Today’s Top Story

Study: General anesthesia linked to increased risk of mortality among elderly hip fracture patients

Findings published online in the journal Clinical Orthopaedics and Related Research suggest that use of general anesthesia and conversion from regional to general anesthesia may be associated with increased risk of mortality for older patients with hip fracture. The authors reviewed data on 16,695 patients aged 65 years or older. Compared with regional anesthesia, they found that patients treated with general anesthesia had a higher likelihood of overall 90-day mortality. However, they also note that when stratified by before and after hospital discharge, but within 90 days of surgery, the increased risk was observed only during the inpatient stay, with no difference in mortality observed after hospital discharge. The authors state that patients who underwent conversion from regional to general also had a higher overall mortality risk compared with those who underwent regional anesthesia. Overall, patients who underwent general anesthesia were at higher risk for all-cause readmission compared with regional anesthesia patients. The authors observed no difference in risk of 90-day Agency for Healthcare Research and Quality outcomes based on anesthesia type.

Read the abstract…

 
 
Other News

Study: Many patients able to return to sports after ORIF for Lisfranc injury

According to a study published online in the journal Foot & Ankle International, patients who sustain Lisfranc injury often return to sport and physical activity following open reduction and internal fixation (ORIF) using a Lisfranc screw combined with bridge plating technique. The researchers conducted a retrospective study of 33 patients with a mean age of 31.2 years (range: 18-55 years). At mean 2.9-year follow-up, they found that 31 patients (94 percent) were able to return to some form of sport, with 22 patients (66 percent) returning to their preinjury level or better. Of the remaining 11 patients, six had ongoing pain, and five were asymptomatic but participated less frequently due to other lifestyle reasons. Overall, 11 patients (33 percent) stated that they had some degree of ongoing pain that might limit their ability to return to sports and physical activities. The researchers also noted a strong correlation between overall Foot and Ankle Outcome Score and the Sports Questionnaire.

Read the abstract…

 
 
 
Study: Many athletes uninformed of concerns about driving after concussion

Data from a study published online in the British Journal of Sports Medicine suggest that although many physicians believe athletes to be at increased risk of motor vehicle crashes after concussion, fewer than half regularly counsel patients on that risk. Members of the research team surveyed 333 members of the American Medical Society for Sports Medicine who manage at least one concussion per month. They found that 83 percent of respondents stated that concussed athletes were at an increased risk of motor vehicle crashes, but only 49 percent said they “almost always” counsel patients regarding driving after concussion. In addition, 82 percent of those surveyed indicated they do not implement testing to determine whether or not an athlete is ready to return to drive, and 30.4 percent said they do not have clear return-to-drive criteria.

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Read the abstract…

 
 
 
AMA and others release “Charter on Physician Well-being” to help reduce burnout

4 – AMA and others release “Charter on Physician Well-being” to help reduce burnout The American Medical Association (AMA), the Collaborative for Healing and Renewal in Medicine, and other organizations have released a “Charter on Physician Well-being” designed to minimize and manage physician burnout and promote physician well-being. Among other things, the charter identifies various commitments, including the following:

  • societal (e.g., trustworthy and supportive culture, policies that enhance physician well-being)
  • organizational (e.g., supportive systems, engaged leadership)
  • interpersonal and individual (e.g., responding to inherent emotional challenges, prioritizing mental health)

“Meaningful work, strong relationships with patients, positive team structures, and social connection at work are important factors for physician well-being,” the authors write. “Although evidence to support some of the recommendations in this charter is still emerging, medical organizations, regulatory groups, and individual physicians share a responsibility to support these needs.”

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Read the charter…

 
 
 
DEA announces locations for Prescription Drug Take Back Day

The U.S. Drug Enforcement Administration (DEA) has announced locations for the National Prescription Drug Take Back Day, to be held on Saturday, April 28, 2018. Last October, the agency collected 912,305 pounds (456 tons) of pills collected across 5,321 collection sites as part of its 14th National Prescription Take Back Day.

Learn more and find a collection site…

View the AAOS pain relief toolkit…

View AAOS information on the storage and disposal of prescription opioids (PDF)…

 
 
 
In the States

Maryland

Two recent studies suggest that implementation of an all-payer global budget program in Maryland may have impacted hospital use and price-standardized spending less than anticipated. The first, published in the February issue of JAMA Internal Medicine, compares changes in hospital and primary care use through the first two years of the state’s global budget program among fee-for-service Medicare beneficiaries in eight Maryland counties and 27 non-Maryland matched control areas. The researchers did not find consistent evidence that Maryland’s hospital global budget program was associated with reductions in hospital use or increases in primary care visits.

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Read the abstract…

 

The second study, published in the April issue of the journal Health Affairs, compares changes in hospital use among Medicare beneficiaries in rural hospitals and an in-state control population, and finds that global budgets in rural Maryland hospitals did not reduce hospital use or price-standardized spending as policy makers had anticipated.

Read the abstract…

 
 
Your AAOS

Call for volunteers: ACGME Board

AAOS seeks prospective nominees to be considered for the Accreditation Council for Graduate Medical Education (ACGME) Board of Directors. Applicants for this position must be active fellows. In addition, all applicants will need to provide the following: an online AAOS CAP application, a brief biography, and a letter of support from a Council of Medical Specialty Societies member organization. All supporting materials must be submitted to Donna Malert by April 6, 2018, at:

malert@aaos.org

Learn more and submit your application…  (member login required)

 

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