Association between selective serotonin reuptake inhibitors use and blood transfusion risk in older adults after hip fracture: a cohort study.

Background: Hip fracture is common and associated with high morbidity and mortality rates. Selective serotonin reuptake inhibitors (SSRIs) influence platelet hemostasis and might result in abnormal bleeding. This study aims to determine whether the use of SSRIs in older patients undergoing hip fracture surgery is associated with the risk of perioperative red blood cell (RBC) transfusion.

Association between Vitamin D Deficiency and Prognosis after Hip Fracture Surgery in Older Patients in a Dedicated Orthogeriatric Care Pathway.

Objectives: Vitamin D deficiency is common in patients undergoing hip fracture surgery (HFS) and has been found to be associated with poor post-operative outcome in other settings. This study aimed to analyze the association between vitamin D status and prognosis after HFS.

Design: Observational, prospective, single-center study.

Exercise Interventions With Trained Home Helpers for Preventing Loss of Autonomy and Falls in Community-Dwelling Older Adults Receiving Home Heath Physical Therapy T4H: A Randomized Controlled Pilot Study.

Background And Purpose: Older adults at risk for falls live independently in the community in their own home and have rehabilitation needs. However, little is known about whether home coaching of older adults can decrease falls at home. We sought to determine whether a novel program for preventing falls and a loss of exercise capacity, the T4H program, in which home helpers act as exercise coaches by using an information technology (IT) device, was acceptable and feasible.

[New collaborative and participatory program for malnutrition management in the elders after hospitalization].

Background: Malnutrition in the elderly people is frequent and serious. Management of malnutrition at home after hospitalization is unsatisfactory. The objective of the study is to evaluate the feasibility and participation of a new collaborative and participative program involving the patient, the general practitioner and the dietician nutritionist, to fight against malnutrition in the elderly people at home after hospitalization.

Attributable Mortality of Hip Fracture in Older Patients: A Retrospective Observational Study.

Hip fracture (HF) in older patients is associated with a high six-month mortality rate. Several clinical conditions may affect outcome, including baseline characteristics, co-existing acute illnesses, perioperative factors, and postoperative complications. Our primary objective was to estimate the respective effect of these four domains on six-month mortality after HF.

[Psychological impact of Wii-empowerment in hospitalized elderly patients who fall: pilot study].

Falls have serious psychological consequences in senior citizens. The practice of Wii, «Wii-habilitation», among senior fallers hospitalized in follow-up care and rehabilitation, improves their quality of life, but without impacting their fear of falling and self-esteem.

[Food and nutrition liaison committees in healthcare facilities].

Since 2002, all healthcare facilities must have a food and nutrition liaison committee. The aim is to improve the management of food and nutrition related issues in hospital. The players concerned undertake a global and cross-disciplinary approach to ensure better food, notably for elderly patients at risk of protein-energy malnutrition.

Retrospective Evaluation of a Restrictive Transfusion Strategy in Older Adults with Hip Fracture.

Objectives: To compare the association between a restrictive transfusion strategy and cardiovascular complications during hospitalization for hip fracture with the association between a liberal transfusion strategy and cardiovascular complications, accounting for all transfusions from the emergency department to postacute rehabilitation settings.

Design: Retrospective study.

Setting: Perioperative geriatric care unit.

[Organising a successful return home].

Discharge from hospital is a major component of the quality and efficiency of the healthcare system. The failures of the return home of elderly people testify to the difficulties of applying guidelines in the area of hospital discharge. The action plan decided in the hospital for a successful return home can be jeopardised for personal, relational, functional and structural reasons originating from the different players involved in the hospital discharge.

[The occupational therapist and the assessment of the elderly person's home].

The falls of elderly people in their home are frequently related to the environment. Plans and photographs of the home provided by the patient's relatives are useful and constitute relevant assessment tools. The home visit is even more effective as it helps to identify areas which pose a high risk of falling which cannot be picked up by the other tools.

Pressure ulcers are associated with 6-month mortality in elderly patients with hip fracture managed in orthogeriatric care pathway.

Unlabelled: Despite orthogeriatric management, 12% of the elderly experienced PUs after hip fracture surgery. PUs were significantly associated with a low albumin level, history of atrial fibrillation coronary artery disease, and diabetes. The risk ratio of death at 6 months associated with pressure ulcer was 2.

Isolated cardiac troponin rise does not modify the prognosis in elderly patients with hip fracture.

Perioperative myocardial infarction remains a life-threatening complication in noncardiac surgery and even an isolated troponin rise (ITR) is associated with significant mortality. Our aim was to assess the prognostic value of ITR in elderly patients with hip fracture.In this cohort study, all patients admitted between 2009 and 2013 in our dedicated geriatric postoperative unit after hip fracture surgery with a cardiac troponin I determination were included and divided into Control, ITR, and acute coronary syndrome (ACS) groups.

Association between Cognitive Status before Surgery and Outcomes in Elderly Patients with Hip Fracture in a Dedicated Orthogeriatric Care Pathway.

Background: Dementia is associated with a worse prognosis of hip fracture, but the impact of a dedicated geriatric care pathway on the prognosis of these patients has not been evaluated.

Objective: According to the cognitive status before surgery, our main objective was to compare mortality rate at 6 months; secondary outcomes were to compare in-hospital complications, the risk of new institutionalization, and the ability to walk at 6 months.

Methods: Between 2009 and 2015, all patients (>70 years) admitted after hip fracture surgery into a dedicated unit of peri-operative geriatric care were included: patients with dementia (DP), without dementia (NDP), and with cognitive status not determined (CSND).

[Needs, uses, cons-pros, good practices and opportunities about walker in elderly with loss of autonomy].

Non-use of the walker may be secondary to an initial inappropriate prescribing, a lack of adequate training, a lack of monitoring and side effects of using. Improving both stability and mobility in users is due to several biomechanical mechanisms. The benefits of walker are: general physiological effects, more confidence, better social life and decrease in the burden of care.

Klebsiella pneumoniae necrotizing fasciitis of the leg in an elderly French woman.

Klebsiella pneumoniae necrotizing fasciitis is a rare infection in regions outside of Asia. Here, we present a case of necrotizing fasciitis of the leg caused by K. pneumoniae in a 92-year-old French woman hospitalized in a geriatric rehabilitation unit.

B12 deficiency increases with age in hospitalized patients: a study on 14,904 samples.

Background: Cobalamin deficiency is responsible for hematological, neurological, neurocognitive, and neuropsychiatric impairments and is a risk factor for cardiovascular diseases, particularly in the elderly people.

Methods: In order to determine B12 status in old inpatients, a total number of 14,904 hospitalized patients in whom B12 measurements were performed in five hospitals in the Paris metropolitan area were included from January 1, 2011 to December 31, 2011. The aims of the study were to determine whether age had an impact on B12 and folate deficiencies and to evaluate correlations between B12 and biological parameters-folate, hemoglobin, mean cell volume, homocystein (tHcy)-and age.

[Improvement of pneumococcal immunization coverage in older patients].

Purpose: To study pneumococcal immunization coverage in older patients in hospital, and the impact of two actions aiming at improving this coverage.

Methods: We reported a prospective and descriptive study conducted from November 2009 to August 2010, including all new patients ≥75 years old received in a geriatric short-stay department and residing in Val-de-Marne, France. This study was performed in three successive three-month periods, to assess the vaccination coverage in the months following hospital release.

Delirium in older people after proximal femoral fracture repair: role of a preoperative screening cognitive test.

Objective: Preoperative cognitive impairment has been identified as a major risk factor for postoperative delirium in older people. The aim of this study was to evaluate whether a validated and rapid screening cognitive test - COgnitive Disorder EXamination (CODEX) - performed preoperatively before proximal femoral fracture repair, was associated with a risk of postoperative delirium.

Study Design: We performed an observational prospective cohort study in orthopedic surgery department of a French hospital.

Neuropsychiatric symptoms in elderly inpatients: a multicenter cross-sectional study.

Background/aims: We determined the prevalence of neuropsychiatric symptoms in geriatric rehabilitation patients to compare neuropsychiatric symptoms between patients with and without dementia, and to evaluate associations linking severity of cognitive impairment and neuropsychiatric symptoms.

Methods: In February 2009, we studied patients aged 75 years or older who had been admitted to four geriatric rehabilitation units in the Paris area. The twelve Neuropsychiatric Inventory items and four neuropsychiatric subsyndromes defined by the European Alzheimer's Disease Consortium were evaluated.

[Which vaccination and cardiovascular prevention in elderly?].

Vaccination especially influenza, tetanus and pneumococcus should be used by the physician as an effective preventive measure. Stop smoking prevents the occurrence of cardiovascular event as the control of blood pressure in elderly healthy. It is very important to treat atrial fibrillation in elderly.

[Anesthesia in the elderly].

A growing number of old or very old patients benefits from a surgical procedure. Age is an independent risk factor of postoperative mortality and postoperative complications including cognitive dysfunction. The choice of anesthetic technique does not significantly modify this risk.

Detection of respiratory syncytial virus antigen after seventy-two hours of culture.

Between September, 1987, and April, 1989, three techniques for the detection of respiratory syncytial virus (RSV) were compared: indirect immunofluorescence (IF) on the sample, indirect immunofluorescence after 72 h of MRC-5 cell culture (IF 72h), and detection of the cytopathic effect (CPE) by MRC-5 and HEp-2 cell culture. A study of 383 nasal aspirates from young children admitted to the Centre Hospitalier de Nantes (CHR) showing miscellaneous respiratory symptoms produced the following results: 143 samples (37%) were RSV positive by IF, 119 (31%) were positive by IF 72h, and 117 (31%) showed RSV-induced CPE. In comparison with tissue culture isolation (TC), the sensitivities of IF and IF 72h were 89% and 80% and their specificities 85% and 91%, respectively.