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Postoperative Complications

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Fractures in the Elderly

Part of the book series: Aging Medicine ((AGME))

Abstract

Not long ago, old patients were frequently denied surgical intervention exclusively based on their age. However, as perioperative management improved significantly over the past decades, many elderly patients with multiple comorbidities have undergone surgical procedures, requiring specialized perioperative care. Contrary to the conventional thought that major complications or death occurs intraoperatively, most adverse events arise postoperatively, particularly within the first 24 h, and morbidity and mortality rates are twice as high compared to the intraoperative period. In this chapter, we will discuss several common postoperative complications that present in the elderly.

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References

  1. McLaughlin M, et al. Preoperative status and risk of complications in patients with hip fractures. J Gen Intern Med. 2006;21:219–25.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Siddiqui AK, Ahmed S, Delbeau H, Conner D, Maffana J. Lack of physician concordance with guidelines on the perioperative use of beta-blockers. Arch Intern Med. 2004;164(6):664–7.

    Article  PubMed  Google Scholar 

  3. Wijeysundera DN, Duncan D, Nkonde-Price C, Virani SS, Washam JB, Fleischmann KE, Fleisher LA. Perioperative beta blockade in noncardiac surgery: a systematic review for the 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. J Am Coll Cardiol. 2014;64(22):2406–25.

    Article  PubMed  Google Scholar 

  4. Hernandez AF, Whellan DJ, Stroud S, Sun JL, O’Connor CM, Jollis JG. Outcomes in heart failure patients after major noncardiac surgery. J Am Coll Cardiol. 2004;44(7):1446–53.

    Article  PubMed  Google Scholar 

  5. Dunlop WE, Rosenblood L, Lawrason L, Birdsall L, Rusnak CH. Effects of age and severity of illness on outcome and length of stay in geriatric surgical patients. Am J Surg. 1993;165(5):577–80.

    Article  CAS  PubMed  Google Scholar 

  6. Shah MR, Hasselblad V, et al. Impact of the pulmonary artery catheter in critically ill patients: meta-analysis of randomized clinical trials. JAMA. 2005;294:1664–70.

    Article  CAS  PubMed  Google Scholar 

  7. Binanay C, Califf RM, Hasselblad V, et al. ESCAPE investigators and ESCAPE study coordinators. Evaluation study of congestive heart failure and pulmonary artery catheterization effectiveness: the ESCAPE trial. JAMA. 2005;294:1625–33.

    Article  PubMed  Google Scholar 

  8. Shah MR, O’Connor CM, Sopko G, et al. Evaluation study of congestive heart failure and pulmonary artery catheterization effectiveness (ESCAPE): design and rationale. Am Heart J. 2001;141:528–35.

    Article  CAS  PubMed  Google Scholar 

  9. Mangano DT. Perioperative cardiac morbidity. Anesthesiology. 1990;72:153–84.

    Article  CAS  PubMed  Google Scholar 

  10. Souders J, Rooke A. Perioperative care for geriatric patients. Ann Longterm Care. 2005;13:17–29.

    Google Scholar 

  11. Goldman L. Cardiac risks and complications of noncardiac surgery. Ann Intern Med. 1983;98:513–4.

    Article  Google Scholar 

  12. Pedersen T, Eliasen K, Henriksen EA. Prospective study of risk factors and cardiopulmonary complications associated with anaesthesia and surgery: risk indicators of cardiopulmonary morbidity. Acta Anaesthesiol Scand. 1990;34:144–55.

    Article  CAS  PubMed  Google Scholar 

  13. Polanczyk CA, Goldman L, Marcantonio ER, Orav EJ, Lee TH. Supraventricular arrhythmia in patients having noncardiac surgery: clinical correlates and effect on length of stay. Ann Intern Med. 1998;129:279–85.

    Article  CAS  PubMed  Google Scholar 

  14. Khoo CW, Lip GY. Acute management of atrial fibrillation. Chest. 2009;135(3):849–59.

    Article  CAS  PubMed  Google Scholar 

  15. Naccarelli GV, Wolbrette DL, Khan M, Bhatta L, Hynes J, Samii S, Luck J. Old and new antiarrhythmic drugs for converting and maintaining sinus rhythm in atrial fibrillation: comparative efficacy and results of trials. Am J Cardiol. 2003;91(6A):15D–26D.

    Article  CAS  PubMed  Google Scholar 

  16. Guralnik JM, Eisenstaedt RS, Ferrucci L, Klein HG, Woodman RC. Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia. Blood. 2004;104(8):2263–8.

    Article  CAS  PubMed  Google Scholar 

  17. Haljamae H, Stefansson T, Wickstrom I. Preanesthetic evaluation of the female geriatric patient with hip fracture. Acta Anaesthesiol Scand. 1982;26:393–402.

    Article  CAS  PubMed  Google Scholar 

  18. Gruson KI, Aharonoff GB, Egol KA, et al. The relationship between admission hemoglobin level and outcome after hip fracture. J Orthop Trauma. 2002;16:39–44.

    Article  PubMed  Google Scholar 

  19. Kulier A, Gombotz H. Perioperative anemia. Anaesthesist. 2001;50(2):73–86.

    Article  CAS  PubMed  Google Scholar 

  20. WC W, et al. Preoperative hematocrit levels and postoperative outcomes in older patients undergoing noncardiac surgery. JAMA. 2007;297(22):2481–8.

    Article  Google Scholar 

  21. Carson JL, et al. Liberal or restrictive transfusion in high-risk patients after hip surgery. N Engl J Med. 2011;365(26):2453–62.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Brunskill SJ, Millette SL, Shokoohi A, Pulford EC, Doree C, Murphy MF, Stanworth S. Red blood cell transfusion for people undergoing hip fracture surgery. Cochrane Database Syst Rev. 2015;4:CD009699.

    Google Scholar 

  23. Gregersen M, Borris LC, Damsgaard EM. Postoperative blood transfusion strategy in frail, anemic elderly patients with hip fracture: the TRIFE randomized controlled trial. Acta Orthop. 2015;86(3):363–72.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Gregersen M, Borris LC, Damsgaard EM. Blood transfusion and overall quality of Life after hip fracture in frail elderly patients-the transfusion requirements in frail elderly randomized controlled trial. J Am Med Dir Assoc. 2015;16(9):762–6.

    Article  PubMed  Google Scholar 

  25. Munoz M, et al. Role of parenteral iron in transfusion requirements after total hip replace ment. A pilot study. Transfus Med. 2006;16(2):137–42.

    Article  CAS  PubMed  Google Scholar 

  26. Garcia-Erce JA, et al. Perioperative stimulation of erythropoiesis with intravenous iron and erythropoietin reduces transfusion requirements in patients with hip fracture. A prospective observational study. Vox Sang. 2005;88(4):235–43.

    Article  CAS  PubMed  Google Scholar 

  27. Cuenca J, et al. Perioperative intravenous iron, with or without erythropoietin, plus restrictive transfusion protocol reduce the need for allogeneic blood after knee replacement surgery. Transfusion. 2006;46(7):1112–9.

    Article  CAS  PubMed  Google Scholar 

  28. Goodnough LT, Monk TG, Sicard G, et al. Intraoperative salvage in patients undergoing elective abdominal aortic aneurysm repair: an analysis of cost and benefit. J Vasc Surg. 1996;24(2):213–8.

    Article  CAS  PubMed  Google Scholar 

  29. Monk TG, Goodnough LT, Brecher ME, et al. A prospective randomized comparison of three blood conservation strategies for radical prostatectomy. Anesthesiology. 1999;91(1):24–33.

    Article  CAS  PubMed  Google Scholar 

  30. Bryson GL, Laupacis A, Wells GA. Does acute normovolemic hemodilution reduce perioperative allogeneic transfusion? A meta-analysis. The international study of perioperative transfusion. Anesth Analg. 1998;86(1):9–15.

    CAS  PubMed  Google Scholar 

  31. Monk TG, Goodnough LT. Acute normovolemic hemodilution. Clin Orthop Relat Res. 1998;357:74–81.

    Article  Google Scholar 

  32. Oldenberg M, Muller RT. The frequency, prognosis and significance of nerve injuries in total hip arthroplasty. Int Orthop. 1997;21(1):1–3.

    Article  Google Scholar 

  33. Farrell CM, Springer BD, et al. Motor nerve palsy following primary total hip arthroplasty. J Bone Joint Surg Am. 2005;87(12):2619–25.

    Article  PubMed  Google Scholar 

  34. Fleming RE, Michelsen CB, Stinchfield FE. Sciatic paralysis. A complication of bleeding following hip surgery. J Bone Joint Surg Am. 1979;61:37–9.

    Article  PubMed  Google Scholar 

  35. Centers for Disease Control and Prevention. Fatalities and injuries from fall among older adults – United States, 1993–2003 and 2001–2005. MMWR Morb Mortal Wkly Rep. 2006;55:1221–4.

    Google Scholar 

  36. Kannus P, Sievanen H, Palvanen M, et al. Prevention of falls and consequent injuries in elderly people. Lancet. 2005;366:1885–93.

    Article  PubMed  Google Scholar 

  37. Nyberg L, Gustafson Y, Berggren D, Brannstrom B, Bucht G. Falls leading to femoral neck fractures in lucid older people. Incidence of falls in three different types of geriatric care. A Swedish prospective study. J Am Geriatr Soc. 1996;44:156–60.

    Article  CAS  PubMed  Google Scholar 

  38. Nyberg L, Gustafson Y, Janson A, Sandman PO, Eriksson S. Incidence of falls in three different types. Scand J Soc Med. 1997;25(1):8–13.

    Article  CAS  PubMed  Google Scholar 

  39. Pils K, Neumann F, Meisner W, Schano W, Vavrovsky G, Van der Cammen TJ. Predictors of falls in elderly people during rehabilitation after hip fracture – who is at risk of a second one? Z Gerontol Geriatr. 2003;36(1):16–22.

    Article  CAS  PubMed  Google Scholar 

  40. Tinetti ME. Preventing falls in elderly persons. N Engl J Med. 2003;348:42–9.

    Article  PubMed  Google Scholar 

  41. Grey-Micelli D, Capezuti E, Zwicker D, Mezey M, Fulmer T, editors. Preventing falls in acute care: evidence-based geriatric nursing protocols for best practice. 3rd ed. New York: Springer Publishing Company; 2008. p. 161–98.

    Google Scholar 

  42. Stevens M, Holman CD, Bennett N. Preventing falls in older people: impact of an intervention to reduce environmental hazards in home. J Am Geriatr Soc. 2001;49:1442–8.

    Article  CAS  PubMed  Google Scholar 

  43. Capezuti E, Maislin G, Strumpf N, Evans LK. Side rail use and bed-related fall outcome among nursing home residents. J Am Geriatr Soc. 2002;50:90–6.

    Article  PubMed  Google Scholar 

  44. Leigzig RM, Cumming RG, Tinetti ME. Drugs and falls in older people: a systematic review and meta-analysis: I. Psychotropic drugs. J Am Geriatr Soc. 1999;47:30–5.

    Article  Google Scholar 

  45. Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988;319:1701–7.

    Article  CAS  PubMed  Google Scholar 

  46. Haines TP, Bennell KL, Osborne RH, Hill KD. Effectiveness of targeted falls prevention programmes in a subacute setting. A randomised controlled trial. BMJ. 2004;328:676–9.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Healey F, Monro A, Cockram A, et al. Using targeted risk factor reduction to prevent falls in older hospital inpatients. A randomised controlled trial. Age Ageing. 2004;33:390–5.

    Article  PubMed  Google Scholar 

  48. Reuben DB, Borok GM, Wolde-Tsadik G, et al. A randomized trial of comprehensive geriatric assessment in the care of hospitalized patients. NEJM. 1995;332(20):1345–50.

    Article  CAS  PubMed  Google Scholar 

  49. Berggren M, Stenvall M, Olofsson B, Gustafson Y. Evaluation of a fall-prevention program in older people after femoral neck fracture: a one-year follow-up. Osteoporos Int. 2008;19(6):801–9.

    Article  CAS  PubMed  Google Scholar 

  50. Tinetti ME. Multifactorial fall-prevention strategies: time to retreat or advance. J Am Geriatr Soc. 2008;56:1563–70.

    Article  PubMed  Google Scholar 

  51. Chang JT, Ganz DA. Quality indicators for fall and mobility problems in vulnerable elders. J Am Geriatr Soc. 2007;55(Suppl 2):S327–34.

    Article  PubMed  Google Scholar 

  52. Naqvi F, Lee S, Fields S. An evidence-based review of the NICHE guideline for preventing falls in older adults in an acute setting. Geriatrics. 2009;64:10–26.

    PubMed  Google Scholar 

  53. American Geriatrics Society Workgroup on Vitamin D Supplementation for Older Adults. Recommendations abstracted from the American Geriatrics Society consensus statement on vitamin D for prevention of falls and their consequences. J Am Geriatr Soc. 2014;62(1):147–52.

    Article  Google Scholar 

  54. Gordon M. Restoring functional independence in the older hip fracture patient. Geriatrics. 1989;44(12):48–53. see also pp 56, 59.

    CAS  PubMed  Google Scholar 

  55. Tolouian R, Alhamad T, Farazmand M, Mulla ZD. The correlation of hip fracture and hyponatremia in the elderly. J Nephrol. 2012;25(5):789–93.

    Article  PubMed  Google Scholar 

  56. Gankam Kengne F, Andres C, Sattar L, Melot C, Decaux G. Mild hyponatremia and risk of fracture in the ambulatory elderly. QJM. 2008;101(7):583–8.

    Article  CAS  PubMed  Google Scholar 

  57. Leung AA, McAlister FA, Rogers SO Jr, Pazo V, Wright A, Bates DW. Preoperative hyponatremia and perioperative complications. Arch Intern Med. 2012;172(19):1474–81.

    Article  PubMed  Google Scholar 

  58. Cumming K, Hoyle GE, Hutchison JD, Soiza RL. Prevalence, incidence and etiology of hyponatremia in elderly patients with fragility fractures. PLoS One. 2014;9(2):e88272.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  59. Tinning CG, Cochrane LA, Singer BR. Analysis of hyponatraemia associated post-operative mortality in 3897 hip fracture patients. Injury. 2015;46(7):1328–32.

    Article  PubMed  Google Scholar 

  60. Rudge JE, Kim D. New-onset hyponatraemia after surgery for traumatic hip fracture. Age Ageing. 2014;43(6):821–6.

    Article  PubMed  Google Scholar 

  61. Tambe AA, Hill R, Livesley PJ. Post-operative hyponatraemia in orthopaedic injury. Injury. 2003;34(4):253–5.

    Article  CAS  PubMed  Google Scholar 

  62. Sah AP. Hyponatremia after primary hip and knee arthroplasty: incidence and associated risk factors. Am J Orthop (Belle Mead NJ). 2014;43(4):E69–73.

    Google Scholar 

  63. Luckey AE, Parsa CH. Fluid and electrolytes in the elderly. Arch Surg. 2003;138(10):1055–60.

    Article  PubMed  Google Scholar 

  64. Hirshberg B, Ben-Yehuda A. The syndrome of inappropriate antidiuretic hormone secretion in the elderly. Am J Med. 1997;103:270–3.

    Article  CAS  PubMed  Google Scholar 

  65. Laczi F. Etiology, diagnostics and therapy of hyponatremias. Orv Hetil. 2008;149(29):1347–54.

    Article  PubMed  Google Scholar 

  66. Snyder NA, Feigal DW, Arieff AI. Hypernatremia in elderly patients: a heterogeneous, morbid, and iatrogenic entity. Ann Intern Med. 1987;107:309–19.

    Article  CAS  PubMed  Google Scholar 

  67. Leung AA, McAlister FA, Finlayson SR, Bates DW. Preoperative hypernatremia predicts increased perioperative morbidity and mortality. Am J Med. 2013;126(10):877–86.

    Article  CAS  PubMed  Google Scholar 

  68. Mc Causland FR, Wright J, Waikar SS. Association of serum sodium with morbidity and mortality in hospitalized patients undergoing major orthopedic surgery. J Hosp Med. 2014;9(5):297–302.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Chassagne P, Druesne L, Capet C, et al. Clinical presentation of hypernatremia in elderly patients: a case control study. J Am Geriatr Soc. 2006;54(8):1225–30.

    Article  PubMed  Google Scholar 

  70. Wallace RB, Wactawski-Wende J, O'Sullivan MJ, et al. Urinary tract stone occurrence in the Women’s Health Initiative (WHI) randomized clinical trial of calcium and vitamin D supplements. Am J Clin Nutr. 2011;94(1):270–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  71. Bolland MJ, Avenell A, Baron JA, et al. Effect of calcium supplements on risk of myocardial infarction, cardiovascular events: meta-analysis. BMJ. 2010;341:c3691.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  72. Bolland MJ, Grey A, Avenell A, Gamble GD, Reid IR. Calcium supplements with or without vitamin D and risk of cardiovascular events: reanalysis of the Women’s Health Initiative limited access dataset and meta-analysis. BMJ. 2011;342:d2040.

    Article  PubMed  PubMed Central  Google Scholar 

  73. Portale AA, Lonergan ET, Tanney DM, Halloran BP. Aging alters calcium regulation of serum concentration of parathyroid hormone in healthy men. Am J Phys. 1997;272:E139–46.

    CAS  Google Scholar 

  74. Garcia Lazaro M, Montero Perez-Barquero M, Carpintero BP. The role of malnutri-tion and other medical factors in the evolution of patients with hip fracture. An Med Interna. 2004;21(11):557–63.

    CAS  PubMed  Google Scholar 

  75. Lichtblau S. Treatment of hip fractures in the elderly – the decision process. Mt Sinai J Med. 2002;69(4):250–60.

    PubMed  Google Scholar 

  76. Huddleston JM, Whitford KJ. Medical care of elderly patients with hip fractures. Mayo Clin Proc. 2001;76(3):295–8.

    Article  CAS  PubMed  Google Scholar 

  77. Lavernia CJ, Sierra RJ, Baerga L. Nutritional parameters and short term outcome in arthro-plasty. J Am Coll Nutr. 1999;18(3):274–8.

    Article  CAS  PubMed  Google Scholar 

  78. Koval KJ, Maurer SG, ET S, et al. The effects of nutritional status on outcome after hip fracture. J Orthop Trauma. 1999;13(3):164–9.

    Article  CAS  PubMed  Google Scholar 

  79. Bastow MD, Rawlings J, Allison SP. Benefits of supplementary tube feeding after fractured neck of femur: a randomised controlled trial. BMJ. 1983;287:1589–92.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  80. Hartgrink HH, Wille J, Konig P, Hermans J, Breslau PJ. Pressure sores and tube feeding in patients with a fracture of the hip: a randomized clinical trial. Clin Nutr. 1998;17:287–92.

    Article  CAS  PubMed  Google Scholar 

  81. Sullivan DH, Nelson CL, Bopp MM, Puskarich-May CL, Walls RC. Nightly enteral nutrition support of elderly hip fracture patients: a phase I trial. J Am Coll Nutr. 1998;17:155–61.

    Article  CAS  PubMed  Google Scholar 

  82. Tidermark J, Ponzer S, Carlsson P, et al. Effects of protein-rich supplementation and nandrolone in lean elderly women with femoral neck fractures. Clin Nutr. 2004;23(4):587–96.

    Article  CAS  PubMed  Google Scholar 

  83. Avenell A, Handoll HH. Nutritional supplementation for hip fracture aftercare in older people. Cochrane Database Syst Rev. 2006;4:CD001880.

    Google Scholar 

  84. Kaye KS, Anderson DJ, Sloane R, Chen LF, Choi Y, Link K, Sexton DJ, et al. The effect of surgical site infection on older operative patients. J Am Geriatr Soc. 2009;57:46–54.

    Article  PubMed  PubMed Central  Google Scholar 

  85. Southwell-Keely JP, Russo RR, March L, Cumming R, Cameron I, Brnabic AJ. Antibiotic prophylaxis in hip fracture surgery: a metaanalysis. Clin Orthop. 2004;419:179–84.

    Article  Google Scholar 

  86. Gillespie WJ, Walenkamp G. Antibiotic prophylaxis for surgery for proximal femoral and other closed long bone fractures. Cochrane Database Syst Rev. 2001;1:CD000244.

    Google Scholar 

  87. Bratzler DW, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health Syst Pharm. 2013;70(3):195–283.

    Article  CAS  PubMed  Google Scholar 

  88. Arozullah AM, Khuri SF, Henderson WG, et al. Development and validation of a multifactorial risk index for predicting postoperative pneumonia after major noncardiac surgery. Ann Intern Med. 2001;135(10):847–57.

    Article  CAS  PubMed  Google Scholar 

  89. Montravers P, Veber B, Auboyer C, Dupont H, Gauzit R, Korinek AM, Malledant Y, Martin C, Moine P, Pourriat JL. Diagnostic and therapeutic management of nosocomial pneumonia in surgical patients: results of the Eole study. Crit Care Med. 2002;30(2):368.

    Article  PubMed  Google Scholar 

  90. Skelly JM, Guyatt GH, Kalbfleisch R, Singer J, Winter L. Management of urinary retention after surgical repair of hip fracture. Can Med Assoc J. 1992;146:1185–9.

    CAS  Google Scholar 

  91. Sigel A, Schrott KM. Disturbances of micturition after general surgical operations. Langenbecks Arch Chir. 1977;345:563–4.

    Article  CAS  PubMed  Google Scholar 

  92. Johansson I, Athlin E, Frykholm L, Bolinder H, Larsson G. Intermittent versus indwelling catheters for older patients with hip fractures. J Clin Nurs. 2002;11:651–6.

    Article  PubMed  Google Scholar 

  93. Smith NK, Albazzaz MKA. Prospective study of urinary retention and risk of death after proximal femoral fracture. Age Ageing. 1996;25:150–4.

    Article  CAS  PubMed  Google Scholar 

  94. Schaeffer AJ. Catheter-associated bacteriuria. Urol Clin North Am. 1986;13(4):735–47.

    CAS  PubMed  Google Scholar 

  95. Sedor J, Mulholland SG. Hospital-acquired urinary tract infections associated with the indwelling catheter. Urol Clin North Am. 1999;26(4):821–8.

    Article  CAS  PubMed  Google Scholar 

  96. Nicolle LE. Asymptomatic bacteriuria: when to screen and when to treat. Infect Dis Clin N Am. 2003;17:367–94.

    Article  Google Scholar 

  97. Stamm WE. Guidelines for prevention of catheter-associated urinary tract infections. Ann Intern Med. 1975;82(3):386–90.

    Article  CAS  PubMed  Google Scholar 

  98. Morrison RS, Chassin MR, Siu AL. The medical consultant’s role in caring for patients with hip fracture. Ann Intern Med. 1998;128:1010–20.

    Article  CAS  PubMed  Google Scholar 

  99. NEW. Prevention and treatment of pressure ulcers: clinical practice guideline. 2014. http://www.npuap.org/resources/educational-and-clinical-resources/prevention-and-treatment-of-pressure-ulcers-clinical-practice-guideline. Last accessed on Sept 10 2015.

  100. Allman RM, Goode PS, Burst N, Bartolucci AA, Thomas DR. Pressure ulcers, hospital complications, and disease severity: impact on hospital costs and length of stay. Adv Wound Care. 1999;12:22–30.

    CAS  PubMed  Google Scholar 

  101. Baumgarten M, Margolis D, Berlin JA, et al. Risk factors for pressure ulcers among elderly hip fracture patients. Wound Repair Regen. 2003;11:96–103.

    Article  PubMed  Google Scholar 

  102. Abrussezze RS. Early assessment and prevention of pressure ulcers. In: Lee BY, editor. Chronic ulcers of the skin. New York: McGraw-Hill; 1985. p. 1–9.

    Google Scholar 

  103. Allman RM. Pressure ulcers among the elderly. N Engl J Med. 1989;320(13):850–3.

    Article  CAS  PubMed  Google Scholar 

  104. Fuhrer MJ, Garber SL, Rintala DH, et al. Pressure ulcers in community-resident persons with spinal cord injury: prevalence and risk factors. Arch Phys Med Rehabil. 1993;74(11):1172–7.

    CAS  PubMed  Google Scholar 

  105. Garber SL, Campion LJ, Krouskop TA. Trochanteric pressure in spinal cord injury. Arch Phys Med Rehabil. 1982;63(11):549–52.

    CAS  PubMed  Google Scholar 

  106. Reuler JB, Cooney TG. The pressure sore: pathophysiology and principles of management. Ann Intern Med. 1981;94(5):661–6.

    Article  CAS  PubMed  Google Scholar 

  107. Barbenel JC, Ferguson-Pell MW, Kennedy R. Mobility of elderly patients in bed. Measurement and association with patient condition. J Am Geriatr Soc. 1986;34(9):633–6.

    Article  CAS  PubMed  Google Scholar 

  108. Lowthian PT. Underpadsin the prevention of decubiti. In: Kenedi RM, Cowden JM, Scales JT, editors. Bedsore biomechanics. Baltimore: University Park Press; 1976. p. 141.

    Google Scholar 

  109. Berlowitz DR, Wilking SV. Risk factors for pressure sores. A comparison of cross-sectional and cohort-derived data. J Am Geriatr Soc. 1989;37(11):1043–50.

    Article  CAS  PubMed  Google Scholar 

  110. Bliss M, Simini B. When are the seeds of postoperative pressure sores sown? Often during surgery. BMJ. 1999;319:863.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  111. Inouye SK, Studenski S, Tinetti ME, Kuchel GA. Geriatric syndromes: clinical, research, and policy implications of a core geriatric concept. J Am Geriatr Soc. 2007;55(5):780–91.

    Article  PubMed  PubMed Central  Google Scholar 

  112. Haleem S, Heinert G, Paker MJ. Pressure sores and hip fractures. Injury. 2008;39(2):219–23.

    Article  CAS  PubMed  Google Scholar 

  113. Nuffield Institute of Health, University of Leeds, NHS Centre for Review and Dissemination. How effective are pressure relieving interventions for the prevention and treatment of pressure sores? Effective Health Care Bull. 1995;2:1–15.

    Google Scholar 

  114. Peromet M, Labbe M, Yourassowsky E, et al. Anaerobic bacteria isolated from decubitus ulcers. Infection. 1973;1(4):205–7.

    Article  CAS  PubMed  Google Scholar 

  115. Livesley NJ, Chow AW. Infected pressure ulcers in elderly individuals. Clin Infect Dis. 2002;35(11):1390–6.

    Article  PubMed  Google Scholar 

  116. Brown NK, Thompson DJ. Nontreatment of fever in extended-care facilities. N Engl J Med. 1979;300(22):1246–50.

    Article  CAS  PubMed  Google Scholar 

  117. Agency for Health Care Policy and Research (AHCPR). Treatment of pressure ulcers. Rockville: US Department of Health and Human Services, Public Health Service, Clinical Practice Guideline Number 15. AHCPR Publication No. 95–0652; 1994.

    Google Scholar 

  118. Pompei P, Murphy JB, editors. Geriatric review syllabus: a core curriculum in geriatric medicine. 6th ed. New York: American Geriatric Society; 2006.

    Google Scholar 

  119. Mumcuoglu KY. Clinical applications for maggots in wound care. Am J Clin Dermatol. 2001;4:219–27.

    Article  Google Scholar 

  120. Bergstrom N, Bennett MA, Carlson CE, et al. Treatment of pressure ulcers. Clinical practice guideline no. 15. Rockville: US Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research; 1994. p. 47–9.

    Google Scholar 

  121. Lyder CH, Preston J, Grady JN, et al. Quality of care for hospitalized Medicare patients at risk for pressure ulcers. Arch Intern Med. 2001;161(12):1549–54.

    Article  CAS  PubMed  Google Scholar 

  122. Bergstrom N, Horn SD, Smout RJ, Bender SA, Ferguson ML, Taler G, Sauer AC, Sharkey SS, Voss AC. The national pressure ulcer long-term care study: outcomes of pressure ulcer treatments in long-term care. J Am Geriatr Soc. 2005;53(10):1721.

    Article  PubMed  Google Scholar 

  123. Marcantonio ER, Flacker JM, Wright RJ, et al. Reducing delirium after hip fracture: a randomized trial. J Am Geriatr Soc. 2001;49(5):516–22.

    Article  CAS  PubMed  Google Scholar 

  124. Todd CJ, Freeman CJ, Camilleri-Ferrante C, et al. Differences in mortality after fracture of hip: the east Anglian audit. BMJ. 1995;310:904–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  125. Anderson FA Jr, Wheeler HB, Goldberg RJ, et al. A population-based perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism. The Worcester DVT study. Arch Intern Med. 1991;151:933–8.

    Article  PubMed  Google Scholar 

  126. Guyatt GH, Akl EA, Crowther M, Gutterman DD, Schuünemann HJ. Executive summary: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2_suppl):7S–47S.

    Google Scholar 

  127. Moser K. Pulmonary thromboembolism. In: Wilson J, Harrison TR, et al., editors. Harrison’s principles of internal medicine, vol. 1. 12th ed. New York: McGraw-Hill; 1991. p. 1090.

    Google Scholar 

  128. Kniffin WD, Baron J, Barrett J, et al. The epidemiology of diagnosed pulmonary embolism and deep venous thrombosis in the elderly. Arch Intern Med. 1994;154:861–6.

    Article  PubMed  Google Scholar 

  129. Geerts WH, Heit JA, Clagett GP, et al. Prevention of venous thromboembolism. Chest. 2001;119:132S–1325S.

    Article  CAS  PubMed  Google Scholar 

  130. Morpurgo M, Schmid C, Mandelli V. Factors influencing the clinical diagnosis of pulmonary embolism: analysis of 229 postmortem cases. Int J Cardiol. 1998;65(Suppl I):S79–82.

    Article  PubMed  Google Scholar 

  131. Stein PD, Beemath A, Matta F, et al. Clinical characteristics of patients with acute pulmonary embolism: data from PIOPED II. Am J Med. 2007;120:871–9.

    Article  PubMed  PubMed Central  Google Scholar 

  132. Wells PS, Ginsberg JS, Anderson DR, et al. Use of a clinical model for safe management of patients with suspected pulmonary embolism. Ann Intern Med. 1998;129:997–1005.

    Article  CAS  PubMed  Google Scholar 

  133. Schouten HJ, Geersing GJ, Oudega R, van Delden JJ, Moons KG, Koek HL. Accuracy of the wells clinical prediction rule for pulmonary embolism in older ambulatory adults. J Am Geriatr Soc. 2014;62(11):2136–41.

    Article  PubMed  Google Scholar 

  134. The PIOPED Investigators. Value of the ventilation/perfusion scan in acute pulmonary embolism: results of the prospective investigation of pulmonary embolism diagnosis (PIOPED). JAMA. 1990;263(20):2753–9.

    Article  Google Scholar 

  135. Stein PD, Hull RD, Pineo GF. The role of newer diagnostic techniques in the diagnosis of pulmonary embolism. Curr Opin Pulm Med. 1999;5:212–5.

    Article  CAS  PubMed  Google Scholar 

  136. Lindeque B, Schoeman H, Dommisse G, Boeyens MC, Vlok AL. Fat embolism and the fat embolism syndrome. J Bone Joint Surg. 1987;69B:128–31.

    Article  Google Scholar 

  137. Rodger M, Markropoulos D, et al. Diagnostic value of the electrocardiogram in suspected pulmonary embolism. Am J Cardiol. 2000;86(7):807–9.

    Article  CAS  PubMed  Google Scholar 

  138. Moores LK, Jackson WL, Shorr AF, Jackson JL. Meta-analysis: outcomes in patients with suspected pulmonary embolism managed with computed tomographic pulmonary angiography. Ann Intern Med. 2007;141:866–74.

    Article  Google Scholar 

  139. Egermayer P, Town GI, Turner JG, et al. Usefulness of D-dimer, blood gas, and respiratory rate measurements for excluding pulmonary embolism. Thorax. 1998;53:830–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  140. Tapson VF, Carroll BA, Davidson BL, et al. American Thoracic Society. Clinical practice guideline: the diagnostic approach to acute venous thromboembolism. Am J Respir Crit Care Med. 1999;160:1043–66.

    Article  CAS  PubMed  Google Scholar 

  141. The Task Force on Pulmonary Embolism, European Society of Cardiology. Guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J. 2000;21:1301–36.

    Article  Google Scholar 

  142. Ginsberg JS, Wells PS, Kearon C, et al. Sensitivity and specificity of a rapid whole-blood assay for D-dimer in the diagnosis of pulmonary embolism. Ann Intern Med. 1998;129(12):1006–11.

    Article  CAS  PubMed  Google Scholar 

  143. EINSTEIN–PE Investigators, et al. Oral rivaroxaban for the treatment of symptomatic pulmonary embolism. N Engl J Med. 2012;366(14):1287–97.

    Article  Google Scholar 

  144. Agnelli G, Buller HR, Cohen A, et al. Oral apixaban for the treatment of acute venous thromboembolism. N Engl J Med. 2013;369(9):799–808.

    Article  CAS  PubMed  Google Scholar 

  145. Hokusai-VTE Investigators, Büller HR, Décousus H, et al. Edoxaban versus warfarin for the treatment of symptomatic venous thromboembolism. N Engl J Med. 2013;369(15):1406–15.

    Article  CAS  Google Scholar 

  146. American Geriatrics Society 2012 Beers Criteria Update Expert Panel. American Geriatrics Society updated beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2012;60(4):616–31.

    Article  Google Scholar 

  147. Kearon C, et al. Antithrombotic therapy for VTE disease: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):e419S.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  148. Mageral F, Tscherne H. Zur Diagnose, Therapie und proplylaxe der fettembolie. Langenbecks Arch Klin Chir. 1966;314:29.

    Google Scholar 

  149. Ganong RB. Fat emboli syndrome in isolated fractures of the tibia and femur. Clin Orthop. 1993;291:208–14.

    Google Scholar 

  150. Collins JA, Hudson TL, Hamacher WR, et al. Systemic fat embolism in four combat causalities. Ann Surg. 1968;167:493–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  151. Johnson MJ, Lucas GL. Fat embolism syndrome. Orthopedics. 1996;19:41.

    CAS  PubMed  Google Scholar 

  152. Fulde GW, Harrison P. Fat embolism – a review. Arch Emerg Med. 1991;8:233–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  153. Kaplan RP, Grant JN, Kaufman AJ. Dermatologic features of the fat embolism syndrome. Cutis. 1986;38:52–5.

    CAS  PubMed  Google Scholar 

  154. Gurd AR. Fat embolism: an aid to diagnosis. J Bone Joint Surg Br. 1970;52b:732–7.

    Article  Google Scholar 

  155. Van den Brande FGJ, Hellemans S, De Schepper A, et al. Post-traumatic severe fat embolism syndrome with uncommon CT findings. Anaesth Intensive Care. 2006;34:102–6.

    PubMed  Google Scholar 

  156. Riska EB, Van Bonsdorrf H, Hakkien S, Japonia O, Kilivoyo O, Papillainen T. Prevention of fat embolism by early fixation of fractures in patients with multiple injuries. Injury. 1976;8:110–6.

    Article  CAS  PubMed  Google Scholar 

  157. Schonfeld SA, Ploysongsang Y, DiLisio R, et al. Fat embolism prophylaxis with corticosteroids. Ann Intern Med. 1983;99:438–43.

    Article  CAS  PubMed  Google Scholar 

  158. Mellor A, Soni N. Fat embolism. Anaesthesia. 2001;56:145–54.

    Article  CAS  PubMed  Google Scholar 

  159. Bulger EM, Smith DG, Maier RV, Jurkovich GJ. Fat embolism syndrome. A 10-year review. Arch Surg. 1997;132(4):435–9.

    Article  CAS  PubMed  Google Scholar 

  160. Bitsch M, Foss N, Kristensen B, et al. Pathogenesis of and management strategies for post-operative delirium after hip fracture: a review. Acta Orthop Scand. 2004;75(4):378–89.

    Article  PubMed  Google Scholar 

  161. Bellelli G, Frisoni GB, Pagani M, et al. Does cognitive performance affect physical therapy regimen after hip fracture surgery? Aging Clin Exp Res. 2007;19(2):119–24.

    Article  PubMed  Google Scholar 

  162. Feil D, Marmon T, Unutzer J. Cognitive impairment, chronic medical illness, and risk of mortality in an elderly cohort. Am J Geriatr Psychiatry. 2003;11(5):551–60.

    Article  PubMed  Google Scholar 

  163. Kiely DK, Bergmann MA, Murphy KM, et al. Delirium among newly admitted post-acute facility patients: prevalence, symptoms, and severity. J Gerontol A Biol Sci Med Sci. 2003;58(5):M441–5.

    Article  PubMed  Google Scholar 

  164. Ely EW, Inouye SK, Bernard GR, et al. Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit. JAMA. 2001;286(21):2703–10.

    Article  CAS  PubMed  Google Scholar 

  165. Inouye SK, Van Dyck CH, Alessi CA, et al. Clarifying confusion: the confusion assessment method: a new method for detection of delirium. Ann Intern Med. 1990;113(12):941–8.

    Article  CAS  PubMed  Google Scholar 

  166. Trzepacz P, Breitbart W, Franklin J, et al. Practice guideline for the treatment of patients with delirium. American Psychiatric Association. Available at: http://www.psychiatryonline.com/pracGuide/pracGuideTopic_2.aspx

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Authors and Affiliations

  1. Department of Medicine, Section of Geriatrics, Baylor College of Medicine, Houston, TX, USA

    So-Dam Kim & Jung-Hoon Kim

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  1. So-Dam Kim
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  1. Chair, Geriatric Medicine and Gerontology, Robert and Arlene Kogod Professor of Geriatric Medicine, Department of Medicine, Mayo Clinic School of Medicine, Rochester, Minnesota, USA

    Robert J. Pignolo

  2. Co-Director, Orthopaedic Trauma & Fracture Reconstruction, Advisory Dean, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA

    Jaimo Ahn

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Kim, SD., Kim, JH. (2018). Postoperative Complications. In: Pignolo, R., Ahn, J. (eds) Fractures in the Elderly. Aging Medicine. Humana Press, Cham. https://doi.org/10.1007/978-3-319-72228-3_8

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