Injury
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Comparative Study
The effects of 'old' red blood cell transfusion on mortality and morbidity in elderly patients with hip fractures--a retrospective study.
Elderly patients admitted with hip fractures often receive allogenic blood transfusion (ABT) in the perioperative period. We examined the effect of the shelf life of the ABT on mortality and morbidity. ⋯ Patients undergoing surgery for hip fractures who received 'old' units of blood did not differ from those receiving 'new' units with regard to mortality and morbidity. Large-scale clinical trials are needed to further investigate this association.
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Biomechanical testing has been a cornerstone for the development of surgical implants used in fracture stabilisation. In a multi-disciplinary collaboration complex at the University of Wales, Swansea, novel computerised clinically relevant models were developed using advanced computational engineering. In-house software (developed initially for commercial aerospace engineering), allowed accurate finite element analysis (FEA) models of the whole femur to be created, including the internal architecture of the bone, by means of linear interpolation of greyscale images from multiaxial CT scans. ⋯ By meshing implants into these models and repeating the mechanism of injury in simulation, periprosthetic fractures were also recreated. Further development with simulated physiological activities (e.g. walking and rising from sitting) along with attrition in the bone (in the boundary zones where stress concentration occurs) will allow further known modes of failure in implants to be reproduced. Robust simulation of macro and micro-scale events will allow the testing of novel new designs in simulations far more complex than conventional biomechanical testing will allow.
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Dementia and fall-related hip fractures both contribute significantly to the burden of illness within elderly populations in Australia and elsewhere. The research presented here uses a large probabilistically linked dataset from NSW, Australia to estimate the prevalence of dementia within hip fracture patients and investigate the impact of dementia on hospitalisation length of stay (LOS) and survival. ⋯ The use of linked datasets with tens of thousands of cases enables the calculation of precise estimates of various parameters. People with dementia constitute a significant proportion of the total population of elderly hip fracture patients in hospitals (up to 29%). Their mortality rate is greater than those without a diagnosis of dementia and their hospital length of stay is shorter, particularly if they are discharged to a residential aged care facility.