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Erschienen in: Wiener Medizinische Wochenschrift 19-20/2013

01.10.2013 | main topic

Treatment and prevention of postoperative complications in hip fracture patients: infections and delirium

verfasst von: Prim. Dr. Peter Dovjak, MD, Prim. Univ.-Prof. Dr. Bernhard Iglseder, Univ.-Doz. Dr. Peter Mikosch, Mag. Dr. Markus Gosch, Prim. Univ.-Prof. Dr. Ernst Müller, Prim. Dr. Georg Pinter, MD, Prim. Dr. Katharina Pils, MD, Dr. Inge Gerstofer, MD, Dr. Heinrich Thaler, MD, Michaela Zmaritz, Dr. Dr. Mag. Monique Weissenberger-Leduc, Dr. Walter Müller, MD

Erschienen in: Wiener Medizinische Wochenschrift | Ausgabe 19-20/2013

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Summary

The course of older patients with hip fractures is often complicated by infections and delirium. Accurate care and high suspicion for these complications are essential, since these conditions are associated with an increase in mortality, length of hospital stay and nursing home placement, poorer mobility, and functional decline. Because of immunosenescence and higher infection rates, older patients need specific care, immediate diagnosis, and treatment of infections. Numerous guidelines of various medical societies outline the management of nosocomial infections, but there is a need of an individualized treatment plan because of comorbidities and polypharmacy. Hygiene measures have first priority to reduce the rate of infections. Treatment of geriatric syndromes like malnutrition, exsiccosis, gait disorders, falls, delirium, urine incontinence, and organ insufficiency are as important as immunization against pneumococci and influenza. Advanced age, cognitive impairment, hearing loss, peripheral vascular disease, prior delirium episodes, sight disorders, and polypharmacy are established risk factors for delirium; thus, older people with several chronic diseases are prone to delirium. A multifactorial approach, comprising standardized screening, oxygen support, intravenous fluid administration and augmented nutrition, monitoring of vital signs, pain treatment, optimized medication, and modification in perioperative management, significantly reduces delirium incidence during hospitalization for hip fracture. An interdisciplinary approach between surgeons and geriatricians may warrant optimized satisfaction of patients’ needs.
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Metadaten
Titel
Treatment and prevention of postoperative complications in hip fracture patients: infections and delirium
verfasst von
Prim. Dr. Peter Dovjak, MD
Prim. Univ.-Prof. Dr. Bernhard Iglseder
Univ.-Doz. Dr. Peter Mikosch
Mag. Dr. Markus Gosch
Prim. Univ.-Prof. Dr. Ernst Müller
Prim. Dr. Georg Pinter, MD
Prim. Dr. Katharina Pils, MD
Dr. Inge Gerstofer, MD
Dr. Heinrich Thaler, MD
Michaela Zmaritz
Dr. Dr. Mag. Monique Weissenberger-Leduc
Dr. Walter Müller, MD
Publikationsdatum
01.10.2013
Verlag
Springer Vienna
Erschienen in
Wiener Medizinische Wochenschrift / Ausgabe 19-20/2013
Print ISSN: 0043-5341
Elektronische ISSN: 1563-258X
DOI
https://doi.org/10.1007/s10354-013-0228-y

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