Proximal femoral fracture: achievements and prospects

Austin, C A; Lawson, Peter J.; Gibson, Richard J.; Philp, Ian

doi:10.1093/ageing/27.6.667

Cited by 9 publications

(3 citation statements)

References 24 publications

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“…For example, our results might be influenced by the aging process itself, but we could not control for age statistically. Although the pain origin of our acute and chronic pain patients is typical in geriatric inpatients and older adults [23,49,61], our results can be generalized only with caution to community‐dwelling older adults and nursing home residents. The treatment of chronic pain patients in a geriatric hospital is often the end point of a long and changeable worsening process of pain and abilities in the community; whereas the reason for hospitalized treatment of patients in the APG was mostly a sudden and injurious event (fall), often as a result of a decline in abilities.…”

Section: Discussionmentioning

confidence: 85%

“…The APG consisted mainly of patients after falls with injuries, constituting a group of geriatric patients at high risk for not returning to their prehospital accommodations, which depends, in part, on the availability of local services [49]. The risk of patients in the CPG moving into a nursing home after their hospital stay was comparable with that of APG patients.…”

Section: Discussionmentioning

confidence: 99%

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Acute and Chronic Pain in Geriatrics: Clinical Characteristics of Pain and the Influence of Cognition

et al. 2004

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Geriatric inpatients with chronic pain differ from acute pain patients in pain description, pain reduction during treatment, use of analgesics, and emotional distress. Cognitive impairment seems to change the ability to localize acute pain. In our study, the perception of pain intensity was independent of cognition. Because of the small sample size, further studies are needed to confirm these findings. Multiprofessional, intense rehabilitation programs for geriatric patients with chronic pain are considered of prime importance.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Acute and Chronic Pain in Geriatrics: Clinical Characteristics of Pain and the Influence of Cognition

et al. 2004

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“…Frau, die 90 Jahre alt wird, erleidet im Laufe ihres Lebens eine PFF. Etwa 20% der Betroffenen sind 6 Monate nach der Fraktur verstorben, die Hälfte der Über-lebenden verliert auf Dauer an Alltagskompetenz und somit an Lebensqualität [5,6,7]. In den USA liegt die Inzidenz der PFF bei über 65-Jährigen bei 6-8/1000 jährlich,mit einem altersabhängigen Anstieg von 1-2/1000 bei 65-jährigen Frauen auf 35-40/1000 bei 95-jährigen Frauen und Pflegeheimbewohnern [8].…”

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Case-Management und funktionelle Ergebnisse nach proximaler Femurfraktur im h�heren Lebensalter

et al. 2003

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The goal of the investigation was to study case management and functional outcome in older patients with hip fracture. A prospective observational survey was performed, including all patients aged 65 years and over presenting with hip fracture in Heidelberg, from 1 July 1999 to 30 June 2000. All patients were reassessed by telephone calls 6 months post-fracture. A total of 331 patients were included (mean age 81.5 years, 81% female,23.8% nursing home residents). Hip fracture incidence per 1,000 was 7.8/year, and nursing home residents had a six times higher incidence rate than those living at home. Prior to the fracture, half of the patients were dependent in ambulation and a third needed support in basic activities. With substantial comorbidity (42% cognitive impairment), complications were common. Geriatric care was needed for 82% of the survivors. In-hospital treatment costs were about 10,000 Euro per fracture. Mortality at 6 months was 19.9%. The majority of survivors showed loss of competence and mobility. Functional outcome in older patients with hip fracture is disappointing. As the majority of the patients are frail, clinical treatment is complicated by "geriatric" problems. Thus, improved interdisciplinary care, with close cooperation between geriatricians and surgeons might result in a better functional outcome.

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