Browsing by Author "Tomanović Vujadinović, Sanja (56029483100)"

Background: Depression is the most common mood disorder in elderly people and one of the most prevalent comorbidities in older people with hip fracture. While several authors have confirmed that depressive symptoms assessed at a later stage after hip fracture impact functional outcome and mortality, the role of depressive symptoms identified at an earlier stage after hip fracture remains understudied. The aim of the present study was to determine if depressive symptoms assessed on hospital admission impact early functional outcome after hip fracture surgery. Methods: We studied 112 patients who underwent surgery for hip fracture during a 6-month period. Depressive symptoms were assessed using the 30-item Geriatric Depression Scale on admission to the acute setting. Multidimensional assessment included sociodemographic characteristics, general health status, cognitive status, functional status prior to injury, and perioperative variables. The primary outcome measure was motor Functional Independence Measure at discharge. Results: Adjusted multivariate regression analysis revealed that the presence of moderate to severe depressive symptoms (Geriatric Depression Scale≥20), older age, and female gender were independently related to motor Functional Independence Measure at discharge. Conclusion: Increasing levels of depressive symptoms in elderly hip fracture patients influence short-term functional outcome. We strongly support the introduction of routine assessment of this baseline comorbidity, especially in female patients. Failure to identify such patients is a missed opportunity for possible improvement of early functional outcome after hip fracture in elderly. © 2014 Japanese Psychogeriatric Society.

Background: Depression is the most common mood disorder in elderly people and one of the most prevalent comorbidities in older people with hip fracture. While several authors have confirmed that depressive symptoms assessed at a later stage after hip fracture impact functional outcome and mortality, the role of depressive symptoms identified at an earlier stage after hip fracture remains understudied. The aim of the present study was to determine if depressive symptoms assessed on hospital admission impact early functional outcome after hip fracture surgery. Methods: We studied 112 patients who underwent surgery for hip fracture during a 6-month period. Depressive symptoms were assessed using the 30-item Geriatric Depression Scale on admission to the acute setting. Multidimensional assessment included sociodemographic characteristics, general health status, cognitive status, functional status prior to injury, and perioperative variables. The primary outcome measure was motor Functional Independence Measure at discharge. Results: Adjusted multivariate regression analysis revealed that the presence of moderate to severe depressive symptoms (Geriatric Depression Scale≥20), older age, and female gender were independently related to motor Functional Independence Measure at discharge. Conclusion: Increasing levels of depressive symptoms in elderly hip fracture patients influence short-term functional outcome. We strongly support the introduction of routine assessment of this baseline comorbidity, especially in female patients. Failure to identify such patients is a missed opportunity for possible improvement of early functional outcome after hip fracture in elderly. © 2014 Japanese Psychogeriatric Society.

Background: Hip fractures in the elderly are followed by increased mortality, which is highest in the period immediately after the fracture. Predictors for early mortality have neither been well identified nor summarized. Identification of early postoperative mortality predictors enables the stratification of high-risk patients and can help in the development of strategies aimed at reducing risk and improving outcome after hip fracture. The primary aim of this study was to investigate the incidence of 30-day mortality. The secondary aim was to investigate factors related to early mortality. Methods: We examined 384 elderly patients with hip fracture. Multivariate logistic regression analysis was used to explore independent prognostic factors for 30-day mortality. Results: By the end of the 30-day follow-up period, 22 patients (6.4%) had died. Postoperative delirium was the only variable independently related to 30-day mortality after hip fracture. Older, male patients with a lower cognitive status had a higher chance of developing postoperative delirium. Discussion: Postoperative delirium is a strong independent marker of high risk for 30-day mortality. Older, male patients with more severe cognitive impairment are at increased risk of developing postoperative delirium. Identifying patients at risk for developing postoperative delirium upon admission and early detection of delirium enable the development of targeted prevention and intervention strategies in older patients with hip fracture. Psychogeriatrics © 2014 Japanese Psychogeriatric Society.

Background: Hip fractures in the elderly are followed by increased mortality, which is highest in the period immediately after the fracture. Predictors for early mortality have neither been well identified nor summarized. Identification of early postoperative mortality predictors enables the stratification of high-risk patients and can help in the development of strategies aimed at reducing risk and improving outcome after hip fracture. The primary aim of this study was to investigate the incidence of 30-day mortality. The secondary aim was to investigate factors related to early mortality. Methods: We examined 384 elderly patients with hip fracture. Multivariate logistic regression analysis was used to explore independent prognostic factors for 30-day mortality. Results: By the end of the 30-day follow-up period, 22 patients (6.4%) had died. Postoperative delirium was the only variable independently related to 30-day mortality after hip fracture. Older, male patients with a lower cognitive status had a higher chance of developing postoperative delirium. Discussion: Postoperative delirium is a strong independent marker of high risk for 30-day mortality. Older, male patients with more severe cognitive impairment are at increased risk of developing postoperative delirium. Identifying patients at risk for developing postoperative delirium upon admission and early detection of delirium enable the development of targeted prevention and intervention strategies in older patients with hip fracture. Psychogeriatrics © 2014 Japanese Psychogeriatric Society.

Background/Aims: In this study we analyzed our experience of suprahilar-posterior intrahepatic Glissonian pedicle approach using an endo-GIA vascular stapling device for the pedicle and hepatic vein division. Methodology: Sixty-eight 68 major and 102 minor liver resections were performed. The hilar extrahepatic structures remain intact, and during parenchyma dissection by CUSA, the whole right or left or the appropriate segmental pedicle was isolated intrahepatically and then transected using a stapler device. Results: The minor liver resections was associated with significantly shorter surgery duration (95.1+31.1 vs. 186.6± 56.5) and transection time (35.9+14.5 vs. 65.3±17.2) than major hepatectomies (p<0.001 for all). The mean blood loss was 255.6+129.9 mL in minor resection and 385.7+200.1 mL in major resection (p = 0.003). The mean blood transfusion requirement was 300.8+99.5 mL for the patients with minor hepatectomy and 450.9+89.6 mL for those with major liver resection [p - 0.067). There was no significant difference in morbidity and mortality between the groups [p = 0.989; p = 0.920). Major as well as minor liver resection were a superior oncologic operation with no significant difference in the 3-year overall survival rates. Conclusions: Liver transection using CUSA with suprahilar endo-GIA stapling of Glisson's pedicle, as well as major hepatic veins represents an effective and safe surgical procedure. © H.G.E. Update Medical Publishing S.A.

This observational study aimed to identify predictors of kinesiophobia and examine its correlation with early functional outcomes in TKA recipients. On the first and fifth postoperative days (POD1 and POD5), we evaluated pain using the International Pain Outcomes Questionnaire (IPO-Q) and created multidimensional pain composite scores (PCSs). The Total Pain Composite Score (PCStotal) assesses the overall impact of pain, taking into account outcomes of pain intensity, pain-related interference with function, and emotions and side effects. Functional status on POD 5 was determined by the Barthel index, 6 min walking test, and knee range of motion. Kinesiophobia was assessed on POD5 using the Tampa Scale for Kinesiophobia (TSK). Among 75 TKA patients, 27% exhibited kinesiophobia. The final regression model highlighted PCStotal on POD5 (OR = 6.2, CI = 1.9–19.9), PCStotal (OR = 2.1, CI = 1.2–3.8) on POD1, and the intensity of chronic pain before surgery (OR = 1.4, CI = 1.1–2.1) as significant kinesiophobia predictors. On POD5, those with kinesiophobia showed increased dependency, slower gait, and poorer knee extension recovery. This study emphasizes the need to identify and address kinesiophobia in TKA patients for better functional outcomes and recovery. Additionally, it is vital to assess different domains of pain, not just pain intensity, as it can lead to kinesiophobia development. © 2024 by the authors.

This observational study aimed to identify predictors of kinesiophobia and examine its correlation with early functional outcomes in TKA recipients. On the first and fifth postoperative days (POD1 and POD5), we evaluated pain using the International Pain Outcomes Questionnaire (IPO-Q) and created multidimensional pain composite scores (PCSs). The Total Pain Composite Score (PCStotal) assesses the overall impact of pain, taking into account outcomes of pain intensity, pain-related interference with function, and emotions and side effects. Functional status on POD 5 was determined by the Barthel index, 6 min walking test, and knee range of motion. Kinesiophobia was assessed on POD5 using the Tampa Scale for Kinesiophobia (TSK). Among 75 TKA patients, 27% exhibited kinesiophobia. The final regression model highlighted PCStotal on POD5 (OR = 6.2, CI = 1.9–19.9), PCStotal (OR = 2.1, CI = 1.2–3.8) on POD1, and the intensity of chronic pain before surgery (OR = 1.4, CI = 1.1–2.1) as significant kinesiophobia predictors. On POD5, those with kinesiophobia showed increased dependency, slower gait, and poorer knee extension recovery. This study emphasizes the need to identify and address kinesiophobia in TKA patients for better functional outcomes and recovery. Additionally, it is vital to assess different domains of pain, not just pain intensity, as it can lead to kinesiophobia development. © 2024 by the authors.