Urinary tract infection in patients with hip fracture: An underestimated event?

Bliemel, Christopher; Buecking, Benjamin; Hack, Juliana; Aigner, René; Eschbach, Daphne-Asimenia; Ruchholtz, Steffen; Oberkircher, Ludwig

doi:10.1111/ggi.13077

Cited by 43 publications

(38 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition to increasing the risk for CAUTI, indwelling catheters are associated with local trauma to the urinary meatus, restriction of mobility, pain, encrustation, delirium and increased risk of mortality. A recent study by Bliemel et al, (2017) of 402 surgically-treated older hip fracture patients concluded that those who developed a CAUTI seemed to be at risk of inferior functional outcomes.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

The International Collaboration of Orthopaedic Nursing (ICON): Best practice nursing care standards for older adults with fragility hip fracture

Meehan

Maher²,

Brent

et al. 2019

International Journal of Orthopaedic and Trauma Nursing

View full text Add to dashboard Cite

Sarcopenia is age-related loss of muscle mass and strength with resulting decrease in function that affects balance, gait, and overall ability to perform tasks of daily living. Decline in skeletal muscle mass begins around age 30 with a significant acceleration after age 65, accompanied by a concomitant reduction in muscle strength (Curcio, et al., 2016). Muscle strength is a critical component of walking and its decrease in the older adult contributes to a high prevalence of falls (Dhillon & Hasni, 2017). Early recognition and intervention can modify some of these detrimental outcomes. Some major risk factors for sarcopenia include; lack of exercise, age-related decreases in hormone concentrations and a decrease in the body's ability to synthesize protein, combined with inadequate caloric and/or protein intake (Dhillon & Hasni, 2017). Acute and chronic illnesses raise the risk level. Screening for sarcopenia may not be routine in many clinical practices. However, screening for impairment in physical function and activities of daily living (ADL's) should be routine for all older adults. Individuals with impaired ADLs and those who describe a noticeable decline in function, strength, or overall health status should have more specific testing for sarcopenia (Brown & McCarthy, 2015). The European Working Group on Sarcopenia in Older people (EWGSOP), in their consensus document, outlined an algorithm to aid the screening and diagnosis of sarcopenia (Cruz-Jentoft, et al., 2010).

show abstract

Section: Accepted Manuscriptmentioning

confidence: 99%

The International Collaboration of Orthopaedic Nursing (ICON): Best practice nursing care standards for older adults with fragility hip fracture

Meehan

Maher²,

Brent

et al. 2019

International Journal of Orthopaedic and Trauma Nursing

View full text Add to dashboard Cite

show abstract

“…The occurrence of NIs (most frequently—UTI) further worsened the ADL disability in their study. In other study, patients with UTI seemed to be at risk of inferior functional outcomes also in the case of older people after hip fracture [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Urinary tract infections in a geriatric sub-acute ward-health correlates and atypical presentations

Wojszel

Toczyńska-Silkiewicz

2018

Eur Geriatr Med

View full text Add to dashboard Cite

PurposeBacterial urinary tract infections (UTIs) are the most frequently occurring infectious diseases in the geriatric population. The aim of the study was to determine the prevalence and clinical features of UTIs in geriatric in-patients and their association with health and functional ability characteristics.MethodsA prospective cross-sectional cohort study was conducted among patients hospitalized on the geriatric ward. Patients were interviewed, examined, and had their hospital records analyzed. An uncontaminated midstream urine sample was collected and cultured in all of the cases suspected for UTI. Relative risks for UTI were counted and multivariable logistic regression model was built.Results246 patients were included, 179 (72.8%) women, 210 (85.4%) 75 + -year-olds. Bacterial UTIs occurred in 18.3% of the patients. The main etiological agent was Escherichia coli (73.3%). The most significant predictors of UTI were recurrent UTI and urinary catheter. The typical clinical UTI symptoms occurred in less than half of the cases (only in 11.1% of cases fever was observed). More often, than in patients without UTIs, they reported symptoms such as delirium (28.9% vs. 18%), tachycardia (11.1% vs. 1.5%) or hypotension (20% vs. 12.1%).ConclusionsBacterial UTIs affect about 1/5 of hospitalized geriatric patients. The clinical picture of these infections very often is atypical and it indicates a need for diagnostic vigilance.

show abstract

“…Therefore, such patients depend on immediate full-weightbearing. In this context, several studies on geriatric trauma patients have shown that postoperative early full-weightbearing mobilization significantly reduces perioperative complications and mortality [10,11]. Modern polyaxially angular stable plates offer a crucial advantage in terms of stability and, therefore, in the treatment of geriatric trauma patients with distal femoral fractures [12][13][14].…”

Section: Discussionmentioning

confidence: 99%

More than a reposition tool: additional wire cerclage leads to increased load to failure in plate osteosynthesis for supracondylar femoral shaft fractures

Bliemel

Anrich

Knauf

et al. 2020

Arch Orthop Trauma Surg

Self Cite

View full text Add to dashboard Cite

Introduction Surgical treatment of supracondylar femoral fractures can be challenging. An additional wire cerclage is a suggested way to facilitate fracture reduction prior to plate osteosynthesis. Denudation to the periosteum remains a problematic disadvantage of this procedure. This study analyzed the effect of an additional wire cerclage on the load to failure in plate osteosynthesis of oblique supracondylar femoral shaft fractures. Materials and methods On eight pairs of non-osteoporotic human femora (mean age 74 years; range 57-95 years), an unstable AO/OTA 32-A2.3 fracture was established. All specimens were treated with a polyaxially locking plate. One femur of each pair was randomly selected to receive an additional fracture fixation with a wire cerclage. A servohydraulic testing machine was used to perform an incremental cyclic axial load with a load to the failure mode. Results Specimens stabilized with solely plate osteosynthesis failed at a mean load of 2450 N (95% CI: 1996-2904 N). In the group with an additional wire cerclage, load to failure was at a mean of 3100 N (95% CI: 2662-3538 N) (p = 0.018). Compression deformation with shearing of the condyle region through cutting of screws out of the condylar bone was the most common reason for failure in both groups of specimens. Whereas axial stiffness was comparable between both groups (p = 0.208), plastic deformation of the osteosynthesis constructs differed significantly (p = 0.035). Conclusions An additional wire cerclage significantly increased the load to failure. Therefore, an additional cerclage represents more than just a repositioning aid. With appropriate fracture morphology, a cerclage can significantly improve the strength of the osteosynthesis.

show abstract

Urinary tract infection in patients with hip fracture: An underestimated event?

Cited by 43 publications

References 34 publications

The International Collaboration of Orthopaedic Nursing (ICON): Best practice nursing care standards for older adults with fragility hip fracture

The International Collaboration of Orthopaedic Nursing (ICON): Best practice nursing care standards for older adults with fragility hip fracture

Urinary tract infections in a geriatric sub-acute ward-health correlates and atypical presentations

More than a reposition tool: additional wire cerclage leads to increased load to failure in plate osteosynthesis for supracondylar femoral shaft fractures

Contact Info

Product

Resources

About