Journal of the American Geriatrics Society
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Multicenter Study
Physicians' views on the importance of patient preferences in surrogate decision-making.
To explore the degree to which physicians report reliance on patient preferences when making medical decisions for hospitalized patients lacking decisional capacity. ⋯ Although a majority of physicians identified patient preferences as the most important general ethical guideline for surrogate decision-making, they relied on a variety of factors when making treatment decisions for a patient lacking decisional capacity.
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Multicenter Study
Poor functional status is an independent predictor of surgical site infections due to methicillin-resistant Staphylococcus aureus in older adults.
Methicillin-resistant Staphylococcus aureus (MRSA) has become a common surgical site infection (SSI) pathogen, particularly in older adults. Risk factors for MRSA SSI in elderly patients have not been described. ⋯ Poor functional status (requiring assistance in >or=3 ADLs) was specifically associated with MRSA SSI. Functional status is an objective, readily available variable that can be used to stratify patients at risk for MRSA SSI.
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Randomized Controlled Trial Multicenter Study
Pragmatic, cluster randomized trial of a policy to introduce low-low beds to hospital wards for the prevention of falls and fall injuries.
To evaluate the efficacy of a policy to introduce low-low beds for the prevention of falls and fall injuries on wards that had not previously accessed low-low beds. ⋯ A policy for the introduction of low-low beds did not appear to reduce falls or falls with injury, although larger studies would be required to determine their effect on fall-related fractures.
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To describe the seriously injured adult population aged 65 and older; compare the differences in injury characteristics and outcomes in three subgroups aged 65 to 74, 75 to 84, and 85 and older; and identify predictors of death, complications, and hospital discharge destination. ⋯ Older adults with severe injuries are at risk of poor outcomes. These findings suggest opportunities for improving geriatric trauma care that could lead to better outcomes.
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Comparative Study
Diagnostic value of procalcitonin for bacterial infection in elderly patients in the emergency department.
To evaluate the diagnostic performance of procalcitonin (PCT) in elderly patients with bacterial infection in the emergency department (ED). ⋯ PCT is sensitive for diagnosing bacteremia in elderly patients with SIRS at ED admission but is helpful in excluding bacteremia only in those aged 75 and older. PCT is not an independent predictor of local infections in these patients.