Abstract:
INTRODUCTION:national reports have highlighted deficiencies in care provided to older surgical patients and suggested a role for innovative, collaborative, inter-specialty models of care. The extent of geriatrician-led perioperative services in the UK (excluding orthogeriatric services) has not previously been described. This survey describes current services and explores barriers to further development. METHODS:an electronic survey was sent to clinical leads for geriatric medicine at all 161 acute NHS health care trusts in the UK. Reminders were sent on three occasions over an 8-week period. The survey examined preoperative and postoperative care and organisational issues. Responses were analysed descriptively. RESULTS:there were 130 respondents (80.7%). One-third (38) of respondents described providing some geriatric medicine input in older surgical patients. Preoperative services existed in 15 (12%), where 14 provided risk assessment and 13 preoperative optimisation. Twenty-six respondents (20%) delivered care postoperatively, of them 10 took a reactive approach, 11 a proactive approach and 5 provided a combination of reactive and proactive care. Barriers to establishing perioperative geriatric medicine services included funding, workforce issues and a lack of inter-specialty collaboration. CONCLUSION:a national appetite exists to provide geriatrician-led services to older surgical patients yet the majority of existing services remain reactive and do not use comprehensive geriatric assessment as an organising principle. This survey suggests that funding for geriatricians in perioperative care has not yet been universally established. Future efforts should focus on dissemination of experiential knowledge and published resources, collaboration with commissioners and empirical research to overcome the barriers described.
journal_name
Age Ageingjournal_title
Age and ageingauthors
Partridge JS,Collingridge G,Gordon AL,Martin FC,Harari D,Dhesi JKdoi
10.1093/ageing/afu084subject
Has Abstractpub_date
2014-09-01 00:00:00pages
721-4issue
5eissn
0002-0729issn
1468-2834pii
afu084journal_volume
43pub_type
杂志文章相关文献
AGE AND AGEING文献大全abstract:Background:the association between pain characteristics and frailty risk is uncertain. Objective:to investigate the separate impact of the frequency, intensity and location of pain on frailty risk and its possible mechanisms. Methods:prospective cohort of 1505 individuals ≥63 years followed between 2012 and 2015 in S...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afy163
更新日期:2019-01-01 00:00:00
abstract:Background:pain is prevalent in frail older adults; however, the association of pain and frailty has not been evaluated yet by a systematic assessment of prospective longitudinal studies. Objective:we aimed to assess the association of persistent pain as a risk factor for frailty incidence, using data from longitudina...
journal_title:Age and ageing
pub_type: 杂志文章,meta分析
doi:10.1093/ageing/afy104
更新日期:2018-11-01 00:00:00
abstract::Among 352 residents of a home for the elderly, who were fully mobile and devoid of most predisposing factors for bacteriuria, 19% of men and 27% of women had two positive cultures within two months. Positive conversion at one year among men and women negative at entry was 11% and 23% respectively, negative conversion ...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/11.3.169
更新日期:1982-08-01 00:00:00
abstract::Joint geriatric/psychiatric wards are a potential solution to improving care of older patients with both psychiatric and medical illnesses in acute hospitals. A literature search using Medline, PsycINFO, Embase and CINAHL between 1980 and 2010 was carried out for information about joint wards for older people. Thirtee...
journal_title:Age and ageing
pub_type: 杂志文章,评审
doi:10.1093/ageing/afr080
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:cranberry juice is often given to older people in hospital to prevent urinary tract infection (UTI), although there is little evidence to support its use. OBJECTIVE:to assess whether cranberry juice ingestion is effective in reducing UTIs in older people in hospital. DESIGN:randomised, placebo-controlled, ...
journal_title:Age and ageing
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/ageing/afi101
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND:exposures in childhood and adolescence may impact the development of diseases and symptoms in late life. However, evidence from low- and middle-income countries is scarce. In this cross-sectional study, we examined the association of early life risk factors with frailty amongst older adults using a large, na...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afz160
更新日期:2020-02-27 00:00:00
abstract:BACKGROUND:dysphagia is common in acute stroke. Accurate detection of the presence or absence of aspiration by bedside swallowing assessment is difficult without objective methods, tending to over-diagnose aspiration. As a result, some patients suffer restricted oral intake unnecessarily. OBJECTIVE:we examined the pre...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/29.6.495
更新日期:2000-11-01 00:00:00
abstract:BACKGROUND:whether socioeconomic position over the life course influences the wellbeing of older people similarly in different societies is not known. OBJECTIVE:to investigate the magnitude of socioeconomic inequalities in life satisfaction among individuals in early old age and the influence of the welfare state regi...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afu004
更新日期:2014-05-01 00:00:00
abstract::Plasma Human Growth Hormone (HGH) was raised in a patient with bronchial carcinoma and hypertrophic pulmonary osteoarthropathy before radiotherapy to the tumour. Though the soft-tissue swelling and pain of hypertrophic osteoarthropathy disappeared two to three weeks after radiotherapy to the carcinoma the HGH plasma l...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/4.2.95
更新日期:1975-05-01 00:00:00
abstract:Background:overactive bladder (OAB) is a common condition in older persons. Antimuscarinic treatment remains the mainstay of treatment of OAB but clinicians have been reluctant to prescribe this to older patients. This study examined efficacy and safety information from patients >65 in fesoterodine trials to reaffirm e...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afw252
更新日期:2017-07-01 00:00:00
abstract::Two hundred and eighteen subjects, out of 250 individuals taken from a general practice register, returned completed questionnaires giving details about rest cramps, and a further 15 were contacted by telephone. The overall prevalence of rest cramps in the survey population was 37%. The symptom was more prevalent in o...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/23.5.418
更新日期:1994-09-01 00:00:00
abstract:BACKGROUND:transcatheter aortic valve implantation (TAVI) has emerged as an alternative to surgical aortic valve replacement for patients with severe aortic stenosis considered inoperable or at high operative risk, but the long-term outcome remains unknown. HYPOTHESIS:we assessed the 4-year clinical and echocardiograp...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afw038
更新日期:2016-05-01 00:00:00
abstract:OBJECTIVE:to assess the validity of the Direct Assessment of Functional Status (DAFS) performance-based functional scale for the staging of dementia severity by comparing it with established clinical, functional and cognitive scales. PATIENTS AND METHODS:93 consecutive Alzheimer's disease patients underwent DAFS. Soci...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/27.5.615
更新日期:1998-09-01 00:00:00
abstract::Capillary fragility has been examined in 110 elderly patients, excluding those patients who might have been expected to have abnormal fragility. Nonetheless, fragility appeared to be greater in elderly patients than in younger subjects. It was much increased in the non-paralysed arm of hemiplegic patients but not in t...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/7.2.96
更新日期:1978-05-01 00:00:00
abstract::The overactive bladder is the commonest underlying bladder disorder causing urinary incontinence in elderly people. Management of the condition relies upon a holistic assessment of the problem, lifestyle adjustment, behavioural management and drug therapy. The majority of currently available drugs rely on their anti-m...
journal_title:Age and ageing
pub_type: 杂志文章,评审
doi:10.1093/ageing/31.4.241
更新日期:2002-07-01 00:00:00
abstract::Japan is a super-ageing society that faces pressures on its aged care system from a growing population of older adults. Naturalistic observations were undertaken at eight aged care facilities in central and northern Japan to explore how aged care is configured. Four aspects of contemporary provision were identified th...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afw144
更新日期:2016-11-01 00:00:00
abstract::Non-steroidal anti-inflammatory drugs are currently being investigated as agents to reduce the incidence and progression of Alzheimer's disease. Paradoxically they have also been reported to induce deleterious effects on the central nervous system, including aseptic meningitis and cognitive decline in the elderly. We ...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afh112
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND:fifteen percent of patients with Crohn's disease (CD) are elderly; they are less likely to have complications and more likely to have colonic disease. OBJECTIVE:to compare disease behaviour in patients with CD based on age at diagnosis. DESIGN:cross-sectional study. SETTING:tertiary referral centre. SUBJ...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afs107
更新日期:2013-01-01 00:00:00
abstract::Ejection fraction was measured directly by a radionuclide method, and indirectly from systolic time intervals, in elderly patients in atrial fibrillation. Both methods show that the ejection fraction averages approximately 55% at mean ventricular rates of 50-70 beats/min and falls to 20% or below as mean rate increase...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/10.4.231
更新日期:1981-11-01 00:00:00
abstract::Muscle cramps are painful and common in elderly patients but have largely escaped medical investigation. Quinine sulphate is usually the sole drug prescribed, even though firm evidence for its efficacy is not available. The results of the present double-blind cross-over study show that quinine was significantly superi...
journal_title:Age and ageing
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/ageing/12.2.155
更新日期:1983-05-01 00:00:00
abstract:OBJECTIVE:to examine whether the Danish 1905 cohort members had more active hospital treatment than the 1895 cohort members from ages 85 to 99 years and whether it results in higher in-hospital and post-operative mortality. METHODS:in the present register-based follow-up study the complete Danish birth cohorts born in...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/aft031
更新日期:2013-07-01 00:00:00
abstract:OBJECTIVE:To compare cognitive performance in participants with and without syncope and unexplained falls in a large population representative sample aged 50 years or older. METHODS:Participants of the Irish longitudinal study on ageing (TILDA) were studied. Participants with a history of syncope and/or unexplained fa...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afu191
更新日期:2015-03-01 00:00:00
abstract::Previous work has shown persistent elevations in plasma cortisol concentration following upper femur fracture in elderly people. To investigate this phenomenon further, we measured plasma cortisol and adrenocorticotrophin (ACTH) and performed overnight dexamethasone suppression tests in carefully characterized patient...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/19.5.304
更新日期:1990-09-01 00:00:00
abstract:OBJECTIVE:the organisation of long-term medicine and geriatric medicine has undergone many changes during the last 15 years. The aim of this study is to gain an overall perspective of the present organisation of geriatric medicine in Sweden. DESIGN:questionnaire survey. METHODS:The Swedish Society for Geriatric Medic...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afh115
更新日期:2004-07-01 00:00:00
abstract::In a city where specialist homes for the elderly mentally infirm (EMI) have been extensively developed, a study was carried out to determine if residents in such homes were mentally impaired to a degree intermediate between that of residents in ordinary homes, and those in psychogeriatric beds. The study, using valid ...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/13.4.218
更新日期:1984-07-01 00:00:00
abstract:BACKGROUND:The risk/benefit ratio of warfarin therapy changes in the over 75s, when haemorrhagic side-effects become more common. These may not always be reported in the literature. CASE REPORT:A woman of 80 years, on long-term warfarin therapy presented with an acute dissecting thoracic aortic aneurysm; on investigat...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afh015
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:a large number of studies have explored factors related to self- and informant ratings of quality of life in people with dementia, but many studies have had relatively small sample sizes and mainly focused on health conditions and dementia symptoms. The aim of this study is to compare self- and informant-rat...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afz177
更新日期:2020-04-27 00:00:00
abstract::Sporadic Creutzfeld-Jakob disease (CJD) is a rare neurodegenerative disorder. It is uniformly fatal. Clinical signs include myoclonus, visual disturbances, cerebellar ataxia, akinetic mutism and pyramidal/extrapyramidal signs in addition to a rapidly progressive dementia. Premortem diagnosis is challenging due to the ...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afaa013
更新日期:2020-04-27 00:00:00
abstract:BACKGROUND AND PURPOSE:The benefit of endovascular thrombectomy (EVT) among nonagenarians (90 years or older) is poorly documented. We aimed to investigate the clinical and imaging factors associated with good outcomes and mortality at 90 days in nonagenarians undergoing EVT for acute ischemic stroke (AIS). METHODS:Da...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afaa243
更新日期:2020-11-17 00:00:00
abstract::Pulmonary embolism (PE) is a potentially severe diagnosis with high short-term mortality. Recently, age-adjusted cut-off values (age × 10 μg/l) of D-dimer were introduced to improve the diagnostic workup in older patients. In clinical practice, PE is considered 'ruled out' in patients with a non-high clinical probabil...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afw132
更新日期:2016-11-01 00:00:00