hip fractures has remained constant during the pandemic. The 30-day mortality rate, time to OR, and length of stay were higher in the pandemic compared to the pre-pandemic. Those who had a longer wait time to OR (≥ 24 hours) had more complications and increased 30-day mortality rates. Some of the surgery delays were related to OR unavailability as a consequence of the COVID-19 pandemic. Surgery was delayed in 3 patients who were on direct oral anticoagulants (DOACs) in pandemic but none for pre-pandemic period. Conclusion: This is the first study to compare the effect of the acute and subacute phases of the pandemic on uninfected hip fracture patients. In the age of COVID-19, to provide the best care for the vulnerable geriatric orthopedic populations, the healthcare system must adopt new protocols. We should still aim to promote prompt surgical care when indicated. It is important to ensure adequate resource availability, such as OR time and staff so that hip fracture patients may continue to receive rapid access to surgery. A multidisciplinary approach remains the key to the management of fragility hip fracture patients during the pandemic.

scholarly journals Morbidity and mortality after fragility hip fracture in a Saudi Arabian population: Report from a single center

2017 ◽  
Vol 45 (3) ◽  
pp. 1175-1180 ◽  
Author(s):  
Mir Sadat-Ali ◽  
Moaad Alfaraidy ◽  
Abdulaziz AlHawas ◽  
Ahmed Abdallah Al-Othman ◽  
Dakheel A Al-Dakheel ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Mortality Rate ◽  
Demographic Data ◽  
Femoral Fractures ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Fragility Hip Fracture ◽  
Asa Score ◽  
Telephone Interviews ◽  
American Society

Objective To determine the functional morbidity and mortality after fragility hip fracture and compare the mortality with three other common diseases. Methods Data were collected from patients admitted to King Fahd Hospital of the University, AlKhobar from January 2010 to December 2014. Demographic data included the preoperative American Society of Anesthesiologists (ASA) score as assessed by the anesthetist and the type of surgery. Personal and telephone interviews were performed, and data were entered into a database and analyzed. Results We identified 203 patients with fragility proximal femoral fractures, and the data of 189 patients (109 male, 80 female; average age, 66.90 ± 13.43 years) were available for analysis. The overall mortality rate was 26.98% (51 patients). The mortality rate was significantly higher among patients with an ASA score of 4 (36.36%) than 1 (20.45%). With respect to morbidity, only 48.23% of patients were able to return to their pre-fracture status; 32.35% of those who required assisted walking and 83.4% of those who required a wheelchair became bedridden. Conclusions Our data demonstrate that patients with fragility hip fractures have high morbidity and a mortality rate approaching 30%. Age and the ASA score significantly influence this high mortality rate.

scholarly journals Influence of bone densitometry on the anti-osteoporosis treatment after fragility hip fracture

2018 ◽  
Vol 31 (10) ◽  
pp. 1525-1529 ◽  
Author(s):  
Peiwen Wang ◽  
Yizhong Li ◽  
Huafeng Zhuang ◽  
Haiming Yu ◽  
Siqing Cai ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Bone Densitometry ◽  
Osteoporosis Treatment ◽  
Fragility Hip Fracture
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