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EB

ONLINE

2nd ed.

Cham : Springer International Publishing AG, 2020

1 online resource (355 pages)

ISBN 9783030481261 (electronic bk.)

ISBN 9783030481254

Practical Issues in Geriatrics Ser.

Print version: Falaschi, Paolo Orthogeriatrics Cham : Springer International Publishing AG,c2020 ISBN 9783030481254

2.1 Introduction -- 2.2 Prevalence of Osteoporosis.

1.4.4 Orthogeriatric Anaesthesia: Chap. 8 -- 1.4.5 Hip Fracture: The Choice of Surgery-Chap. 9 -- 1.4.6 Proximal Humeral Fractures: The Choice of Treatment-Chap. 10 -- 1.5 Pillar II: Rehabilitation-Chaps. 12 and 13 -- 1.5.1 Rehabilitation Following Hip Fracture: Chap. 12 -- 1.5.2 The Psychological Health of Patients and Their Caregivers: Chap. 13 -- 1.6 Pillar III: Secondary Prevention-Chaps. 14-16 -- 1.6.1 Fracture Liaison Services: Chap. 14 -- 1.6.2 Current and Emerging Treatment of Osteoporosis: Chap. 15 -- 1.6.3 How Can We Prevent Falls?-Chap. 16 -- 1.7 Cross-Cutting Issues: Chaps. 17-19 -- 1.7.1 Nursing in the Orthogeriatric Setting: Chap. 17 -- 1.7.2 Nutritional Care of the Older Patient with Fragility Fracture: Chap. 18 -- 1.7.3 Fragility Fracture Audit: Chap. 19 -- 1.8 Concluding Remarks -- References -- 2: Epidemiology of Fragility Fractures and Social Impact ---

2.1 Introduction -- 2.2 Prevalence of Osteoporosis.

Intro -- Preface to the Second Edition -- Contents -- Part I: Background -- 1: The Multidisciplinary Approach to Fragility Fractures Around the World: An Overview -- 1.1 Introduction -- 1.2 General Developments Since 2016 -- 1.2.1 The Global Call to Action -- 1.2.2 The Formation of National FFNs -- 1.2.3 Initiation of New Hip Fracture Registries -- 1.2.4 Implications of These General Developments for the Design of This Second Edition -- 1.3 Background: Chaps. 2-4 -- 1.3.1 Epidemiology of Fractures and Social Costs: Chap. 2 -- 1.3.2 Osteoporosis in Older Patients: Chap. 3 -- 1.3.3 Frailty and Sarcopenia: Chap. 4 -- 1.4 Pillar I: Co-Management in the Acute Episode-Chaps. 5-11 -- 1.4.1 Establishing an Orthogeriatric Service: Chap. 5 -- 1.4.2 Pre-hospital Care and the Emergency Department: Chap. 6 -- 1.4.3 Perioperative Orthogeriatric Care: Chaps. 7 and 11 ---

3.7.1.3 Quantitative Ultra-Sound (QUS) -- 3.7.2 X-Ray of the Dorsal and Lumbar Spine -- 3.7.3 Laboratory Tests -- 3.8 Management of Osteoporosis -- 3.8.1 Lifestyle Modification -- 3.8.1.1 Prevention of Falls -- 3.9 The Importance of Vitamin D, Calcium and Protein Intake -- 3.9.1 Vitamin D -- 3.9.2 Calcium -- 3.9.3 Protein -- 3.10 Therapeutic Adherence in Osteoporosis and the Role of Health Professionals -- References -- 4: Frailty and Sarcopenia -- 4.1 Frailty -- 4.1.1 The Nature of Frailty -- 4.1.2 Epidemiology of Frailty -- 4.1.3 How Does Frailty Develop? -- 4.1.4 Assessment of Frailty in Clinical Practice -- 4.1.5 Incorporating Frailty into Treatment Plans and Service Design -- 4.2 Sarcopenia -- 4.2.1 The Nature of Sarcopenia -- 4.2.2 Epidemiology -- 4.2.3 How Does Sarcopenia Develop? -- 4.2.4 Assessing Sarcopenia in Clinical Practice ---

5.2.8 Step 8: Embrace the Support of Regional, National and International Organisations -- 5.3 Conclusion -- References -- 6: Pre-hospital Care and the Emergency Department -- 6.1 Pre-hospital Care -- 6.1.1 Clinical Assessment: Primary Survey -- 6.1.2 Clinical Assessment: Secondary Survey -- 6.1.3 Patient History -- 6.1.4 Physical Assessment and Vital Signs -- 6.1.5 Management of Pain -- 6.1.6 Fluid Replacement -- 6.1.7 Extrication -- 6.1.8 Transportation -- 6.2 The Emergency Department -- 6.2.1 Nutrition and Hydration -- 6.2.2 Management of Pain -- 6.2.3 Ongoing Analgesia -- 6.2.4 Local Nerve Blocks -- 6.2.5 Skin Care -- 6.2.6 Referral for Early Surgery -- 6.3 Summary -- References -- 7: Pre-operative Medical Assessment and Optimisation -- 7.1 Pre-operative Medical Assessment -- 7.2 Information Gathering -- 7.3 Cardiovascular Disease -- 7.3.1 Valvular Heart Disease -- 7.3.2 Heart Failure ---

11.4 Pain Management -- 11.5 Post-operative Hypotension and Fluid Management -- 11.6 Management of Postsurgical Anaemia -- 11.7 Nutritional Supplementation -- 11.8 Post-operative Medical Complications -- 11.9 Prevention and Management of Specific Complications -- 11.9.1 Delirium -- 11.9.1.1 Prevention of Post-operative Delirium -- 11.9.1.2 Management of Post-operative Delirium -- 11.9.1.3 Post-operative Cognitive Dysfunction -- 11.9.2 Cardiovascular Complications -- 11.9.2.1 Myocardial Infarction -- 11.9.2.2 Heart Failure -- 11.9.2.3 Supraventricular Arrhythmias -- 11.9.3 Infections -- 11.9.3.1 Post-operative Fever -- 11.9.3.2 Pneumonia -- 11.9.3.3 Urinary Tract Infection -- 11.9.3.4 Surgical Site Infection -- 11.9.4 Other Complications -- 11.9.4.1 Acute Kidney Injury (AKI) -- 11.9.4.2 Gastrointestinal Complications -- 11.9.4.3 Pressure Ulcers -- 11.10 Final Remarks -- References -- Part III: Pillar II: Rehabilitation -- 12: Rehabilitation Following Hip Fracture -- 12.1 The Need for Increased Provision of Rehabilitation Worldwide -- 12.2 The Principles of Rehabilitation Programmes after Hip Fracture -- 12.3 What Is Known about the Pattern of Recovery Following Hip Fracture? -- 12.4 Factors Associated with Poor Outcomes After Hip Fracture -- 12.5 Key Elements of a Rehabilitation Pathway -- 12.6 What Programmes Should We Recommend to Help with Recovery? -- 12.6.1 In-hospital Rehabilitation -- 12.6.2 Rehabilitation in the Community -- 12.6.3 Rehabilitation in Low Resource Settings -- 12.7 Rehabilitation and Cognitive Impairment -- 12.7.1 Enhanced Interdisciplinary Inpatient Rehabilitation and Care -- 12.7.2 Enhanced Interdisciplinary Inpatient and Home-Based Rehabilitation -- 12.8 Psychosocial Factors and Rehabilitation -- 12.9 Delivery of Rehabilitation Following Hip Fracture in LMICs.

2.3 Factors Affecting Bone Mineral Density -- 2.4 Osteosarcopenia -- 2.5 Falls -- 2.6 Incidence of Fragility Fractures -- 2.7 Hip Fracture -- 2.8 Other Osteoporotic Fractures -- 2.9 The Burden of Fragility Fractures -- 2.10 The Costs and Social Impact of Hip Fracture -- 2.11 The Costs and Social Impact of Other Osteoporotic Fractures -- 2.12 Conclusions -- References -- 3: Osteoporosis and Fragility in Elderly Patients -- 3.1 Definition -- 3.2 Epidemiology -- 3.3 The Anatomy of Bone -- 3.4 The Physiology of Bone -- 3.5 Pathogenesis -- 3.6 Risk Factors for Fragility Fractures -- 3.6.1 BMD -- 3.6.2 Age -- 3.6.3 Previous Fractures -- 3.6.4 Family History of Fracture -- 3.6.5 Comorbidities -- 3.6.6 Drugs -- 3.6.7 Assessment of Fracture Risk -- 3.7 Diagnosis -- 3.7.1 Instrumental Diagnosis -- 3.7.1.1 Dual X-Ray Absorptiometry (DXA) -- 3.7.1.2 Quantitative Computerised Tomography (QCT) ---

7.4 Management of Anticoagulants and Anti-platelets -- 7.5 Anaemia -- 7.6 Diabetes -- 7.7 Chronic Kidney Disease (CKD) -- 7.8 Respiratory Disease -- 7.9 Medication Review -- 7.10 Preventing Complications: Thromboembolic Events -- 7.11 Antibiotic Prophylaxis -- 7.12 Appropriate Ceilings of Care -- 7.13 Conclusion -- References -- 8: Orthogeriatric Anaesthesia -- 8.1 Introduction -- 8.2 The Relationship Between Anaesthetist and Orthogeriatrician -- 8.3 Preoperative Care -- 8.3.1 Preoperative Analgesia -- 8.3.2 Preoperative Preparation -- 8.3.3 Ethical and Legal Considerations -- 8.4 Intraoperative Care -- 8.4.1 General or Spinal Anaesthesia? -- 8.4.2 Peripheral Nerve Block -- 8.4.3 Spinal Anaesthesia -- 8.4.4 Sedation -- 8.4.5 General Anaesthesia -- 8.4.6 Avoiding Ischaemia -- 8.4.7 Bone Cement Implantation Syndrome (BCIS) -- 8.4.8 Standardisation of Anaesthesia -- 8.5 Postoperative Care -- References -- 9: Hip Fracture: The Choice of Surgery -- 9.1 Aim of Surgery -- 9.2 Fracture Types -- 9.2.1 Intra-capsular Fracture Types -- 9.2.2 Extra-capsular Fracture Types -- 9.3 Implants -- 9.4 Surgical Management -- 9.4.1 Intra-capsular Operations -- 9.4.2 Extra-capsular Operations -- 9.5 Surgical Algorithms and National Guidelines -- References -- 10: Proximal Humeral Fractures: The Choice of Treatment -- 10.1 Aim of Treatment -- 10.2 Evidence and Literature -- 10.3 Epidemiology -- 10.4 Fracture Classification -- 10.4.1 Minimally Displaced Fractures -- 10.4.2 Displaced Fractures -- 10.5 Treatment -- 10.5.1 Non-surgical Treatment -- 10.5.2 Surgical Management -- 10.6 Complications -- 10.7 Outcome Assessment -- 10.8 Conclusions -- References -- 11: Post-operative Management -- 11.1 Multidisciplinary Management -- 11.2 Predicting the Risk of Post-operative Complications -- 11.3 Early Mobilisation.

3.7.1.3 Quantitative Ultra-Sound (QUS) -- 3.7.2 X-Ray of the Dorsal and Lumbar Spine -- 3.7.3 Laboratory Tests -- 3.8 Management of Osteoporosis -- 3.8.1 Lifestyle Modification -- 3.8.1.1 Prevention of Falls -- 3.9 The Importance of Vitamin D, Calcium and Protein Intake -- 3.9.1 Vitamin D -- 3.9.2 Calcium -- 3.9.3 Protein -- 3.10 Therapeutic Adherence in Osteoporosis and the Role of Health Professionals -- References -- 4: Frailty and Sarcopenia -- 4.1 Frailty -- 4.1.1 The Nature of Frailty -- 4.1.2 Epidemiology of Frailty -- 4.1.3 How Does Frailty Develop? -- 4.1.4 Assessment of Frailty in Clinical Practice -- 4.1.5 Incorporating Frailty into Treatment Plans and Service Design -- 4.2 Sarcopenia -- 4.2.1 The Nature of Sarcopenia -- 4.2.2 Epidemiology -- 4.2.3 How Does Sarcopenia Develop? -- 4.2.4 Assessing Sarcopenia in Clinical Practice ---

4.2.5 Incorporating Sarcopenia into Treatment Plans and Service Design.

5.2.8 Step 8: Embrace the Support of Regional, National and International Organisations -- 5.3 Conclusion -- References -- 6: Pre-hospital Care and the Emergency Department -- 6.1 Pre-hospital Care -- 6.1.1 Clinical Assessment: Primary Survey -- 6.1.2 Clinical Assessment: Secondary Survey -- 6.1.3 Patient History -- 6.1.4 Physical Assessment and Vital Signs -- 6.1.5 Management of Pain -- 6.1.6 Fluid Replacement -- 6.1.7 Extrication -- 6.1.8 Transportation -- 6.2 The Emergency Department -- 6.2.1 Nutrition and Hydration -- 6.2.2 Management of Pain -- 6.2.3 Ongoing Analgesia -- 6.2.4 Local Nerve Blocks -- 6.2.5 Skin Care -- 6.2.6 Referral for Early Surgery -- 6.3 Summary -- References -- 7: Pre-operative Medical Assessment and Optimisation -- 7.1 Pre-operative Medical Assessment -- 7.2 Information Gathering -- 7.3 Cardiovascular Disease -- 7.3.1 Valvular Heart Disease -- 7.3.2 Heart Failure ---

7.3.3 Conduction Defects, Pacemakers and Implantable Cardiac Defibrillators (ICD) -- 7.3.4 Atrial Fibrillation (AF).

11.4 Pain Management -- 11.5 Post-operative Hypotension and Fluid Management -- 11.6 Management of Postsurgical Anaemia -- 11.7 Nutritional Supplementation -- 11.8 Post-operative Medical Complications -- 11.9 Prevention and Management of Specific Complications -- 11.9.1 Delirium -- 11.9.1.1 Prevention of Post-operative Delirium -- 11.9.1.2 Management of Post-operative Delirium -- 11.9.1.3 Post-operative Cognitive Dysfunction -- 11.9.2 Cardiovascular Complications -- 11.9.2.1 Myocardial Infarction -- 11.9.2.2 Heart Failure -- 11.9.2.3 Supraventricular Arrhythmias -- 11.9.3 Infections -- 11.9.3.1 Post-operative Fever -- 11.9.3.2 Pneumonia -- 11.9.3.3 Urinary Tract Infection -- 11.9.3.4 Surgical Site Infection -- 11.9.4 Other Complications -- 11.9.4.1 Acute Kidney Injury (AKI) -- 11.9.4.2 Gastrointestinal Complications -- 11.9.4.3 Pressure Ulcers -- 11.10 Final Remarks -- References -- Part III: Pillar II: Rehabilitation -- 12: Rehabilitation Following Hip Fracture -- 12.1 The Need for Increased Provision of Rehabilitation Worldwide -- 12.2 The Principles of Rehabilitation Programmes after Hip Fracture -- 12.3 What Is Known about the Pattern of Recovery Following Hip Fracture? -- 12.4 Factors Associated with Poor Outcomes After Hip Fracture -- 12.5 Key Elements of a Rehabilitation Pathway -- 12.6 What Programmes Should We Recommend to Help with Recovery? -- 12.6.1 In-hospital Rehabilitation -- 12.6.2 Rehabilitation in the Community -- 12.6.3 Rehabilitation in Low Resource Settings -- 12.7 Rehabilitation and Cognitive Impairment -- 12.7.1 Enhanced Interdisciplinary Inpatient Rehabilitation and Care -- 12.7.2 Enhanced Interdisciplinary Inpatient and Home-Based Rehabilitation -- 12.8 Psychosocial Factors and Rehabilitation -- 12.9 Delivery of Rehabilitation Following Hip Fracture in LMICs.

12.9.1 Key Evidence-Based Recommendations and Their Implementation in LMICs.

2.3 Factors Affecting Bone Mineral Density -- 2.4 Osteosarcopenia -- 2.5 Falls -- 2.6 Incidence of Fragility Fractures -- 2.7 Hip Fracture -- 2.8 Other Osteoporotic Fractures -- 2.9 The Burden of Fragility Fractures -- 2.10 The Costs and Social Impact of Hip Fracture -- 2.11 The Costs and Social Impact of Other Osteoporotic Fractures -- 2.12 Conclusions -- References -- 3: Osteoporosis and Fragility in Elderly Patients -- 3.1 Definition -- 3.2 Epidemiology -- 3.3 The Anatomy of Bone -- 3.4 The Physiology of Bone -- 3.5 Pathogenesis -- 3.6 Risk Factors for Fragility Fractures -- 3.6.1 BMD -- 3.6.2 Age -- 3.6.3 Previous Fractures -- 3.6.4 Family History of Fracture -- 3.6.5 Comorbidities -- 3.6.6 Drugs -- 3.6.7 Assessment of Fracture Risk -- 3.7 Diagnosis -- 3.7.1 Instrumental Diagnosis -- 3.7.1.1 Dual X-Ray Absorptiometry (DXA) -- 3.7.1.2 Quantitative Computerised Tomography (QCT) ---

4.3 The Implications of Frailty and Sarcopenia on Falls, Fractures and the Recovery After Fractures -- 4.4 Concluding Statement -- References -- Part II: Pillar I: Co-management in the Acute Episode -- 5: Establishing an Orthogeriatric Service -- 5.1 Introduction -- 5.2 Designing the Orthogeriatric Service -- 5.2.1 Step 1: Process Mapping the Hip Fracture Pathway -- 5.2.2 Step 2: Identify a Core Multidisciplinary Team and Form a Steering Group -- 5.2.3 Step 3: Analyse and Review the Patient Pathway -- 5.2.4 Step 4: Evaluate the Resources Required to Drive Change Within the Organisation -- 5.2.5 Step 5: Develop the Business Case for the Orthogeriatric Service -- 5.2.6 Step 6: Implementing and Sustaining the Service -- 5.2.7 Step 7: Collect Evidence of Service Improvement: Audit ---

7.4 Management of Anticoagulants and Anti-platelets -- 7.5 Anaemia -- 7.6 Diabetes -- 7.7 Chronic Kidney Disease (CKD) -- 7.8 Respiratory Disease -- 7.9 Medication Review -- 7.10 Preventing Complications: Thromboembolic Events -- 7.11 Antibiotic Prophylaxis -- 7.12 Appropriate Ceilings of Care -- 7.13 Conclusion -- References -- 8: Orthogeriatric Anaesthesia -- 8.1 Introduction -- 8.2 The Relationship Between Anaesthetist and Orthogeriatrician -- 8.3 Preoperative Care -- 8.3.1 Preoperative Analgesia -- 8.3.2 Preoperative Preparation -- 8.3.3 Ethical and Legal Considerations -- 8.4 Intraoperative Care -- 8.4.1 General or Spinal Anaesthesia? -- 8.4.2 Peripheral Nerve Block -- 8.4.3 Spinal Anaesthesia -- 8.4.4 Sedation -- 8.4.5 General Anaesthesia -- 8.4.6 Avoiding Ischaemia -- 8.4.7 Bone Cement Implantation Syndrome (BCIS) -- 8.4.8 Standardisation of Anaesthesia -- 8.5 Postoperative Care -- References -- 9: Hip Fracture: The Choice of Surgery -- 9.1 Aim of Surgery -- 9.2 Fracture Types -- 9.2.1 Intra-capsular Fracture Types -- 9.2.2 Extra-capsular Fracture Types -- 9.3 Implants -- 9.4 Surgical Management -- 9.4.1 Intra-capsular Operations -- 9.4.2 Extra-capsular Operations -- 9.5 Surgical Algorithms and National Guidelines -- References -- 10: Proximal Humeral Fractures: The Choice of Treatment -- 10.1 Aim of Treatment -- 10.2 Evidence and Literature -- 10.3 Epidemiology -- 10.4 Fracture Classification -- 10.4.1 Minimally Displaced Fractures -- 10.4.2 Displaced Fractures -- 10.5 Treatment -- 10.5.1 Non-surgical Treatment -- 10.5.2 Surgical Management -- 10.6 Complications -- 10.7 Outcome Assessment -- 10.8 Conclusions -- References -- 11: Post-operative Management -- 11.1 Multidisciplinary Management -- 11.2 Predicting the Risk of Post-operative Complications -- 11.3 Early Mobilisation.

001894703

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(Au-PeEL)EBL6313878

(MiAaPQ)EBC6313878

(OCoLC)1203574059