Prehospital Pain and Analgesic Therapy in Elderly Patients with Hip Fractures

Pain Practice ◽  
2015 ◽  
Vol 16 (5) ◽  
pp. 545-551 ◽  
Author(s):  
Ludwig Oberkircher ◽  
Natalie Schubert ◽  
Daphne-Asimenia Eschbach ◽  
Christopher Bliemel ◽  
Antonio Krueger ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Hip Fractures ◽  
Analgesic Therapy

The effects of ‘old’ red blood cell transfusion on mortality and morbidity in elderly patients with hip fractures – A retrospective study

Injury ◽  
2013 ◽  
Vol 44 (6) ◽  
pp. 747-750 ◽  
Author(s):  
Assaf Kadar ◽  
Ofir Chechik ◽  
Eldad Katz ◽  
Itay Blum ◽  
Gabrielle Meghiddo ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Elderly Patients ◽  
Blood Cell ◽  
Hip Fractures ◽  
Red Blood Cell ◽  
Red Blood Cell Transfusion ◽  
Mortality And Morbidity

scholarly journals Elderly Patients with Pertrochanteric Hip Fracture: In Hospital Care

2019 ◽  
Vol 3 (4) ◽  
pp. 1-8
Author(s):  
Faour Martín O
Keyword(s):  
Health Care ◽  
Hip Fracture ◽  
Elderly Patients ◽  
Hip Fractures ◽  
Cost Reduction ◽  
Hospital Care ◽  
Scientific Evidence ◽  
Clinical Results ◽  
Fracture Management ◽  
Care Of Elderly

Objective: To evaluate the improvement in the care of elderly patients hospitalized due to pertrochanteric hip fractures. Methods: A comparative study of two cohorts of patients admitted due to pertrochanteric hip fractu re before (2010) and after the application of in hospital management protocols (2018). The intervention consisted in the implementation of multidisciplinary measures during hospitalization based on current scientific evidence. An evaluation of the clinical results was performed, as well as the health care impact. Results: The characteristics of patients admitted for hip fracture in 2010 (216 patients) and 2018 (205 patients) were similar in age, sex, Barthel index and the Charlson abbreviated index. In 2018 patients had more comorbidity. A significant reduction of preoperative stay and overall stay in the cohort of 2018 was achieved. Detection of delirium, malnutrition and anaemia was higher in 2018, and a reduced incidence of infection and a better function al efficiency was achieved in this period. Conclusion: The introduction of measures for the improvement of the pertrochanteric hip fracture management reduces hospitalization with consequent cost reduction. Unification of criteria among professionals may b e an opportunity for better clinical results and reduction of complications.

scholarly journals Landmark-guided Versus Modified Ultrasound-assisted Paramedian Techniques in Combined Spinal-epidural Anesthesia for Elderly Patients with Hip Fractures: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Bo Qu ◽  
Luying Chen ◽  
Yuling Zhang ◽  
Mengting Jiang ◽  
Caineng Wu ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Success Rate ◽  
Hip Fractures ◽  
Controlled Trial ◽  
Median Number ◽  
Needle Insertion ◽  
Success Rates ◽  
First Pass ◽  
Ultrasound Assisted ◽  
Ultrasound Group

Abstract Background: Combined spinal-epidural (CSE) anesthesia is considerably challenging for elderly patients with hip fractures due to spine degeneration and limitations in positioning. This study aimed to investigate the ability of a modified preprocedural ultrasound-guided technique to improve the success rate and efficacy of CSE anesthesia for elderly patients with hip fractures. Methods: This prospective, single-blinded, parallel-group randomized controlled trial included 80 patients (aged ≥ 65 years) who were scheduled for elective hip fracture surgery with CSE anesthesia. Patients were randomly allocated into landmark group (n = 40) or the ultrasound group (n = 40). The primary outcome was first-pass success rate. Secondary outcomes included first-attempt success rate; number of needle insertion attempts; number of needle passes; locating, puncture, and total time; level of block; procedural adverse reactions and postoperative complications; and patient satisfaction score. Patients were blinded to group allocation.Results: 80 patients completed the study and were included in the final analysis. The first-pass success rates for the landmark and ultrasound groups were 20% and 70%, respectively (P < 0.001). The first-attempt success rates in the landmark and ultrasound groups were 42.5% and 85%, respectively (P < 0.001). The median number of attempts was lower in ultrasound-assisted group (1[1,1]) than landmark-guided group (2[1,2]), P < 0.001). The median number of needle passes was lower in ultrasound group (1[1,2]) than in landmark-guided group (3[2,4], P < 0.001). The locating time (P < 0.001) and total time (P = 0.001) were longer in the ultrasound group, while puncture time was shorter (P = 0.003). No significant difference was found regarding the incidence of adverse reactions and complications. More patients in the ultrasound group had a high satisfaction score of 4–5 (P = 0.007). Interestingly, subgroup analysis demonstrated benefits for ultrasound in patients with scoliosis.Conclusions: Modified ultrasound-assisted CSE anesthesia increases first-pass and first-attempt success rates, and reduces needle insertion attempts, passes, and puncture time for elderly patients with hip fracture, especially those with scoliosis. This technique improves patient satisfaction and warrants consideration for application in clinical practice.Trial registration: Chinese Clinical Trial Register (identifier, ChiCTR1900020819; date of registration, January 20, 2019).

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