RESUMO
PURPOSE: The purpose of this study was to: 1/ describe the characteristics of a cohort of patients over 75 years of age hospitalized in perioperative geriatric units (UPOG) for iterative fractures; 2/ investigate the risks of institutionalization related to the first fracture; and 3/ search for potential risk factors for iterative fracture. METHODS: This is a retrospective single-center study analyzing patients over 75 years old, hospitalized in UPOG. RESULTS: Of the 3207 patients hospitalized, 292 patients had a refracture (9.1%), with a mean age of 85.4+/-5.8 years. Initial fractures were mainly intertrochanteric (43.2%) and the femoral neck (32.9%). Refractures occurred mainly in the first year (55.5%), with a median delay of 9.6 months. Refractures were mainly intertrochanteric (29.5%), periimplant (prosthesis, osteosynthesis) (28.8%), and femoral neck (26.7%). Dementia was the only factor for institutionalization after the first fracture episode (p = 0.0002). Proximal femoral fracture (PFF) and female gender were risk factors for iterative fracture (10.2% vs. 6.8%, p = 0.003; 10.7% vs. 6.8%, p = 0.005 respectively), but not age (85.4 vs. 85.8 years, p = 0.24). PFF were more likely to result in the same fracture type in the second episode (58.1% vs 7.1%, p<0.0001). The time to refracture was shorter in case of periimplant fracture (p = 0.0002), or discharge directly to home (p = 0.04). CONCLUSION: PFF and female gender are risk factors for recurrent fracture, which is even more likely to occur early in case of home discharge or periimplant fracture.
Assuntos
Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/enfermagem , Desidratação/diagnóstico , Desidratação/enfermagem , Desequilíbrio Hidroeletrolítico/etiologia , Desequilíbrio Hidroeletrolítico/enfermagem , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Humanos , Diagnóstico de EnfermagemRESUMO
In the elderly, urinary tract infections are frequent. Diagnosis is not always evident because symptoms are often absent. In doubt, a urinary strip evaluation must be performed. Prevention begins with simple lifestyle and dietary rules, such as good voiding and adequate fluid intake. Asymptomatic bacteriuria is treated only in certain cases. Other urinary tract infections require antibiotics, which must be adapted to renal function.
Assuntos
Infecções Urinárias/diagnóstico , Infecções Urinárias/terapia , Idoso , Antibacterianos/uso terapêutico , Feminino , Humanos , Masculino , Fatores de Risco , Fatores Sexuais , Infecções Urinárias/epidemiologiaAssuntos
Idoso Fragilizado , Avaliação Geriátrica , Cônjuges , Acidentes de Trânsito , Idoso , Transtornos Cognitivos/complicações , Feminino , Fraturas Ósseas/diagnóstico por imagem , Fraturas Ósseas/etiologia , Traumatismos Cranianos Fechados/etiologia , Humanos , Masculino , Ossos Pélvicos/diagnóstico por imagem , Ossos Pélvicos/lesões , RadiografiaAssuntos
Infecções por Pasteurella/diagnóstico , Dor Abdominal/etiologia , Idoso de 80 Anos ou mais , Animais , Mordeduras e Picadas/complicações , Gatos , Febre/etiologia , Humanos , Masculino , Infecções por Pasteurella/tratamento farmacológico , Pasteurella multocida/isolamento & purificação , Vômito/etiologiaRESUMO
For patients at the end of life, caregivers must sometimes make choices between prolonging life and quality of life. There are several tools to assist in the decision-making process and the implementation, notably with regard to the limiting of active treatment. The issues to consider include limiting or stopping treatment, Leonetti's law with advance directives and the fight against unreasonable obstinacy and, more recently, the "mandate for future protection". The patient must always remain the focus and be allowed to express their wishes, if they want to, directly or with the help of a third party.
Assuntos
Diretivas Antecipadas , Direito a Morrer , Recusa do Paciente ao Tratamento , Diretivas Antecipadas/legislação & jurisprudência , Idoso , França , Humanos , Direito a Morrer/legislação & jurisprudência , Recusa do Paciente ao Tratamento/legislação & jurisprudênciaRESUMO
Improving the management of a vitamin K antagonist (VKA) treatment helps to reduce the risk of haemorrhage. To assess the treatment methods and the quality of education of elderly patients, a telephone survey was carried out in 2011 of 100 patients treated with a VKA. The patients, or main carers managing the treatment at home, have adequate knowledge of their treatment. The education of elderly patients therefore seems to be a reasonable and viable objective.