Factors affecting surgical outcome in the elderly at Auckland Hospital

El‐Haddawi, Falah; Abu‐Zidan, Fikri M.; Jones, W. O.

doi:10.1046/j.1445-2197.2002.02484.x

Cited by 38 publications

(29 citation statements)

References 9 publications

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“…The median (range) ISS was 4 (1-16) and the median (range) GCS was 15 (12)(13)(14)(15). Four (4.3%) patients were admitted to the Intensive Care Unit.…”

Section: Resultsmentioning

confidence: 99%

“…Even low energy trauma in the elderly can be serious because they have decreased physiological reserve and associated comorbidities 8,14 . It is important to note that age alone does not reflect the patient's physiological status and each patient should be considered individually 9,15 . Hazards at home, such as uneven surface or slippery floor, can increase the risk of falls in the elderly 11,16 .…”

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confidence: 99%

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Geriatric fall-related injuries

Hefny¹,

Abbas²,

Abu‐Zidan³

2016

Afr H. Sci.

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Background: Falls are the leading cause of geriatric injury. Objectives: We aimed to study the anatomical distribution, severity, and outcome of geriatric fall-related injuries in order to give recommendations regarding their prevention. Methods: All injured patients with an age ≥ 60 years who were admitted to Al-Ain Hospital or died in the Emergency Department due to falls were prospectively studied over a four year period. Results: We studied 92 patients. Fifty six of them (60.9%) were females. The mean (standard deviation) of age was 72.2 (9.6) years. Seventy three (89%) of all incidents occurred at home. Eighty three patients (90.2%) fell on the same level. The median (range) ISS was 4 (1-16) and the median GCS (range) was 15 (12-15). The lower limb was the most common injured body region (63%). There were no statistical significant differences between males and females regarding age, ISS, and hospital stay (p = 0.85, p = 0.57, and p = 0.35 respectively). Conclusion:The majority of geriatric fall-related injuries were due to fall from the same level at home. Assessment of risk factors for falls including home hazards is essential for prevention of geriatric fall-related injuries.

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“…The median (range) ISS was 4 (1-16) and the median (range) GCS was 15 (12)(13)(14)(15). Four (4.3%) patients were admitted to the Intensive Care Unit.…”

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

Geriatric fall-related injuries

Hefny¹,

Abbas²,

Abu‐Zidan³

2016

Afr H. Sci.

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“…The American Society of Anesthesiologist Physical Status Classification (American Score Anesthesiologist-ASA) is routinely used to evaluate the risk of death in each patient who is candidate to surgery (Dripps et al, 1961;Owens et al, 1978). Several studies demonstrated that the ASA score is highly reliable also in older patients in different surgical settings (Hosking et al, 1989;Bufalari et al, 1996;El-Haddawi et al, 2002;Arenal and Bengoechea-Beeby, 2003). The Acute Physiology and Chronic Health Evaluation (APACHE) is another valid tool for the risk assessment in patients of a wide range of age, particularly in those who are candidate to emergent surgical procedures (Knaus et al, 1985;Giangiuliani et al, 1989;Barie et al, 1995;Koperna et al, 2001).…”

Section: Introductionmentioning

confidence: 99%

Predictive factors of clinical outcome in older surgical patients

Cacello

Ghiggia

et al. 2007

Archives of Gerontology and Geriatrics

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We aimed to identify predictors of mortality and length of stay-in hospital in older surgical patients. In 294 patients (mean age 74.1 AE 6.4 years, 153 men), consecutively admitted to four surgery units of a university-teaching hospital to receive elective surgery (ES, 56.5%) or urgent surgery (US, 43.5%), the following variables were evaluated: demographics, clinical history (hypertension, diabetes mellitus (DM), coronary heart disease (CHD), heart failure (HF), cerebrovascular accidents, chronic obstructive pulmonary disease (COPD), active neoplasm, cognitive impairment, immobilization, pressure ulcers), physiopathology (Acute Physiology and Chronic Health Evaluation, APACHE, II), cognition/function (Short Portable Mental Status Questionnaire, SPMSQ; activity of daily living, ADL; instrumental activity of daily living, IADL), comorbidity (Cumulative Illness Rating Scale, CIRS, 1 and 2) and anesthesiology (American Score Anesthesiologist, ASA). The vital status of the patient at 1 month after discharge and the duration of hospitalization were recorded. One-month mortality rate was 6.1%. Low hemoglobin and body mass index (BMI) values, increasing ASA score, and, only in US patients, ADL dependence and higher CIRS 1 score, were independently predictive of mortality. Low hemoglobin levels and, only in ES patients, higher CIRS 1 score were associated with prolonged hospitalization. Prognostic indicators specific to older people have limited value in mortality models in elderly surgical patients. #

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“…This is especially true for patients, such as ours, that can be described using the term "frailty, " a multifactorial state of general physical weakness, often under recognized patient vulnerability and decreased physiologic reserve. Perioperative risk is heterogeneous in this group, as age and comorbidities may fail to accurately predict functional deficits and often cannot adequately predict operative and perioperative morbidity and mortality in this population group [35,[40][41][42][43][44][45][46].…”

Section: Discussionmentioning

confidence: 99%

Initial Experience Using a Novel Reticulated Open Cell Foam Dressing with Through Holes during Negative Pressure Wound Therapy with Instillation for Management of Pressure Ulcers

Fernández¹,

Ellman²,

Jackson³

2017

J Trauma Treat

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Several published reviews and recommendations exist for the use of negative pressure wound therapy (NPWT) with instillation and a dwell time (NPWTi-d) in acute and chronic wounds. Specific dressings for use with NPWTi-d have also been developed, including a reticulated open cell foam dressing with through holes (ROCF-CC) that assists in removing thick wound exudate and infectious materials. ROCF-CC is especially helpful for wound cleansing when debridement is not possible or appropriate in patients.We report our initial experiences in using NPWTi-d with ROCF-CC in patients with pressure ulcers. An algorithmic approach was used to determine appropriate treatment to reach the goals of therapy (i.e., wound bed preparation, granulation tissue formation, and removal of infectious materials). Previous therapies included honey and gauze soaked in Dakin's solution. All patients received antibiotics and debridement when possible.Five patients (3 females and 2 males) received NPWTi-d with ROCF-CC (instillation of saline or a hypochlorous solution with a dwell time of 10 minutes, followed by 2-3 hours of -125 mmHg NPWT). Patient comorbidities included obesity, diabetes mellitus, hypertension, and peripheral artery disease. Mean age of patients was 65.2 years (range: 50-82 years). After an average of 6 days of therapy (range 2-9 days), all wounds treated with NPWTi-d with ROCF-CC showed rapid granulation tissue formation.We also noted improved removal of devitalized tissue and subsequent granulation tissue formation in patients receiving hypochlorous solution compared to patients receiving saline during NPWTi-d with ROCF-CC. All patients were eventually transferred to a skilled nursing facility. In our clinical practice, NPWTi-d with ROCF-CC provided effective and rapid removal of the thick exudate and infectious materials and promoted excellent development of underlying granulation tissue.

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Factors affecting surgical outcome in the elderly at Auckland Hospital

Cited by 38 publications

References 9 publications

Geriatric fall-related injuries

Geriatric fall-related injuries

Predictive factors of clinical outcome in older surgical patients

Initial Experience Using a Novel Reticulated Open Cell Foam Dressing with Through Holes during Negative Pressure Wound Therapy with Instillation for Management of Pressure Ulcers

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