Geriatric Outcomes Are Improved by a Geriatric Trauma Consultation Service

Fallon, William F.; Rader, Erin; Zyzanski, Stephen J.; Mancuso, Charlene; Martin, Berni; Breedlove, Linda; DeGolia, Peter Alexander; Allen, Kyle R.; Campbell, James W.

doi:10.1097/01.ta.0000238652.48008.59

Cited by 116 publications

(75 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These include co-management by surgeons and geriatricians (30), as well as creation of formal geriatric trauma consultation services (31,32). This need for focused care has also led to the creation of geriatric trauma centers, with requirements for specialized personnel (including fulltime geriatrician coverage), practice standards for conditions common in older populations, and close ties with post-acute care facilities.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Unplanned Readmissions in Older Adult Trauma Patients in Washington State: A Competing Risk Analysis

Fawcett

Flynn-OʼBrien

Shorter

et al. 2015

Journal of the American College of Surgeons

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Risk Factors for Unplanned Readmissions in Older Adult Trauma Patients in Washington State: A Competing Risk Analysis

Fawcett

Flynn-OʼBrien

Shorter

et al. 2015

Journal of the American College of Surgeons

View full text Add to dashboard Cite

“…Various international studies have described the benefits of similar initiatives in terms of a reduction in complications, mortality, and the number of readmissions within 30 days. [12][13][14]16,20,21,[24][25][26] A comparison is difficult because of the different types of study designs, the outcome measures, and health care systems.…”

Section: Discussionmentioning

confidence: 99%

Geriatric Fracture Center

Folbert

Smit

Velde

et al. 2012

Geriatr Orthop Surg Rehabil

View full text Add to dashboard Cite

Objective: Since April 1, 2008, patients aged 65 years presenting with a hip fracture at Ziekenhuisgroep Twente, Almelo (ZGT-A), The Netherlands, have been admitted to the geriatric fracture center (GFC) and treated according to the multidisciplinary treatment approach. The objective of this study was to evaluate how implementation of the treatment approach has influenced the quality of care given to older patients with hip fracture. Design: Prospective cohort study with historical control group. The use of the multidisciplinary treatment approach led to a significant reduction in the number of readmissions within 30 days after discharge. It appears to be associated with improved short-term treatment outcomes for older patients with a hip fracture.

show abstract

“…At 1 yr, only surgical consultation was associated with a lower risk of death. Recent reports have noted the benefit of collaborative care on improving outcome from geriatric trauma (48,49). Consultative services categorized as "other" included services such as acute pain service, substance abuse, ostomy nurse, and dentistry.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the effect of intensity of care on mortality after traumatic brain injury

Thompson

Rivara

Jurkovich

et al. 2008

Critical Care Medicine

View full text Add to dashboard Cite

Objectives-To evaluate the effect of age on intensity of care provided to traumatically braininjured adults and to determine the influence of intensity of care on mortality at discharge and 12 months postinjury, controlling for injury severity.Design-Cohort study using the National Study on the Costs and Outcomes of Trauma (NSCOT) database. Risk ratio and Poisson regression analyses were performed using data weighted according to the population of eligible patients.Setting and Patients-A total of 18 level 1 and 51 level 2 non-trauma centers located in 14 states in the United States and 1,776 adults aged 25−84 yrs with a diagnosis of traumatic brain injury. Measurements-Injury severity was determined by the motor component of the Glasgow ComaScale score, the Injury Severity Score, pupillary reactivity, and presence of midline shift. Factors evaluated as contributing to intensity of care included: admission to the intensive care unit, mechanical ventilation, placement of an intracranial pressure monitor, placement of a jugular bulb catheter, placement of a pulmonary artery catheter, critical care consultation, the number of specialty care consultations, mannitol use, treatment with barbiturate coma, decompressive craniectomy, number of nonneurosurgical procedures performed, the presence of a do-not-resuscitate order, and withdrawal of therapy.Main Results-Controlling for injury-related factors, sex, and comorbidity, as age increased, the overall likelihood of receiving various interventions decreased. After controlling for injury severity, sex, and comorbidity, factors associated with higher risk of in-hospital death were: being aged 75 −84 yrs (relative risk [RR] 1.32, 95% confidence interval [CI] 1.13, 1.55), pulmonary artery catheter use (RR 1.56, 95% CI 1.30, 1.86), intubation (RR 4.17, 95% CI 2.28, 7.61), the presence of a donot-resuscitate order (RR 3.21, 95% CI 2.21, 4.65), and withdrawal of therapy (RR 2.33, 95% CI 1.69, 3.23). In contrast, a higher number of specialty care consultations (surgical consults: RR 0.63, 95% CI 0.54, 0.74; medical consults: RR 0.87, 95% CI 0.79, 0.95; and other consults: RR 0.43, 95% CI 0.26, 0.69) were associated with decreased risk of death. The results were similar for factors associated with death at 12 months, with the exception that the number of medical consultations was not significant, whereas the number of nonneurosurgical procedures performed was associated with lower risk of death (RR 0.96, 95% CI 0.92, 0.99), as was obtaining critical care consultation services (RR 0.84, 95% CI 0.71, 1.0).Conclusions-There is a lower intensity of care provided to older adults with traumatic brain injury. Although the specific contributions of specialists to patient management are unknown, theirThe authors have not disclosed any potential conflicts of interest.Work for this study was performed at the University of Washington, Seattle, WA. By the year 2030, the number of Americans aged ≥65 will exceed 70 million, doubling current figures (1). Along with this increase in the...

show abstract

Geriatric Outcomes Are Improved by a Geriatric Trauma Consultation Service

Abstract: Outcomes of older patients can be improved through geriatricians' expertise by addressing new and existing medical issues and reducing hospital-acquired complications such as functional decline, falls, delirium, and death.

Cited by 116 publications

References 16 publications

Risk Factors for Unplanned Readmissions in Older Adult Trauma Patients in Washington State: A Competing Risk Analysis

Risk Factors for Unplanned Readmissions in Older Adult Trauma Patients in Washington State: A Competing Risk Analysis

Geriatric Fracture Center

Evaluation of the effect of intensity of care on mortality after traumatic brain injury

Contact Info

Product

Resources

About