Chondrocyte Viability After Intra-articular Calcaneal Fractures in Humans

2007 ◽  
Vol 28 (6) ◽  
pp. 665-668 ◽  
Author(s):  
Scott T. Ball ◽  
Kyle Jadin ◽  
R. Todd Allen ◽  
Alexandra K. Schwartz ◽  
Robert L. Sah ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Calcaneal Fractures ◽  
Patient Age ◽  
Chondrocyte Viability ◽  
Articular Fractures ◽  
Patient Âgé ◽  
Post Traumatic ◽  
The Impact ◽  
Traumatic Arthritis ◽  
Time From Injury

Background: Chondral damage from the impact of injury may contribute to the high incidence of post-traumatic arthritis after calcaneal fractures, but this has yet to be proven. We sought to study the effect of intra-articular calcaneal fractures on chondrocyte viability and to correlate these effects with injury severity, time from injury to surgery, and patient age and co-morbidities. Methods: Irreducible osteochondral fragments from 12 patients undergoing operative treatment for intra-articular calcaneal fractures were analyzed. Control cartilage was obtained from four tissue donors who died of unrelated causes. The cartilage was assessed for chondrocyte viability through the full thickness of tissue using a Live/Dead assay followed by laser scanning confocal microscopy. Patient demographics including injury classification and severity, time from injury to surgery, and patient age were recorded. Results: Chondrocyte viability from fracture patients averaged 72.8% ± 12.9% (range 53% to 95%), which was significantly lower than the 94.8% ± 1.5% viability observed in the control specimens ( p = 0.005). Chondrocyte viability declined with higher energy injuries ( p = 0.13), time from injury to surgery ( p = 0.07), and increasing patient age ( p = 0.07). However, none of these factors reached a level of statistical significance. Conclusions: A significant decline in chondrocyte viability occurs after intra-articular fractures of the calcaneus. This may contribute to the development of post-traumatic arthritis.

The impact of patient age and procedure type on postoperative opioid use following ambulatory pediatric urologic procedures

2021 ◽  
Author(s):  
Michael F. Basin ◽  
Zoë G. Baker ◽  
Melissa Trabold ◽  
Terry Zhu ◽  
Lorraine I. Kelley-Quon ◽  
...  
Keyword(s):  
Opioid Use ◽  
Patient Age ◽  
Patient Âgé ◽  
The Impact ◽  
Procedure Type

scholarly journals Initial Experience with Digital Patient Briefing in Computed Tomography

2018 ◽  
Vol 191 (06) ◽  
pp. 540-546
Author(s):  
Babak Alikhani ◽  
Bennet Hensen ◽  
Arne Grosser ◽  
Maria Inés Cartes Febrero ◽  
Markus von Bestenbostel ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Statistical Significance ◽  
Age Groups ◽  
Patient Age ◽  
Open Questions ◽  
Patient Âgé ◽  
Significant Difference ◽  
Student’S T ◽  
The Individual ◽  
Time Required

Purpose To assess digital patient briefing as an alternative to conventional paper documentation. Materials and Methods 502 patients with a planned computed tomography (CT) examination were selected for digital patient briefing using the E-ConsentPro software from Thieme Compliance on an iPad by Apple (Cupertino, California, USA). For the analysis, three age groups were formed. The time required for the patient briefing, the number of open questions as well as the time needed for discussion with physicians were determined. Student’s t-test was performed to assess statistical significance. Results There was no significant difference between patient age and briefing time which was about 20 minutes on average. The number of open or unclear questions increased with patient age. While patients younger than 30 years of age had about 2 open questions, patients over 30 and 60 years had about 4 and 5 questions, respectively. The total time needed for discussion with physicians was less than 2 minutes on average. A significant difference in the time required for discussion with physicians could not be observed between the individual age groups. Conclusion Tablet-based digital briefing allows the storage of patient documents with reasonable time and effort. Furthermore, it minimizes the risk of data loss. Key Points  Citation Format

Prehospital Emergency Medical Services Departure Interval: Does Patient Age Matter?

2016 ◽  
Vol 31 (6) ◽  
pp. 608-613 ◽  
Author(s):  
Bruno Schnegg ◽  
Mathieu Pasquier ◽  
Pierre-Nicolas Carron ◽  
Bertrand Yersin ◽  
Fabrice Dami
Keyword(s):  
Response Time ◽  
Emergency Medical Services ◽  
Time Of Day ◽  
Medical Services ◽  
Time Interval ◽  
Patient Age ◽  
Emergency Medical ◽  
Patient Âgé ◽  
Prehospital Emergency ◽  
The Impact

AbstractIntroductionThe concept of response time with minimal interval is intimately related to the practice of emergency medicine. The factors influencing this time interval are poorly understood.ProblemIn a process of improvement of response time, the impact of the patient’s age on ambulance departure intervals was investigated.MethodThis was a 3-year observational study. Departure intervals of ambulances, according to age of patients, were analyzed and a multivariate analysis, according to time of day and suspected medical problem, was performed.ResultsA total of 44,113 missions were included, 2,417 (5.5%) in the pediatric group. Mean departure delay for the adult group was 152.9 seconds, whereas it was 149.3 seconds for the pediatric group (P =.018).ConclusionA statistically significant departure interval difference between missions for children and adults was found. The difference, however, probably was not significant from a clinical point of view (four seconds).SchneggB, PasquierM, CarronPN, YersinB, DamiF. Prehospital Emergency Medical Services departure interval: does patient age matter?Prehosp Disaster Med. 2016;31(6):608–613.

The impact of patient age and comorbidities on the occurrence of “never events” in cerebrovascular surgery: an analysis of the Nationwide Inpatient Sample

2014 ◽  
Vol 121 (3) ◽  
pp. 580-586 ◽  
Author(s):  
Timothy Wen ◽  
Shuhan He ◽  
Frank Attenello ◽  
Steven Y. Cen ◽  
May Kim-Tenser ◽  
...  
Keyword(s):  
Hospital Costs ◽  
Patient Characteristics ◽  
High Risk Population ◽  
Health Care Administrators ◽  
Patient Age ◽  
Medical Comorbidities ◽  
Patient Âgé ◽  
Never Events ◽  
Tract Infections ◽  
The Impact

Object As health care administrators focus on patient safety and cost-effectiveness, methodical assessment of quality outcome measures is critical. In 2008 the Centers for Medicare and Medicaid Services (CMS) published a series of “never events” that included 11 hospital-acquired conditions (HACs) for which related costs of treatment are not reimbursed. Cerebrovascular procedures (CVPs) are complex and are often performed in patients with significant medical comorbidities. Methods This study examines the impact of patient age and medical comorbidities on the occurrence of CMS-defined HACs, as well as the effect of these factors on the length of stay (LOS) and hospitalization charges in patients undergoing common CVPs. Results The HACs occurred at a frequency of 0.49% (1.33% in the intracranial procedures and 0.33% in the carotid procedures). Falls/trauma (n = 4610, 72.3% HACs, 357 HACs per 100,000 CVPs) and catheter-associated urinary tract infections (n = 714, 11.2% HACs, 55 HACs per 100,000 CVPs) were the most common events. Age and the presence of ≥ 2 comorbidities were strong independent predictors of HACs (p < 0.0001). The occurrence of HACs negatively impacts both LOS and hospital costs. Patients with at least 1 HAC were 10 times more likely to have prolonged LOS (≥ 90th percentile) (p < 0.0001), and 8 times more likely to have high inpatient costs (≥ 90th percentile) (p < 0.0001) when adjusting for patient and hospital factors. Conclusions Improved quality protocols focused on individual patient characteristics might help to decrease the frequency of HACs in this high-risk population. These data suggest that risk adjustment according to underlying patient factors may be warranted when considering reimbursement for costs related to HACs in the setting of CVPs.

scholarly journals The effect of patient age, the presence of infection and neoplastic disease on the occurrence of dehiscence laparotomy

2011 ◽  
Vol 58 (4) ◽  
pp. 89-92
Author(s):  
Milorad Paunovic
Keyword(s):  
Prospective Study ◽  
General Surgery ◽  
T Test ◽  
Neoplastic Disease ◽  
Patient Age ◽  
Younger Patients ◽  
Neoplastic Diseases ◽  
Abdominal Organs ◽  
Patient Âgé ◽  
The Impact

Background/Aim. Dehiscence after laparotomy is one of the major complications of laparotomy. Laparotomy is a partial or complete wound with disruption and evisceratio abdominal organs and require urgent reintervention. The aim of this study was to determine the impact of age, infection and neoplastic disease on the occurrence of dehiscence laparotomy. Methods. A retrospective-prospective study were included 826 patients operated at the Clinic for General Surgery in Nis in the period from January 2008 to December 2009. The effect of patient age, the presence of infection and neoplastic disease on the occurrence of dehiscence laparotomy. Results are displayed numerically and in percentages. Results. Of the total 32 patients with dehiscence laparotomy, 20 patients were male or 62.5% and 12 female patients, or 37.5%. Patients with dehiscence laparotomy were significantly younger than patients without dehiscence laparotomy (T-test t=3.237, p<0.05). The average age of respondents with dehiscence was 57.93 years, while patients without dehiscence 63.97 years. There is a statistically highly significant correlation between laparotomy dehiscence and infection (X2=62.024, p<0,01). There was a statistically significant association between dehiscence laparotomy and neoplastic diseases (X2 =42,196; p<0,01). Conclusion. With respect to age, dehiscence laparotomy is significantly more common in younger patients. Infection was significantly more frequent in patients with dehiscence laparotomy. In patients with neoplastic diseases dehiscence laparotomy is common.

scholarly journals The Impact of Patient Age on Foot and Ankle Arthrodesis Supplemented with Autograft or an Autograft Alternative (rhPDGF-BB/β-TCP)

2020 ◽  
Vol 5 (4) ◽  
pp. e20.00056-e20.00056
Author(s):  
Gregory C. Berlet ◽  
Judith F. Baumhauer ◽  
Mark Glazebrook ◽  
Steven L. Haddad ◽  
Alastair Younger ◽  
...  
Keyword(s):  
Ankle Arthrodesis ◽  
Foot And Ankle ◽  
Patient Age ◽  
Patient Âgé ◽  
The Impact

Predictors of Prehospital On-Scene Time in an Australian Emergency Retrieval Service

2019 ◽  
Vol 34 (03) ◽  
pp. 317-321
Author(s):  
Patrick T. Fok ◽  
David Teubner ◽  
Jeremy Purdell-Lewis ◽  
Andrew Pearce
Keyword(s):  
Model Building ◽  
South Australia ◽  
Therapeutic Interventions ◽  
Arterial Line ◽  
Patient Age ◽  
Line Placement ◽  
Patient Âgé ◽  
Time Required ◽  
The Impact ◽  
Rotary Wing

AbstractIntroduction:Prehospital physicians balance the need to stabilize patients prior to transport, minimizing the delay to transport patients to the appropriate level of care. Literature has focused on which interventions should be performed in the prehospital environment, with airway management, specifically prehospital intubation (PHI), being a commonly discussed topic. However, few studies have sought additional factors which influence scene time or quantify the impact of mission characteristics or therapeutic interventions on scene time.Hypothesis/Problem:The goal of this study was to identify specific interventions, patient demographics, or mission characteristics that increase scene time and quantify their impact on scene time.Methods:A retrospective, database model-building study was performed using the prehospital mission database of South Australian Ambulance Service (SAAS; Adelaide, South Australia) MedSTAR retrieval service from January 1, 2015 through August 31, 2016. Mission variables, including patient age, weight, gender, retrieval platform, physician type, PHI, arterial line placement, central line placement, and finger thoracostomy, were assessed for predictors of scene time.Results:A total of 506 missions were included in this study. Average prehospital scene time was 34 (SD = 21) minutes. Four mission variables significantly increased scene time: patient age, rotary wing transport, PHI, and arterial line placement increased scene time by 0.09 (SD = 0.08) minutes, 13.6 (SD = 3.2) minutes, 11.6 (SD = 3.8) minutes, and 34.4 (SD = 8.4) minutes, respectively.Conclusion:This study identifies two mission characteristics, patient age and rotary wing transport, and two interventions, PHI and arterial line placement, which significantly increase scene time. Elderly patients are medically complex and more severely injured than younger patients, thus, may require more time to stabilize on-scene. Inherent in rotary wing operations is the time to prepare for the flight, which is shorter during ground transport. The time required to safely execute a PHI is similar to that in the literature and has remained constant over the past two years; arterial line placement took longer than envisioned. The SAAS MedSTAR has changed its clinical practice guidelines for prehospital interventions based on this study’s results. Retrieval services should similarly assess the necessity and efficiency of interventions to optimize scene time, knowing that the time required to safely execute an intervention may reach a minimum duration. Defining the scene time enables mission planning, team training, and audit review with the aim of improved patient care.

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