Nonopioid analgesic use in older patients admitted for orthopedic rehabilitation.

Background: Multimodal analgesia (MMA) combines opioids with nonopioid analgesics (NOAs) to mitigate opioid-related adverse events and development of opioid use disorders. Although MMA has become the standard for orthopedic perioperative pain management, guidance is less clear for the approximately 15% of patients who go on to require inpatient orthopedic rehabilitation (IOR) postoperatively. The IOR population tends to be older and frailer and hence likely more vulnerable to adverse events.

Post-stroke delirium and challenges for the rehabilitation setting: A narrative review.

Introduction: Post-stroke delirium (PSD) is a common yet underrecognized complication following stroke, with its effect on stroke rehabilitation being the subject of limited attention. The objective of this narrative review is to provide an overview of core issues in PSD including epidemiology, diagnostic challenges, and management considerations, with an emphasis on the rehabilitation phase.

Methods: Ovid Medline and Google Scholar were searched through February 2023 using keywords related to delirium, rehabilitation, and the post-stroke period.

Opioid use in older orthopedic rehabilitation inpatients: a retrospective study.

Background: While there is much evidence about pain management for orthopedic patients in the immediate perioperative setting, little is known about how opioids are used during inpatient rehabilitation, particularly in older adults. A safe upper limit of 50 mg oral morphine equivalents (OME) is frequently cited in guidelines.

Aim: The aim of this study was to characterize the dosing of opioids in an older adult population undergoing inpatient orthopedic rehabilitation (IOR).

Older patients with active cancer have favorable inpatient rehabilitation outcomes.

Objectives: To investigate the characteristics and rehabilitation outcomes of older patients with active cancer (OPAC) undergoing post-acute inpatient rehabilitation (IR), and to evaluate which clinical factors are associated with poor rehabilitation outcomes.

Materials And Methods: This is a retrospective study of patients aged ≥65 with active cancer undergoing IR following acute hospitalization at our tertiary hospital centre (N = 330). We collected data on patient, malignancy, and hospitalization characteristics, and IR outcomes including function, mobility, discharge destination, and mortality.

Teaching physicians the GPGP method promotes deprescribing in both inpatient and outpatient settings.

Background: In complex older patients, inappropriate medication use and polypharmacy (IMUP) are commonplace and increasing exponentially. Reducing IMUP is a challenge in multiple clinical contexts, including acute admission and family practice, due to several key barriers. In the global effort against this epidemic, educational programs geared toward changing physicians' prescribing patterns represent an important means of promoting deprescribing.

Recurrence of biliary disease following non-operative management in elderly patients.

Introduction: The purpose of this study was to determine the proportion of symptomatic recurrence following initial non-operative management of gallstone disease in the elderly and to test possible predictors.

Methods: This is a single institution retrospective chart review of patients 65 years and older with an initial hospital visit (V1) for symptomatic gallstone disease, over a 4-year period. Patients with initial "non-operative" management were defined as those without surgery at V1 and without elective surgery at visit 2 (V2).

Gallstone disease in the elderly: are older patients managed differently?

Background: This study aimed to describe the differences in the management of symptomatic gallstone disease within different elderly groups and to evaluate the association between older age and surgical treatment.

Methods: This single-institution retrospective chart review included all patients 65 years old and older with an initial hospital visit for symptomatic gallstone disease between 2004 and 2008. The patients were stratified into three age groups: group 1 (age, 65-74 years), group 2 (age, 75-84 years), and group 3 (age, ≥ 85 years).