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Geriatric Consultation Reduces High-risk Medication Usage at Discharge in Elderly Trauma Patients

Background Traumatic injury in a growing geriatric population is associated with higher mortality and complication rates. Geriatric consultation (GC) is vital in reducing risk factors that contribute to adverse outcomes. This study aims to determine if receiving a GC had an impact on high-risk medic...

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Autores principales: Sharma, Jyoti, Parulekar, Manisha, Stewart, Peter, Blatt, Melissa, Zielonka, Tania, Nyirenda, Themba, Rogers, Christopher, Tank, Lisa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351116/
https://www.ncbi.nlm.nih.gov/pubmed/30723648
http://dx.doi.org/10.7759/cureus.3649
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author Sharma, Jyoti
Parulekar, Manisha
Stewart, Peter
Blatt, Melissa
Zielonka, Tania
Nyirenda, Themba
Rogers, Christopher
Tank, Lisa
author_facet Sharma, Jyoti
Parulekar, Manisha
Stewart, Peter
Blatt, Melissa
Zielonka, Tania
Nyirenda, Themba
Rogers, Christopher
Tank, Lisa
author_sort Sharma, Jyoti
collection PubMed
description Background Traumatic injury in a growing geriatric population is associated with higher mortality and complication rates. Geriatric consultation (GC) is vital in reducing risk factors that contribute to adverse outcomes. This study aims to determine if receiving a GC had an impact on high-risk medication usage. Methods Patients eligible for a GC, age ≥ 65, and length of stay > two days, were identified via a chart review from July 2013 to July 2014 at a Level II trauma center. This population was divided into those with and without a GC. Data collected included demographics, injury severity, medications, delirium, mortality, and readmissions. High-risk medications were defined using the Beers Criteria. Statistical analysis involved using appropriate standard tests to compare groups, including multivariate logistic regression. Results Forty-nine of a total of 104 patients received a GC. Groups were comparable on injury severity score, co-morbidities, and high-risk medication use upon admissions. The GC group was 74% less likely to be discharged on high-risk medications than the non-GC group. Conclusion GC in elderly trauma patients reduces high-risk medication use upon discharge. Further studies are needed to explore how GC impacts readmission rates and mortality. A multidisciplinary trauma team, including a geriatrician, must exist to address the unique medical, psychological, functional, and social issues of a growing, aged trauma population.
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spelling pubmed-63511162019-02-05 Geriatric Consultation Reduces High-risk Medication Usage at Discharge in Elderly Trauma Patients Sharma, Jyoti Parulekar, Manisha Stewart, Peter Blatt, Melissa Zielonka, Tania Nyirenda, Themba Rogers, Christopher Tank, Lisa Cureus General Surgery Background Traumatic injury in a growing geriatric population is associated with higher mortality and complication rates. Geriatric consultation (GC) is vital in reducing risk factors that contribute to adverse outcomes. This study aims to determine if receiving a GC had an impact on high-risk medication usage. Methods Patients eligible for a GC, age ≥ 65, and length of stay > two days, were identified via a chart review from July 2013 to July 2014 at a Level II trauma center. This population was divided into those with and without a GC. Data collected included demographics, injury severity, medications, delirium, mortality, and readmissions. High-risk medications were defined using the Beers Criteria. Statistical analysis involved using appropriate standard tests to compare groups, including multivariate logistic regression. Results Forty-nine of a total of 104 patients received a GC. Groups were comparable on injury severity score, co-morbidities, and high-risk medication use upon admissions. The GC group was 74% less likely to be discharged on high-risk medications than the non-GC group. Conclusion GC in elderly trauma patients reduces high-risk medication use upon discharge. Further studies are needed to explore how GC impacts readmission rates and mortality. A multidisciplinary trauma team, including a geriatrician, must exist to address the unique medical, psychological, functional, and social issues of a growing, aged trauma population. Cureus 2018-11-28 /pmc/articles/PMC6351116/ /pubmed/30723648 http://dx.doi.org/10.7759/cureus.3649 Text en Copyright © 2018, Sharma et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle General Surgery
Sharma, Jyoti
Parulekar, Manisha
Stewart, Peter
Blatt, Melissa
Zielonka, Tania
Nyirenda, Themba
Rogers, Christopher
Tank, Lisa
Geriatric Consultation Reduces High-risk Medication Usage at Discharge in Elderly Trauma Patients
title Geriatric Consultation Reduces High-risk Medication Usage at Discharge in Elderly Trauma Patients
title_full Geriatric Consultation Reduces High-risk Medication Usage at Discharge in Elderly Trauma Patients
title_fullStr Geriatric Consultation Reduces High-risk Medication Usage at Discharge in Elderly Trauma Patients
title_full_unstemmed Geriatric Consultation Reduces High-risk Medication Usage at Discharge in Elderly Trauma Patients
title_short Geriatric Consultation Reduces High-risk Medication Usage at Discharge in Elderly Trauma Patients
title_sort geriatric consultation reduces high-risk medication usage at discharge in elderly trauma patients
topic General Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351116/
https://www.ncbi.nlm.nih.gov/pubmed/30723648
http://dx.doi.org/10.7759/cureus.3649
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