Clinical conundrums and challenges during geriatric orthopedic emergency surgeries

Bajwa, Sukhminder Jit Singh

doi:10.4103/2229-5151.152342

Cited by 1 publication

(2 citation statements)

References 71 publications

(89 reference statements)

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“…In the geriatric population with hip fracture, increased age and the presence of comorbidities are independent predictors for postoperative complications. [ 8 9 ]…”

Section: Discussionmentioning

confidence: 99%

“…Researchers have always been working consistently to minimize such postoperative complications by adopting suitable perioperative measures, especially in patients with comorbidities. [ 9 ] There is a high prevalence of moderate to severe valvular heart disease in the elderly. [ 10 11 ] Severe aortic stenosis due to degenerative calcific stenosis with a prevalence of 2%–7% is one of the main causes of morbidity and mortality in this age group which increases substantially when such patients present to the emergency trauma ward.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of preoperative echocardiography on perioperative management in geriatric hip trauma: A retrospective observational study

Sawhney

Trikha

Janani

et al. 2017

Int J App Basic Med Res

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Background and Aim:Hip fractures are associated with a significant risk of morbidity and mortality in the elderly population. Current guidelines propose that these patients should be operated as early as possible. Preoperative cardiac investigations, especially echocardiography, have been considered to delay surgery with few changes in the patient management. The present study has been conducted to evaluate whether preoperative echocardiography improve or worsen the prognosis in such hip trauma surgery.Materials and Methods:In this retrospective study, we reviewed the records of elderly patients with hip trauma operated in the tertiary care trauma center of our institute over a period of 1 year. Out of 120 patients, preoperative echocardiography was done in 30 patients. We compared the patients for whom echocardiography was done with the patients who did not undergo echocardiography. Descriptive statistical methods were used to analyze the results and observations.Results:We observed that preoperative transthoracic echocardiography led to an escalation in cardiac medication in 53% patients when compared with 23.3% in patients who did not undergo echocardiography. No preoperative cardiac intervention was done in any patient. However, there was a delay of 2.5 days in surgery in the echocardiography group as compared to the patients of nonechocardiography group. Rate of regional anesthesia was comparable in both the groups (54% vs. 56.6%).Conclusions:In the present study, it was observed that echocardiography significantly delays surgery without a significant change in preoperative cardiac medication or anesthesia technique. This may have a potential possible adverse effect on the outcome in geriatric hip trauma which was not observed to a significant limit in the present study as the study was not a longitudinal study. For “fast tracking” of geriatric hip trauma, institutional guidelines should be developed depending on the resources available.

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“…In the geriatric population with hip fracture, increased age and the presence of comorbidities are independent predictors for postoperative complications. [ 8 9 ]…”

Section: Discussionmentioning

confidence: 99%