Attitudes toward the adoption of eHealth amongst healthcare professionals in trauma surgery - the new digital normal?

Background: As in many other countries, the Dutch emergency healthcare system is under pressure due to increasing numbers of patients, limited budgets, and constrained (human) resources (TraumaNet AMC 19 May, 2016; Int J Emerg Med 6:41, 2013). eHealth, enlarged by the COVID-19 pandemic, has been advocated to substitute face-to-face care to alleviate the pressure of the burden of care (Ministry of Health Welfare and Sport, 2022; Dutch Society of Hospitals, 2022). In order for eHealth solutions to be adopted in daily practice, is it essential to assess healthcare professionals' attitudes toward its usefulness.

Automated EEG-Based Brainwave Analysis for the Detection of Postoperative Delirium Does Not Result in a Shorter Length of Stay in Geriatric Hip Fracture Patients: A Multicentre Randomized Controlled Trial.

: Delirium in postoperative geriatric hip fracture patients is a serious and often preventable condition. If detected in time, it can be treated, but a delay in the diagnosis and initiation of treatment impairs outcomes. A novel approach to detect delirium is to use point-of-care electro-encephalogram (EEG) recording with automated analysis.

Predictors of mortality over time in geriatric patients with hip fracture.

Objectives: The aim of this study was to determine the variations in effect for predictors of mortality over time and risk of in-hospital complications in geriatric patients with a hip fracture. Many studies have investigated risk factors of short-term and long-term mortality separately. In current literature, little is known about the variations in effect of risk factors over time and no comparison with the general population is made.

Patient and proxy perspectives in decision-making for geriatric hip fracture management in the Netherlands: a qualitative study.

Objective: The objective of this study was to explore the perspectives with the decision-making process between surgery and palliative, non-operative management of geriatric hip fracture patients and their proxies.

Design: qualitative interview study was performed. Patients and proxies were asked to participate in semi-structured interviews.

Shared decision-making for non-operative management versus operative management of hip fractures in selected frail older adults with a limited life expectancy: a protocol for a nationwide implementation study.

Background And Purpose: Recent research has highlighted non-operative management (NOM) as a viable alternative for frail older adults with hip fractures in the final phase of life. This study aims to guide Dutch physicians and hospitals nationwide in a standardised implementation of shared decision-making regarding surgery or NOM in selected frail older adults with a hip fracture.

Methods And Analysis: The patient population for implementation includes frail older adults aged ≥70 years with an acute proximal femoral fracture, nursing home care or a similar level of care elsewhere and at least one additional criterion (ie, malnutrition, severe mobility impairment or ASA≥4).

The Impact of Implementation of Palliative, Non-Operative Management on Mortality of Operatively Treated Geriatric Hip Fracture Patients: A Retrospective Cohort Study.

(1) Hip fracture patients with very limited life expectancy can opt for non-operative management (NOM) within a palliative care context. The implementation of NOM in the palliative context may affect the mortality of the operatively treated population. This retrospective cohort study aimed to determine whether the operatively treated geriatric hip fracture population would have a lower in-hospital mortality rate and fewer postoperative complications after the introduction of NOM within a palliative care context for patients with very limited life expectancy.

Let's Agree to Disagree on Operative Versus Nonoperative Treatment for Distal Radius Fractures in Older People: Protocol for a Prospective International Multicenter Cohort Study.

Background: Distal radius fractures are the most frequently encountered fractures in Western societies, typically affecting patients aged 50 years and older. Although this is a common injury, the best treatment for these fractures in older patients is still under debate.

Objective: This prospective study aims to compare the outcome of operatively and nonoperatively treated distal radius fractures in the older population.

Health Care Professionals' Experiences With a Mobile Self-Care Solution for Low Complex Orthopedic Injuries: Mixed Methods Study.

Background: To cope with the rising number of patients with trauma in an already constrained Dutch health care system, Direct Discharge (DD) has been introduced in over 25 hospitals in the Netherlands since 2019. With DD, no routine follow-up appointments are scheduled after the emergency department (ED) visit, and patients are supported through information leaflets, a smartphone app, and a telephone helpline. DD reduces secondary health care use, with comparable patient satisfaction and primary health care use.

Identification of neutrophil phenotype categories in geriatric hip fracture patients aids in personalized medicine.

Objectives: The number of geriatric hip fracture patients is high and expected to rise in the coming years, and many are frail and at risk for adverse outcomes. Early identification of high-risk patients is crucial to balance treatment and optimize outcome, but remains challenging. Previous research in patients with multitrauma suggested that neutrophil phenotype analysis could aid in early identification of high-risk patients.

The goals of care in acute setting for geriatric patients in case of a hip fracture.

Purpose: For geriatric hip fracture patients, the decision between surgery and palliative, non-operative management is made through shared decision making (SDM). For this conversation, a physician must be familiar with the patient's goals of care (GOC). These are predominantly unknown for hip fracture patients and challenging to assess in acute setting.

Cast versus removable orthosis for the management of stable type B ankle fractures: a systematic review and meta-analysis.

Purpose: There is currently no consensus on nonoperative management in adult patients after a stable type B ankle fracture. The aim of this review is to compare a removable orthosis versus a cast regarding safety and functional outcome in the NOM of stable type B ankle fractures.

Methods: A systematic review and meta-analysis were performed using randomized clinical trials and observational studies.

Proxy-reported experiences of palliative, non-operative management of geriatric patients after a hip fracture: a qualitative study.

Objective: The objective of this study was to explore the experiences from the period after the choice was made for palliative, non-operative management for geriatric patients with a hip fracture, to the most important factors in the process, as reported by a proxy.

Design: Semistructured interviews were conducted between 1 August 2020 and 1 April 2021 to investigate by-proxy reported patient experiences of non-operative management after hip fracture. Interviews followed a topic guide, recorded and transcribed per word.

Let's Agree to Disagree on Operative versus Nonoperative (LADON) treatment for proximal humerus fractures: Study protocol for an international multicenter prospective cohort study.

Background: The proximal humerus fracture is a common injury, but the optimal management is much debated. The decision for operative or nonoperative treatment is strongly influenced by patient specific factors, regional and cultural differences and the preference of the patient and treating surgeon. The aim of this study is to compare operative and nonoperative treatment of proximal humerus fractures for those patients for whom there is disagreement about optimal management.

Effect of music on clinical outcome after hip fracture operations (MCHOPIN): study protocol of a multicentre randomised controlled trial.

Background: Patients undergoing proximal femur fracture surgery are at high risk of postoperative complications, with postoperative delirium occurring in 25%-40% of patients. Delirium has profound effects on patient outcome and recovery, the patient's family, caregivers and medical costs. Perioperative music has a beneficial effect on eliciting modifiable risk factors of delirium.

Robot-assisted fracture fixation in orthopaedic trauma surgery: a systematic review.

Unlabelled: To investigate the applications of robot-assisted surgery and its effect on surgical outcomes in orthopaedic trauma patients.

Data Sources: A search was performed in PubMed and Embase for articles in English, Dutch, German, or French, without restrictions on follow-up times, study size, or year of publication.

Study Selection: Studies were included if they investigated patients undergoing robot-assisted fracture fixation surgery for orthopaedic trauma.

Complications After Surgical Treatment of Geriatric Ankle Fractures.

The incidence of geriatric ankle fractures is rising and the potential for complications is high in this population. Little is known about factors associated with increased postoperative complications after surgical fixation of ankle fractures in older-age patients. The purpose of this retrospective cohort study was to assess the epidemiology and risk factors for complications after surgically treated ankle fractures in geriatric patients.

Efficacy of two integrated geriatric care pathways for the treatment of hip fractures: a cross-cultural comparison.

Introduction: Many studies have focussed on the implementation and outcomes of geriatric care pathways (GCPs); however, little is known about the possible impact of clinical practices on these pathways. A comparison was made between two traumageriatric care models, one Swiss (CH) and one Dutch (NL), to assess whether these models would perform similarly despite the possible differences in local clinical practices.

Materials And Methods: This cohort study included all patients aged 70 years or older with a unilateral hip fracture who underwent surgery in 2014 and 2015.

Mindfulness in Patients with Upper-Extremity Conditions: A Summary of Existing Literature.

Mindfulness implies entering a mental state of awareness which allows for the reframing of an experience, and functionality has shown to be influenced by mindset. The aim of this systematic review was to assess effects of mindfulness in patients with upper-extremity conditions. PubMed, Embase, Cochrane, and CINAHL databases were searched on June 19, 2019, for studies investigating mindfulness in patients with upper-extremity conditions.

Orthogeriatric Trauma Unit Improves Patient Outcomes in Geriatric Hip Fracture Patients.

Introduction: An aging population in developed countries has increased the number of osteoporotic hip fractures and will continue to grow over the next decades. Previous studies have investigated the effect of integrated orthogeriatric trauma units and care model on outcomes of hip fracture patients. Although all of the models perform better than usual care, there is no conclusive evidence which care model is superior.

Development and Internal Validation of a Prediction Model for In-Hospital Mortality in Geriatric Patients With a Hip Fracture.

Objective: To develop and validate a prediction model for in-hospital mortality in patients with hip fracture 85 years of age or older undergoing surgery.

Design: A multicenter prospective cohort study.

Setting: Six Dutch trauma centers, level 2 and 3.

Operative vs Nonoperative Treatment of Distal Radius Fractures in Adults: A Systematic Review and Meta-analysis.

Importance: No consensus has been reached to date regarding the optimal treatment for distal radius fractures. The international rate of operative treatment has been increasing, despite higher costs and limited functional outcome evidence to support this shift.

Objectives: To compare functional, clinical, and radiologic outcomes after operative vs nonoperative treatment of distal radius fractures in adults.

Conservative vs. operative treatment for humeral shaft fractures: a meta-analysis and systematic review of randomized clinical trials and observational studies.

Background: This meta-analysis aimed to compare conservative vs. operative treatment for humeral shaft fractures in terms of the nonunion rate, reintervention rate, permanent radial nerve palsy rate, and functional outcomes. Secondarily, effect estimates from observational studies were compared with estimates of randomized clinical trials (RCTs).

Long-term outcomes after open reduction and internal fixation of bicondylar tibial plateau fractures.

Introduction: To establish normative data, long-term patient-reported functional outcome and health-related quality of life (HrQoL) after operative treatment of bicondylar tibial plateau fractures. Secondly, to identify risk factors associated with functional outcome and HrQoL.

Patients And Methods: We performed a retrospective cohort study at two Level I trauma centers.